Friday, February 23, 2007

Club Sandwich

Are you in your thirties or forties and desperate? I am--and no, it's not what you think, get your head out of the gutter. I have found myself lately part of the Sandwich Generation, more specifically, a Club Sandwich, defined as "those in their 30s and 40s, with young children, aging parents and grandparents" (thanks to several readers who emailed me to ask me to post on this topic). I do not have any grandparents left and my father died over four years ago at 68, but I am now trying to help my mother, who has health problems and is in her late sixties--and I have a middle schooler who is dealing with well, all of those middle school issues. Add this to trying to work, take care of a house, etc. and it's no wonder so many of us--both men and women-- feel exhausted.

Brian Williams on the Nightly News recently had a series on caring for aging parents and had viewers write in with their personal stories that range the spectrum from heartbreaking and caring to resentful at having to deal with parents, to wistful that their parents died early and they did not get to see them into old age. I think it is a privilege that we get to care for our parents as they get older but that does not mean that it is easy. So many health problems, emergencies (my own mother fell and fractured her foot in the middle of trying to move her to an independent care facility yesterday) and the day to day chores that need to get done are difficult at times, but in the end, all that matters is that we care for each other the best way that we can. Do you have a parent or parents that you care for? If so, how are you coping or not with the situation?


Anonymous Anonymous said...

My father is 84 and lives in Jersey. I live in Inidana but am blessed that has a girlfrind, aged 54 that takes very good care of him. We are too much alike to spend more than one week in the same house with a blow up and am very thankful she is there. Age diiference? This is a guy who got his last tattoo at 76 (a spider on the back of his hand). All I can say is "good on you!!

8:49 AM, February 23, 2007  
Blogger KG2V said...

Oh I know the sandwich well - 2 children, 5 and 9

Mom has advanced stange Lung Cancer - maybe a couple of months left, Dad has Dementia

The funny thing is that together, Mom and Dad have made a OK team - Mom is still mentally sharp, and a home health care aide a few ours a day for the last few months have helped

With Mom in the hospital right now, I'm bringing Dad over for dinner every night, doing his shopping, and relying on the aide a bunch more. Once Mom goes, I don't know what to do - I'm scrambling to figure that out right now. The MDs and faimly friends (and I) agree that Dad is probably better off in some sort of assisted living community once Mom goes - but he says "NO - I want to live in my HOME" - Mom is talking to him - trying to get him to realize that he CAN'T take care of himself alone


Rough time

8:49 AM, February 23, 2007  
Blogger Helen said...


How lucky that your father has a caring girlfriend to help him, maybe that is the answer, find someone 30 years younger to help out.

Rough Time,

Hang in there, I am very sorry to hear of your troubles. Naturally, most people want to stay in their own home, but the worry over a parent living alone who has health problems is huge. One fall or injury can set the person back for months or longer.

9:11 AM, February 23, 2007  
Blogger SGT Ted said...

While I dont want to minimise what folks are going thru, I find this sudden discovery of a "problem" a bit much. Like other generations haven't had to deal with similar situations. I see it as yet another self-indulgent navel gazing moment of the ageing boomers as they yet again "discover" something unpleasant in their lives that will become So Important that the rest of us should stop and take special notice of it.

9:41 AM, February 23, 2007  
Anonymous Anonymous said...

Dad had a femoral bypass about eight or ten years ago, and never really finished recovering from it. We found out recently that his abdominal wall was herniated in multiple places. That would explain his slow, incomplete recovery.

But the result of it was that he has been in a long, slow decline, and the hardest part for me was knowing when I should start minding his business. One day, his sister called me, saying we had to do something, 'cause something wasn't right.

I went over there and found him to be clumsy, and slurring his words. Of course, he didn't want to go the hospital. I am fortunate to have a professional health care provider in the family who came over and intimidated him into riding to the emergency room with us.

He'd had a stroke. He spent six weeks in a recovery center that everyone worked very hard not to call a rest home. He's home now and living mostly independently again, although he can no longer drive. He's improved to the point that I'm willing to think that he might drive again one day, but it won't be soon.

