Woman pushing a stroller with one hand and holding her elderly mother's hand with the other, behind them is an sandwich, a slice of bread is behind the stroller and the elderly woman, and a tomato slice is behind the woman in the middle

A Toast to Sandwich Caregivers

When I became a full-time caregiver for my mom, who lives with dementia, I was also raising three small children. None of my peers were in the same boat. It felt lonesome, and like a weight I wasn't sure I could carry.

One day, I heard the words "sandwich generation," describing caregivers who are "sandwiched" between caring for a generation above and below them. I pictured my mom as one slice of bread, my kids as the other slice of bread, and me as the smashed BLT in between.

It was still a crummy place to be (pun intended!), but suddenly I was part of a bigger community and didn't feel so alone.

What are sandwich caregivers?

Sandwich caregivers provide unpaid care to an adult and are also responsible for children living in their homes. Most typically care for aging parents and their own children, but the term can include many different care recipients, like grandparents, neighbors, friends, other children, or adult children with disabilities.

In a 2019 study by the National Alliance for Caregiving, there were 11 million sandwich caregivers in the United States. The sandwich caregivers were an average age of 41, about 12 years younger than caregivers without children at home. About 31 percent of sandwich caregivers were millennials, and 49 percent were from the Gen X generation. Another study estimates that more than one in 10 parents in the United States also cares for an adult.1,2

Sandwich caregivers are defined in the NAC study as helping their care recipient with at least one crucial area of life, like the ones listed in activities of daily living (ADLs), instrumental activities of daily living (IADLs), or more complex medical and nursing tasks. Sandwich caregivers reportedly devoted an average of 22 hours per week to caring for their loved ones.1

They most commonly reported helping with transportation (80 percent), housework (76 percent), and preparing meals (62 percent). This is consistent with dementia research, which found that in people living with dementia, IADLs like driving and housework are the first to decline, while basic ADLs like dressing and eating are usually unaffected at first.2

My dream of a normal life was on a roll

Here's what I pictured my life would be like as a young parent and (much later!) as a caregiver to my parents. I was very surprised when reality hit.

In my 20s, I hoped to meet the dream guy, get married, and someday start a family. Then by my 30s, I thought we'd have some beautiful kids and I'd be hard at work building my career. We'd travel a lot, spend time with friends, and visit family. We'd have great friends who were parents of young kids too.

All of our parents would still be working or in early retirement. They would be independent, involved with their children and grandchildren, busy with their hobbies and communities, and mostly healthy, though maybe with a few more health problems than in the past.

Then, when my kids were out of the house for college or starting their own families, and we were empty nesters, we'd be freed up from the responsibilities of caring for children and ready to jump into the role of caring for our parents. Our friends would be starting to care for their parents too. I felt like this was a completely natural expectation to have of my future life. Right?

A sandwich-shaped reality check

My reality check came when I actually became a sandwich caregiver in my 20s. My days look wildly different from what I pictured.

Instead of two neatly separate stages of life, I'm constantly torn between raising my children and helping care for my mom. My dreams of a chronological progression from one caregiving task to another were toast.

A typical day for me might include school drop-offs and pickups, grocery shopping for everyone because I cook for mom, too, cleaning my house, and cleaning mom's rooms. I'll help with mom's dog, schedule various appointments for both my kids and my mom (and the dog), and call family members to update them on mom's health.

Somewhere in there, I try to get some work done, pay bills for both my mom and me, make dinner, do the bedtime routine for the kids, check that mom remembers her appointment in the morning, and get ready for the next day to do it all again.

Sandwich caregivers have a lot on their plates

Any way you slice it, sandwich caregivers have a lot on their plates. Roughly a third of sandwich caregivers report high levels of emotional stress. Sandwich caregivers are often also working on a career in addition to caring for both an adult and a child in their home. One in five reports feeling the financial and physical strain. Sandwich caregivers who co-reside with their care recipients and those who care for a close relative are the most likely to report high strain.1

But we're also not coming in unprepared. Younger sandwich caregivers in the NAC study reported feeling more prepared than older, non-sandwich ones. Researchers think this might be because we've grown up in the internet era, where information is always accessible and usually instantaneously.1

We also are asking for help. About half of sandwich caregivers report having help from other unpaid caregivers, and one in four say they use paid aides or services to care for their adult care recipient.1

Great caregivers are not born, they're "bread"

Some days it can be a lot, but I remember that our kids are learning valuable lessons about caregiving and also getting to know their grandmother better. My mom greatly benefits from being around her grandkids too. I'm thankful for the lightheartedness that kids bring wherever they go.

There's no way around the hard things, and I won't pretend it's not challenging. Don't forget to ask for help and take care of yourself and your little family too. But the tough parts of sandwich caregiving can be softened by holding on to the purpose and long-term rewards of the whole experience.

Sandwich caregivers, take heart and know you're not alone, and we'll get through this together. We are doing the right thing for our loved ones in both generations, and it's helping us caregivers grow too. I'll toast to that.

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