The Challenges of the "Sandwich Generation": Raising Children and Taking Care of Elderly Parents

The "sandwich generation" refers to adults who are raising their own children while taking care of elderly parents at the same time.  It's called the "sandwich generation" because these individuals are caught between their responsibilities for their children and their aging parents.

Raising Children and Taking Care of Elderly Parents

What Are the Challenges Faced By the "Sandwich Generation"?

Here are the most common challenges for individuals trying to balance their roles as caregivers for their children and their elder parents:

• Stress and Emotional Toll: Juggling these two major caregiving roles can lead to high levels of stress, exhaustion and feeling overwhelmed.

• Role Reversal: The role reversal of taking care of parents can be emotionally challenging, especially as parents' health declines.

• Time Constraints: These individuals spend a good deal of time balancing their responsibilities for their children and their parents which can leave little time personal time (see my article: Self Care For Caregivers).

• Financial Strain: The cost of taking care of children and elderly parents can create a significant financial burden.

How to Cope With the Challenges

• Get Organized: Keep track of appointments, medications and finances to address stress and confusion.

Raising Children and Taking Care of Elderly Parents

• Don't Forget Self Care: Try to find time for self care. Make sure you get enough rest, eat healthy meals and get exercise at a level that is appropriate for you.  Also, try to find time to do activities you enjoy (see my article: Learning to Balance Taking Care of Your Own Needs and the Needs of Your Loved Ones).

• Communicate Openly With Family Members: If you (or you and your partner) are bearing the brunt of taking care of elderly parents, have an honest conversation with family members about your feelings and needs.

• Seek and Accept Help: After you have had an honest and open talk with family members, delegate certain tasks to them when possible. If that's not possible, ask them if they can help financially so you can hire a home attendant (see the clinical vignette below).

• Set Boundaries: Learn to say "no" to additional responsibilities and try to avoid taking on too much (see my article: Setting Boundaries Without Guilt).

• Look For Small Joys: Try to find moments of joy and connection with your loved ones--even in the midst in all you have to do. 

Clinical Vignette

The following clinical vignette, which is a composite of many cases, illustrates how to deal with some of the challenges of being part of the "sandwich generation":

Dina

As the oldest of three daughters, Dina took in her elderly parents when they could no longer live on their own.  At the same time, she and her husband, Tom, were raising their two teenage sons.

When Dina was growing up, she was expected to take on responsibilities, as compared as the oldest child and her two younger sisters took on none.  Her parents expected her to do many of the household chores while her sisters were allowed to go out with their friends.

When she graduated high school, Dina attended an out of state college to get away from her family responsibilities and, after she graduated, she got an apartment with her former college roommates.

Years later, after Dina got married and she had children, she continued to help her parents, but after they could no longer live on their own, she felt obligated to take them in. 

Raising Children and Taking Care of Elderly Parents

Before her parents came to live with Dina and Tom, Tom urged Dina to talk to her sisters about helping out more. Tom had always been generous in helping Dina's parents, but he could foresee the toll it was going to take on each of them. Dina was so accustomed to taking on responsibilities as the oldest child that she didn't question whether her sisters should help and she didn't want to talk to them about it.

Their teenage sons helped out when they could, but they were busy with school, their friends, applying to college and sports, and Dina didn't want to rely on them or deprive them of what they needed and wanted to do.

Within a few months, Dina and Tom felt overwhelmed taking care of her parents. Dina wasn't sleeping well and she had very little appetite. She also stopped her usual self care routines--meditation and yoga practices because she didn't have time. She also stopped seeing her close friends. 

Tom also curtailed his outings with friends because he was trying to do as much as he could to help Dina. He was also concerned about his elderly parents who were independent at that point, but he didn't know when they would also need help.

One day when Tom came home from the grocery store, he found Dina in their bedroom sobbing. She looked stressed and worn out. When she saw him, she tried to dry her tears and act like she was alright, but Tom knew Dina had reached her limit.

Tom sat next to Dina and put his arm around her, "We need to talk to your sisters. I know what you're going to say--that as the oldest you've always been the one to take on all the responsibilities, but we can't keep going on like this."

At first, Dina insisted she could continue to take care of her parents, but she knew Tom was right, so they talked about how to approach her sisters.  

A week later, Dina's sisters, Paula and Meg, came over for lunch on a Saturday. At that hour, their parents were upstairs napping. 

Dina felt anxious and guilty. She felt she was abducating her responsibilities. She also anticipated that Paula and Meg wouldn't respond well to her asking them to help.

When Dina told her sisters that she was completely overwhelmed with taking care of their parents, she had to endure her sisters' silence and discomfort. Both sisters looked off in the distance and appeared annoyed.

Tom supported Dina in the conversation and told them that they needed to help.  Paula and Meg responded with many excuses about why they didn't have the time and couldn't help. Soon after that, they both left in a hurry.

Dina felt angry, resentful and sad after they left. She and Tom talked about what they could do next and they decided to have another meeting with Paula and Meg, but this time they would include a third party, a geriatric care manager, there to mediate their discussion.

Initially, Paula and Meg continued to make excuses for not helping at all. While they spoke, the geriatric care manager listened carefully and empathized with them.  Then, she tried to find a compromise where they could offer financial help so Dina and Tom could hire a home attendant for help.

Dina's sisters were so relieved that they didn't have to take their parents in that they readily agreed to offer financial help so Dina and Tom could have more time for themselves.  After that, Dina and Tom felt a lot less stressed because they had help and more time to themselves.

A few months later, Dina's parents decided they would prefer to live in an assisted living facility, so Dina and Tom went with them to see several facilities until they found one they liked and could afford.

After this experience, Dina realized she was so conditioned since childhood to take on most of the responsibilities and she had not learned to take care of herself.  

Once her parents were situated in the assisted living facility, she began therapy to work on this.  Her therapist helped Dina to feel entitled to take care of herself. Dina also worked through the sadness, anger and resentment she had been unaware of for most of her life.  

Conclusion

Being in the dual role of taking raising children and taking care of elderly parents is stressful and emotionally draining for most people.

Without even realizing it, you might be repeating lifelong patterns of doing too much and not taking care of yourself, as discussed in the vignette above.

In certain situations, there might be ways to help alleviate the stress if other family members are willing to help.  If not, you might be able to use the services of a geriatric care manager or someone who is outside the situation who can mediate family discussions to see if there is a compromise.

If you're able, you could benefit from working with a licensed mental health professional who can help you to cope with the stress and emotional toll. She can also help you to overcome old behavioral patterns that keep you stuck.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR,AEDP, EFT (for couples), IFS, Somatic Experiencing and Certified Sex Therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.