Helping “The Sandwich Generation” Find Work/Life Balance

Written by on October 31, 2014 in Insight - No comments

OlderCoupleWEBThe Sandwich Generation—if you have at least one parent age 65 or over, and are raising children and/or financially supporting a grown (18+) child, you’re part of it.  The term, coined in 1981 by Dorothy Miller, a social worker, originally referred to women, generally in their 30s and 40s, who were “sandwiched” between young kids, spouses, employers and aging parents.  Over time, while the underlying concept has stayed the same, the demographics have expanded to include both men and women, and a larger age range as childbearing is sometimes delayed, grown children move back home more frequently (or never leave) and parents are living longer.

As a societal phenomenon, being a member of the Sandwich Generation is increasingly recognized—and also linked to higher levels of stress, financial uncertainty, and downstream effects such as depression and greater health impacts that caregivers are known to suffer.  If you’re already providing caregiving to make a living, this may feel like a club you really don’t want to belong to.  It’s important to understand that the impact of caregiving is real and tangible—and to take it seriously and approach it in a manner that protects your physical, mental and financial wellbeing.

 Physical and Mental Health Impacts

The American Psychological Association[1] found in their 2007 Stress in America study that mothers in the sandwich generation, ages 35-54, felt more stress than any other age group.  The study found that nearly 40% of those aged 35-54 reported extreme levels of stress (versus 29% of 18-34 year olds and 25% of those older than 55).  Women reported higher levels of extreme stress than men, and also that they were less effectively managing their stress.  This impacted personal relationships—83% reported that relationships with their spouse, children and family were the top source of their stress—and  also their own wellbeing as they struggled to take better care of themselves.   An APA spokesperson noted, “It’s not surprising that so many people in that age group are experiencing stress.  The worry of your parents’ health, and your children’s wellbeing as well as the financial concern of putting kids through college and saving for your own retirement is a lot to handle.”

Another study[2] examined the impact of caregiving on wellbeing.  Employed caregivers had an average age of 43.3 and 51.8% were female.  Using various indices to evaluate different aspects of wellbeing, the study found, in comparing employed caregivers vs. non-caregivers:

  • 40% higher levels of stress and worry
  • 44% higher levels of diagnosed depression
  • 7% lower overall physical health

A third study[3] focused exclusively on health-related issues and found significantly higher rates of prevalence for caregiving employees of:

  • Diabetes, high cholesterol, hypertension, COPD and heart disease across all ages and both genders
  • Depression, which was one-third more prevalent for caregivers vs. non-caregivers
  • Stress in general and at home across all age and gender cohorts

Financial Impacts—and Less Tangible Support

A recent Pew Research report[4] talks about a “perfect storm” of issues which can appear overwhelming for those who are caught in it.

The report, based upon a survey that was conducted in late 2012, not only addresses the pressures that adults aged 40-59 are facing due to providing financial support to both their grown children and aging parents, but also touches on the emotional support they are often also providing, especially to the older generation.

Consider these statistics from the study:

  • 48% of adults aged 40-59 have provided some financial support to at least one grown child (aged 18 and over) in the past year and 27% have provided primary support; that number jumps to 73% providing some support when just considering those who have children 18 and over.
  • 21% have provided some financial support to a parent aged 65 and older in the past year; that number jumps to 32% for those with a parent aged 65 and older
  • 38% said both their grown children and parents rely on them for support
  • For those who are providing financial support for both a parent and children of any age, 28% said they are living comfortable compared to 41% who are not financially supporting an aging parent.  (Other respondents range from those who don’t have enough money to meet basic needs to those who have enough to meet basic needs with a little left over)

Beyond the financial support they are providing, the Sandwich Generation is often also involved in caregiving and providing emotional support.  The study finds that a third of adults in the 40-59 age group are providing assistance with daily living to their aging parents, and that number increases as parents age, not surprisingly.

Similarly, over two-thirds of this cohort with 65+ parents report that their parents rely on them moderately or extensively for emotional support.  Added to this, those with grown children report overwhelmingly that, even without financial support, their children rely on them moderately to extensively for emotional support.  This number increases if they are also providing financial support.

 Helping the Sandwich Generation

We talk a lot about the importance of work/life balance, and this is central to being able to cope effectively with the many demands healthcare providers face, especially those who are members of the Sandwich Generation.

