5 Geriatric Care Management Tips for the Sandwich Generation

The Sandwich Generation refers to a generation of people who are caring for their aging parents while supporting their own children. If you’re a caregiver in this generation you might liken the associated financial and emotional stress with the feeling of being “sandwiched” between the two responsibilities that are taking up most of your time.

Sandwich generation providers can create a care management sandwich that meets their needs and the needs of their aging parent(s) through effective planning, support, and advocacy.

5 crucial ingredients for a balanced care management sandwich:

  • Emotional well-being
  • Financial Planning
  • Healthcare
  • Career
  • Family

1. Emotional Well-being

For those taking on the greatest time commitment for providing care for an aging parent or parents and also trying to fulfill their own parenting obligations, finding time for self is an important part of maintaining balance in life. Caregiver burnout can seriously impact your quality of life and your ability to continue caring for your loved ones. It is essential that you carve out some time for yourself every day to do something for yourself. It might be a session at the gym, coffee with a friend, reading a book, or any activity that recharges your emotional batteries.

2. Financial Planning

Perhaps one of the biggest contributors to sandwich generation caregiver stress is managing the costs associated with raising children and maintaining the health of aging parents.

To help ease the financial burden talk to your family members and involve them in the financial planning process. Assess all of your financial resources and create separate accounts with allocated budgets for long-term care management and day-to-day expenses for the whole family. If this task seems too overwhelming, seek the help of a Certified Financial Planner that deals with long term care planning. Contact us to help find a specialist that meets your needs.

3. Healthcare

As your parents age, medical issues are likely to arise. Advance planning for possible physical and mental healthcare issues is key to effectively managing them. It is helpful for caregivers to visit and evaluate several long-term care facilities well ahead of the need for placement. Understand that institutionalization may be a normal progression in the process. Encourage the completion of a Durable Power of Attorney for Health Care form or an Advance Health Directive for Dementia in the event of your aging parent(s) being unable to make healthcare decisions for themselves at a later stage. Also see: Practical Advice on Caring For a Parent with Dementia5-step Geriatric Care Management Plan for Dementia Patients and the Families Caring for Them

Part of your planning should also include ways of keeping your aging parent(s) active. Involve them, as far as possible, in the day-to-day chores in the household and plan simple mental and physical activities like reading to the children, doing a crossword, going for a walk, joining a senior activity group etc.

4. Family

Multiple generations living together in one household can be stressful. There are so many voices that need to be heard, and often not enough time for everyone to have their say. Open, honest family communication is so very important for maintaining household balance. Try and set aside a time, perhaps around the dinner table, for each family member to talk about their day or share a personal experience. Plan a monthly family outing, even it’s in the back yard with a ball. Laugh together as often as you can and learn to sweat the small stuff.

5. Career

Juggling work-life balance is an art that requires a lot of planning and support – from your family and your employers. Don’t be afraid to ask your family members and colleagues for help if you need it, and you probably will. A geriatric care manager can also help you find the care management support and resources you need.

Choose Love, Not Stuff

I wrote this while my mother was ill some time ago, but the message is still true: Choose balance, choose love, and replace “things” with treasured memories and happy days.

There is never enough time.

Find time for balance in your lifeAs I sit here in the ICU with my ailing mother I lament on what I should have done. What else could I have done? There is never enough time. We all have choices as to how we live our lives and sometimes it is difficult to know when you need to take time away from work to help someone else or when it will be ok to just carry on your day.

I am so aware of my actions and emotions these days that I often feel that ignorance is bliss. How much easier it would be to just react and not be proactive. I have to catch myself and encourage myself to live in this moment. Last night I thought my mother wasn’t going to last through Christmas she was so sick. Today is a good day. She is alert, smiling and eating. I am happy, in this moment, at this time to have her, to love her.

I am reminded of the story “I’ll Love you Forever.” It is a story of a mother that cares and nurtures her son. As a baby she rocks him and tells him she will love him forever. As the story goes on it depicts the relationship of the mother and son and how it changes until the little boy is a grown man caring for and nurturing his mother, rocking her as she had rocked him. As I am blessed to be able to care for my own mother I realize that this transition has occurred. I am now her parent.

