June 2008 Issue
Experts offer advice to the Sandwich Generation about caring for older loved ones.
You have an 8 a.m. meeting with your mother’s doctor to discuss her new medication that’s not working, followed by a noon presentation to a potential client your boss is counting on you to land. Don’t forget your son’s 6 p.m. soccer game and the college visit you and your daughter have planned for tomorrow, which will mean spending yet another Sunday afternoon playing catch-up in the office.
This is your life, baby boomer. As a member of the Sandwich Generation, caring for an elderly loved one, working outside the home and tending to spousal and children’s needs is a balancing act that even Wonder Woman would have a hard time pulling off.
Roland Hornbostel, deputy director of the Ohio Department of Aging, takes the stressful scenario a step further by describing what he calls “the Club Sandwich Generation”: people over 50 years of age tending to the needs of a parent, raising children and assuming the responsibility of caring for grandchildren.
“The economic value of caregiving in Ohio alone by family members has been estimated to equal more than $12 billion a year,” he says. “Clearly, people are being squeezed at both ends.”
The predicament many boomers find themselves in, explains Elinor Ginzler, AARP’s director of livable communities, is caused by changing sociological norms, coupled with advances in science.
“People are not getting married at 20 –– they’re getting married at 33, and having their first child at age 37 as opposed to 22,” Ginzler says.
The other part of the equation revolves around the fact that older people are living longer and longer. Many of them have chronic conditions that are disabling, and it’s often a family member who is providing the assistance.
The result is a juggling act fraught with angst, guilt and many a sleepless night.
Fortunately, help is at hand. Ohio’s Aging Network (866/243-5678) provides caregiving tips and helps arrange for an individualized assessment of your loved one’s need for long-term services.
“It’s important for caregivers to realize they are not alone,” says Linda Mauger, program manager for Ohio State University’s Office of Geriatrics and Gerontology, who integrates issues about aging into the university’s curriculum. “Those who find themselves in that role are usually take-charge kind of people used to handling things on their own.
“But caregiving can be such a long-term endeavor: You raise your children for 18 years officially, and then unofficially for another 30. And, at the same time, your parent is likely needing care for 10 or 15 years.”
Flying solo on these issues leads to burnout in every facet of life. To combat that, it’s necessary to become a good communicator, discussing not only your loved one’s needs but your own as well.
“There’s a fine balance between your personal well-being, the welfare of the family you’re raising –– which you only get one chance at doing –– and your duties as a caregiver to an elderly parent,” Mauger says. “That’s why it’s crucial to enlist the aid of siblings and other family members. It’s time to say, ‘Look, here’s what we’re facing with mom and dad, how are we going to share this?’ ”
Ideally, this conversation will have taken place before a crisis hits.
“It used to be that people would be born in a community, grow up in that community, go to work in that community and retire in that community,” Hornbostel says. “That’s not true anymore. As families get more dispersed, the caregiving does become more burdensome. So it’s never too early to discuss how responsibilities will be divided up.”
The sister who’s the financial whiz, for example, can decipher the maze of bills, while the brother who lives closest can provide transportation to medical appointments and the grocery store. Out-of-town relatives can lend a hand by keeping a list of questions family members need to address with their loved one’s health-care professionals, as well as scheduling family conference calls.
Every family is different, and that’s no more apparent than during dis-cussions of potentially life-altering changes. Especially when the transition involves moving to a place that can help your loved one as his or her health needs change.
AARP’s Ginzler encourages adult children and parents to employ honesty –– mixed with a health dose of diplomacy –– when discussing housing options. “It’s OK for adult children to share their own perspective,” she says. “We need to be honest. The way to do that is to say something to the effect of: ‘I get so worried about you alone in that house. I am afraid you might fall down those steep basement stairs’ or ‘I’m afraid that your arthritis is getting worse and you need more help than you’ve got right now.’ ”
As conversation ebbs and flows, Ginzler adds, it’s important not to lose sight of the person who needs to be at the center of it: the aging loved one.
“At all times, we have to respect the wisdom of that older person and his or her place in the family,” she says.
Just as it’s never too early to talk about what kind of move to make when health needs change, neither is it premature to visit communities for your loved one.
“You want to look at a lot of places,” Ginzler says. “My line is ‘If you’ve seen one assisted-living facility, you’ve seen one assisted-living facility.’ Not only is each place different, people are going to react to each one differently. I might like it. You might hate it.”
And, she adds, when it’s time to begin making visits, once is not enough. It’s crucial to see how staff members on all shift levels interact with residents, as well as learn how they and those in their care feel about the place.
“If you hear that the peas are cold, that’s one level of concern. But if you hear, ‘I can never get anybody to come help me when I need them,’ that’s an entirely different level,” Ginzler says. “Employee satisfaction is also important. If staff members have been there for a long time, that’s often an indicator of quality. If it’s a good work environment, they like it there and do their jobs well.”
The Ohio Department of Aging’s Hornbostel encourages visitors to understand the parameters of each one. “Some assisted-living facilities, for example, will say that if mom is incontinent, she needs to leave,” he explains. “Others will say no problem. Each facility’s tolerance level is different, and it’s important to know that before you make a final decision.”
Ginzler also advises that those making the decision think of each facility as an extension of the life your loved one has been living. Consider the comfort level of the person who will be moving. Does he or she like the idea of being in an environment that’s very social? If so, you’ll want to look at places known for providing engaging activities. If you choose a community that has a tradition where everyone gets together and engages in social activities, and that’s not your loved one’s idea of a good time, will he or she be comfortable there?
However, she’s quick to add, an entirely new environment can be a change for the positive, especially if your loved one is a social butterfly who’s been resigned to living alone.
“It’s really amazing how many times people are appropriately nervous about making the move and then, upon reflection, say, ‘The opportunity to now engage with people and have so much fun and be involved in so many activities is a new lease on life. What a great idea it was to move,’ ” Ginzler says.
But even in the best circumstances, it’s often hard for caregivers to give up day-to-day duties with a loved one. Many are plagued with the nagging feeling they are letting that person down.
To that reasoning, Ginzler offers food for thought.
“Let’s think about this,” she says. “Your loved one is now going into a medical facility where there will be probably about 15 paid professionals taking care of them. The facility is staffed by different people around-the-clock so no one person is doing a straight 24 hours of care. It is multidisciplinary, so you’ve got doctors and nurses and nursing assistants and physical therapists and rehabilitation therapists and speech therapists and occupational therapists and nutritionists –– an entire team.
“Why would you think that you, one person, could match the work of 15 people? It’s just not possible.
“And the other thing to remember is that you’ve not stopped being a caregiver. You’re still going to be a part of that team, you’re just getting people to join you in the care.”