But he constantly struggles with what the docs call a "congitive deficit," and he calls "I can't think right." He stays frustrated and depressed, and feeling like he can't "get on with his life."

I can't fix it, and I feel a constant guilt because I didn't detect the problem sooner. I saw him every week or so, but there's no e-mail that shows up telling you that it's time to check on your Dad daily.

I've got help. (His sister and his cousin, plus my spouse.) But no matter what we do, we can't make it right, and accepting that isn't coming easy, especially not for him.


9:56 AM, February 23, 2007  
Anonymous Anonymous said...

I'm a club sandwich with a side order of My parents divorced when I was very young. Neither remarried. Mom is bipolar and has been in and out of the psyche ward. Dad had autonomic failure/emphysema/COPD. In addition to caring for both of my parents at different times, I was my maternal grandfathers guardian.

My observations one year after my dad passed:

-If you come from a divorced family, and either of the divorced parents health begins failing, the eldest child is thrust into a role of responsibility that is normally reserved for the spouse in that situation. This creates a heaping mound of added stress on the eldest child, especially if they have younger children. (Four under 7 yrs. including a newborn in my case). This would also hold true of a person who has already lost one of their parents. By default, the eldest (or most able) child becomes an active participant in the care of the remaining parent.

- I was on of those career women who waited until 30 years of age to have children. What I didn't factor into my decision to postponing marriage and chilbirth, was this issue that caring for aging parents would over lap with the children.

As far as how I've coped with the situation...A most loving and supportive husband has been a God send.

At one point, once the reality of the situation with my Dad had sunk in, I fully embraced this new role and adopted a "take it one day at a time" attitude. When you have all these other "needs" that take priority over your own, you get very good at suppressing your own needs. But the key for me was finding ways to unwind/decompress after particularly stressful days.

One time, I had Dad (62yrs old) passing out at the breakfast table, my 4 year old in the bathroom screaming "WIPE ME!", my newborn crying and needing a diaper change, and a 6 yr old asking me to read her a story...all at the same time.

As stressful and insane as the experience was at times to get through, I wouldn't trade it for the world. I'm grateful to have had that 2.5 yrs of time Dad was here in the house. It was certainly a time when I feel I grew and became stronger in many ways.

10:08 AM, February 23, 2007  
Anonymous Anonymous said...

I've been another "club sandwich" for five years now, and I've been at various times at every single point in that spectrum you described. My MIL has Parkinson's disease, alzheimer's, diabetes, and suffers TIAs. She's had a couple of larger stroke episodes as well, largely because of poor management of her diabetes.

Oh, the stories I could tell! For my youngest daughter, there are no good memories of a kindly, loving grandmother. Grandmother is a lunatic who leaves screaming, accusing messages on our answering machine. (Oh, we've stolen her car, you name it.) Grandmother was the reason she had to withdraw from several of the activities she enjoyed; I couldn't transport her and participate with her because there weren't enough hours in a day, and "grandmother" wanted to live where she wanted to live, which was a 60 mile round trip for me. She would fire her aides, because she "didn't need the help" then complain that they weren't showing up. You name it. For her, grandmother is the reason that she hasn't had a mother like her friends do.

Then there are the calls from well-meaning friends and family who want to berate us for not visiting her; I am there every single day. She just doesn't remember. I could go on. It's been awful. People line up with advice and criticism, but genuine help is absolutely nonexistent. Unless you are the individual with primary responsibility, it is impossible to recognize what a huge job it is. The fact that they appear to be doing well is actually a sign of how hard their caregiver is working, and not necessarily that they are doing "okay" on their own.

She had finally declined enough that we were able to get her transferred to a nursing home after a hospitalization at Christmas time. (Yes, in the past five years she has spent every holiday season from Thanksgiving to Christmas in the hospital, each time with a different cause.)

It was like the weight of the world was off our shoulders to finally have her in a safe environment. She's close (2 miles away) and we still visit every day. But when I go to see her, unlike before, she's clean, dresssed appropriately, and smells nice. Her room is tidy and clean, and she's been decently fed. We know that if she falls, she won't spend the night in the floor with a broken hip. And we know that she won't wander off (she'd been doing a bit of that as well) and die of exposure, or trigger a statewide manhunt.