When I was a little girl I used to love to be rocked, (truth be told, I still rock when I am stressed). Instead of asking my mother if she would rock me, I would ask her “Momma, can I rock you?” I, like the son in the story, would love nothing more than to pick her up and rock her to sleep. Sleep, with sweet, sweet dreams of heaven.

Only God knows when he will take her, but I know she is ready. She has told me so. What a blessing to know that she is satisfied with her life and that she, while frightened of the unknown like all of us, is at peace knowing she is going “HOME” soon.

Part of having a balance in life is being able to live with the choices you make. Loving and being loved go hand-in-hand.

May you always realize that time and love are your greatest gifts. May you always remember what is important in life. May you make good choices, starting with choosing happiness and love over objects and clutter.

10 Safety Tips for the Elderly during the Icy Winter Months

Winter Safety Tips for Seniors

Remember the excitement you felt as a kid when you got a snow day?!  Your imagination went wild as you fantasized about the snow fort you would make next to your perfect snow man.

Unfortunately as we age, snow days become less exciting and more of an inconvenience, and sometimes even dangerous.  Making sure your car starts, getting someone to look after the kids (who are overjoyed at staying home from school), keeping the house warm without breaking the bank, trying to get to work without getting into an accident with that jerk in the SUV who always travels way too fast in bad weather…

If you have an elderly family member that you care for, the weather causes an even bigger issue as they are at greater risk in snowy conditions and freezing temperatures. Slipping on ice, Winter depression, nutritional deficiency and even carbon monoxide poisoning are major concerns for the elderly during the icy winter months.

Here are 10 safety tips to assist your elderly loved one during the winter season:

1. Set up grocery or (better yet) pre-made meals delivery service

This will ensure that your loved one has the food they need on a regular basis and will take some of the strain off you. Make sure that they are eating a varied diet rich in Vitamin D so as to avoid a deficiency from lack of exposure to the sun. Proteins like salmon, tuna, mackerel, beef liver and egg yolks, dairy products like milk and cheese, and certain grains and cereals are all Vitamin D rich foods that can prevent any nutritional deficits.

2. Hire a service or young neighbors to shovel or snow blow your family member’s driveway and sidewalks if there’s a storm

Preventing slips and falls is crucial for the elderly in icy conditions. The older you get the more fragile your muscles and bones become, and one small slip could cause major injuries requiring extensive and painful surgery.

3. Make sure their furnace is in working order and turned on

Have a service come out to check the furnace (before there’s an issue) to make sure it’s in working order. Also check the carbon monoxide detector and replace the batteries if necessary.

4. Connect with your loved one’s neighbors

Exchange information with them so that if you’re not able to get to your elderly loved one due to weather conditions, you can contact them to check in on your loved one.

5. Ask younger neighbors if they would mind checking the mail every few days

This will enable your family member to stay inside and avoid the possibility of falling and breaking a hip on the ice.

6. Put a list of emergency numbers on their refrigerator

Include contact numbers for non-emergency police, fire, immediate relatives and neighbors.

7. Create an emergency plan

If you are unable to get to your loved one during a severe winter storm, create a plan that includes who will check in on your loved one during the storm, where they will go in case of a power outage and who will be in charge of coordinating and implementing the plan. Make sure there are working flashlights with extra batteries and warm blankets around the house in case of a power outage.

8. Encourage fluid intake

Heating a home can cause the house to become dry and cause dehydration.  Pick up some bottled water to keep in their fridge. Remind them that sugary drinks, caffeine, and alcohol act as diuretics so interchanging those fluids with water is important.

9. Encourage your elderly loved one to wear layers and avoid going outside if at all possible

If they must go outside, ensure that they wear rubber soled boots/shoes for traction, and use an adaptive device such as a 3 prong cane for support.

