This material has been developed by and is presented by The Sandwich Generation ®

CONVERSATIONS WITH CAROL #1
Being a Sandwich Generationer
By Carol Abaya, M.A.

This is Carol Abaya.

I hope our visit today will be the first of many.  I do want to share with you what I learned  over a 6 year period as my parents became frailer and more needy.  There is so much we don’t know about the aging psyche and the emotional roller coaster elders go through.  And there is much we are just becoming to understand about the emotional needs of adult children, who either gradually or suddenly become involved in the every day lives of their parents.

My objective is to help caregivers better understand the elder’s psyche and the emotional roller coaster through which family members are going.

Taking care of the elderly, frail, sick and often confused, can be a tough scenario.  At the same time, it can be very rewarding.

In recent years, a new phrase has been coined -- the sandwich generation^© ™ .  What is it?  Believe me, it has nothing to do with food.

If you are "in" the sandwich, rest assured you are not alone.

Let me give you some more statistics.  They will help you better understand your own situation.

This means that the sandwich generation is also one of the fastest growing population groups.  If you are a family caregiver -- you are a sandwich generationer --  caught in a multi-generational responsibilities scenario.  You join millions of others  who now have to help parents  as they age and can no longer do  everything for themselves.  If you are a professional  in the health care field,  then you are  dealing  both with the elderly and with their families, who are struggling to handle this new situation.

To put everything into an historic perspective, I always like this number.

What does all this really mean to each and every one of us?

Quite frankly, a  big dilemma.  Dr. Joanne Schwartzberg is Director, Department of Geriatric Health, of the American Medical Association.  She says, "Society is now faced with the first large-numbered generation which is living to be quite elderly.  Therefore, there is no peer model with which to fall back on, to "tell" sandwich generationers and the elderly how to handle this new situation."

My  own philosophy is that unless parents die suddenly or at a young age, all adult children are going to be faced with elder/parent care situations.

There are many people who reject the idea of role reversal.  But I am a believer that at some point along the way we do in fact become parents to our parents, in one way or another.

Sometimes the decline in capabilities and health is gradual.  We first become "concerned" rather than "involved."  More often we are thrown into a crisis situation, with no emotional preparation.  No one can rehearse for having to deal with a crisis.  Nothing can ever prepare us for having to take over parent care.

How we handle this new role and the strength we garner from within ourselves is the key to the balancing act -- of handling all of our responsibilities.  Those we knowingly have taken on, and now in relation to aging parents, those we have no choice about.

After a short time of being involved with my parents daily life, I came to the conclusion that being a sandwich generationer is a new  role on the stage of life for which no one can ever rehearse.

Certainly, I had no time to rehearse.

One day my mother was attending to her real estate business, taking care of the house and my father.  The next day she was in the hospital extremely ill.  She remained in the hospital for 2 months.  And when she returned home, I had a team of 4 people providing 24 hour, 7 day a week care.

At the time, my mother was 85, and loved every minute of trying to sell houses to families -- families who came back years later and said "Oh, Sarah,  we really love living in the house you sold us."

My father was 90 , did 2 to 3 miles a day on his exercise bicycle; had a vegetable garden in the summer, did anagram puzzles, and listened to one baseball game on the radio and another one on TV, both at the same time.

I mentioned that being a sandwich generationer was a new role on the stage of life.

Let’s look at life’s roles because a lot of the emotional issues tied to aging and elder care come from the new role we are forced to play.

From the very second we are born to the moment we die, we "play"  multiple roles.  We are a son or daughter; a brother or sister; a grandchild, and more.  I’ve come up with 31 different roles a person might play during a lifetime.

As we grow up, we add new roles to our life, and move from one to the next without consciously thinking about the changes.

Roles have been established over many years, and expectations have been set up over time by society.  Parameters of acceptable behavior have also been set up by society.  As we move from one role to another, we are "prepared" to play out that role.  We more or less know what we are to do now that we’ve reached this stage in our life.

For most of these roles, society has helped us move into them, grow in them, move through them.  The exceptions relate to being elderly and frail or sick and to being a parent to a parent.

Today, we’re going to focus on the parenting role.

Someone made the comment to me that parenting is a continual learning process.

Thinking about this I could only agree.  Then I projected the concept to the elder care environment.  I realized that over the 6 years I was involved with my parents’ care,  there were always new challenges to meet because conditions changed.  I had to learn "new" things and approaches at every turn of events.

Let’s take a closer look at being a parent.  A parent is some who nurtures, protects, loves and respects someone else -- a child -- as a human being.

For an infant, a parent feeds, dresses, baths, changes diapers, loves, protects, keeps safe, and has fun with.

As the child grows older, a parent helps the child learn to do new things, to become  independent.  At the same time, parents respect the child’s own personality, likes and dislikes.

As the child grows further, the parent is there to encourage the child to do his or her  "own" thing.

As parents, we also often get upset with a child -- frustrated, impatient that the child won’t do what we think he or she should do.  We can also get angry, be anxious.   

These are tough feelings to deal with.  But we deal with them as a normal part of child rearing.