11:25 AM, February 23, 2007  
Blogger NerdMom said...

sgt ted, I do think that it has changed a bit. My grandmother got married young and had kids, as did my mother. Which means I am in my early 30's, mom is in her early 50's and grandmom is in her early 70's. I think that is more of how it used to be. The situation that is also traditional is my husband's. He is the baby of 7 so his mom is in her 70's (75 this year) but there are many hands to help out. I think that when we decided to be pushing 40 when we have kids, we have to remember what that will look like into their lifetime too. I am not saying don't do it, just think about it. If my kids all leave by their 20th birth day (and I doubt they will be allowed to stay much longer;) I will be 52 when the last one moves out. Hopefully that will leave me in a position to still be vibrant in my grandkids life.

I am with you that it is great to help with you parents. If my Mother in Law ever needed a place to stay or more help, I hope that I could do it graciously.

11:29 AM, February 23, 2007  
Blogger Captain Holly said...

My mother lived with us for two years after my father died. She passed away last October.

She moved in shortly after we moved into our new house, but it worked out quite well because we had built it with an extra room and handicapped bathroom in anticipation of caring for at least one of our parents.

The problem was that within a 30-day period in late 2004, my fourth child was born (by c-section), my father died, and my mother moved in.

Needless to say, I was quite busy during that time. Fortunately, my mother didn't need that much help -- even though she was unable to live on her own -- allowing me to concentrate on taking care of my wife and the kids.

My wife was truly heroic, because even though deep down she didn't really like the situation she made the best of it for nearly two years. I cannot sing her praises loud enough, and I have already made it clear that when her mother needs help she is welcome to live with us so I can return the favor.

And I second what willbdone said: It was a blessing to have her in our house, especially for our children who have fond memories of their grandmother. I am reminded of what the Marines told me when I was in boot camp:

Nothing good ever comes easy.

Everything worthwhile takes diligence, dedication, and hard work.

11:30 AM, February 23, 2007  
Anonymous Anonymous said...

Dad passed away 6 months to the day after Mother died. During those 6 months I moved into his house to care for him. He had had a stroke which left him unable to communicate and very unsteady on his feet. Neither caring for both parents at a distance while my mother was alive nor living with Dad prior to his passing was easy, in fact I look back on that time and wonder how I ever did what I did. Now, almost 7 years later, I know that I was the luckiest person ever because I was able to do what I did. I only wish my mother had been a wee bit less independent and allowed me to move in before she died or allowed us to move them in with us.

1:40 PM, February 23, 2007  
Anonymous Anonymous said...

Hey Sarge, I think another difference has to do with mobility. Our families are more nuclear, less extended. So the duty of child and parent care falls on fewer shoulders.

For instance, I moved to Nashville and my parents and sister lived in Montgomery. When mom got sick, it was my sister who cared for her. I would come down a lot, but with our triplets being babies, I could not come down every weekend.

The kicker of the story is that my mother, God bless her, had an awful relationship with my sister. Mom's fault to be honest. And my sister took care of her like she was a queen. She showed such grace and class, it brings tears of admiration to my eyes to write this. She had her own child to take care of, and no husband. But she rose to the occasion in a most impressive way. Thanks Fay.

Dad's illness was less physically demanding, but more emotionally devastating for both of us. Bottom line, while I learned where the potholes were on I-65 between Nashville and Montgomery, I am guilt free.

My advice is to be SURE to schedule self-care time along with the other care demands. We cannot operate on fumes for too long without showing it. It is not selfish to balance self-care with parent and child care: It is essential. So pay for the babysitter and have a date, see a movie, drink a glass of wine, go see a comic. But know that in doing so you are taking care of the person who takes care of your loved ones.

End of sermon.


1:46 PM, February 23, 2007  
Anonymous Anonymous said...

I'm very fortunate in that both of my parents are still living, in their early 80s, and very active with their church. My mom even serves communion once a month to the church's shut ins, several of whom are younger than she is. My dad is a Mason and still takes part in some lodge activities.

