Parenting Your Elderly Parents: The Sandwich Generation

“My child, take care of your parents when they are old; grieve them not as long as they live.  Even if their minds fail”.  Sirach 3:12-14

Twenty two per cent of the American population has eldercare responsibilities.  By 2020 there will be 15 million Americans 85 years and older. By 2050 twenty two percent of the population will be 65 year and older (Newman, 2004).  With so many people waiting to have children there are many people who are members of the “Sandwich Generation” parenting minor children as well as elderly parents (Chisholm, l999).  The main group facing caretaking responsibilities today are the “Baby Boomer Generation” who are caretaking their parents some from a distance while others in their homes. Another group of the elderly live in assisted living facilities which is becoming a true reality for “people of means” while other elderly live in nursing homes.  Ninety two of every 1000 elderly live in nursing homes.

Caretakers manifest more stress symptoms, depression, chronic illness and take more psychotropic drugs than non care giving population (Berman& Shulman, 2001).  Caregivers commit from 5-35 hours per week to their elderly parents.  With elderly parents living longer, caregivers are at heightened risk for mental and physical complications. The mental decline of the elderly is an emotionally very tough time for caregivers because more stress and caregiving is required.  As the elderly declines, loss becomes more pronounced and eventual death becomes more evident which is very sad for the both the caregiver and the elderly.  The elderly becomes more fearful and depressed as they find themselves many times in new surroundings and unable to care for themselves.

The adult child who becomes the main caretaker of the parents is usually decided well in advance of the parental decline.  It is determined in the roles assigned within the family (eg. the responsible one, the favored one, the escape artist).  Yes, the responsible one takes on the job only to find that exhaustion, burnout and resentment become a constant companion until he/she can gather the necessary support both emotionally and physically.  The elderly parents take on roles as they progress through the aging process (competent parent, unnecessarily needy parent, parent in denial, realized parent).  Types of elderly parents have been identified (co-operative and independent, co-operative and dependent, un-co-operative and unnecessarily dependent, un-co-operative and dependent, significantly organically compromised-co-operative and significantly organically compromised and un-co-operative) Pitta (2004).

To make a decision how to manage the needs of the elderly parents is the first struggle the caretaker faces.  The caretaker is pulled by feelings of guilt and shame when trying to make decision based on what is best to do for their parent(s) while also managing their own lives.  The caretaker not only cares for the elderly but acts as the switchboard for other family members concerns and issues.  Ideally, a family that can take on shared responsibilities for the care of the elderly enabling the so called “caretaker” to better navigate this stage of life as well as take care of him/herself.  Making decisions as to the physical and emotional well being of the elderly, the caretaker needs input from family members who contribute to the care of the elderly, friends who can listen and give support and support groups and professionals who have experience in these issues.

What is a Caregiver to do?

  • It is essential that a caregiver:
  • Allows yourself to mourn the loss of your parents abilities( take time to feel the feelings).  The only reason one mourns is that you love and feel hurt and you care.
  • Express your feelings which will set yourself free emotionally.  By doing this, energy will be available to deal with the necessary tasks at hand.
  • Set boundaries around what you can do, will do and can’t do.
  • Communicate with elderly in a respectful and compassionate manner( be truly attentive, validate your parents words, consider yourself and parents as having a conversation between equals-even if parents are compromised, don’t give advice unless asked, be encouraging with positive words, talk about the good old days and if you don’t live with them, visit and call them within a schedule you can meet. And, refuse to accept the assignment of being the responsible one for their irresponsibility, unreasonable demands and un-cooperativeness.
  • Exercise- find a routine that you can do easily (walk 20 minutes a day, go to gym).  It is important to get a release from tension and stress and feed endomorphins to the brain that fights depression.
  • Bring in distant siblings who are willing to help.
  • Bring in other family members who are willing to help.
  • Get help with the elderly- Get as much as you can.  If you can pay for it, do it!!
  • Talk with loving family and friends.  If stress still too high, seek support groups and/or therapy.
  • Do have fun.  It is essential that the caregiver continues to have his/her own life so that you do not “burn out” and lose the focus of your being.

Dr. Pitta is featured in a video entitled, “Parenting Your Elderly Parents” published by American Psychological Association (2004).