The Mental Load of Being a Sandwich Generation Caregiver
Nearly a quarter of parents are part of the 'sandwich generation,' caught in an embrace as they tackle caring for both their parents and their kids.
Writer and musician Tanuja Desai-Hidier lives in a multigenerational home in Maine with her aging parents and two teenage daughters. Between online schooling and "hematologists, nephrologists, cardiologists, rheumatologists, dermatologists, gastroenterologists, colorectal surgeons, labs, and all kinds of stuff," nearly everything falls on Desai-Hidier. "Nothing can be hidden from me because I'm managing everything," she says. "On my bluer days, I feel extremely squeezed and scattered at the same time."
When Katie Schlott's divorced mother was diagnosed with a rare autoimmune disease which left her in pain and fairly incapacitated, Schlott took charge of her care: In conjunction with lawyers, she sold her mother's house, applied for government assistance, and found her mother long-term care. "To say this was difficult is just an understatement," says Schlott, an Illinois-based mom of two. "But I am privileged. I could pay for people to help me figure out these systems. And so many people have to navigate it alone. It's so broken and so frustrating."
Seattle-based Olivia Chiong balances care at a distance: her mother, in Las Vegas, recently had a stroke. Chiong and her wife are in the process of obtaining guardianship of her mother, as well as power-of-attorney, so they can make hard decisions about the future of her care, while also raising two young children. "We flew there for five days, but because my kids are still in school, we had to come back," she says. "I'm trying to manage things from Seattle, trying to file court paperwork and figuring out, 'When do we go back? When will she need us?'"
Related: Why We Need to Bring Attention to the Sandwich Generation
Growing Numbers, Rising Anxiety
These stories are three of many. About a quarter of U.S. adults (23%) are now part of the so-called "sandwich generation," according to a Pew Research Center survey conducted in October 2021. These are a group of Americans who are caring for children under 18 and older relatives at the same time, providing hours of unpaid labor—from transportation and doctor visits, to liaising with insurance companies, care facilities, and lawyers, while also dealing with the demands of being a parent.
Being a multigenerational caregiver is a financial, logistical, and emotional challenge, especially in the absence of robust social supports. The U.S. has no nationwide paid parental leave policy and provides limited access to subsidized child care. Elder care is expensive and increasingly-complex; it's often a full-time job to navigate the bureaucracies of health care and finance. These systemic gaps are not accidental, and deeply rooted in capitalism and patriarchy: in the U.S., care work has long been thought of as the responsibility of the family, wrapped up in moral judgments of what it means to be a good parent or child. Furthermore, care work is highly gendered, and such feminized labor is discounted economically and devalued socially. "In America, we don't have a social safety net; we have mothers and we have women," says Angela Garbes, author of Essential Labor: Mothering as Social Change. This has been the story since the beginning of our country. We fall back on that because it's just ingrained—that's what society has said is acceptable."
This burden of care is only expected to grow. The number of people who are 65 or older is projected to increase by 2050. Americans are having children later, and family size is shrinking.
What the Sandwich Generation Can Do
So what can caregivers do? Individually, those sandwiched between an aging parent and their own children should take time for themselves when possible, and lean on others. Care is a community function, says Garbes. "Building solidarity starts with sharing our stories and realizing, 'This work is very hard for me, but I'm not alone,'" she says. "Solidarity is in the everyday let-me-help-you community-level stuff. Every bit we do to help each other is important."
Jessica Stern, Ph.D., a postdoctoral researcher in psychology at the University of Virginia, concurs. Prioritize self-care, in the true sense of the word—sleeping, eating, drinking water, and, most importantly, being connected with others. "Emotional labor requires our whole being," she says. "It asks us to be emotionally regulated ourselves, to have emotional intelligence about other people, and to have a lot of self-control." Our species evolved through cooperation and intimate bonds in small communities, she explains, and close relationships are vital to sustaining mental health and sanity when caring for others. "I like the term 'fictive kin'—a person who you consider part 'my people.' If you don't have somebody like that in your life, you should invest in creating a relationship like that."
Chiong lives the adage, "You can't take care of others if you're not taking care of yourself." She sees her therapist weekly. "Even if there's nothing to talk about, just having that support and knowing that every week I have a time where I can just talk and vent has been really helpful," Chiong says. "And making sure that I make time to do stuff that I care about and that I enjoy. That's the thing that allows me to keep going even though my life is going crazy."
Cultivating a new mindset has been helpful for Desai-Hidier. "A sense of humor, it's like a total gift for survival, and to see the joys," she says. "I get overwhelmed by the doctors and the portals and everything, but I don't want the alternative. I try to see the sandwich squeeze as an embrace. I want the older generation here. I want the younger generation here. There is a lot of stress, but there's also safety in that embrace."
Change Is Needed To Help the Sandwich Generation
But attitudes and systems have to change, experts say, especially because existing inequities burden marginalized people more. "That's not to say that a middle class family can't feel burnout, but it does mean that the stressors that are placed on women of color and families living in poverty are just much higher," Stern says.
Stern conceded that her exhortations to vote might sound "cheesy," or even futile, but it can be a real lever of power if wielded in community with others. "And between voting cycles, we need to be advocating for subsidized child care, elder care, paid parental leave, grandparental leave, and systems and structures that can sustain us better, like mental health care and couples counseling."
These asks are not radical, Garbes says. "They are human rights; we have normalized privatizing those things and not treating them as a public resource," she says. "We need to speak on those things. We need to name the ways that our country has failed us."
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