Watching out for elders has always come naturally for me. I grew up close to my grandparents, and during my teenage years, my paternal grandmother lived with us. We even built a new house to accommodate her stay.
When my elderly neighbor, Joe, was widowed, I did what most neighbors would do. I didn’t know him or his wife well, but I knew he was completely deaf and that he was probably lonely. I started to visit, thinking I could help him if he needed groceries or something. What began as a neighborly check-in continued into a kind of adoption of Joe, by myself and my two sons, ages six and eight. For five years, the kids and I were Joe’s family.
Shortly after Joe passed, my aunt and uncle moved from Virginia to North Dakota to be near us, their only family. Then my parents and in-laws began having health troubles. In all, I cared for seven elders over the span of two decades. During that time, I was also busy raising two kids, one of whom had multiple health problems. To the best of my knowledge, there was never a word at the time to describe what I was doing. I was just following my instincts while elders fell like dominoes into my care.
Caregiving Is a Job
During the last few years of my caregiving, while my mother-in-law and my parents were still alive, my son was still having major health issues, and I was working full time, I read about the term “sandwich generation.” I remember thinking it was a clever concept, but it still didn’t occur to me that I was a member of this group. I was merely a caregiver and a mom.
Maybe I didn’t have the time or the will to reflect on my own situation. That is the case with many caregivers. In fact, when I give presentations to groups of caregivers and professionals, I always stress self-identification. Caregiving is a job. When you have more than one generation to care for, it’s like working overtime or taking on a second job. Yes, sandwich generation is a very apt term. I was just an early practitioner and a slow learner when it came to recognizing what all I actually had on my plate.
Balancing Everyone’s Needs
The challenges of being a member of the sandwich generation are many, but there is one universal issue that I ran into and continue to hear about as I converse with my readers and speak to groups: carefully weighing all of your loved ones’ needs.
One day years ago, my son was coming out of a severe asthma attack and resting in his room when my mother’s medical alert system went off. The dispatcher called to have me go to her apartment to check on her, and I was immediately faced with a difficult decision.
“Can I leave Adam?” I thought. “Will he be okay?” Someone had to check on Mom. “She’s probably lying on the floor again…”
This particular time, Adam recuperated quickly and his older brother was home, so I quickly ran to Mom’s apartment. Yes, she was on the floor. I had to call for firefighters to help, but we got her up and amazingly she was unhurt. I got her to bed and hurried back home to my sons.
Who Needs More Support: Your Kids or Your Elderly Loved One?
Hard choices are the hallmark of the sandwich generation. My kids were not involved in sports, but they still had plenty of school functions, musical performances, awards ceremonies and parent-teacher conferences. This meant that I was constantly stretched between meeting the vastly different needs of children and seniors.
When my aunt was on her deathbed in the hospital, my parents were still in fairly good shape. They were able to sit with her while I attended my oldest son’s very first band concert. How could I miss such a milestone?
Yet, throughout the entire performance I couldn’t help thinking, “What if Auntie Marion dies while I’m here?” I’ve since learned that we are all faced with painful choices, and we must live with our decisions. The bottom line is this: what would your loved one want you to do if they could tell you themselves? I knew my aunt well enough to know she would have wanted me to see my son’s band concert. That knowledge made the decision easier, but I still felt conflicted.
When Caregiving Affects Your Work
During a time when I had five elders dependent on me to varying degrees and a young son still undiagnosed with chronic health issues, my then-husband was pressuring me hard to “get a job.” In his eyes, what I was doing 24 hours a day, seven days a week, was not work.
So, I found a part-time job at a local thrift store. I was also freelance writing, but that didn’t pay much. The thrift store, as you can imagine, did not pay much either, but it was considered “real work.”
One day, my mom called saying she had slipped on some ice and fallen in a parking lot while trying to get my uncle to the doctor. She was uninjured but shaken, and I had to go rescue them both. That day Adam was home in severe pain from a juvenile rheumatoid arthritis flare-up. I kicked into action, handled everyone’s needs and was home with my son by noon.
That is when I remembered I worked mornings at the thrift shop. I had completely blocked out this responsibility in order to get everyone safe and settled! I called the thrift shop, apologized profusely and gave notice the next day. I had never let an employer down like that, and I could not believe I did. The truth of the matter was the job simply wasn’t at the top of my priority list, and neither was the measly salary. So, I quit. I continued to freelance and sought out opportunities that paid more and allowed me to work from home.
