Plus, advice from experts on how to navigate this life stage.
Like many other people in midlife, I never anticipated joining the “sandwich generation” — adults in their 40s to 50s with both elderly parents and children that need some kind of physical, financial, legal or medical support at the same time. It’s a whole new ballgame when you live at a distance — whether that be 50, 500 or, like me, 3,500 miles — from some of your family.
An October 2021 survey from the Pew Research Center found that about 23% of U.S. adults are part of the sandwich generation, with at least one parent older than 65 and at least one child under the age of 18 (or providing financial support to an adult child). Most of us in the sandwich generation are between 40 and 59 years old.
This year, I joined that demographic from a distance. I live in England with my children, and my parents are on the East Coast in the United States. I’m fortunate that my parents made the decision in 2020 to sell their home and move into an assisted living retirement community while they were still mentally and physically able, though COVID travel restrictions meant I couldn’t be with them to help pack up and clear out. They became active members of their retirement community, but this summer my father’s health took a turn for the worse, and my daughter’s 25-year-old boyfriend was diagnosed with cancer. For the first time, I understood what sandwich generation really meant, as I wondered how to deal with two different crises at the same time. How do I hold myself together when I want to care for my parents, my 23-year-old daughter, her partner, and my 19-year-old, who is halfway in and out of the nest?
I turned to some experts to get advice on how to navigate this overwhelming life stage (particularly when it comes to helping elderly parents) and learned that there are four areas to focus on: communication, practicalities, asking for help, and self-care. Don’t expect to deal with these all at once — bite-size chunks are best.
Communication
Meagan Buckley, president and CEO of Wake Robin, a nonprofit retirement community in Shelburne, Vermont, estimated that half of the community’s 400 residents have children who live more than an hour away, making care and involvement difficult. To help with this process, Buckley advised having “a conversation that is honest and future thinking,” asking your parent: “What’s important to you as you age? Where can I help, and where do you want control and privacy? How can we talk about each of our worries and hardships?”
All of the experts I spoke with stressed not going in with a “take charge” attitude. Alex Banta, clinical director and therapist at Thriveworks in Columbus, Ohio, recommended beginning hard conversations about an aging parent’s needs with a “soft start and explaining the motivation behind why you want to be included.”
“Let your parent know that this is not because you don’t trust them or feel they aren’t capable. It’s about streamlining and ensuring the best outcomes,” Banta said. She often uses the metaphor of a sports team: Your parent is the head coach, but you’re the assistant coach, double-checking decisions and providing input as needed. Approach conversations by wanting to understand your parent’s wishes and needs and how you can help them meet those. (That is, of course, if they are still mentally competent.) It’s important for your parents to feel they are still in control of their lives.
Practicalities
Having a support system in place and crucial paperwork complete before you need them makes this stage in life much easier. Sarah Milanowski, a geriatric care expert at LifeCircles PACE in Michigan, told HuffPost that it is crucial to make time for discussions before a crisis arises.
“Being a long-distance caregiver feels like solving a puzzle from afar. The key is having proactive conversations and establishing support systems before they’re urgently needed,” Milanowski said. She suggested finding someone who can be your “boots on the ground” — neighbors who can check in or a professional care coordination service — as well as video calls to visually check the parent’s wellbeing.
It’s important to create a caregiving toolkit, Milanowski noted. This should include things like a power of attorney for medical and financial decisions; advanced healthcare directives and “do not resuscitate” preferences; an updated will and any estate planning documents; Health Insurance Portability and Accountability Act release forms; current lists of medications and health conditions, along with names and phone numbers for healthcare providers; and funeral arrangement preferences. Any financial concerns should also be addressed. It’s a lot and shouldn’t be approached all at once. Break it down into manageable chunks, create a checklist and practice patience. None of this is easy for anyone.
Self-Care
It’s imperative you look after yourself and your family. Take breaks — even a short walk or a few quiet minutes — enlist support and communicate with siblings and partners about needs, expectations, and what is realistic for you to do. Forward planning will help make that self-care and time for your children and partner easier to find. It’s also important to identify what you have power over in these situations. Banta noted that many of her clients in the sandwich generation feel helpless, so it’s best to address those feelings by identifying what you do have control over, accepting those limits and letting go of the rest.
Banta also suggested setting realistic expectations and being kind to yourself. Sometimes your children will need you more than your parents, and only you can decide who gets the attention. Taking a few minutes for yourself can give you the space to think more clearly and make decisions you can feel comfortable with.
Asking For Help
A recent Carewell study found that 63% of caregivers advised looking for and accepting help by joining an online or in-person support group, asking family and friends to run errands, prepare meals or have a chat, and looking into respite care services that can offer short-term help.
There are countless resources online and available through hospitals and retirement communities. Use them for advice and help. Buckley noted that parents “don’t wish to burden their children with the pressures and ailments of aging. Most residents in our community see the act of moving to our community as their largest gift to their children — to ease worry.”
That was my parents’ hope when they moved — to maintain their independence while also having support systems in place for when they are needed. And though it was a difficult choice for our family to come to terms with, it has eased some of the worry, knowing they literally have a village of people to check in on them when needed.
“Our parents should be able to control and make decisions, even when they might feel worrisome for us as children,” Buckley said. “They have most often navigated all parts of their lives in a thoughtful manner. Sharing that we are available and showing up even when not asked makes a difference.”
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