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The Sandwich Generation: Caretaking Times Two

02 Jun, 2023

The Sandwich Generation: Caretaking Times Two

The day Hurricane Katrina swept herself 150 miles inland into my hometown, my parents were in a pretty difficult stage of their Sandwich Generation era.

Papaw, my paternal grandfather, sat with us at the kitchen table while we watched the forest surrounding my parents’ house begin to fall trees, one by one. My Mamaw, his wife, was in a temporary medical facility half an hour away.

Our house was miraculously unscathed, but both cellular towers and landlines were down for days, power was down for over a week, and my dad spent the night in his car at the gas station with half of the rest of our town waiting for the gas truck to arrive.

Only then were we able to drive the distance to where my Mamaw was located to know for sure that she was safe.

We drug mattresses across town and all lived at my dad’s workplace for a few days until power was restored, because the August heat and humidity was simply too dangerous for my grandparents.

My memories of Hurricane Katrina are incredibly mild compared to others, and I also recognize that it also stands out as an extreme circumstance of caretaking. But for some reason that experience stands out as one of the first moments I was brutally aware of the burdens placed on my parents in simultaneously raising three children and managing the care of their aging parents.


What is the Sandwich Generation?

The Sandwich Generation is a term used to describe caretakers who are caring for both younger and older family members. Typically you may see this in the form of parents who have children still at home but who also are active in the caretaking of their own aging parents.

Why is this phenomenon happening?

Simply put, baby boomers are getting older and living longer, but “there’s been no significant change in the level of mild to moderate disability for older people.” While people may be living longer lives, those lives are not necessarily healthier ones [8].

Also, census data tells us that the mean age of women having children is increasing [5]. Families are having children later than generations before us. There was a time in which seasons of empty nesting and middle age seemed to be concurrent life events, but now middle age finds many families still in the active child-rearing stage of life.

How many people are part of this sandwich generation?

12% of parents (as defined as someone who has a child under the age of 18 in their home) in the United States also serve as unpaid caregivers for one or more adults [4].

This number is estimated to be about 11 million people, or 28% of all caregivers [1].

What are the impacts/ challenges for sandwich generation caregivers?

Adults in this sandwich generation may be constantly attending to medical events, balancing personal careers, and often struggling to find time for partners or the management of their own homes [3]. Even if a loved one has full-time residential or in-home medical care, sandwich generation caretakers are probably still actively present for emergency room visits and doctor’s visits, and help with managing insurance concerns, finances, and general tasks.

Most sandwich generation families are also impacted financially, by directly helping cover medical and living expenses for loved ones, or indirectly by needing to decrease work hours to manage family the member’s care [8].

It is estimated that “a third of sandwich generation caregivers report a high level of emotional stress and a fifth report high levels of financial and physical strain” [1].

One can see how the emotional toll of this role is warranted.

And, the management of emotions can be quite complicated for someone in the Sandwich Generation.

Maybe a person feels…

Guilt for being less present with their spouse or children

Frustration if the parent they are caretaking was not always kind or supportive to them

Anticipatory grief while making end-of-life decisions for a loved one whose health is declining

Stress over finances or time management

Confused about how to manage the changing mental state of the person they are caring for

…and none of these feelings are wrong! They are normal and often expected, but they may require some extra support at times.

How caring for yourself heals the whole sandwich

Caring for a parent can, as we say in the counseling world, “bring up a lot” for a person. Imagine for a moment that your brain has a cardboard box of every experience and resulting emotion you’ve had regarding your parent: it’s a hodgepodge of good, bad, and ugly memories. Maybe this box is shoved in a forgotten closet under some vintage Christmas decorations and the Pythagorean theorem and your first boyfriend’s home phone number. You stashed it there to keep yourself from swinging too heavily into hurt or even rage. Maybe your relationship with your parents is best at balance when you’ve decided to avoid certain topics. But all of those topics are right here in this box.

The relationship balance is skewed when you begin more actively managing your parent’s day-to-day life tasks. The role of caregiver shifts from parent to child, and each of you responds accordingly. Chances are, this box gets pulled out into the daylight and dumped in the front yard of your brain.

These are tough emotions to manage. Family work is tough and complicated, even if your childhood was seemingly ideal.

A therapist can help you sort through this box, reorganize it, and heal—even in the midst of a sandwich generation time of life.

And you know what is best about healing your own childhood wounds? You become a better parent to your children. This is where you can stop the generational hurt for good while actively repairing relationships in the whole sandwich.

The Sandwich Generation will not fade from reality.

The US Census Bureau projects that by 2034, people over the age of 65 will outnumber children for the first time in United States history [6].

This is a phenomenon that has countless impacts on society as a whole.

I think often about the time that I will most likely be an active-duty member of the Sandwich Generation, myself. Is anyone ever really ready for the caregiving roles to turn on end?

There are ways we can prepare ourselves for the caretaking roles in our future, and support those who are in these roles now.

What you can do now.

