Module 14 : The Sandwich Generation: Work/Life Balance of Child and Elder Caregiving

• 44% of Americans between the ages of 45 and 55 have aging parents or in-laws as well as children under 21. The Sandwich Generation phenomenon.
• 59%-75% of family or informal caregivers are women.
• The average caregiver is age 46, female, married and working outside the home earning an annual income of $35,000 per year.
• Nearly half of all baby boomers aged 45-55 have children still living at home and elder care responsibilities.
• 64% of caregivers are employed full-time or part-time.
• More than 14 million US workers care for aging family members.
• Fastest growing population group is older Americans.
• Most rapid population growth is among people 85+ with the majority being females.
• An estimated 7 to 10 million adult children are caring for their parents from a long distance.
• Nearly two-thirds of Americans under age 60 think they will have elder care responsibilities in the next ten years.

• 61% elder caregivers are between the ages of 18 and 49.
• Typical caregiver is a married woman in her mid-forties.
• Provides an average of 18 hours/week of caregiving.
• Works full-time.
• Lives near the care recipient.
• Has an annual household income of approximately $35,000.
• Gender and Realities of Working Families
• 73% of all family elder caregivers are women.
• Research shows that fathers and sons are taking an increased role in caregiving.
• Less than 25% of new mothers leave the paid labor force for a substantial period after childbirth.
• 63% percent of women with children under age six are in the labor force, and 78% of women with children 6-17 are in the labor force.
• 25%, 14 million, of all U.S. households with children are headed by women alone.
• 4.2 million were below the poverty level which represents 34.6% of all families with female householders.

• 73% of all family elder caregivers are women.
• Research shows that fathers and sons are taking an increased role in caregiving.
• Less than 25% of new mothers leave the paid labor force for a substantial period after childbirth.
• 63% percent of women with children under age six are in the labor force, and 78% of women with children 6-17 are in the labor force.
• 25%, 14 million, of all U.S. households with children are headed by women alone.
  • 4.2 million were below the poverty level which represents 34.6% of all families with female householders.

Caregiving Trends of the Future:

• Continued increase in prevalence of caregiving for American families.
• Increasing numbers of working caregivers.
• Increase in male caregivers.
• Increase in long-distance caregivers.

Time and Money:

• Time: Average length of time spent on caregiving was about eight years, with about one-third of the respondents providing care for 10 or more years.
• Money: Almost all respondents reported helping the care recipient with some expenses, most frequently with food, transportation, or medications. On average, caregivers helped with expenses for two to six years and spent a total of $19,525 in out-of-pocket expenses.

• Most women will spend 17 years caring for children and 18 years helping an elderly parent.
• 89% percent of all women over age 18 will be caregivers to children, parents or both.

• Relatively new phenomenon of adults balancing three major responsibilities.
• Raising their own children.
• Leading their own lives, including full time jobs.
• Helping their aged parents.
• Significant number of families are three and four generation families.

Survey on Caregiver Self-Identification, 2001 National Family Caregivers Association www.nfca.org

• Driving to and from doctor and other health care appointments.
• Communicating with health care professionals.
• Contacting or helping someone communicate with community service organizations such as the Area Agency on Aging or the Alzheimer`s Association.
• Assisting someone to pay their bills.
• Helping someone clean their home or arranging for housecleaning.
• Assisting someone or arranging for home repairs.
• Arranging for or helping someone to arrange for Meals on Wheels.
• Helping arrange for home health care or hospice services.

• Explain that some needs are better met with professional help.
• Explain that the services are designed to help them remain independent.
• Explain the service.
• Offer to supplement the cost of care, if possible or necessary.
• Assist with arrangements to pay for the service.
• Offer the services as a gift.
• Engage someone they respect to suggest the services.
• Accompany the individual to gather information about the service.

• Funds set aside by the Administration on Aging through the Older Americans Act, Title III-E.
• Administered through the states units on aging.
• Administered by Texas Department on Aging (TDoA) in Texas.
• Projects planned and implemented by the Area Agencies on Aging (AAAs).
• Caregivers may be of any age; care receivers must be over age 60.

5 Categories of Service:

• Information about services.
• Assistance with accessing services.
• Individual counseling and support groups and caregiver training.
• *Respite care.
• Supplemental services such as adults day care, homemaker assistance, and home repair.
• Up to 10% of funds may be set aside to support people over age 60 who are raising children under the age of 18.

• Area Agencies on Aging (listed by state).
• 2-1-1 information and referral centers. (fact sheet in .pdf format).
• United Way agencies.
• Texas Department of Human Services.
• Meals on Wheels- local or Association of America, Phone: 703-548-5558
• Medical and disability organization web sites:
• Arthritis Foundation
• Alzheimer`s Association
• American Heart Association
• MHMR
• Texas Rehabilitation Commission
• Telephone directories.
• Libraries (listed by state).
• Internet.

Click here for a list of caregiver education available on other sites.

• Work/Life balance.
• Grief.
• Guilt.
• Lack of support.