10. Look out for Winter Depression in your elderly loved one

The cold and isolation can lead to depression, so it’s important to make regular contact with your loved one, and ask neighbors, friends and other family members to do the same. Regularly check in on elderly relatives, friends and neighbors in person if possible. If you live far away, contact another relative, neighbor or someone from their local church/synagogue who can stop by and check on them.

Read more on Depression in the elderly here:

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com. Adapted from: https://theworkingcaregiver.org

Dementia and Caregiving Challenges

You probably know that caring for a loved one with dementia won’t be easy, but these sometimes embarrassing and unfamiliar behaviors might drive you nuts.

Dementia and Caregiving Challenges

  • Dementia Sleep disorderSleep problems and caregiver exhaustion are two of the most common reasons persons with dementia are placed in nursing homes. Causes of sleeplessness in dementia patients include pain, lack of exercise and activities, anxiety, agitation, or too much fluid or caffeine late in the day.
  • Urinary incontinence is the second leading reason that families institutionalize their loved ones with dementia. Urinary incontinence in persons with dementia should be evaluated for treatable causes, including urinary tract infections, electrolyte and calcium abnormalities, prostatic hypertrophy, and estrogen deficiency. A regular toileting schedule at two to three-hour intervals or verbal prompting may also alleviate this symptom.
  • Agitation and aggressive behavior have been reported in 65 percent of community-dwelling persons with dementia. Reasons for agitation or aggression include overstimulation, physical discomfort, unfamiliar surroundings or persons, complicated tasks, and frustrating interaction, as well as more serious reasons as paranoia, delusions, or hallucinations.
  • Caregivers may be embarrassed or ambivalent about discussing inappropriate sexual behaviors exhibited by persons with dementia.
  • Persons with dementia are often reluctant to stop driving when safety is at issue.
  • Repetitious questions may be due to short-term memory loss and an under-stimulating/over-stimulating environment leading to anxiety, feeling out of control, or fear.

Also see:

Information for this blog cited from the Alzheimer’s Association and the American Medical Association

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from: https://theworkingcaregiver.org

Recognizing the Signs of Caregiver Burnout

You try to hide the feeling of being overwhelmed, however; caregiver burnout is serious and can lead to significant physical and mental health issues.  It is critical to know the signs and take steps to take care of yourself.

Here are some signs of caregiver burnout:

  • Overreacting to minor frustrations
  • The constant feeling of exhaustion
  • Loss of interest in things you use to enjoy/ isolation from social gatherings
  • Decreased work productivity
  • Increased use of alcohol/stimulants
  • Change in eating or sleeping patterns
  • Scattered thinking
  • Feelings of resentment towards the person you are caring for
  • Being short-tempered with family members

If you see yourself in any of these points you need to make some drastic changes NOW before it becomes critical.

Some Self-Care Tips:

Seek Help Emotionally:

Support group

Group therapy

Though it seems that you have no time to add another thing to your calendar it is important to make the time Group participants will understand how challenging the caregiving journey is and how hard it is, at times, to remain patient with the mental and physical decline of someone you love.  As well as how frustrating it is trying to “navigate the health care system”.

Get an “on-call” friend

Ask someone in your close circle of friends to act as a sounding board (sometimes just a venting board) so you can release the pent-up emotions without concern of judgment or criticism.


Sometimes writing things down can help you express your emotions. Sharing your emotions via a blog can help others in realizing they are not alone in their struggles with their care journey.

Consider counseling

This can assist you in dealing with the natural feelings that come with caregiving. Among these are anger, frustration, sadness, anxiety, and guilt. Some feelings are part of the grieving process you and your care receiver are experiencing. Unfortunately, many caregivers don’t take time for counseling until their caregiving days are over. (If you are a working caregiver, counseling may be provided as part of your health insurance package, so call your health insurance provider. Companies offering Employee Assistance Programs (EAP’s), may also cover counseling. Caregivers aged sixty or over may qualify for counseling under the Older Americans Act, Title III-B.)

Seek Help Physically:

Ask for help

If you have other family members in the area, call and ask them to help you with the care needs. Then LET THEM DO IT! Let go of the need to control because it is part of the cause of your burnout.

