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Six months after Anna Simms divorced and became a single parent to her 5-year-old son, she received a dreaded phone call. Her father, who lived 45 minutes away with her mother, had suffered a stroke. Anna’s world, already in turmoil, was turned upside down, as weekend visits to her parents’ home became part of her new normal. Before long, she realized her mother was showing signs of Alzheimer’s.

“She was a danger to herself and my father,” Anna says. “And it was getting to the point where I needed to do something.”

Anna didn’t know it then, but she’s part of the so-called “sandwich generation,” people typically in their 40s and 50s caring for at least one parent age 65 or older and a child or children 18 years old or younger. And she’s hardly alone in her plight.

In 2013, the Pew Research Center reported that 47 percent of adults in their 40s and 50s had a parent age 65 or older and were either raising a young child or financially supporting a grown child (age 18 or older). By all accounts, this population is growing at an astonishing rate, and it’s no surprise that these “sandwiched” caregivers face personal, emotional and financial stress.

Sandwich Generation

The “sandwich generation” is defined as being people typically in their 40s and 50s who are caring for at least one parent age 65 or older and a child or children 18 years old or younger.

Perhaps, like Anna, these folks are single parents with one child or married with multiple children. Maybe they serve as live-in caregivers to one or two parents, or they could be overseeing Mom or Dad’s nursing home care.

“The stress in this type of scenario is also impacted greatly by things like how much time do you have, do you work, do you have to work, do you have a sibling who can help, how much money do you have?” Anna says.

Regardless of the exact scenario, life under these circumstances is challenging. And just as there are countless variables involved in “sandwich” situations, there’s no one-size-fits-all solution for navigating this overwhelming phase of life. But with Anna’s been-there-doing-that advice and a little help from family therapist Kate Pennington, we’ve put together some tips in hopes of making life a bit easier for those who find themselves smack dab in the middle of the proverbial sandwich.

Ask for help.

It’s often easier said than done and can make people feel needy, but Kate reminds caregivers that it’s not just OK to ask for help in this situation — it’s vital to do so.

“There will be things you can assign to other people to help, but you need to figure out what you are willing to give up,” Kate says. “[Ask yourself] Where am I allowing myself to receive help and what are the things that I need to be directly involved in?

Once caregivers make that determination, they can assign tasks to others. She encourages people to tap into their support system. Who can help with errands, meals or shuttling children from place to place? “Who is that friend that you can call and say, ‘I’ll explain later, but can you do this for me?’” she says.

Anna advises folks to research community resources, such as Meals on Wheels or adult day care, to help with elderly parents.

“You are just looking for someone to lay eyes on your loved one,” Anna says. “You want someone to tell you that they’re OK and give them the interaction that they deserve.”

Focus on what you can control, and let yourself feel.

Caregivers can also utilize their parent’s friends and church community, but in Anna’s case, it didn’t take long for her to realize that she needed to move her parents closer to her home. When she was looking for nursing homes in her parents’ hometown, she received advice from a friend that she’ll never forget.

“She took me verbally by the shoulders and said, ‘Their friends are dying. They don’t need their church people. They need you. Bring them to Nashville,’” Anna says.

So, she did. Her father passed away about seven years ago, but throughout his time in Nashville, she could easily make trips to the nursing home as needed. Her mother is now 89, and just as Anna’s friend pointed out, her parents’ friends stopped being able to visit years ago. But Anna’s close proximity to her mom is key, as she can slip away from work to the nursing home for a quick visit or lunch date.

In this instance, Anna was able to act on something she could control. Kate says it’s so important for caregivers to recognize what is in their control and be intentional about honoring their parent in a way that works for their family. “It may not mean you’re on call 24/7 or it could, but you have to figure out what works for you,” she says.

Yet, even the best intentions and plans often give way to guilt. Whether it’s because she missed a ball game or couldn’t make it to the nursing home for three days, Anna says this phase of life is all about guilt. “You feel guilty because it seems like there’s not enough time in the day to a great job anywhere,” Anna says.

Kate reminds people in Anna’s shoes to allow themselves to feel that guilt, or grief, or whatever it may be, without judgment. “The key is recognizing when these feelings are impacting you to a degree that it’s affecting your work life, your home life or your relationships with other people,” she says. “That’s when you may need to see someone that can help you work with that, like a therapist or your doctor.”

Take care of yourself.

While asking for help from friends and professionals goes a long way toward looking out for themselves, sandwiched caregivers must also be mindful of their most basic needs.

“We hear all the time with children that they need to be fed and get plenty of sleep,” Kate says. “That applies to all of us. When you find that your basic needs are not being met, you’re going to really struggle to cope with the stress that these roles bring on.”

It may feel impossible, but it’s also crucial that folks set aside some time to do something they love to burn off a little of that stress. “It’s really easy to lose a sense of self when you’re constantly caring for others,” Kate says.

Anna says it’s challenging to find time to do things that she enjoys, but she’s gotten better at it through the years. She and her son, for example, can take 4-day-long vacations now, a luxury that wasn’t possible when her father was in poor health. “I was afraid to go too far,” she says. “But my mom is in good physical health. I can’t know when her time will come, and I can’t change it. My son and I deserve a little time, and he’ll be gone before too long, so I want to grab that time while I can.”

Seek financial assistance.

Financial stress, Kate says, increases stress and anxiety in every situation, so it’s always a good idea to talk to a financial planner when navigating a caregiving role. With children in the mix, parents will likely be saving for college as well as their retirement, so it’s important to seek advice if an elderly parent needs financial assistance. Anna was fortunate because her father prepared for retirement and had a good long-term care policy. Though she makes it clear that she’s not a financial or insurance expert, she feels strongly that everyone over the age of 59 should reach out to a broker to purchase long-term care insurance. “That long-term care policy saved me, and even though it ran out several years ago, I didn’t have to tap into my father’s savings for years, so that money continued to grow,” she says.

What about the kids?

Anna’s son is 17 now. He’s witnessed his mother’s struggle since he was 5 years old, but he’s been there every step of the way. She couldn’t afford to hire babysitters, so he came along on nursing home tours, and frequent weekend trips to his grandparents’ house and their nursing home became a part of his routine.

“When kids are in that environment, it gives them a look at what life is really like, and they can bring joy to other people who they’re not even kin to,” she says. “I think he’s more empathetic than he maybe would have been had he not been exposed to this situation.”

Kate reminds parents that there is also value in letting their kids see them struggle. “Allowing our children to see that we don’t always have it together is OK, because then, when they struggle their freshman year of college or with their new job, they don’t feel alone,” she says.

Talking to kids in an age-appropriate manner allows them a window into the situation. When parents have to be somewhere else and can’t make it to a game or other activity, they can explain to the child how it makes them feel and ask the child to do the same.

“Even if it’s something you don’t want to hear, let them talk,” Kate says. “We can sometimes shut things down as parents by saying something like you’re just being ungrateful, but give your child some grace and hear them out.”

Just as children can learn and grow from this experience, their parents can also find joy in this phase of life. “It might be hard to recognize fulfilling moments if you’re stretched too thin, but don’t forget to look for them,” Kate suggests.

Perhaps Anna explains this best: “The only thing my mom cares about is seeing me, and she still knows who I am,” she says. “She lights up like a Christmas tree when I walk into the room, and I can carry that with me.”


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