Let’s summarize these words -- nurture,  love, protect,  respect, guide, empower, provide emotional support, set behavior parameters.

When you think of words to describe your role and relationship with your aging parents, do these words come into your mind?

You may also feel helpless, pulled in too many different directions, tied down, alone, and that awful word guilty.

Generally, a combination of both of these sets of words are common to describe our relationship with aging parents.  And even in cases, where we’re not involved on a daily basis with elder parent care, these same words are appropriate.

As we become more involved, we continue to love them, want to protect them, and keep them safe and independent.  We worry about them.  What is new is that we now need to nurture them on an emotional basis.  We need to help them retain their own individuality and integrity as a human being.

As we did with our children, we sometimes get angry, frustrated, upset.  All the words we just mentioned.  But in a sense, can’t we feel this way in any relationship?

With a spouse?  A sibling?  A friend?

These are normal feelings and responses to events and situations.  Admittedly, the outcome is different.  Children become more independent and move out.  Aging parents become more dependent and move in.

But it is important that we accept the declining of a person’s physical and mental capabilities as a normal human aging process.  It is important that we focus on the love and respect we had for our parents when they were healthy and independent.  When they did for us.

This is not easy.  It’s very difficult to see once vibrant active people become frailer and less able to take care of themselves.

Early on, I came to the conclusion that the most difficult element to handle involved emotions, feelings; my own and my parents as they became more needy.

Actions and reactions are all tied up with emotions.  Everything anyone does is tied up with feelings and how things are perceived.  Most caregivers do not have the time to step back and look at the emotions of those around them. But it certainly makes things easier if we know where that other person is coming from.

Let’s go back to roles.  You need to take your head off of your own shoulders and put on the head of your parent.  A once physically and mentally dynamic human being is emotionally battered.   She (and I use ‘she’ in a generic sense because more elderly are women) has lost a number of roles that were important to her.  She may no longer be a wife or mother in the traditional sense.  She may have lost a number of people who were important to her.  Her spouse, possibly siblings, friends, relatives, and maybe even one of her own children.  She may have lost her home, in which she lived all or most of her married life.  She has lost many of her abilities to do for herself and for others. 

Think of the losses your parent has had in recent years.  Think about how your aging parent must be feeling?  Needless to say, she may not be a happy camper.

As we, as caregivers, feel we’re being pulled in many directions and torn apart, our parents are going through the same emotional process.  They feel they are being pulled in different directions by other people, sometimes by strangers.  And they feel -- and in many cases correctly so -- that they have lost control of their own lives.

As we age and lose capabilities, and are no longer playing the roles society has expected of us, lowered feelings of self-esteem come into play.  Unfortunately, society looks down on people who do not play a productive role.

So the biggest challenge of being a sandwich generationer is to understand the feelings of aging parents and to deal with them in a way that the dignity of the older person is preserved.

An integral part of role reversal -- of our becoming a parent to our parents -- is our taking the leadership role.  This is not easy and presents both a societal and individual  dilemma.  This new role certainly impacts the relationship between every aging parent and their adult children.

As a parent with young children, society says it is ok to do everything for them and no one challenges you.  You, as a parent, are the control point.

Also, society acknowledges that it’s ok to get angry and frustrated as kids struggle to develop themselves as people and may not ‘listen’ to us.

With elders, society has not yet acknowledged adult children’s feelings and their frustrations.  So everyone needs to reach the point where we say to ourselves and to our parents,  yes, it’s ok to do these tasks for our parents and to have the same feelings of frustration, anger, anxiety, and the desire to protect them  -- often from themselves.

In our first visit, we’ve talked about the various role we play throughout our lifetime -- focusing on the parent role -- first, as a parent to young children; and then as a parent to an aging parent.

As a parent to young children, we know what to do; what is expected of us.  Our objective is to help the child grow and become independent.  We are the boss.  We feel comfortable in that role because society has set up behavior parameters and expectations.

However, when we have to become a parent to our own parents, it’s a different ball game.  We are dealing with mature people who have controlled their lives and lifestyle very well without us.  Now, their capabilities -- often both physical and mental -- begin to fail.

As I’ve said, one of the greatest challenges is to nurture their feelings of self-esteem.

This means we need to take the leadership role in bringing more happy things into a parent’s life.  This is relatively easy when they are healthy.  But as they become ill or frail, it may not be so easy.  But it is important to them -- to be accepted for who they now are and loved even though they can no longer play the traditional roles.

In between being more and more concerned with their loss of capabilities, I tried to bring more happy events into my parents’ lives.  My sister had a surprise 60th wedding anniversary party for my parents.  My father had tears in his eyes as he looked at all the family and friends gathered together.  I’m glad we did it.  They did not reach their 61st anniversary. 

I had a surprise 90th birthday party for my mother at a local hotel.  The next year, I just invited a few close relatives to the house for a pizza lunch.  My mother was the center of attention, and she loved that.  I’m glad I did it because she passed away several months before her 92nd birthday.

In the days to come, in our visits together, we’ll talk about Choices and Self Protection; Helping a Parent maintain independence and self esteem; evaluating alternative care, and much much more.  I look forward to our next visit.