Geriatric Care Managers and the Sandwich Generation

The term "Sandwich Generation" has been used to define adult children who are "sandwiched" between caring for their children and their own aging parents.

The fastest growing segment of the population in the United States is the 85 plus age group. Of this portion only about 25 percent are in nursing homes.

The rest of the 75 percent are living independently or in assisted living. The 85 plus group is the most likely to need care and assistance. The children of this age group may have completed or nearly completed the tasks of child rearing. The youngest may be entering college or moving out on their own. Parents might be experiencing the "empty nest" and now their parents need care and assistance with daily living.

The research clearly shows that children do not abandon their elderly parents. The type and frequency of contact depends on the physical and mental capacity of the parent or parents. Contact between elderly women and their daughters may be more frequent. However, this does not mean that the quantity of contact translates to quality time. The parent/child relationship may be reversing with the child making decisions for the parent. This can be a particularly distressing time for the child or children of the elderly.

A common complaint from the elderly is the lack of attention from the children; "It's like I don't count anymore." A common complaint from the children; he/she "won't tell me what they want." This ambiguity does not enhance the relationship. The tension that occurs can be damaging to both parent and child. The child may need to distance themselves from the parent. The parent may want more contact. The emotional ramifications can take a toll on the overall relationship.

Generally, older people do not want to live with their children, but they want to live near their children. The parent wants to maintain as much control over their life as possible.

Despite possible physical problems, family tension, work and geographical distance the care of the elderly parents fall on the children. Most of the children accept this responsibility willingly. Even thought they themselves have not had much respite between the tasks of childrearing and caregiving of the parents. So, perhaps this is not the "Sandwich Generation" as much as the "In need of respite Generation."

Perhaps, this is where social services can assist the family. The much needed respite can be obtained if the family is informed and educated regarding services that are available in their own community. Families are the strongest link in the social network. The family can be assisted to maintain their elderly in the home, not in an institution, with help from community resources.

A practical approach for the family to consider is what does the elder individual actually need for every day living. Some things to consider might be; shopping, laundry, mobile meals or transportation to appointments and social outing. Assistance with finances and bill paying may be needed as well as someone to provide home maintenance. Make a list of services or tasks that need to be done or provided on a routine basis.

When discussing this with the parent ask for their input. Work with the parent instead of "telling" them what is to be done. Let the parent make the decisions and negotiate any unrealistic goals or potentially harmful plans.

A good place to begin finding respite is with a Geriatric Care Manager. They specialize in coordinating services and handling the specifics that take a lot of time and cause a lot of stress on caregivers.

Information Provided by:
Barb Banchich, MRC,CRC,LSW,LPN

Acknowledgement to ElderCare Advocates for their kind permission to reproduce this article.

If you have any question/ concerns or need assistance contact your local Geriatric Care Manager: Sheri D. Fanning, RN,CMC at 269-5888 or e-mail to sheri@caremate.com