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Caregiving Chronicles

News and analysis on caregiving topics in MetroWest and beyond.

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Caregiving Chronicles will present news and analysis on caregiving topics in MetroWest and around the world, in-depth Q&As with experts in fields related to caregiving and updates and announcements about caregiving resources available in MetroWest from CaregivingMetroWest.org Program Director Douglas Flynn.


Caregiving Chronicles Q&A: The "sandwich generation" and coping with caring for children and parents at the same time
By Douglas Flynn / September 21, 2015
Editor’s note: The Caregiving Chronicles blog has partnered with Century Health Systems to bring additional expert information and advice to the MetroWest caregivers we strive to serve at CaregivingMetroWest.org.

Century Health Systems, the parent corporation of Distinguished Care Options and the Natick Visiting Nurse Association, has allowed Caregiving Chronicles to get some valuable insight from its staff for our ongoing series of Q&A sessions with caregiving experts. In this entry, we cover some of the issues facing caregivers in the "sandwich generation" caring for both their own children and for aging parents or other relatives. Providing insight is Judith Boyko, MBA, MS, RN, who has served as the CEO of Century Health Systems since it was established in 2001.

Boyko holds a Bachelor of Science degree in Nursing from the University of Pittsburgh, a Master of Science in Public Health from the University of Massachusetts, Amherst and a Master of Business Administration from Clark University. She has been recognized by the Home & Health Care Association of Massachusetts as Manager of the Year in 1997 and received the Deborah Blumer Community Health Leader Award from the MetroWest Community Health Care Foundation in 2007. She can be reached at infonvna@natickvna.org.

Boyko: Many of us have been there. We care for our aging parents while also raising our families. Some in this “sandwich generation” may have responsibilities caring for a loved one who lives on her own, and some may have even adapted a home to accommodate an aging – or handicapped – older relative.

Caregiver.com says that “the typical American Sandwich Generation Caregiver is in her mid-forties, married, employed and cares for her family and an elderly parent, usually her mother. With this said, it is important to note that there are more and more men that find themselves in a caregiving role and even squeezed in between the generations.”

But the population is aging, which means that more and more people will need support with their caregiving duties – or caregiving for themselves.

Caregiving MetroWest: How common is it for family caregivers to find themselves in this situation of caring for two different generations of loved ones at the same time? Has the “baby boom” generation reaching retirement age increased this trend?

Boyko: According to AARP, there are 66 million Americans who care for their parents, their children and a spouse. The Sandwich Generation used to include mostly members of the Baby Boom generation (those born between 1945 and 1964), but today, 42 percent of generation X-ers (those born in the early 1960s through the early 1980s) comprise the Sandwich Generation, according to Pew Research Center.

In fact, almost half of adults who are in their 40s and 50s have a parent aged 65 or older and are also “raising a young child or financially supporting a grown child (age 18 or older),” according to Pew’s “The Sandwich Generation.”

CGMW: How are the needs and issues facing sandwich generation caregivers different than other caregivers?
Boyko:
What’s unique about the needs of the sandwich generation is that they are providing support to an aging relative while they are also engaged in active parenting. Caregiver support can be physical, emotional and/or financial in nature. It also includes helping an elder with everyday activities of daily living, adding to caregiver stress. Additionally, members of the sandwich generation may be planning for their own retirement while still financially supporting multiple generations.

These caregivers may also maintain full-time jobs. The Family Caregiver Alliance says that caregiving “costs businesses $17.1 billion annually” due to time taken away from the office, a reduction in hours worked and even having to quit work. That also means that caregiving can lead to lost wages – a dangerous proposition for people caring for multiple generations. In fact, 70 percent of working caregivers have made changes to their work schedules to accommodate their caregiving schedules.

Caregivers without full-time paying jobs can feel that there’s “no escape” from their role as caregiver. They make themselves available every hour of every day, which can be very taxing and lead to caregiver burnout.
 
Other stressors for sandwich generation caregivers can include how to manage time; how to tend to one’s marriage; how to feel like part of a family rather than solely a caregiver; and how to manage the guilt that often accompanies those who focus more on caring for others than themselves.

CGMW: What supports are there for sandwich generation caregivers to call upon?
Boyko:
Because caregiving is often accompanied by high levels of stress, guilt, feeling overwhelmed, a loss of sleep and other illnesses, it is imperative that all caregivers seek out support. That support can come in several forms: asking a loved one for help; seeking professional help, such as therapy or home care; and attending a caregiver support group, to name a few.