My brother and sister and I keep in touch with our folks to make sure they're doing okay. We do pay particular attention to dad, since he's had three heart attacks, a quintuple by-pass, an arterial stent, plus he suffers from Type II diabetes.

Mom, however, has only been in the hospital once in the past 20 years, and that was for a kidney stone. She's the 10th of 11 children, and, with three exceptions, all her other siblings lived to be in their 90s.

2:14 PM, February 23, 2007  
Anonymous Anonymous said...

My father died when I was 23 and I miss him every single day. Be glad for your 'burden'.

2:38 PM, February 23, 2007  
Blogger Manos said...

Both of my parents died in their late 50's. I'm in my mid-30's with a newborn. Right now all I can think of is how much I could have learned from them. And how much they would have enjoyed spending time with their grandson.

I would be willing to put up with dealing with their medical problems to still have them around.

2:51 PM, February 23, 2007  
Anonymous Anonymous said...

One thing I've never seen discussed anywhere is another syndrome--the boomerang kid who comes back ostensibly to "take care" of the aging parent but really cannot support themselves, maybe has alcohol and drug problems, wrests control of the parent's finances, spends up the credit card, etc., while other siblings howl--I've seen it over and over. Sometimes the boomerang kid is a comfort, overall, and sometimes just another problem.

I've seen it happen in my family and in others. I'm a lawyer so the siblings often comet to me to figure out what to do but it's really hard to "fix" a situation like that if you're not willing to take the parent on youself, OR the parent doesn't want to leave their home anyway.

On top of that, add the heirs' concerns about their future interest the parent's estate, even if it's just an old house. It's the perfect storm of conflicting interests.

5:14 PM, February 23, 2007  
Anonymous Anonymous said...

I watched my dad take care of his aunt--he visited her every day, unfailingly. She wasn't the easiest person to deal with but I never heard Dad complain. Not once. My siblings and I complained plenty though, when we had to stop at her house so Dad could check on her. Now, I realize what a fabulous example Dad set for us and I hope I can do as well for my children. (Anon 11:25, I thought of you while I typed this. Your daughter may not grow up with all the activities her friends have, but she has something better--your example of how to be a good person.)

After Mom went to a nursing home, she got very confused and stopped answering her phone. Either she couldn't reach it or she didn't recognize the ringing phone as hers. I live in another city and I couldn't believe how painful it was to be unable to chat with Mom anymore. I could go visit her, sure, but there was no more picking up the phone for a quick chat. In the last month or so, she has begun answering her phone and she sounds like herself. I feel blessed every time I get to talk to her.

My sister takes care of her, visiting every day, doing her laundry, handling her finances. My brothers stop by--one frequently, one semi-regularly, and one infrequently. A friend tried to explain why the one brother doesn't visit very often: "It's probably hard for him to see his Mom when she's not really herself anymore." Hmmmm.... and it's a piece of cake for the rest of us? And what about Mom? I can't imagine it is very easy for her to be the way she is.

My husband is an only child. Watching him deal with his mother makes me glad we have two children and sorry we didn't start early enough to have more. I'm glad my children will have someone to share the burden with. Chances are, I'll be a burden for them at some point.

People who work in nursing homes deserve a special place in heaven. People who hate working in nursing homes--but work there anyway--deserve a special place in hell.

10:45 PM, February 23, 2007  
Anonymous Anonymous said...

I fled back to New York from Chicago two years ago (three months after my mother died), partially out of fear that I'd get stuck caring for my father as his health declines. I'm ashamed of that, but not ashamed enough to go back yet.

He's a very difficult man, and no one ever figured that he would outlive our mother. Her death was sudden, and when we lost her, we lost our Dad buffer, which all of us utilized extensively.

So far he seems to be doing okay, but he's 75 with macular degeneration and a newly installed pacemaker. All of my siblings live within a mile or so of him, so he's not necessarily isolated, although really no one enjoys spending time with him, and he doesn't seem to enjoy spending time with anyone else, either.

I speak to him on the telephone every week or so, and deep in my heart I know I should be back out there, but I just don't have the strength of character to do it yet.

