Caregiver Stress and the Sandwich Generation

Social worker Dorothy Miller, originally coined the term “sandwich generation” back in 1981, to describe women in their 30s to 40s who were “sandwiched” between young children and aging parents as their primary caregiver. A lot has changed since then. Women are delaying child-bearing and seniors are living longer. Because of these added variables, the “sandwich generation” definition has morphed along the way and tends to target both genders and the predominant age is 40-65 years old.

According to a 2013 Pew research report, “Nearly half (47 percent) of adults in their 40s and 50s have a parent age 65 or older and are either raising a young child or financially supporting a grown child (age 18 or older). And about one-in-seven middle-aged adults (15 percent) is providing financial support to both an aging parent and a child” (Parker & Patten). In 2005, the sandwich generation was largely made up of baby boomers.

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Fast forward to 2014, and the boomers have started to age out of the sandwich generation and become the recipients of care from the new sandwich generation. Generation X is now the predominant demographic in the sandwich generation. In addition, Pew research reports three-in-ten Hispanic adults (31 percent) have a parent age 65 or older and a dependent child. This compares with 24 percent of whites and 21 percent of blacks. Compound this data with the growing number of children/dependent adult children and seniors who require complex care related to increased autism and chronic disease diagnosis, and the stress on the sandwich generation magnifies ten-fold.

Who cares for the sandwich generation? In many cases, no one cares for this group of caregivers, who usually has the added burden of working a full-time job. Additionally, this group often has to juggle an unexpected hospitalization of their loved one with their career obligations. Many outsiders to this issue may think a hospitalization might give the caregiver some respite, when in fact most caregivers have an added stressor when a loved one is hospitalized and their already hectic daily routine is altered.

Self-care is typically neglected by the sandwich generation. Learning to integrate simple self-care tips into your daily routine will help caregivers to stay healthy. The heathy caregiver provides a higher level of physical and emotional care to their loved one and this is a gift that keeps on giving.

Caregiving tips:

1. Be kind to yourself
Often we are kind to others while we push ourselves beyond our own limits. The first step in dealing with caregiver stress, anger, or frustration, is to care for yourself. Well-meaning friends and relatives often tell you to take care. But no one will actually tell you how to take care of yourself while supporting a loved one or sitting at his or her side at the hospital.

One of the first things to learn is to ask for and accept help. It’s important to clearly identify your needs and acknowledge that you can’t do it all alone. This can be hard to do. Make a list of people you know who would be willing to help. Help doesn’t necessarily mean caregiving, but every task or chore that is removed from your full plate will give you a few more minutes of you time every day!

2. Take spontaneous and unplanned breaks
If your loved one is in the hospital and needs to have a test, give the nurse your cell number and go sit outside for ten minutes. If caring for someone at home, consider the use of a wireless doorbell system to enable your loved one to call when needed. This allows the caregiver on duty the freedom to be in another room or go outside.

A walk to the mailbox can be a mini-vacation. Sun, and even rain, can be good for the soul. Exercise of any kind can help to release some of the frustration that caregivers experience.

3. Pack a caregiver bag of your own
Find an attractive cloth bag for essential personal items when you visit the hospital with your loved one. Keep hand lotion, lip balm, a journal, a novel, or any item that is soothing for you.

4. Be mindful and meditative
Every hospital has a chapel. Most have a chaplain, at least on-call. Consider utilizing available resources for prayer or reflection. Pick up a book on mindfulness meditation. Carry a book on mindfulness with you and read a passage or two when you have a few minutes. Use a journal to jot down your thoughts and feelings. Being mindful reminds us to have gratitude for even the small mundane things — after all; they can go away in a flash. When caring for your loved one, be mindful of how he or she feels, smells, talks, laughs, etc. Appreciate the beauty of it all. The memories you make in doing so can be conjured up at a moment’s notice… forever. Seize the opportunity to be present in the moment. Refuse to let stress or anger rob you of valuable time.

5. Nourish your body with healthy food
It is all too easy to rely on junk food and vending machines. Avoid using alcohol or drugs (including caffeine) to get through the day. These will only complicate things and add to the stress, anger, and frustration. Eating healthy food will give you the physical and mental stamina to deal with whatever is thrown your way during the day. Ultimately, it will help you to deal with adversity more effectively.

6. Sleep whenever you can
Many of us struggle with sleep even without a life crisis. If you have an unexpected two-hour break in the middle of an afternoon, take a nap and refuse to feel guilty about it. Sleep, like healthy food, helps all of us handle adversity better. In addition to sleep, keep up with your own health needs. Don’t skip annual medical screenings or allow yourself to run out of prescription medicine. If you do not take care of yourself, you can’t do a good job of caring for your loved one.

7. Laugh, laugh, laugh
We all know the power of a good belly laugh! Try to see the humor in life.

8. Avoid hard and fast plans
Purchasing tickets for concerts or signing up to take a class and then being unable to attend can add to your frustration. You are often better off using any free time to take a walk, shop, or even nap. Time becomes ever so precious. Learn to use it wisely.

9. Consider counseling
Many counselors specialize in anger, the stress of caregiving, and grief. If you need help in getting through a stressful time in life, you are not weak or unusual. Think about what you need or want. Do you just want to talk to someone? Maybe a therapist or support group is what you need. If you think you might need medications, consult your PCP or a psychiatrist. Many caregivers have trouble sleeping or find themselves battling anxiety. Don’t be ashamed or embarrassed to ask your doctor for medications to help with sleep or anxiety problems. If your loved one is hospitalized and you are caring for him or her far from where you live, ask a nurse or doctor to refer you to the appropriate professional near the hospital. Health care providers and social workers are used to assisting out-of-town visitors with their health care needs. Regardless of your location, if you are having difficulty coping with the anger or frustration of being a patient or caregiver, reach out to a mental health professional. For those caregivers unable to leave the home but in need of support, many online support groups are available. Support groups for caregivers, relating to specific diseases, are constantly being added to the online community. For a list of current online support communities, type “online caregiver support group” into your digital search engine.

By Ruth Tarantine, DNP, RN

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