Never before have so many people lived so long, never before have so many children seen their parents become so dependent on them for care, and never before have so many had to be caregivers to their parents while still caring for their own children at home – members of the new “Sandwich Generation.” They are sandwiched between two forces like between two pieces of bread. The top slice represents their parents’ needs and the bottom slice represents their children’s needs. Sometimes, an added pulling force is a retired spouse with dreams of travel and free time.

Many caregivers living today can recollect memories of grandmom coming to live with Mom and Dad. Perhaps she was “acting funny” or getting confused. Or, it was whispered, she was getting “senile”. Perhaps, also, she was reaching the ripe old age of 70. In those early decades of the 20th century, the elderly were those who had escaped death from heart attacks, strokes, TB, and cancer, and lived to an old age of 65 or 70. How times have changed.

Today’s elderly are protected, medicated, regulated, and monitored sufficiently to reach their 80’s, 90’s, and beyond. In these later years, many fall victim to other disabilities like dementia and Alzheimer’s, Parkinson’s, strokes, osteoporosis, and frailty. Their dependency on others occurs at later ages, but it surely occurs and in far greater numbers.

Although many exceptions can be singled out, most caregivers today are between the ages of 50 and 64. These are the children of the elderly. Few Americans will escape this call to be a caregiver. The group just now facing this responsibility are the “baby boomers,” the largest segment of people in the country. This group is 78 million strong. The first “baby boomers” are just reaching their retirement age of 66 years of age; the youngest of them are about 46. In another 10 years, some of the youngest boomers may be caregivers for some of the first baby boomers.

Looking farther into the 21st century we see a new challenge looming. This new challenge is for a system to deal with chronic care. By definition, this means care for conditions that are not curable and will be long-lasting, usually with specific health consequences. Longer life expectancy means that the number of elderly persons is increasing and among elderly Americans, chronic conditions such as heart disease, crippling arthritis, pulmonary disease, and mental confusion or dementia will be commonplace.

Often, these chronic conditions do not require hospitals or medical care. In fact, most people with chronic conditions – estimated to be over 100 million Americans – live and work among us and are struggling to remain independent and continue in the work force. But not all can do so, and as many as 50 million require some assistance to lead normal lives. Some 25% of those, over 12 million, are unable to live without involving caregivers in their lives.

The services these 12 million chronically ill and dependent persons will need will not all be medical, but assistance with daily living and activities. Some of the providers of these services will be paid medical personnel in the home. But many services will be provided by volunteers, family, community, and government agencies. Today’s caregivers must learn how to access various services and orchestrate the care each can provide. They will be involved with:
  • Social services for transportation and homemaking assistance
  • Custodial services for safety and day care
  • Rehabilitation services for speech or mobility
  • Psychological services for depression or feelings of isolation, and
  • Family services for shopping, housekeeping, cooking, banking, driving, and bathing.
A startling statistic is that the average woman will spend 17 years caring for her children, and 18 or more years caring for her aging parents. Her tasks will increase in time and intensity over those years. They may begin as grocery shopping, driving, cooking, housekeeping, and banking chores, and develop into providing housing and personal care with bathing, feeding, and assistance with walking.

The sandwich generation will experience many strong forces pulling them from opposite ends. Indeed, about 15% of all caregivers switched from full-time jobs to part-time work to care for a loved one and another 12% have left the work force to be a full-time caregiver. The trend will not lower these numbers nor decrease the impact on families.

Caregiving roles vary significantly from one caregiver to another. What starts out as an occasional need for a driver, companion, or cook often progresses to a need for one to bathe, dress, medicate, or toilet an aging parent. What starts out as a caregiving role as a visitor two or three times a week may ultimately become, for many, a live-in caregiver’s role shared by husband, wife, and children.

Former First Lady Rosalynn Carter once said: There are only four kinds of people in the world—those who have been caregivers, those who currently are caregivers, those who will be caregivers and those who need caregivers.”
 
Caregiving is in the future for all of us in one way or another. Any assistance we can get in dealing with this ever growing issue is essential to the wellbeing of the caregiver and the care recipient.




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