-Begin having conversations with your parents now about their wishes and plans for this upcoming time of life prior to any major medical events or decline of mental capacities. While you may need to reassess some of these points later, this allows you to at least know what their current thoughts are on particular topics. Assisting your aging parents in maintaining as much dignity as possible as you slowly (or quickly, in some cases) begin to manage areas of their lives is of great importance.

– Understand how they manage finances. Have a trusted place for passwords. A New York Times article on this topic identified that it “may take years” for an aging parent to accept help, especially in the area of finances [3]. Who do they trust most to be the go-to for handling money management?

– Ask your parents about their medications. Are their medications being well-organized? If something happens, do you know what they take and when? Often, aging individuals begin to struggle with keeping track of medications and basic doctor’s appointments. Even if it seems like a while before your own parents could need this help, it is important to know where the information exists.

-Have contact information for your parents’ trusted professionals. Who are their doctors, lawyers, and faith leaders? Who mows the lawn or cleans the house? These are people you may be in direct contact with in the future. Know who they are.

Know who your support system will be in this endeavor. Do you have siblings who can share the load? Do you have trusted friends willing to help with driving your parents or your kids to different places? Talk to your circle about how you can support one another when and if you become a sandwich generation caretaker. Maybe your brother-in-law is great at understanding investment accounts, while your sister has no problem talking assertively to insurance companies and managing medication schedules. Your next-door neighbor loves dog-sitting, a lady at church does in-home hair appointments for the elderly,

and your best friend is great at cracking jokes just exactly when you need them. Lean on these individuals.

Believe me, you will need them.


While my parents have not had children to raise for quite some time now, their active-duty roles as caretakers to aging parents is currently creeping toward the 20-year mark. Watching my parents serve family members humbly and patiently (and sometimes not so patiently, to be honest) all this time has offered me a long-term case study in generational family systems.

I could easily paint a rosy picture for you and say that it has been glorious for them to be so present and that not a night of sleep or moment taken from other areas of their lives has been lost. But honestly, it has been very challenging at times to witness my parents through this season of life. It reminds me that serving another person, however much we love them, is never without sacrifice or hardship.

And yet, difficulty should not sway us from serving the best we can, in the most reasonable and sustainable way that we can for everyone involved. Remember, the health of the whole sandwich is important.

Sweet side effects of these difficulties exist, though. The New York Times article, It’s Pretty Brutal: The Sandwich Generation found that 23 percent of sandwich generation caretakers identify that the experience has strengthened their relationship with their aging relative.

I can think of several memories with my grandparents, like those from the weeks following Hurricane Katrina, that I kind of wish I never had to know.

But however raw and heartbreaking some of those moments felt, I witnessed them for the reality that they were, and I am a better person for all of them.

The most honest approach any of us can have about the prospect of aging parents, caretaking, and decision-making for the years of someone’s final season of life is this:

We honor our relative’s dignity and autonomy as much as possible, make the best decisions with the options we have at our disposal at the time, lean into tenderness, patience, and forgiveness, and find that grief and bravery can co-exist.

Shoot, this may just be the definition of being human.


1. Caregiving and the sandwich generation. Mental Health America. (n.d.). Retrieved April 20, 2023, from https://mhanational.org/caregiving-and-sandwich-generation

2. The economist/YouGov poll December 28 – 31, 2019 – 1500 US adult citizens. (2020, January). Retrieved April 21, 2023, from https://d25d2506sfb94s.cloudfront.net/cumulus_uploads/document/2r6hyqtv9p/econTabReport.pdf

3. Grose, J. (2020, February 18). ‘it’s pretty brutal’: The sandwich generation pays a price. The New York Times. Retrieved April 25, 2023, from https://www.nytimes.com/2020/02/11/parenting/sandwich-generation-costs.html

4. Livingston, G. (2018, November 29). More than one-in-ten U.S. parents are also caring for an adult. Pew Research Center. Retrieved April 21, 2023, from https://www.pewresearch.org/short-reads/2018/11/29/more-than-one-in-ten-u-s-parents-are-also-caring-for-an-adult/

5. Mathews, T. J., & Hamilton, B. E. (2016, January). Mean age of mothers is on the rise: United States, 2000–2014 – CDC. Retrieved April 21, 2023, from https://www.cdc.gov/nchs/data/databriefs/db232.pdf

6. United States Census Bureau. (2018, March 13). Older people projected to outnumber children for first time in U.S. history. Census.gov. Retrieved April 20, 2023, from https://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html

7. United States Census Bureau. (2020, June 25). 65 and older population grows rapidly as baby boomers age. Census.gov. Retrieved April 21, 2023, from https://www.census.gov/newsroom/press-releases/2020/65-older-population-grows.html

8. Waters, S. (2022, May 27). The sandwich generation, understanding who they are. The Sandwich Generation, Understanding Who They Are. Retrieved April 20, 2023, from https://www.betterup.com/blog/sandwich-generation

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