The Sandwich Generation
Mike Hamaker, MA, ACHE | 07.26.13
The “sandwich generation” is caring for aging loved ones while raising their own children.
Millions of baby boomers have put their own retirement plans on hold to help their aging parents navigate the golden years. Often referred to as the “sandwich generation,” this group is now caring for aging loved ones, while still raising their own children.
According to the 2010 U.S. Census report, there are 4.4 million U.S. households that include three or more generations living under one roof—a 15 percent increase from 2008. One recent study revealed that two-thirds of these family caregivers are women in their late 40s caring for a mother or other female relative
“People often say their parents are ‘getting old’ when in reality it could be early signs that caring for that parent is necessary,”explains Michael Hamaker, M.A., A.C.H.E., president of WellSpan VNA Home Care.
“Those in the ‘sandwich generation’ often find themselves in a very difficult position since they are caring for both their parents and their own children. This can result in little time to care for their own needs or live the life they originally envisioned.”
Inevitably, the demands take a physical and emotional toll, and caregivers are more likely to say their health is fair or poor. Does any of this sound familiar? Is it possible to prevent this situation from “sneaking up on you?”
Where do you start?
Once you determine a parent requires extra care (see below), a good first step is to assemble a list of your parent’s:
- Locations of important papers (e.g., will, bank and investment accounts, mortgage contract)
- Safe deposit box information
Other tough but necessary conversations you should have with your parent include the importance of executing the following legal documents:
- Living will: Expresses your parent’s wishes about end-of-life medical treatment in the event she cannot communicate these wishes directly.
- Health care proxy: Allows your parent to appoint a trusted family member or friend to make medical decisions in the event he cannot make them.
- Durable power of attorney: Allows your parent to authorize a personal representative to act on her behalf in private affairs, business and other legal matters.
Take the process in pieces “If your parent begins having challenges with the activities of daily living, it might be time to have the local VNA perform a home care assessment,” Hamaker offers. He explains that an assessment is a good way to begin considering care options for your parent, and that it’s not an automatic step to your parent entering a nursing home.
People often want to age where they’ve always lived. Sometime basic safety measures can go a long way toward making that possible, including:
- Installing grab bars in bathrooms and showers
- Removing tripping hazards
- Wearable alarm or call button
Be realistic about your ability to help out. It is not always a question of what you want to or is willing to do—the issue is what is realistic. For example, if a parent needs to be lifted and you have a bad back or can’t be with him all day, you may need help.
If your parent needs more assistance with daily activities, you need to determine your own comfort level. Are you comfortable handling personal care like bathing or changing an adult diaper?
The best thing you can do is continue asking questions. Caring for a parent is not just about Mom’s or Dad’s needs, it is also about the needs of you and your family.
“Involve everyone in your discussions and decisions,” says Hamaker. “Looking to an outside agency for help and guidance can provide a different viewpoint and help facilitate the best for all parties.”
Trust your intuition
When Dad isn’t remembering things or Mom isn’t keeping the house tidy anymore, don’t brush this off as old age. Ask yourself, and any siblings, if you think everything is really okay. Food spoiling in the refrigerator, stacks of papers or mail, appliances being left on all can suggest your parent may have problems handling everyday tasks.
Ask about routine activities such as church or bingo. An early sign of depression is withdrawal from social activities.
- Ask about routine home and vehicle maintenance to make sure it’s being done.
- Listen for differences in speech patterns. Some patterns are warning signs of medical problems that need immediate attention.
- Ask if there have been any recent falls, slips or trips in or around the home. Falls are a leading cause of injury.
- Learn the medication schedule and then ask, “Now, remind me again, what’s that pill you take in the morning?” Your loved one may not be taking medicine at the times the doctor prescribed.
A personal visit to your loved one’s home is the best way to determine their health and well-being. By evaluating his/her appearance and home you can assess his/her condition.
- Examine his/her clothes. Is the clothing stained? Does he/she wear pajamas all day?
- Examine his/her personal hygiene and appearance. Does he/she appear healthy? Does he/she have unexplained bruises or weight lose? Is his/her hair combed and teeth brushed?
- Examine the house. Is the house as clean now as in the past? Is mail, garbage or clutter accumulating? Are there unpleasant odors (cupboards and refrigerator)?
- Review any prescriptions. Do the medications come from different doctors and different pharmacies? Are the medications expired?
If a personal visit is not possible, asking questions can often give you insight into your loved one’s physical and mental status.
- Ask what was eaten for breakfast. If he or she can’t remember or the meal seems to lack nutritional value, it could indicate a problem.
- Ask about their last haircut. Send a new type of toothpaste, then ask how it’s working. Not keeping up with personal hygiene is another sign that someone needs help.
- To check memory, call two days in a row and ask about the previous conversation.
For more information about WellSpan VNA Home Care or other local resources, please call (877) 862-6006 or (717) 812-4433, or visit www.wellspan.org/VNAHomeCare.
Mike Hamaker, MA, ACHE, president,
WellSpan VNA Home Care