1. Choose to take charge of your life.
2. Honor, value and love yourself. You`re doing a very hard job and you deserve some quality time, just for you. Self care isn`t a luxury. It`s a necessity.
3. Seek, accept, and at times demand help. Don`t be ashamed to ask for help. When people offer assistance, accept it and suggest specific things that they can do.
4. Stand up and be counted. Stand up for your rights as a caregiver and a citizen.

• 91% believe “preserving your health” is a message that should be told to all family caregivers.
• 30% exercise regularly since becoming caregivers, compared with 61% who exercised before becoming caregivers.
• 47% seek prompt medical attention for themselves compared to 70% who did so before becoming caregivers.
• 92% like the idea of caregivers being considered a special group within the population.

Source: National Family Caregivers Association, 2000

What advice would you give someone who is new to caregiving?

• Calendar: use one that suits your personality and responsibilities.
• Ask yourself the question: “What is the best use of my time right now?”
• Break overwhelming tasks into a series of small steps.
• Schedule all activities to ensure they are done – unless they just are not important.
• Are you over committing your time?
• Look ahead/plan ahead.
• Document completions/note successes.

• Check e-mail no more than 3 times per day.
• Use bookmarks.
• Learn as much as your can about newest technology only if it really helps you manage your time and life.
• Are you backing up information?
• When do you need a hard copy?

• Set aside uninterrupted time that you do not answer the telephone.
• Suggest specific times for people to call you.
• Use voice mail, answering machines, email, Call Notes.
• Be specific in leaving messages about the best time to return your calls.

• Make lists and use the A-B-C system.
• Remember the Pareto`s 80/20 rule*.
• Handle paper and information once.
• Delete it.
• File it.
• Delegate/forward.
• Do something and complete.
• Make lists – one book method.

* “Eighty percent of your troubles will come from 20 percent of your problems.”

• Learn about nutrition and practice a healthier relationship to food.
• Drink 64 ounces of water each day.
• Eat your vegetables.
• Consume plenty of fiber.
• Consider B vitamins and other supplements.
• Breathe.
• Walk whenever you can.
• Respect your body and listen to it.
• Become an active partner with your physician and other health care providers to manage your health.
• Exercise/sports.
• Find a system or plan that works for you:
• Walking, running, weight training, dancing, yoga.
• Make exercise a priority.
• Consistently practice.

• Communicate.
• “What did I do today to show my (family) (co-workers) that I value them.”
• “Did I keep all my commitments?
• Focus on Your Mental and Spiritual Life.
• Keep your mind active.
•  Read.
• Attend adult education classes.
• Participate in community activities.
• Find or re-discover a spiritual path.
•  Prayer
•  Meditation.
• Organized worship.
• Set aside quiet time or “down time” every day.
• Enjoy nature; take a walk.

• Manage stress before the situation becomes a crisis.
• Reframe your perception of situations.
• Ask for help. Set up a Job Jar of things that you need help with and when someone asks what they can do let them choose a task to do.
• Recognize your history and what triggers your stress response. “If you always do what you have always done you will always get what you always got.”
• What do you have control over? What can you influence?
• Take care of your physical and mental health.
• Have some fun.
• Respond – don`t react.
• BREATHE.
• Practice letting go.
• Prioritize activities according to their importance and available time. Activity does not necessarily mean productivity.
• Decide and “Just do it.”
• Recognize the harmful effects of perfectionism and take steps to be more flexible.
• Remind yourself about the high cost of worry and the low return.
• Be willing to accept that sometimes enough is okay.
• Take one day at a time and value it as if it were your last.
• Join a support group.

Reasons Someone Joins a Support Group:

• It was the only place where I could say how I felt and people would understand.
• I learned where to go for help in caring for my loved one.
• I realized it was possible to laugh at some of the impossible, crazy things that happened during the day.
• I discovered that it was important to have some time for myself to do the things I want to do, and NOT feel guilty.
• I learned to stop trying to teach and correct or reason with my loved one. Instead, I learned to accept that the way he saw things was very real to him.
• Establish and Maintain Winning Relationships.
• Communicate; take the initiative.
• Surround yourself with winners.
• Avoid negative and critical people.
• Be real and true to yourself.
• Believe that “what goes around comes around.”
• Listen.

• “Am I sure about what matters most?”
• “What am I learning?”
• “What am I doing to take care of myself?”
• “What can I delegate or ask help with?”
• “What can I say “no” to?”

Top 10 Ways to Manage Your Time and Your Stress Apologies to David Letterman

Taking Care of Yourself!

• What would you tell someone else in your shoes?
• Make a commitment to yourself to take your own advice and take care of you!
• If you do, you will take better care of your loved one.

Follow-up Reminder To Walk the Talk

• Write yourself a letter, dated today, reminding yourself about what you decided to do today about managing your stress and time.
• Address an envelope to yourself.
• Seal the letter in the envelope.
• In 30 days mail it to yourself.
• When you receive it open it, read it and walk the talk!

What Are You Willing to Do Differently?

• It is up to you and you are worth it.
• “If it is to be it is up to me.” *

*Hattie Hill