Respite Care

If you care for someone in a home setting you can hire a caregiver to come to the home to manage their care for a week or two. Consider scheduling a respite stay at an assisted living or skilled nursing facility.

Get a physical

Schedule an appointment with your doctor for a complete physical and KEEP IT. Though caregiver burnout feels more like an emotional issue, it can lead to serious health issues if left unmanaged.

Get away

Take a vacation, even if it’s just for a weekend or an overnight stay somewhere away from your regular hectic schedule.

Find ways to take care of yourself TODAY!  Putting it off will only continue the downward spiral which can lead to critical, life-altering decisions and behaviors. Read more about the Impact of Being the Caregiver.

takecontrolPlease note: If you are feeling overwhelmed and are afraid you will hurt your care receiver if you don’t find help right away(800) 971-0016 is a twenty-four hour crisis and information line.

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from: https://theworkingcaregiver.org

Practical Advice on Caring For a Parent with Dementia

Mental Health CareWhen a diagnosis of dementia is made, the physician is pivotal in providing the knowledge and resources that are needed to care for the patient. Because family members provide the majority of care for persons with dementia, they are an essential resource for the patient and the health care system. Making sure physicians who are overseeing medical care for your loved one understand your needs as a family caregiver and the challenges you face are essential aspects of caring for the person with dementia. A physician/caregiver/patient relationship is the recommended approach for meeting the needs of both you and your loved one.

Dementia Caregiving and the Health Care System

Physicians can provide a proactive approach to support by providing you with information about dealing with your loved one’s dementia symptoms, and linking you with resources (e.g., the Alzheimer’s Association). This can improve your capabilities as a caregiver and lead to more successful and enduring caregiving.

Make sure your loved ones’ physician:

  • Works collaboratively with their other physicians, nurses and/or social workers who are knowledgeable about symptom and behavioral management strategies;
  • Understands that you are physically, emotionally, and financially vulnerable;
  • Understands that to be an effective and knowledgeable caregiver, you often rely on physicians to provide information about dementia symptom management and the availability of support services.

5 Steps Caregivers can take to Prepare for Dementia Care Problems

Dementia and the Health Care System

Because dementia is a deteriorating condition that develops over an extended period of time, care problems can be anticipated and planned for well in advance. Use these tips to get started:

  1. The physician can help family members anticipate changes, plan for role transitions, and arrange for education and support that is needed to provide care.
  2. In the earliest stages of the disease, it is helpful for caregivers to identify a health care proxy for the person with dementia. Encourage the completion of a Durable Power of Attorney for Health Care form (your physician should have copies available in their office.) The copy of completed forms becomes part of patient’s record. (See What is a Health Directive for Dementia? for a downloadable dementia-specific health care form.)
  3. Caregivers need to maintain their personal health and vitality to provide continuing care for the demented patient. (see Recognizing Caregiver Burnout and Dementia and Caregiving Challenges).
  4. Caregivers should become familiar early in the illness with adult day-care services and in-home or in-facility respite services.
  5. It is helpful for caregivers to visit and evaluate several long-term care facilities well ahead of the need for placement. Understand that institutionalization may be a normal progression in the process.

Information for this blog was cited from the Alzheimer’s Association and the American Medical Association.

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from: https://theworkingcaregiver.org

This Job Sucks! Choosing the right Power of Attorney is imperative

Sibling Power of AttorneyWhile visiting with a friend who just lost his sister, he shared how difficult it was for him because his sister had chosen him (above her parents, children and other siblings) to be her Power of Attorney (POA). His sister was in the final stages of cancer when he had to make some very difficult decisions about her care at the end. Having spoken with her at length about what she did and did not want done to prolong her life, he followed her wishes and made decisions accordingly, which meant not approving a procedure that would have been very painful and would have done little to change the outcome of her prognosis.

Those who have never had to make potentially life/death decisions cannot imagine the strength it takes to make these types of choices, even if it is following the directions of your loved one to the letter.