12:04 AM, February 24, 2007  
Anonymous Anonymous said...

Anon 10:45
We keep reminding ourselves that, at the end of it all, we'll look back and be glad that we did the right thing. In our case, it would be nearly easier without siblings because my husband's siblings are so disengaged, stopping by to meddle but unwilling to offer actual assistance. As I said, it's gotten better since she entered the nursing home. The continuous worry is gone and, although she didn't want to go, she actually is doing better cognitively and physically because of the excellent support at the facility and the rigid routines.

I think, as well, the experience of caring for an elder, especially one with dementia, brings up old relationship issues over a lifetime. My MIL was a difficult person BEFORE she got dementia, i.e. manipulative, disciplined by guilt-tripping, etc. Family counselling helped my husband a lot to get over th ose feelings about her. I wish his siblings would go. I'm more angry with them, and their failure to support their mother and my husband. My MIL is so pitiful, I can't be angry with her.

I hear people say so often that they would NEVER put their loved one in a nursing home (assisted living, etc. depending on need) but I want to say that our experience has been that a good facility can actually give them a much better quality of life than spending hours at home alone, disoriented, and without social opportunities.

8:39 AM, February 24, 2007  
Anonymous Anonymous said...

"Naturally, most people want to stay in their own home, but the worry over a parent living alone who has health problems is huge. One fall or injury can set the person back for months or longer. "

Ironically, you are less likely to fall in your own home where you have lived and know it like the back of your hand. Pay or organize family to visit, shovel walks, stock the freezer, etc. and elderly proof the house early, with ramps, accessible showers and toilets etc. You may pay to remodel, but it will be less costly and more convenient if you do it now, knowing old age is coming. Looking backward, after an injury is worse than planning ahead, opening up spaces and elderly proofing your own home to stay put with neighbors you know.

12:50 PM, February 24, 2007  
Blogger Randy said...

Yes. My dad died sooner than anticipated a couple of weeks ago, the day after my mom arrived home after an 8-week hospitalization due to Guillain Barré Syndrome. My mom had been his primary caregiver in his multi-year struggle with COPD. When she was hospitalized, I assumed the task. It was not easy but it was privilege. I will probably be both haunted and inspired by it for a long, long time.

I was fortunate that, unlike most people, I could take the time off to do it and lived less than a mile away. While I wrote about it on my blog, it was far easier to write about my mom's problems than the everyday existence with my dad.

Now that he is gone, it is easier to write about him than it is the incredibly slow, occasionally painful, and often tedious recovery that my mom must endure before she can walk again.

3:01 PM, February 24, 2007  
Anonymous Anonymous said...

I've never thought of myself as a Club Sandwich, but I guess I am. I have four kids infant to 13 years. My mom passed away 11 years ago and my dad (73) has multiple medical problems, all of which are manageable now, but he doesn't always take care of them and I can see the time coming when they won't be. My husband's mother (50-something) has COPD and is much sicker than my dad, but not so sick that we have to take care of her yet. She is sick enough that we are the primary emergency contact for my hubby's 87 year old grandmother. She comes from a family of women who live into their 100's, so she's still able drive and does lots of things for herself, but I have seen a decline in her abilities in the last year that frightens me. For instance, she recently called me at work and asked me if she could talk to my husband. I kind of blew it off to her, but he and I had a long talk about it that night because that kind of thing is happening more and more often. My 13 year old helps her keep her house clean and my 10 year old helps her with getting the garbage to the curb and the lawn. It works out and we would never complain because we know we are lucky to have her.

3:55 PM, February 25, 2007  
Anonymous Anonymous said...

Of course it's more difficult to care for aging parents now: The elderly live longer with pills and pace-makers to keep them going, nuclear families are mostly dual income (less time for your spouse to care for your mother in law...), children often live towns or several states away from their aging parents, and the young ones in the family are involved in more activities than ever before (not necessarily a great thing).

All you can do is your best. It's hard to deal with the emotions and any resentment from the past when the kid has to become the parent. Each situation is different, and it really irritates me when people judge others.

