Squeezed: The Sandwich Generation
Taking Care of Young Children and Aging Parents at the Same Time
His 19th century farmhouse in Middletown, N.J. has three bedrooms, but Bruce Lindstedt has spent the past few months sleeping on an air mattress in his family room. He’s there to be closer to Mable, in case she tries to escape or needs him in the middle of the night.
Mable Eremus, 95, is the mother of Lindstedt’s husband, Jon, a local high school teacher. The couple also has an 11-year-old son, Vincent, but since Mable was diagnosed with dementia in 2012 following a hip fracture, caring for her has occupied “110 percent” of Lindstedt’s time. Lindstedt retired from his job as a financial analyst.
“Jon still works as we do not want to put her in a nursing home so long as I can take care of her,” said Lindstedt. “We have an aide that comes in five days a week to get her up, showered and dressed. I do that the other two days of the week. I had to do that for both of my parents when they were failing so I know what is involved. It is taxing to say the least but I wouldn't have it any other way. If she went into a nursing home, no one could give her the one on one care that we do.”
Caregivers like Lindstedt make up what experts call the “sandwich generation,” caring for young children and aging relatives at the same time. Amy Goyer, caregiving and family expert for AARP, says that the role is far from uncommon. “The average caregiving age is 45 to 60ish, so if you're looking at someone who's 45 years old, they're less apt to have young kids, but they're quite likely to have a 10-year-old, and definitely to have teenagers or young adults."
Demographically, that role has traditionally fallen to women, typically in their forties, caring for their mother and working.
But gay men like Lindstedt, 63, who start families in their forties or fifties, may skew somewhat older, with children still in elementary school or younger. Either way, Goyer says, sandwich generation caregivers face risk of isolation, marital troubles, financial hardship and isolation.
“One in five caregivers is a spouse [of the adult child of the relative needing care],” she said. “They're more likely to have less income, they're more likely to be women, they're more likely to have lower education; many issues point to them being more vulnerable."
In a 2012 Pew Research Center survey, 41 percent of those caring for an aging parent and supporting a child of any age reported they were just getting by or didn’t have enough money to cover basic expenses. In contrast, the same percentage of middle-aged adults not supporting a parent said that they were financially comfortable.
And the job often comes with few thanks, as aging parents often resist shifting roles and accepting support from the child they formerly supported. Often, according to Goyer, they simply don’t want to face the fact that they’re no longer able to care for themselves. For LGBT adult children whose parents may still not have entirely accepted their children’s sexual orientation or gender identity, that shift can be even more difficult.
"Gay adult children and their parents can have a complicated relationship to begin with. It may be that they're still struggling with all of that, and now they're in the situation where they really need to care for their parents."
Lindstedt says that he was much more fortunate. When he and Eremus first met, in 1996, Mable filled the void left by the recent death of his own mother. They got along so well that the couple eventually moved into the house she inherited from her grandparents in 1937. Mable found a willing audience in Linstedt. “She told me all the stories of her parents and grandparents and [about] the area that I was now living in. Jon had heard the stories before and would get bored. Me, it was like she was telling them to someone for the first time.”
The main challenge he and Eremus faced, and continue to face, was from family members who first questioned their decision to adopt Vincent, born drug-exposed and in fragile health, and then failed to help when Mable needed care.
The Pew survey found that while the numbers of middle-aged Americans caring for children and elderly parents has not grown substantially over recent years, those in that situation are feeling more squeezed than ever. Nearly half reported providing financial support to at least one adult child forced by economic factors to move back home. One in five reported providing financial support to an elderly parent.
Interestingly, the same survey found that more affluent adults, with annual household incomes of $100,000 or more, were significantly more likely to be sandwiched between generations.
Dallas resident Lane Terrell, 47, always considered himself lucky to have had the financial ability to spend more than a decade traveling with his grandmother, 99-year-old Tina Terrell Rupp. “My grandma and I have always been extremely close,” he said. “When she and I were younger, we’d travel the world every summer, visiting over 60 countries and six continents throughout our adventures together.”
Now he considers himself lucky to be able to afford full-time care for her in his Dallas home, where she lives along with his partner of ten years, Cody Burnette, and their sons, Couver, age 5, and Camden, age 4. “She has been the matriarch of our family for years and I love that she can continue that role with her new living arrangements – plus it’s nice to have some feminine influence in the house.”
In spite of the full-time help, he says the family is just an extra emergency away from chaos, their experience in February when Tina fell and fractured her hip. “Daily routine is easy to manage, but when more than one crisis erupts, it can be very hard to manage,” he said. “Yes, I slept in the hospital with her and I was occupied for two weeks after that making sure that her recovery was on track, but it was manageable. However, literally the day she came home from rehab, my mother [also] broke her hip and then I had to go into crisis mode.”
Goyer says that’s when it becomes essential for caregivers to pay attention to their own wellbeing. “That’s the hardest thing, that there are all these people around you whose needs are more important than yours, because you’re not 83 years old and you’re not 2½. If you're not doing the basic things to take care of your health, your emotional wellbeing, and if you don’t have a support system in place, you will eventually have a lot of crashes."
Goyer recommends that caregivers take advantage of information and resources available from organizations such as The Family Caregiver Alliance, The American Society on Aging, and AARP, and to make sure they get ample sleep, exercise and connect with groups of friends or other support networks.
Linstedt says finding time is one of his biggest challenges. “You could say there’s just no time for this, or that you fit it in when the aide comes, two hours a day, five days a week, when you’re able. I have a dog so I get exercise that way taking him for a walk, or when I mow the lawn during the summer. My “me” time will come after she is gone.”
Grandchildren can also help, both with the day-to-day tasks of caregiving, in the case of older children, or, if the children are younger, as a motivation for grandparents to stay healthy.
“All I see are the benefits of my kids getting to know and love their great-grandmother in a way that would never have been possible with her living in a different state,” said Terrell. “I’ve seen my youngest son, who occasionally has nightmares, go and climb in her bed to be comforted and go back to sleep, rather than searching for me. As for my grandma, it has given her a new purpose in life. When she broke her hip and was about to be wheeled in for surgery, she told me, ‘I have to see those boys grow up, so you don’t worry about me; I’ll get through this just fine.’ And of course, she did.”
Linstedt says that while Mable’s dementia often makes it difficult to recognize her own son, the identity of 11-year-old Vincent is clearer. “She always remembers him, and more often than not, his name, but thinks there are more of him than there are,” Linstedt said. “Whether that is because of shadows from the past, possibly ghosts or memories of her own children, I do not know. But he is her anchor at times.”
But both Lindstedt and Terrell said that in spite of the stress of caring for young children and aging relatives at the same time, they don’t regret their decision to start a family in midlife.
“Heck no, you are as young as you feel,” said Terrell. “My grandma is living proof of that. But do I feel old and haggard some days? You bet. I think age gives you maturity and patience. I was in my forties when I became a dad and I think I am much better parent than I would have been in my twenties or thirties.”
“Would we do it again the same way had we known that Mable would be in this condition?” asked Lindstedt. “Absolutely. Vincent has learned a lot through all of this and offers to help by sitting and doing his homework with her so I can get dinner on the table or do laundry.”
Perhaps most importantly, both agree that in many ways, being squeezed between child and elder is easier now than it would have been earlier in life.
“I am better as a father now at this age,” said Linstedt. “Money is freer, [there are] more advantages. I'm not stressed with working, and raising children along with everyone else. I have a lifetime of experience.”