As I have shared in my speaking and blogging, choosing a POA (and making sure it is the right person for the job) is imperative. (See What is a Power of Attorney?). However, being named as the “chosen one” has its burdens as well.

Here are just a few:

  • You may question why you were picked and wonder if you are the best choice;
  • Others may question why you were picked, thinking they would have been a better choice;
  • Knowing the right time/situation to step in to help someone in making difficult health-care decisions isn’t easy;
  • You need the strength to make difficult decisions IN SPITE OF your emotions and/or the emotions of other family members; and
  • You need the courage to make difficult decisions IN SPITE OF the criticism of those around you.

Sounds daunting but have heart; there is hope.

Family WishesHere are some steps you can take to encourage the person who has chosen you as the Power of Attorney, and to make the job a lot easier for yourself:

  • Have a very direct and serious conversation about what they want/don’t want in certain situations. Use these Proactive Questions as a starting point.
  • Ask them to write down in DETAIL what they would or would not want if certain situations were to arise (helpful tool – 5 wishes)
  • Ask them to share their decision to choose you with other family members (family conflict can arise when someone else thinks they are in charge, only to realize they were not the “chosen one”),
  • Respect your family members’ wishes by asking them to write them down in detail so you can follow their instructions and include them in the caregiving process.
  • Make sure that everyone in the family understands that this was their decision and that this is not about “favorites”, it is about who THEY FEEL is able to manage the care in the fashion requested by the assignee.

Important point!!

**Just because someone asks you to be his or her power-of-attorney does not mean you have to say “yes”.

You must be willing and able to follow their wishes IN SPITE OF your own thoughts, feelings or emotional connection and have thick skin and an unwavering spirit to face the potential hostile response/criticism that may come from other family members. If you do not think you can do that, you should be honest with them and graciously decline and share the reasons.

Written by Author and Keynote Speaker Sue Salach-Cutler. Sue has a Master’s degree in Gerontology and has worked in the healthcare field for over 25 years.  She is the Author of “Along Comes Grandpa”, a caregiving resource guide, and the novel “If I Walked in Her Shoes”. Her programs and books provide the vital resources needed to help family caregivers as they maneuver through the caregiving journey. Find out more about her books and programs here: CaregiverLife.com.  Adapted from: https://theworkingcaregiver.org

Geriatric Care Management for Adults with Schizophrenia

Drawing on our firsthand experience with the effects of mental health issues on a family, we focus our efforts on maximizing every support resource available.

Our first step toward achieving and Living Life With Dignity is recognizing what role mental health plays in a client’s life.

During an initial assessment with a client, the family and doctors, we learn which issues have been resolved and where struggles continue to occur. Following that meeting, an assessment is developed based on the results of that collaboration. We provide an assessment document highlighting recommendations for a life/care plan, as well as an affordable fee structure.

A life/care plan is then developed through additional, very specific client interviews and outreach to our network of community resources. Our associates work hand-in-hand with clients, their families and/or caregivers to make sure the plan works in everyday situations.

Case Study

Supporting adults with schizophreniaThis case study involves a 62-year-old female diagnosed with Schizophrenia. At the time, Alice* was living in a nursing home with outside advocacy. Alice’s father was appointed as her guardian after her mother’s death; however, health issues prevented him from assisting in her care.

Alice believes that her mother is still alive and that her family has faked her mother’s death. She was oppositional at first but is now compliant, although still delusional after a year of treatment. She suffers from mild paranoia and does not maintain activities of daily living unless prompted.

She was in a secure environment; however, her Attorney was concerned that she was not getting proper care. She needed clothes, toiletries and reading materials, and her father needed to be removed as guardian due to his competency issues.

  • Living Life with Dignity stepped in and provided the following services:
  • We were appointed as Alice’s Guardian;
  • We attended to all of her care plans;
  • We advocated for her legal rights;
  • We accessed her current mental health status to acquire a more appropriate living environment and facilitated her change in residence;
  • We secured outside professionals for additional evaluations; and
  • We visited regularly to ensure proper care and to provide companionship.

*Not her real name.