Not every caregiver is able to eliminate work from their list of responsibilities. Bills still have to get paid. But it does help to take a step back periodically to take inventory of your obligations and determine if there is any way you can still make ends meet while reducing your hours or workload.
Balance Your Priorities: Work, Children & Elderly Parents
When each of my parents was dying, I was still working full time. I had to juggle their need to see me each day in the nursing home with the need to coordinate their care, my son’s needs and my professional workload. I ended up using my vacation time as “caregiving time” to get my dad to his doctor’s appointments, make trips to the emergency room when my mother fell, and accompany my son to countless medical appointments. Quality time with my small family and time to myself to recharge fell by the wayside.
Then came setting up hospice care, first for my dad and then for my mom. As if keeping vigil at a dying loved one’s bedside isn’t difficult enough, I spent this precious time with my parents wondering how my children were managing at home, both physically and psychologically.
Needless to say, between work, a sick kid and dying elders, it was hard to keep my brain fully functional and focused. When I was working, I was thinking of my loved ones’ needs. When I was with my loved ones, I was distracted, wondering how I’d be able to get my work done. It was nearly impossible to ever be fully present in any given moment.
Why the Sandwich Generation Should Accept Help
I was the designated primary caregiver, and my elders were all spoiled rotten. They each had their wants and needs, and they preferred things done in a certain way. I went to their house, condo or nursing home each day and saw to each of their needs. Of course, in addition to chores and daily responsibilities, they wanted my company as well.
My sister lived less than 40 miles away at the time, and she did her best to make it to town every weekend. She usually came to visit on Sundays. We have joked that our kids were raised in a nursing home. Since she’s 12 years younger than me, she had little ones in tow on most of her visits. My children were older, but their lives were totally centered around the needs of elders as well.
Looking back, I should have said to myself, “Gee, my sister is coming in to see the folks today, therefore I should take the day off.” But maybe I am a glutton for punishment. My parents still wanted to see me, and my mom wanted me to get out her clothes, fill her ice bucket, and see to all the other preparations so she could enjoy the visit with my sister. It got to a point where our mother would totally forget my sister’s visit by the following day, which was disturbing. But my sister still came anyway.
The moral of my story is this: do not be a martyr. I didn’t complain or whine during my time providing care, but I did feel compelled to do everything my elders wanted even though I knew my sister would be there and she could see to some of these tasks. I was generally exhausted and too tired to fight them on it or wrap my head around things transpiring in another way.
Our parents may not have had us both, and they may not have had every detail tended to just as I did it daily, but that was not reason enough for me to avoid taking a day off from providing care. I could have spent valuable time with my children, free from distraction. I could have taken the time to engage in vital self-care. I could have caught up on my work or simply taken a day to do nothing at all. I encourage fellow caregivers to be smarter than I was. Take advantage of respite care in any form you can get it! Whether you realize it or not, you need it.
If you are part of the sandwich generation, please make a point of having another “filling” in the sandwich. Make it a “peanut butter and jelly” by ensuring you have someone to share the load with you, even if it is just occasionally. This second filling can be a family member, a friend, a professional caregiver hired through a home care company or, better yet, all three. Having a care team and back-up help is much more interesting and beneficial for all involved.
Actually, my sister coined the term “peanut butter and jelly girls” when I told her I was writing this article. Her phrase made so much sense to me. I was the peanut butter. I stuck to the job daily and gave it the substantive “nutrition,” if you will. I provided the daily protein of attention to detail and availability for emergencies and decisions. My sister was the jelly, the sweetness, without which the sandwich would have been gluey and boring. She gave my parents that sweet treat they needed.
I should have slipped out on those Sundays and let them just enjoy a jelly sandwich now and then. We would have all have been better off.
By Carol Bradley Bursack
For the Sandwich Generation, Caregiver Support is becoming an increasingly prevalent mental health concern. Adults between the ages of 30-40 are juggling the responsibilities of children and aging parents. Erica Greenspan, LICSW of Kennedy Counseling Collective Counseling Metro DC, will work with you to navigate the burden that can come with balancing roles, while making time to care for yourself.