What does this mean?   As providers come to us when they’re feeling overwhelmed, there are often multiple presenting issues, and as we work with them, we learn that they are sometimes linked.  Financial stress can lead to family or relationship strains, for example.  Stress, anxiety and depression can be caused by jugging too much between home and work.  Responsibilities for dependent children or supporting a spouse or partner who are out of work can be daunting, in and of themselves, for many, but the added levels of support for grown children and/or aging parents can push even the most resilient past their tipping point.

For some, employers may have resources and programs that can help.  Providing more flexible scheduling to allow employees to better handle family responsibilities can be very helpful.  Some employers also offer eldercare benefits which can help with planning and identification of resources.

It’s also helpful to learn from others.   Speak to your HR department about help forming and promoting a lunchtime or after-work support group for “sandwiched” employees to share experiences and resources—and providing the space for it to meet.

Most larger healthcare organizations also offer an EAP, which can provide valuable counseling and support around such things as:

  • Coping skills and resilience-building
  • Prioritizing and time management
  • Setting and maintaining appropriate boundaries
  • Finding resources to assist with caregiving
  • Eldercare-related education and resources around financial and life planning for your parents
  • Financial and budget planning to better manage your money wisely, and still plan for your own retirement, as well as your children’s college expenses and other needs

Regardless of programs that your employer may have, things that you should do to help yourself include:

  • Watch for depression.  As numerous studies have shown, this is something for which caregivers are at higher risk, and may be something that creeps up on you.  If you or a spouse or partner have access to an EAP, those counselors can help with this.  Otherwise, if you’re experiencing some signs of depression, speak to your primary care physician for a more complete screening and assistance—or a referral to a therapist or psychologist.
  • Put yourself in the “balance” equation.  You need to be intentional about setting aside time for yourself.  If you wait until you have free time, you may well be waiting until retirement—leaving you susceptible to burnout.  Set regular time aside for self-care, such as a taking a yoga or exercise class, or scheduling time to jog with a friend.
  • Set boundaries.  This is not only reasonable, but critical so that you have time for the important things, plus take care of yourself.  Be honest about what is absolutely necessary—and where there is room for compromise or to say no.  Being at your child’s school play?  Non-negotiable.  Baking cookies for the party afterward?  Not likely anyone will remember 15 minutes after the party ends if you don’t.
  • Ask for help.  People ask you for help all the time.  Ask them to return the favor.  They can always say no, but most won’t—and may be delighted to lend a hand.
  • Hold family meetings.  This is important—to set expectations and boundaries, get help, and enlist others share some of the responsibilities.  There are ways even young children and frail elders can be part of the solution, but you have to let them understand the needs and give them a chance to meet them.
  • Find and use a financial planner.  You can alleviate a lot of stress by helping yourself and your parents protect your future and manage the present, and set reasonable boundaries and conditions around financial support for grown children and elders.

Eldercare can be especially challenging—but there are many sources of help.  A good place to start is through the Eldercare Locator, a federally funded service that connects caregivers with local resources.  Every county or multi-county area in the country has an Area Agency on Aging which receives federal funding to provide information and referral to family caregivers on aging and caregiving services, such as adult day care, respite care, home repair and modification, personal care and more.  The area agency can be reached through the Eldercare Locator toll-free number (1-800-677-1116) or website at

[1] APA Psychology Help Center, “Sandwich Generation Moms Feeling the Squeeze.”  Accessed 03/01/2014:

[2] Coughlin, J, “Estimating the Impact of Caregiving and Employment on Well-being,” Outcomes & Insights In Health Management, 2:1, May 2010.

[3] Albert, SM et al, “The MetLife Study of Working Caregivers and Employer Health Care Costs,” National Alliance for Caregiving, University of Pittsburgh Institute on Aging and MetLife Mature Market Institute, February, 2010.

[4] Taylor, P et al, “The Sandwich Generation:  Rising Financial Burdens for Middle-Aged Americans,” Pew Research Center, January 30, 2013.  Accessed 3/01/2014:

By Deb Wood, PhD
Senior Consultant
Physician Wellness Services

(a division of Workplace Behavioral Solutions, Inc.)

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