Do you have any questions about support and advocacy for adults suffering from schizophrenia? Post a comment below!

Guardianship of Adult Children

This article was kindly contributed to us by Roman J. Seckel from the Drendel & Jansons Law Group.

In my high school psychology class, my history teacher came and spoke to us one day about his disabled son. He read to us a short story in which he compared having a disabled child to a trip to Europe. The story began with a couple planning to go to Italy to tour all of the beautiful sights in Italy, however, instead of landing in Italy, the couple landed in Holland. While the couple was initially shocked at landing in Holland, they came to appreciate Holland’s beautiful landscapes, windmills, and tulips. In short, they found beauty and comfort in their surprise trip.

The surprise trip is an allegory to having a disabled child. Having a disabled child may be an initial shock; but, in the end, having a disabled child is as awarding if not more so, than having a non-disabled child. In working with many clients of disabled children, I have seen some great examples of parenting, and I have been inspired by them.

Inevitably, our children grow up, including our disabled children. One subject that gets little attention is how to protect a disabled child once he or she becomes an adult. This short article will help parents of disabled children understand the process of establishing guardianship of adult children.

Under Illinois law, a person who is 18 years or older is presumed to be an adult, regardless of physical or mental capabilities. Absent some determination of incapacity, a person who turns 18 becomes free to make decisions and be responsible for his or her own actions. An adult with significant disabilities, however, may be unable to manage his or her own affairs. Adults with significant disabilities are dependent on other people who need to have the legal authority to care for them, manage their affairs and make decisions for them.

The responsibility of caring for a disabled adult often falls on parents or other family members. Healthcare providers, including doctors, pharmacists, and therapists, require proof of legal authority for one person to make personal and healthcare decisions for another person who is an adult. Health care providers will not even discuss or share health care information without some waiver of privacy or other authority. The legal means to accomplish this is through a guardianship proceeding.

A guardianship proceeding is handled through the court system pursuant to the Probate Act (755 ILCS 5/11A-1 et seq.) The process begins by filing a petition for guardianship, obtaining a physician’s report and providing notice to the persons entitled to receive the notice who are identified in the Act (the closest adult relative including parents and adult siblings). Many counties have forms available online through the local clerk of the circuit court’s website.

After notices are given as required by law, an initial court date will be set in which the judge will appoint a guardian ad litem. The purpose of the guardian ad litem is to determine that a guardianship is warranted and that the proposed guardian is suitable. A guardian ad litem becomes the eyes and ears of the judge. A request can make to bypass the appointment of a guardian ad litem, which creates delay and increases cost Judges may waive the guardian ad litem appointment, especially when a natural parent is seeking guardianship before the child turns 18.

In fact, the entire process can be streamlined if it is begun before the child turns 18. Before a child turns 18, a parent still has legal authority over the child so service on the child is not separately required. Presumptions in favor of the parents apply, and the appointment is usually perfunctory. After a child reaches adulthood (18), judges are required by law to impose the procedural safeguards required for adults.

There are some additional considerations to bear in mind. Parents should consider establishing a special needs trust that will allow the disabled adult to qualify for government assistance while making assets available for things other than base support and health care. Divorced parents may want to discuss and plan for care for their child who is a disabled adult in their divorce decree. A disabled adult may be eligible for support from one or both parents under 750 ILCS 5/513. Unlike child support under 750 ILCS 5/505, the responsibility of the parents to contribute to the needs of their adult children is not set as a specific percentage of net income; rather it is determined by the financial needs of the child and the respective ability of the parents to contribute to those needs.

As with anything, advance planning and thought can save time, cost and frustration down the road. Caring for a disabled child who is now an adult can present legal obstacles that are not issues while the child is a still minor. Planning for the care and management of a disabled child’s needs before reaching adulthood is highly recommended. If you are beyond that point, and your disabled child has already reached legal adulthood, there is no reason to lose heart. The law provides a relatively easy means for establishing the authority for you to continue caring for your child and making the decisions that need to be made through the means of a legal guardianship.

