The Sandwich Generation: Balancing In-Home Elder Care and Parenting

In the blink of an eye, your household has transformed. One or both of your aging parents are now living with you, impacted by health issues or life’s inevitable trials – a mobility-limiting accident, a dementia diagnosis, or general health deterioration. Despite your earnest efforts, you feel the burden of caregiving stretching you thin as you strive to balance the needs of your parents and your children.

Welcome to the world of in-home care, an increasingly prevalent situation among the “sandwich generation.” These are individuals, often in their 30s or early 40s, juggling responsibilities between their own children and aging parents.

The reality is, you’re far from alone in this journey. Approximately a quarter of American families are also part of this care paradigm, striving to provide care for their parents while managing their daily routines.^[1]

In-home care encompasses a wide range of support, such as managing medication schedules, coordinating medical appointments, and offering companionship to combat loneliness, to hands-on caregiving, including help with bathing, dressing, and eating. All while ensuring your children’s needs are equally catered to, making the task even more challenging.

Taking on the role of a multigenerational caregiver is undoubtedly tough – physically, mentally, and emotionally. Nevertheless, with the right strategies, a balance can be found, ensuring the needs of everyone in your care are met effectively and compassionately.

Navigating the dual role of parent and caregiver for your elderly parents can be challenging. Balancing familial obligations, emotional strains, and self-care often seems unachievable, but with appropriate strategies, it’s possible. Your duty extends beyond ensuring your family’s safety to prioritizing your wellbeing.

Your circumstances will be fluid, contingent on the health of your loved ones and the state of your family unit. The complexity of caregiving, especially when caring for both the elderly and young children, is immense. However, support and resources are available to help you cope and endure.

Think of the airplane emergency protocol: you’re instructed to don your oxygen mask first. This metaphor applies to your caregiving role: take care of yourself first. Ensuring your wellbeing allows you to better serve your family.

Feeling alone, despite being surrounded by family, is common among caregivers. Balancing elderly care, work, home life, and child-rearing can lead to stress and resentment. Finding balance isn’t just advisable—it’s necessary. Taking time for yourself isn’t selfish, it’s a form of self-preservation. It’s about wearing your ‘oxygen mask’ first.

Don’t be alarmed. Mindfulness is not meditation. Besides, who has time to relax? Take heart. Mindfulness is simply the ability to push the ‘Pause’ button for a few moments (or longer if you can) to rest your mind. 

One of the best ways to practice mindfulness is to take in what’s around you with all your senses. Close your eyes and inhale the aroma of the grass or a flower. Watch that squirrel flicking its tail in the tree outside. Listen to the hum of a bee. Relish that taste of a piece of chocolate. Feel the fur while you stroke your pet. Your senses in that moment keep you grounded. Your brain will distract you so that you can be free to explore your surrounding environment in the moment. Even a minute or two can do wonders for the soul.

Make those moments of mindfulness part of your daily routine to help keep you grounded. It’s not only healthy, but can help you deal with your daily stress of caring for family and aging loved ones.^[2]

Taking care of your physical self is also very important for any caregiver, regardless of circumstances. Eating a balanced and healthy diet will keep your body nourished, both physically and mentally. Exercise can also help relieve a build-up of adrenaline that often occurs during stressful times, and help ease negative emotions like frustration, anger, or resentment.

Time is precious. You might have to squeeze in exercise here and there. Whether it’s a quick walk around the block, a few minutes of stretching or yoga, or lifting some weights, do what you can to keep your body limber, strong, and healthy. 

You can’t do it alone. Don’t underestimate the value of a support system. You’ve got to be able to release your own emotions and frustrations in a healthy way. Talk to a close friend on the phone. Because you might not have a lot of time to get away from the home, also consider online support groups focused on the needs of caregivers. The advice, encouragement, and the tips you receive from those going through the same thing you are can be priceless.

While it goes without saying, ensuring your parents’ well-being as their caregiver is important as it not only preserves their dignity and quality of life but also affirms their value and significance within the family unit. Their physical and emotional health greatly impacts the overall atmosphere of the home, affecting all members including children, so maintaining their well-being is integral to maintaining household harmony.

Additionally, taking care of their health and happiness allows you to model empathy, respect, and responsibility to your children, teaching them invaluable life lessons.

