Caregiver’s Place in the Sandwich Generation

Caregiver’s Place in the Sandwich Generation

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Sandwich GenerationBy Karen Distelhorst, MSN, RN, GCNS-BC | Clinical Nurse Specialist

“Wait…when did I become the mother in this relationship?” Many adult daughters (and sons, too) find themselves in this awkward position of “role reversal” as parents age and health declines.

Being a part of the “sandwich generation” — taking care of both children and parents — can be a stressful time, but it can also be very rewarding and the lessons that it can teach your children are priceless. In order to navigate this time in your life, you will need some help and a plan. 

Priority One: Communication

A strategy to manage this time in your life is communication. Ask your parents key questions about what they would want in their later years:

• Where would you want to live if you cannot take care of yourself?

• How do you feel about other people coming into your home to help you?

• Who do you most trust to help you make decisions about your care?

Do not wait until there’s a problem to discuss this information. It’s also important to communicate with siblings and other family members about any plans. Difficulty occurs when you have to make decisions quickly, for example in a crisis, and when family members are not “on the same page.”

Becoming a Caregiver

What does a caregiver do exactly? You may find yourself helping with meals, housekeeping, transportation, finances or even physical care. You can also be a caregiver by making sure that others provide the care for your parent appropriately. This is called being an advocate, and it’s an important role.

Karen Mullen, president of Akron General’s Visiting Nurse Service and Affiliates, says it’s a good idea to talk to the family physician who can help identify resources such as home care.

However, sometimes you may feel like there are many similarities between taking care of your children and your parent. Remember that your parent is an adult, so they should respectfully be involved in all decision making.

sandwich2Promoting an Independent Life

Most people age 65 and older want to remain in their home, according to a study by AARP. Here are a few things that you can easily do to help promote your ­parent’s independence and safety at home.

• Safety checks. Daily phone calls can ease your mind that your parent is safe, and can also serve as a reminder for certain activities, such as taking medications, if needed.

• Socialization. Seniors who socialize have better mental health than those who do not. Studies have shown that social interaction for older adults may even reduce the risk of Alzheimer’s disease. Encourage your parent to participate in local senior centers, church groups or arrange lunch dates with old friends.

• Daily routines. Maintaining a consistent daily routine helps memory and improves sleep quality for older adults, both of which are important to maintain function and independence. To be consistent also helps for planning when outside assistance is needed.

• Family traditions and rituals. Activities such as ­Sunday dinner with extended family or baking holiday cookies with Grandma are traditions that improve the well-being of an older adult through reminiscence and life review. It also provides an important family bond that will benefit your children as they grow.

• Divide and conquer. Sometimes older adults need a lot of support to remain at home. If you have siblings or other family members who are willing to help, make a list of who can do what. One sibling may have a talent for balancing a checkbook, while another family member is handy with repairs. Use your individual talents. Don’t be afraid to delegate; if your sister is organized, have her plan the appointments.

Transitioning Care

Sometimes, even using all of the strategies above, your parent’s needs may be more than you and your family can handle alone. Fortunately, there are services available that bring additional help into the home, including home health care, home-delivered meals or an emergency response system (such as Lifeline).

Mullen says private home health aides may do light housekeeping or help with bathing, as it depends on the level of need.

That support can also include a home health provider. Older adults who have recently had major surgeries, but would like to stay home during recovery, can seek counsel from their doctor, if that’s appropriate.

“With folks coming out the hospital, home care bridges the gap to make them successful at home,” Mullen says.

Options for care outside of the home range from senior independent living apartments with enhanced services (like group meals and transportation), to assisted living, to a long-term care facility (nursing home). There are also continuing care communities that provide all of these levels in one place.

When will you know if your parent should not stay alone in their home anymore?

A few “red flags” that you should watch for include incorrectly taking medications for conditions, frequent falling, memory loss or the need for hands-on physical care.

The Area Agency on Aging can help you determine what the best level of care is for your parent. The AAOA is one of the non-profit agencies that is a resource for programs, services and information for older adults and their families.

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