I'm only 26 and my parents are in their 50s. Hopefully I won't have to deal with this for another 20 years, but it is still in the back of my mind to be looking out for them. My dad's parents still live on their own, and fortunately their house is only a short walk through the woods, so a lot of the WORRY (one of the biggest problems) is gone.

My mom's mom, 85, is a different story. Her husband died the year before I was born, and grandma always got on well and stayed independent. Every now and then she would have a large medical problem, but always seemed to recover and keep on going. For a very long time she's been frail physically, but mentally she is mostly "with it."

When, a few years ago, her health really went down hill it was time for her to move in with my parents. They were happy to have her live with them. It meant constant nagging and an end to privacy, but that's simply what you do for a loved one.

However, things got worse and worse. The village in which they live is small and has a virtually non-existent network for helping the elderly, so grandma would be left alone in the house all day while my parents worked full-time. When they'd get home, they never knew if grandma would be lying on the floor because she tripped, or if they would only step in diarrhea because she couldn't get to the bathroom in time. As grandma says, "Getting old takes courage." I entirely agree with the previous commenter who said that if an elderly loved one seems to be getting on well, it's a sign of the quality of their caregiver.

In the meantime, my mom's two brothers were out of the picture. One (married, great job, no kids) lived a two-day drive away and called once a week. The other (married, comfortably retired, kids grown with families of their own) lived five hours away and visited about four times a year, for a day and a half each. This was one of the biggest problems for my mom- she was essentially an only child dealing with this with no moral or financial support from my uncles. (Yes, it was financially difficult for my parents to have the heat running all day long, higher electricity and phone bills, etc.)

For example, one time grandma stayed with the nearby son for a week. She needed a bandage changed at a doctor's office. Months later, after the invoice had been sent numerous times to my uncle, he sent the bill to my parents (so they could get it to her insurance, etc.). The bill was for $20, and he was too cheap to pay it at the time it was due. Yet grandma worships the ground he walks on. This, of course, brings up the resentment issues I mentioned.

Fortunately, over a year ago, grandma moved to a terrific assisted living place. She "only" lived with my parents for about 20 months, but they could not give her the care she needed, even though my mom is a nurse. She loves where she lives and has perked up considerably. It's a 150 mile round-trip drive for my parents, but they still see her at least once a week. The one son has visited about three times (now a four hour drive each way), and the other son has been to see her once. Thankfully, grandma had the foresight to buy assisted living insurance decades ago and it covers the $2,000/month cost.

One more thing, and I'll be off the soapbox; if you live too far away to give physical support to your parent(s) and your sibling(s) is/are shouldering the responsibility, please, please do what you can to help them. My parents would have appreciated a simple thank-you from my uncles.


1:29 PM, March 01, 2007  
Blogger Am I Conservative or Lil' Libertarian? said...

I'm so glad Dr. Helen chose to post on this subject, I just knew we weren't alone.

While going through a very rough divorce, my parents were there for me and my 3 then small children. I was back in college full time, the kids in school.

During the 4th and final year of the divorce process, (did I mention it was 'rough'?), my mom had a stroke. My dad decided to sell their home and move to FL, but not before providing a downpayment for a townhome for the kids and me.

3 years later, they came up for the youngest child's middle school graduation, my mom fell and broke her hip. Had another stroke while recuperating.

They moved in with me, that was 7 years ago. All but the youngest are finished with college, my mom died 2.5 years ago. My dad found out he has cancer 2 months ago.

Has it been hard? Very. But my children are all very caring, they had to help grandma get to the bathroom and sometimes not be able to say what she wanted. They also sat on the hospital bed, set up in the living room on 9/11 to comfort her and let her know that all would be defended. They reassured her the same as she had done for them, all those years.

We all grew and I've been blessed with the best brother, sister-in-law, nieces and nephews that have done what they could, considering my parents felt more comfortable living with me.

11:00 PM, March 02, 2007  
Blogger Serket said...

My maternal grandparents are 72 & 68 and they seem to do very well on their own. My paternal grandma is 62 and she re-married, after my grandpa died, and they seem good also.

6:05 PM, April 02, 2007  
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