For caregivers who don’t have a background in healthcare, understanding what’s going on with your parent is often confusing. Navigating the medical maze of different doctors, medications, and treatments is challenging for many. It’s extremely important to learn as much as you can about your parent’s current condition and its prognosis. Talk to their healthcare provider/s. Ask for printed materials to help you in their care. Go online and research, but only use reliable resources, meaning don’t rely on symptom checkers.

Understand the basics (as well as limitations) of your loved one’s physical, mental, and emotional status. For example, taking care of a patient with dementia can make caregiving not only perplexing, but requires more of your time, attention, and patience. 

Know the difference between advanced directives and a living will. Talk to your parents about their wishes for end-of-life care. The key is to educate yourself so you’re better prepared to provide the care your parent might need.

Make modifications to your home as needed. For example, remove throw rugs that create trip hazards, as can lamp cords. Remove or rearrange furniture if needed to aid use of walkers or wheelchair use. Your parent might feel safer with a shower chair or bench (and it will save your back!). You ‘baby-proofed’ your home at one time, didn’t you? Now you need to make sure that you reduce fall and other risk hazards for your parents. 

The Family Leave Medical Act (FLMA) enables a covered employee between 12 to 26 weeks of leave without fearing loss of their job so they can care for a loved one. You won’t get paid for the time you’re off, but you won’t lose your job.^[3] 

To utilize the benefits provided by FMLA, start by having a frank discussion with your employer’s HR department, who can guide you through the process. Keep in mind, FMLA eligibility is dependent on your employment history and company size. The law requires you to have worked at least 1,250 hours over the past 12 months at a company employing 50 or more people within a 75-mile radius. Following approval, you’ll need to submit appropriate medical certification to validate your need for leave.

Despite being unpaid, this leave safeguards your health benefits, providing peace of mind during challenging times. Additionally, your job or an equivalent position will be waiting for you upon your return.

Having an elderly grandparent in the home that requires medical care or one who has experienced a stroke or some other physical or mental injury that makes communication or movement difficult can be scary for a child. 

Talk to your children about what is going on with Grandpa or Grandma, but cater that information in a way that they can understand. They need to know ways in which they might help. Explain to your child why they need to have a ‘quiet time’ or why you can’t take them to the park as often as you used to.

Frequently reassure your children that you love and care about them. Children often act out when they feel they’re not getting enough attention, so keep that in mind. Relieve their anxiety by explaining to them (age-appropriately, of course) what’s happening and why. 

Soothe their fears about Grandma or Grandpa. Most importantly of all, include them in decision making processes whenever possible. They will benefit from feeling needed and respected and not kept in the dark about the situation. 

Ensuring set-aside time with your kids is a very important part of caregiving with aging parents in the home. Spending time with the kids, whether outside playing, a trip to the movies or a park, or even a walk, goes a long way toward maintaining some sense of stability in their home life. This also ensures maintenance of a strong parent/child bond, regardless of age.

The importance of empathy and the concept of responsibility is also a valuable lesson for children to learn, at any age. When you involve your children in age-appropriate interactions with aging parents, everyone benefits. Whether it’s sitting with Grandpa or Grandma after school for a short time or helping with chores, involving your children in caring for aging relatives also teaches responsibility. Children learn by example. They’re watching you, whether you realize it or not. 

Managing your time effectively between caring for your elderly parents and supporting your children can often feel like navigating a precarious tightrope. Creating a balance between the two is by no means straightforward. Each family grappling with this reality faces a unique set of circumstances and challenges. However, through careful planning, education, and repeated practice, you and your family can formulate an in-home care strategy that benefits all parties involved.

Be ready to strike compromises, and most importantly, prioritize self-care. In the context of in-home care, remember the oxygen mask analogy. You must first ensure you’re in good health and well-cared for before you can effectively take care of others. This will enable you to provide the best care possible for your family while maintaining your own wellbeing.

Caregiving is an act of love, even at its most difficult. Getting old is scary. So too is losing your ability to take care of yourself in the manner in which you’ve grown accustomed to. Don’t forget that your parent likely feels just as bad about the situation as you do.

You might be unprepared to become a part of the sandwich generation, but as you muddle through it, you will be rewarded for your efforts in ways you might never have expected. No matter how challenging the journey, you will be changed forever, as will your own perspective on life. You will grow old someday. Someday, your own children might be taking care of you. You’re making a difference you can be proud of.

1. https://mhanational.org/caregiving-and-sandwich-generation
2. https://positivepsychology.com/how-to-practice-mindfulness/
3. https://www.dol.gov/agencies/whd/fmla