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March-April 2012, Vol. XXVII, No. 2
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Dealing with angina
'Sandwich generation' stress
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Your Health

'Sandwich generation' caregivers can face health challenges

Sandwich generation

They've been dubbed the "sandwich generation" - middle-aged people caring for aging parents while still taking care of their own children. According to the Pew Research Center, one of eight Americans age 40 to 60 is "sandwiched" between two generations, both raising a child and caring for a parent. Those numbers are only expected to rise as the population ages.

Pulled in many directions, these family jugglers risk stress, depression and other health problems. The demographics of our society may make it impossible to avoid being sandwiched, but there are steps those in the middle can take to protect their physical and emotional health.

The facts

Thanks to advances in life expectancy, more and more middle-aged people have parents still living. Over 70 percent of the baby boom generation (people born between 1946 and 1964) has at least one parent alive. So it's not surprising that boomers make up the majority of the estimated 50 million family caregivers in the United States.

Besides caring for aging parents, many middle-age people also face the strain of providing financial support to both parents and children. According to the Pew Research Center, 10 million baby boomers are raising young children and/or supporting an adult child while also giving a financial hand to an aging parent.

At the same time, boomers worry about their own retirement funds and job security in the midst of stock market swings, a troubled economy and high unemployment. Among employed boomers ages 50 to 61, six of 10 say they may have to postpone retirement due to the recession.

The impact

Given today's reality, it's no surprise that middle-age people are stressed out. According to the Centers for Disease Control, major depression rates are highest among men and women ages 45 to 64. Women, who shoulder the majority of sandwich responsibilities, are particularly affected. According to a 2010 Gallup-Healthways Well Being Index report, women between 45 and 64 have the lowest well-being of any age group.

But there is good news. The sandwich generation can do a lot to maintain mental and emotional health. Being open and honest about how much responsibility you can handle and recognizing early signs of stress and depression can help. Also:

Ask for help. Many family caregivers are reluctant to ask for help because they are burdened by guilt and a sense of obligation, say experts featured on Be Smart. Be Well. But it's in the best interest of both the caregiver and the aging parent to acknowledge when help is needed.

"They feel like they're failing if they say, 'I can't do this anymore. I need someone to help me.' But this is actually a very healthy response," says Dorothy Northrop, VP of Research and Clinical Operations at the National Multiple Sclerosis Society. "They're realizing, 'I want to keep doing this for a long time, and if I'm going to be able to do it, I've got to have some support.'"

Take time for yourself. It's also vitally important for people caring for children and parents to carve out a few moments for themselves each day.

"There has to be a boundary so they can actually take care of themselves and keep themselves healthy spiritually, emotionally and physically," says Jewel Dallas-Bruner, a licensed clinical social worker who works with families of people with Alzheimer's disease.

Pay attention to your own health. While shuttling relatives to and from doctors' appointments, don't skip your own. "When family caregivers don't take care of themselves, not only are we mismanaging our own body and our own life, but if we fall apart, then what happens?" asks Suzanne Mintz, president of the National Family Caregivers Association. (Learn more about caregiver stress and health issues at

Know depression warning signs

They include sadness lasting for weeks, loss of interest or pleasure in activities you used to enjoy, weight change, difficulty sleeping or sleeping too much, energy loss, feelings of worthlessness, and thoughts of death or suicide.

If you do feel overwhelmed, stressed or depressed, talk to a healthcare provider.

"Mental illnesses are like any other illness," says Michael Fitzpatrick, executive director of the National Alliance on Mental Illness. "They're treated the same, with medication and rehabilitation, and with the idea that people can recover." (Learn more about the prevention and treatment of mental illness at

More online at BeSmartBeWell®.com

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