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What is the sandwich generation's dilemma?

People in their forties and fifties are now caregivers to ageing parents as well as young children. Being pulled in both directions is leading to frustration, and helplessness of not being able to do enough

Besides raising children, the sandwich generation is also shouldering a growing responsibility of their ageing parents. Photo: iSTOCKPHOTO

By Azera Parveen Rahman

LAST PUBLISHED 17.06.2023  |  01:00 PM IST

I am nearly 40—my child has almost reached double-digit age—and my parents are in their 60s and 70s. We live in different cities—as do my in-laws—and lead independent lives. Each time I visit home, however, the inevitable reality of old age catching up with my parents becomes even more stark. The tables have gradually turned: I chide them for not eating enough fruit, urge them to monitor excessive gadget time, and push them to take regular walks. Group text message conversations with my two sisters usually revolve around our parents’ health, getting essentials home-delivered and checking on the domestic help.

When I look around, most other women—and men—in my age group are doing the same. Besides raising children, they are also shouldering the growing responsibility of their ageing parents. We all are part of the sandwich generation, a demography of people in their 40s-50s who have become caregivers to two generations. Being pulled at both ends can lead to frustration, a looming sense of guilt and helplessness at not being able to do enough. And when not managed, say counsellors, this stress can affect mental as well as physical health.

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The term “sandwich generation" was coined in the early 1980s by two women, Dorothy Miller and Elaine Brody, and was primarily introduced to social workers and gerontologists. “Many of this group have arrived at a time of relative equilibrium, in both their economic and marital and personal relationships," Miller wrote in her paper, presented at the annual meeting of the Western Gerontological Association in California in 1980, “They are ready for relaxation and self-indulgence only to realise that their grown children are not quite independent and their parents have moved from autonomy to a degree of dependence."

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Shaina Matthew, 41, first felt this when her “fiercely independent mother (who lived in Kerala) began developing arthritis, which made some days very difficult to even move around," says Matthew, who lives in Pune, Maharashtra, with her husband and two children. She began to take over some of her mother’s chores, such as paying the electricity bill and ordering vegetables and groceries online. But it was not enough. “For instance, even if I took the doctor’s appointment for her on the phone, she would have to manage going there on her own," she says. “My mother’s sisters live close by and our neighbour is a family friend of many years. But everyone has their own lives and asking them every time felt small. I felt guilty of not being able to help when my mother needed me."

Her children have their own needs. “My daughter, who is 12, is almost a teenager. Suddenly there are a lot more ‘friends’ issues, insecurities, curiosity to try new things. I don’t want to miss any of that. My son, 10, on the other hand, is still the family’s baby, who needs me for everything," she says. Being available for everyone while juggling a job and the household means she is stretched for time.

It’s not easy for those with parents living close by either. A friend who lives in the same city as her parents and in-laws feels that the fact that she “could be" available any time for them somehow ups the guilt factor. “The last two years have been particularly challenging because my mother and father-in-law have been in and out of hospital for various ailments," she says. The couple drew up a weekly schedule of who would accompany whom on doctor’s visits. But this meant they would sometimes miss certain milestones of their six-year-old daughter—like her first stage performance in school, or when she lost her first tooth and expected tooth fairy to leave a gift under the pillow. “She was with her grandmother that night," the friend says. “She will probably not remember this later but I don’t think I can overcome that guilt of not being there for her. It’s as if I am always in a tug-of-war between being a good daughter and a good mother. And either way, I am losing."

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Cognitive and emotional exhaustion among the sandwich generation is becoming more and more common, says counsellor Aarti Bakshi, who works in the National Capital Region (NCR). “The most common statements are, ‘I am exhausted’, ‘I feel lonely in my own home’. Their patience wears thin and taking care of everyone means reducing conversations to basic questions, like, ‘Have you taken your medicine?’ to an elderly parent or ‘Have you done your homework?’ to the child," she says.

There is also a clash of mindsets at this juncture. “The new generation is taught to think for themselves and the senior generation does not like to be told what to do. Your own mindset at 40 is not the same as them," adds Bakshi.

Aside from emotional needs, the sandwich generation is often faced with a lot of tough financial decisions at this point. “Both the generations’ financial needs increase at this point," notes Mumbai-based counsellor and psychologist Kiran Makhijani. “With retired and ageing parents, medical bills begin to rise and adolescent children’s educational expenses increase too."

Bengaluru-based mental health professional Mini Sukumaran Nair adds: “Like in the West, children are moving out of their homes after 18, but unlike the West, they are still financially dependent on their parents until at least a few years after."

This increasing emotional and financial need can, at times, put a strain on other relationships, like siblings of the sandwich generation. “Often, the sibling who lives in the same city as the parents is entrusted with the main responsibility of their care," says Makhijani. Naturally, they have their hands full, but siblings that live away suffer in guilt as well. “They are not sure if they can be there immediately if an emergency arises and are always asking, what more can I do?" she adds.

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All of this often leads to stress and anxiety. Many live in denial and are not able to manage the stress. “There are guilt trips. Over time, this can lead to mental health issues, blood pressure problems and diabetes. I have seen women with high stress going through early menopause," explains Makhijani. Does the response to such situations differ with gender? “Women’s reactions are sharper while men tend to withdraw," says Bakshi. Makhijani adds that while she had more women coming to her earlier with such issues, an increasing number of men are now seeking help too.

So how does one juggle it all? “You cannot pour from an empty cup," says Bakshi. The key, therefore, is to carve out some time to focus on one’s own well-being. “It doesn’t have to be much, maybe just 10 minutes a day—to exercise, meditate or indulge in oneself—but it will make a difference in helping one regulate their emotions," she adds. “Be kind to yourself."

Azera Parveen Rahman is a writer currently based in Bhuj, Gujarat