The Sandwich Generation: Caring for Multiple Generations

  • When I was at my caregiving peak, with multiple elders who needed me plus two children - one with chronic health issues - there wasn't a term for people like me. Or, if there was, I didn't have time to read about it. Later, I became aware of the then emerging term "the sandwich generation." Generally speaking, this now popular and descriptive term refers to situations like mine, where adult children who have children of their own are also caring for their aging parents.


    I know all too well the feeling of being torn between the needs of different generations. My life consisted of running from one elder to another, then back home to take care of my kids' needs. Once, I had to leave my deaf, elderly neighbor Joe at the eye doctor's office with cab money and instructions for the receptionist to send him home in a cab, because the doctor was running an hour late and I had young children to pick up from school. Joe was used to taking cabs and the checkup was routine, but still I felt like I let him down. 

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    Another time, I had to choose between sitting with my dying aunt for the evening or going to my oldest son's first band concert. Again, I was lucky, in that my aunt had my parents with her, so I did go to my son's concert. But I was not there when she died. That hurt.


    I knew in both cases these elders would have wanted me to do what I did. Even during the many years of caring for my parents in their dementias, I kept that fact in mind. "What would they want me to do if they could think like they used to?" was my touchstone when I made decisions. That didn't make choosing easily, but it helped.


    They had been good parents. They had taken care of their parents. I firmly believed that they would have wanted me to take be available for my kids, unless there was an emergency, of course.


    There is an even worse scenario than mine, and we are seeing it more often now as the trend for people having children in later years has collided with more diagnosed early on-set dementia and the fact that people live through strokes and other ailments that used to kill them.


    That scenario is the struggle some caregivers must endure between the needs of a spouse with dementia or other limiting factors and teenaged, or even younger, children with many needs of their own.


    I received a phone call from a reader who described just such a case and she was at her wits end. She wanted her daughter to remember the father as he was before his Alzheimer's took over. Also, she was exhausted from caring for her husband alone and trying to keep him safe. She was unable to go to her daughter's activities and felt guilty about that. Her daughter couldn't have friends over because it upset the father. Also, the daughter's friends were unsettled by the father's behavior.


    This woman knew that an assisted living center with an Alzheimer's unit was in the picture. She couldn't withstand much more. She needed help. She asked me, "How do I get over the guilt of putting him in a home?"


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    We talked for quite awhile, but all I could really do was repeat that she was a parent as well as a spouse and she had some tough choices to make. I asked her, "What would your husband have said if you'd asked him about this before the Alzheimer's set in?"


    I told her I suspected that he would have said the teenager deserved a parent. I told her, also, that she could see her husband every day at the assisted living center, if she chose. The home she was looking at was one I was familiar with and it is an excellent facility. The daughter could also visit at will.


    Everyone has to make their own decisions based on their own challenges and beliefs. However, I did tell this woman that if guilt was eating her up, she should get support through a group, and counseling if necessary. She was doing all that was humanly possible. She admitted she was at a breaking point. I gave her what support I could, and told her she had nothing to feel guilty about. I hope she made the right decision for her family - whatever that was - and that they are doing as well as their situation allows. 


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Published On: February 07, 2010