As the best-selling author Gail Sheehy famously documented in her 2010 book, "Passages in Caregiving," caring for an ailing loved one can be an overwhelming, chaotic and stressful task. Sheehy learned that lesson firsthand while taking care of her husband as he fought cancer for over 10 years.
Four years after her book came out, the challenge Sheehy described is even more common among women in their 40s, 50s and 60s, and can be particularly difficult for those who are simultaneously raising children and holding down jobs. A report released this summer, "Caught in the Middle: How Does the Sandwich Generation Woman Not Get Squeezed?" from the Family Wealth Advisors Council, a network of fee-only wealth management firms, found that the typical sandwich generation woman in her 40s or 50s spends at least 20 hours a week raising children or caring for aging family members while also working at least a part-time job. The stress of it all can hurt her health and longevity, as well as cause her to lose an average of $324,044 in lost earning power and Social Security benefits.
"The stress extends beyond the immediate situation. Do you sell the house? How much for? What do you do with the proceeds? Even something as simple as helping someone get a house on the market has all these trickle-down decisions. That's what's so complicated and stressful for the sandwich generation," says Sharon Allen, president of Sterling Wealth Management in Champaign, Illinois, and co-author of the report.
Research conducted among 1,880 staff members at the University of Rhode Island by Barbara Silver and Helen Mederer, work and family researchers at the school's Schmidt Labor Research Center, found that 1 in 3 workers currently face elder care responsibilities, and that figure is growing, with 45 percent of workers anticipating having elder care responsibilities in the next five years. Meanwhile, 43 percent of the workers in the survey faced child care responsibilities, and 12 percent had both child and elder care obligations.
Mederer and Silver -- who presented their findings at the June 2014 Work and Family Researchers Network conference -- note that caring for aging parents differs from raising children in that it can "go from zero to 100 overnight," and it's a sad, difficult process. Their research also shows that workers caring for older adults report higher levels of stress, overwork and work-life conflict than workers caring for children. "Elder care is not as acceptable a reason for [workplace] flexibility," Mederer observes, and it can also be less predictable, with parents suddenly needing a lot of assistance.
"People who have elder care responsibilities felt less supervisory support for their needs" compared to workers with child care responsibilities, Silver says. That can add to the stress of adult children caring for their aging parents, especially given the emotional toll that such caregiving can take. "Caring for people who cared for you is a difficult emotional transition to make. ... End-of-life care is also much more emotional and stressful, and family members don't always get along. The whole dynamic of elder care giving can be more stressful," Silver explains. AsSheehy says in a promotional video for her book, caregiving "flips the roles upside down." "Suddenly the parents who always took care of you, you're caring for them," she says. "...[It's] hard,"
Mederer and Silver's research also found that workers charged with elder care often were less clear on the quality of care that their parents were receiving during the day. About 63 percent of workers caring for elders said they were satisfied with the arrangements, compared with 75 percent who said they were satisfied with child care arrangements. About 27 percent said they were "unsure" whether they were satisfied or not with elder care arrangements, which Mederer and Silver point out could indicate that it's more difficult to judge the quality of elder care.
One positive sign for workers who find themselves juggling those responsibilities is that companies seem increasingly sensitive to the demands on those caring for aging parents. The Families and Work Institute found that in 2014, employers were more likely to say they offer elder care resources and referrals to employees than in 2008 (43 percent versus 31 percent). In addition, three in four employers said they currently offer either paid or unpaid leave for employees who need to care for elders. (The institute also notes that the Family and Medical Leave Act of 1993 does not require this flexibility, only that employees can take family leave for "seriously ill" family members.)
For caregivers dealing with this situation, experts offer the following tips:
1. Talk it out.
Caregiving can quickly get stressful once a crisis hits, which is why Allen recommends talking out plans for caring for an ailing parent, like how financial burdens will be shared, before health begins to deteriorate. That includes talking with siblings, too, so you know how much help each family member plans to provide and how involved he or she may be.
"Start the conversation with both ends of the sandwich -- your aging family members and your kids," Allen says. "... So often, people don't communicate, and they make assumptions about what others are thinking. Lay out the expectations for different family members so they know what's expected."
2. Get papers in order.
Allen also recommends making sure essential documents such as health care directives, wills and records of financial accounts and computer passwords are stored in a safe place that will be accessible to the caregiver when he or she needs them.
3. Take care of yourself, too.
Caregivers, especially when they are caring for children and working, can experience high levels of stress. That's why it's essential for caregivers to also take care of themselves by taking breaks, calling on support groups and fellow family members to assist, and getting enough sleep and exercise. Sheehy urges caregivers to develop a "circle of care," and emphasizes that no one can handle caregiving for an ailing loved one alone. She urges caregivers to take a break for at least one hour a day to replenish their reserves.
"I don't think people give themselves enough space to take care of themselves when they're caring for elderly people," Silver says. "My advice would be to acknowledge the burden you're absorbing and get plenty of support."