Sandwiched! Challenges And Coping Mechanisms For These Unique Caregivers

“Better access to health and education has benefited us and also given birth to a new demographic – the sandwiched caregiver. Unique challenges need appropriate strategies that can help cope.”

The Merriam-Webster dictionary acquired a new word in 2006 – “sandwich generation”. This was a clear nod to the growing population of adults who are caught between two generations, both of which need their care. Sandwiched caregivers are typically those raising young children while simultaneously caring for their parents, in-laws or other elderly relatives.

Greater longevity, dropping birth mortality and better healthcare are increasing the number of caregivers in this situation. In India, the UN World Population Prospects 2017 anticipates an increase in the proportion of adults above 60 from 8% in 2010 to 19% in 2050. The increasing number of couples opting to have children later in life is also a contributing factor. Thus, many adults in their 40s are juggling multiple financial demands such as college fees of children and medical expenses of the elders. Needless to say, these responsibilities also involve physical and emotional investment besides the financial costs and the challenges include:

Splitting time and energy between roles: The caregiver is often left wondering how to apportion their time between their young wards and the elders. Even the most meticulously laid out schedules can go haywire if an emergency arises, and the result becomes a “zero sum game” with one suffering at the cost of another. For instance, when a woman with school-going children has to take her mother to the hospital in an emergency, naturally the kids’ after-school activities may be affected. Similarly, a parent with a hyperactive teenager may be too drained at times to be emotionally available for his elderly relative.

Inability to Focus on Career: In most societies, a majority of caregivers are women, though men have increasingly been sharing or assuming caregiving roles. A study conducted by Oxfam revealed that in India, women spend 16 billion hours daily on unpaid caregiving work. A large number of women working full-time are also likely to be primary caregivers to children and elders at home and are caught between the competing demands of career and multiple caregiving roles. Some caregivers are made to or opt to stay at home. Others are forced to compromise either on their career progression or their caregiving duties. It is not surprising, then, that female workforce participation in India fell from 36.7% in 2005 to 26% in 2018.

Finances: Increased longevity implies that in India, where multi-generational families are the norm, the number of sandwiched caregivers is on the rise. This has important financial implications.  The average Indian household spends Rs. 4125 on caring for the elderly. Caught between rising health care costs on the one hand and exorbitant tuition fees on the other, caregivers and their spouses may need to put some of their own needs that require substantial financial investment (for instance, purchasing a house or undergoing medical check-ups) on the back burner.

Relationships, self-care and health: Being a parent to a young child is exhausting enough. With the additional task of constantly navigating a labyrinth of caregiving needs of parents, the biggest casualties are relationships and “Me-time”. Married sandwich couples find romance and movies giving way to squabbles over who should attend the next PTA meeting or how much to spend on adult diapers. Socialising is restricted to chats with other moms at pick-up time. As for self-care, wouldn’t it be selfish to book a salon appointment or go shopping with friends when so many people and chores have to be taken care of? The net result is physical and mental fatigue, guilt, diminished self-esteem, social isolation, relationship issues, stress-induced disorders, depression and burnout.

It is an irony that in their attempt to ensure that those receiving  their care are healthy and happy, caregivers often end up leaving everyone, including themselves, feeling a little hurt and unappreciated. With a little planning, conscious self-care and a robust support system, the sandwiched caregiver can create a more balanced and happier life for themselves and their families.

  • Don’t hesitate to ask for assistance. Superheroes are fantasy. Sometimes, all the effort to keep up the appearance of normalcy results in even the immediate family taking the caregivers for granted. Call a family meeting and let family members volunteer to share tasks and responsibilities. Ask for, and accept help from friends and co-workers. You will always have opportunities to give back.
  • Organize and prioritize. Perfection can be elusive, especially when there are multiple dimensions of caregiving involved. Focus on the bigger picture, and let go of smaller things when possible. Organize your day and week, with adequate leeway for emergencies. Try the Caregiver Saathi App to better organize your day and that of your loved one. Technology can be a saviour for caregivers with multiple responsibilities. From medicine delivery Apps to digital monitors, there are numerous forms in which technology can alleviate the stress of the sandwiched caregiver.
  • Create channels for open communication in the family. The sandwich generation needs support and understanding from both the older and younger generations. This can generate negativity and stress. Take the lead by talking about your day and opening up about your emotions, involving everyone in the process. You will discover unexpected sources of advice and energy!
  • Review financial plans. While being a sandwiched caregiver is financially demanding, there is always a better way of managing your resources. Do some research about retirement plans, medical insurance, education loans, holidays (!) or other plans relevant to your situation. Consider taking professional help if necessary.
  • Take time out for yourself. To care for your loved ones effectively, you need to ensure your own well-being. Schedule a little time every day – even a few minutes can make a difference – to do whatever makes you happy and relaxed. Devote quality time to your marriage/relationships. Practise mindfulness and stress management. Do not neglect your diet, sleep or exercise. As the South Indian saying goes, “You cannot draw the picture without the wall”! So, make self-care a priority without feeling guilty.
  • Seek out others with experience: For anyone struggling to find time and energy for even the most essential tasks, it is a lonely world out there. With no time to socialise, the sandwiched caregiver ends up feeling isolated and helpless. The good news is that once you make the effort to reach out, there are plenty of avenuesfor sharing your concerns with other caregivers and relevant resource persons, and also for learning from their experiences. There are many support groups for caregivers of people with specific disabilities or conditions such as autism or Alzheimer’s. Other groups like Caregiver Saathi focus entirely on the caregiver, and offer a wide range of useful resources. Forming a circle of friends who are in similar situations can be valuable too.

Whether you’re a traditional sandwich with elders and children to attend to, or a more complex club sandwich with additional layers such as grandparents, siblings requiring care or even pets, you are constantly aware of the multiple stressors in your life. What you may not hear often enough is that caregiving can have multiple benefits too. Firstly, you know that your loved one is safe in your care, and that nothing is being compromised. Secondly, the experience can transform you and impart a newfound confidence – if you can handle this, you can handle anything! The most significant benefit, however, is the sense of connection you develop with the ones under your care. The caregiving experience is not just about daily tasks and checklists – it is also about nurturing relationships, finding balance in life, and ultimately, realizing what the truly valuable things are.

About The Author

Lakshmy Menon

“I am a content writer and teacher with several years of experience in business writing. I have also worked with NGOs in the fields of disability and fair trade. I have an MBA in HR from XLRI, Jamshedpur. I am passionate about promotion of adoption in India, and day-dream of writing an adoption-themed children’s book.


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