There are myriad websites dedicated to supporting caregivers, including those that provide local resources, advice, forums and more. Some of those that we find especially valuable are:

•    Caregiving MetroWest
•    CaregivingCafe
•    Caregiver Action Network
•    National Alliance for Caregiving
•    Caregiver.com
•    Caring.com
•    CaringInfo
•    Well Spouse Association
•    Medicare

CGMW: How can sandwich generation caregivers manage to find the time to devote the attention and care needed by both their children and their elder loved ones? Is there any advice to help find the right balance?
Boyko:
It’s not unusual for family members of caregivers – spouses and children – to feel neglected. They may also feel resentful toward the caregiver because the caregiver’s priorities have shifted to elder care. Of course, this means that caregivers may experience feelings of guilt for not being able to focus on their immediate family.

But there are ways by which caregivers can manage their time and find the balance they need to remain healthy, happy and able to serve the important role of caregiver:

1.    Those in caregiving roles should try to make time for other family members, whether it’s through a daily walk, a frequent phone date or a weekly lunch.
2.    Seek out a confidant. The stress of caregiving, coupled with the routine stress of life, can take its toll. Caregivers can do well by identifying a trusted relative to confide in. This not only provides emotional support for the caregiver, but it can also bring other family members into the caregiving fold.
3.    Hire people. While hiring professionals comes at a cost, it cannot be compared with the cost of a caregiver’s emotional well-being. Hire people for general yard and maintenance work and light housekeeping, for example. Of course, home health aides can help people with activities of daily living, like bathing, toileting, meal preparation and getting dressed. This is a wonderful way for caregivers to get more time for themselves while also knowing that their loved one’s needs are being addressed.

CGMW: How can caregivers manage the needs of their marriage or relationships and the demands of work?
Boyko:
Employee Assistance Programs (EAPs) are a great place to start. Ask your employer’s HR representative if your company has an EAP. EAPs are confidential resources to help employees with a wide range of issues, including personal issues that affect their workplace performance, their health and their overall well-being.

Employees should also approach their employers’ human resources departments to find out what kind of employee support is available. That support can include telecommuting, PTO/flexible schedules and on-site wellness programs, to name a few.

The National Alliance for Caregiving for ReACT, in its 2012 report, Best Practices in Workplace Eldercare, said that “Discounted back-up home care for emergency needs was a popular option for many employers ... This new benefit is an important innovation for employed caregivers. Research suggests that employed caregivers are more likely than caregivers without a job to rely on professional home care services.”

CGMW: How important is it for caregivers to find time to take care of themselves, and how can they do so while caring for both children and older loved ones?
Boyko:
While there’s not a one-size-fits-all approach to finding a balance, the following tips can apply to most caregivers:

•    Talk. Schedule routine talks with spouses, children and other loved ones. Communication is imperative; a caregiver can use a talk as a platform to ask for help, to discuss feelings and to simply update the family on what’s happening.
•    Schedule a date night. Ask a trusted friend or relative to take a shift or two from your caregiving schedule so you can spend time with your spouse, a close friend or another family member.
•    Celebrate. Whether it’s a birthday, an anniversary, a holiday or the coming of spring, take the time to enjoy it.
•    Create new traditions. Identify a block of time during the week and set it aside for “together time” to spend with a spouse and/or children. This will minimize any resentment family members may have about not being the central focus of a caregiver’s time, and it enables the caregiver to take a break from caregiving responsibilities.

CGMW: Is there any other advice you can offer to sandwich generation caregivers?
Boyko:
Some very basic points that all caregivers should keep in mind for their well-being:

•    Get enough sleep
•    Exercise
•    Try yoga or meditation as a coping mechanism
•    Communicate with close friends and family
•    Stay organized
•    Ask for help whenever you need it


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Caregiving MetroWest is a no-cost program of BayPath Elder Services, Inc. and was made possible in part by grants from the MetroWest Health Foundation.

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BayPath Elder Services, Inc.'s Family Caregiver Support Program and Caregiving MetroWest are grateful for the generous support of our community partner, Avidia Bank, which helps us continue to give area family caregivers the information, resources and support they need.