A New Take on Caregiving

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You’re probably familiar with the term “sandwich generation.” First used in the early 1980s, it describes caregivers, often women, who find themselves “sandwiched” between two generations in need of care: their children and their aging parents. Most of us in this stage are in midlife, which can complicate things further.

Caring for elders is different for each family. For some, caring for Mom, Dad, or other older relatives at home is the norm. June, 80, reminisces about how the arrangement worked with her own mother, Maria, who lived to be nearly 100.

Maria moved in after her husband died and became a part of her daughter’s household: cooking, cleaning, doing laundry, becoming a fixture at the kids’ sports practices and games, and living with them until she was hospitalized for a final illness. Her presence allowed June to earn a master’s degree in education as well as to pursue some self-care by taking tai chi classes and coaching volleyball.

Siya, 56, was born in India, another place where elders are traditionally cared for by family members and extended families often live together or close by. However, Siya’s experience has not been as straightforward as June’s. Her husband travels extensively for work, so parenting her college-age son and teen daughter generally falls to her. Meanwhile, her father is experiencing the onset of dementia but insisting that he can stay in the apartment he shared with Siya’s mother before she died.

Siya also runs her own business as an accountant, but perimenopause is affecting her energy level and concentration. She is starting to feel overwhelmed by the intersection of midlife, parenting, career, and caregiving.

“My own health is starting to suffer,” says Siya. “I know I need to exercise, but it just falls by the wayside with all I have to do.” A primary care physician who could talk with Siya’s father about what is most important to him could help the whole family. Working with a care team – perhaps a social worker, a day center for seniors, and a primary care provider – could help ensure that her father receives support for his emotional and social needs as well as his physical health. Caregiving can be a group activity rather than a load carried by just one person.

David, 62, works with a neighbor to care for his mom, who lives two hours from him. While David visits once a month, bringing groceries, cooking a meal, and helping with chores, he also checks in regularly with Sandra, the next-door neighbor, who has a deep friendship with his mother and drives her to medical appointments and the local senior center. David’s mom raised him on her own, and he finds a deep sense of purpose in making sure she is well cared for in turn. Occasionally he visits her synagogue, another place where she receives care through social interaction and spiritual support.

“When Mom needs more help with physical needs, she plans to move to a retirement community a few blocks away from me,” he says. “My house has too many stairs for her, and she’s very sociable, so living nearby but not with me will work.” What means most to David and his mom is keeping their connection while also being free to pursue independent activities.

Caregiving choices and your life stage

The challenges of caregiving change as you move through the decades of your own life. But what if the caregiver is in the same stage as the person who needs care? It’s not uncommon to see one member of an older couple caring for the other despite their own health concerns.

DeeAnne noticed her father Clarence working to load the car after a holiday dinner, then returning to help her mother – and her mother’s walker – down the stairs. Family members gathered to assist, but DeeAnne still felt worried about her father’s caregiving burden. DeeAnne’s mother had recently experienced a stroke, and her left side remained weak. Her father, the primary caregiver, had congestive heart failure and obesity.

Cal and Rebecca haven’t yet experienced any age-related illnesses, and as caregivers, they are younger than Clarence. They recently took in Cal’s 95-year-old mother, and they share the physical duties of caregiving. Their home has enough room for everyone to have their own space, and their children and grandchildren visit often, providing company and entertainment.

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A cultural perspective: who cares for elders, and where?

As the stories above show, both life stage and cultural background affect elder care choices and expectations. Many countries around the world have no tradition of commercial elder care. For example, in Italy, France, and Germany, older relatives are usually cared for by family members. In Italy, this is leading to research and policy plans centered on caregiver support.

In the United States, almost half of Hispanic adults receive needed care from family members. Other cultures that consider intergenerational living the norm include the Amish, whose family properties often include a small home called a Daadi Haus for elders to live in. If your family is from Eastern Europe, the Middle East, or Asia, you may also have a strong tradition of multigenerational living.

Is caregiving always a burden?

In the United States, we value independence and privacy more highly than some other societies do. “You all disappear into your houses at night,” says Goran, who recently immigrated from Serbia. “America can be lonely.”

Caregiving can foster social bonds that benefit both the receiver and the person giving care. When Monique brings her grandmother groceries twice a week, they both enjoy the opportunity to sit together, chat, and on Monique’s part, learn family history.

As you learn about your elders’ lives, you may gain inspiration, as Etan did when he helped his grandfather type up his diary for a local history project. “He’s a Holocaust survivor,” Etan says. “It was a privilege to help him share his story.”

Considering your options

Should you provide live-in care for a family member? Or consider other options? One place to start is by having a conversation with your parents or the other person who needs care.

Here are some questions to ask from a life stage and cultural perspective:

• What life stage are you currently in? What are the life stages of your family members?
• How does your culture, family, or community offer caregiver support?
• Is there cultural or familial pressure to become a caregiver or continue caregiving at any cost?

You may also want to take time to create a list of all the people, organizations, and other resources available for caregiving support. Even if you come from a culture that expects in-home caregiving and intergenerational living or if you dearly wish to have your elder with you, you may need and want help. Caregiving doesn’t have to be a solo responsibility.

Finally, most caregivers for elders in the United States are female relatives. Psychotherapist Roberta Satow, Ph.D., has some helpful suggestions for women who are considering a caregiving role.

Supporting yourself and finding resources

Whole-person health means caring for your own body, mind, and spirit. Doing so means you have more to share as a caregiver. Learn more about self-care, including how to connect with your community.