Roman J. Seckel
Drendel & Jansons Law Group
111 Flinn Street
Batavia, IL 60510
(630) 406-5440
(630) 406-6179 fax

The Customized Sandwich Generation

Sandwich Generation caring for children and aging parents.If you’re feeling the squeeze of caring for your own children and your aging parents, you might liken the feeling to being “sandwiched” between the two responsibilities that are taking up most of your time.

The term “Sandwich Generation” has been around since 1981 when a social worker named Dorothy Miller coined the term to describe those individuals who were taking care of both their own children and providing some level of care for their aging parent(s). Since that time, numerous books and articles have been written about the subject from various perspectives.

This particular piece will extend the metaphor to discuss the specific components involved in the sandwich generation concept as though they are actual parts of a sandwich. The goal here is to give the reader a clear-cut understanding of what aspects must be considered when one takes on the role of sandwich provider; in this case from the specific standpoint of care assistance for the aging parent.

Creating the Sandwich You Want


The Financial: Figuratively speaking, the bread forms the outer layer of the sandwich and is the driver for which all other sandwich decisions are made. That is, the financial resources available in each individual situation largely determine the flexibility for building the rest of the sandwich. So, for example, if resources are available to afford specialty, artesian bread then chances are the aging parent will get the benefit of private pay in-home care or housing in a respected congregate care facility such as an independent or assisted living residence. If, conversely, white bread is all that can be afforded, then the family will likely be forced to cobble together an in-home plan of care that involves any number of family members and friends with little or no private pay care involved. On the residential side, the options are often limited to Medicaid providers at the skilled nursing level.


The Personal: For those taking on the greatest time commitment for providing care for an aging parent or parents and also trying to fulfill their own parenting obligations, finding time for self, which we refer to as the cheese of the sandwich, is an important part of maintaining balance in life. For many this can be a huge struggle. The amount of direct care that needs to be provided to the older adult (which often goes back to the financial bread of the sandwich) will help determine whether one can enjoy the benefit of a specialty cheese, i.e. carve out time for a structured activity of some type on a regular basis or be forced to economize with American cheese and find 15-20 minutes a day just to reflect and “breathe.”


One’s own health: Hand in hand with caregiving responsibilities can often be health problems that develop for the caregiver as a result of the burdens on him or her. Caregivers need to develop their own set of health practices which may include the consumption of some meat in their sandwich, e.g. maintaining fairly expensive health club memberships or similar set-ups, or they can choose to go the less expensive vegetarian route developing their own routines for maintaining the healthiest sandwich possible.


Career: Adding a job of any kind, in this case condiments, to the sandwich mix can be a double-edged sword. For some, a job can provide enough extra income to “tip the balance” in terms of the amount and quality of care the aging parent/parents will be able to receive. A job may also have some emotional and psychological benefits for the caregiver that gives him/her a role outside of the sandwich. Conversely, jobs can be a tipping point for caregivers by adding too much to their sandwiched lives and leading to an even messier sandwich.

Warm vs. Cold

Family: The final component of the sandwich involves “warm” versus “cold” options. Caregivers often find it difficult given all their competing responsibilities to maintain supportive relationships both with their own immediate family and their extended family (e.g. siblings) if any are involved. At the same time, it can be a big challenge to stay on positive terms with one’s aging parent(s) given that the caregiver may need to make unpopular decisions in providing care to them. The ideal is to serve the sandwich “warm” where all parties, including one’s own immediate family, extended family (if any), and the aging parent(s) all have a stake in the creation of what the individual sandwich looks and tastes like and in some way can benefit from its content on a regular basis. Alternately, when the sandwich goes cold for too long, i.e. neglect occurs in any parts of the system, it can quickly become unpalatable for those involved.

The five components outlined above tend to be the most common faced by sandwich caregivers balancing their own family responsibilities and those posed by their aging parent(s). The perfectly balanced sandwich will look different for every family, but every sandwich should have some part of all five elements. With effective planning, support, and some financial resources, caregivers can create a customized sandwich to meet the needs of their particular situation.

Living Life with Dignity offers comprehensive life planning and care management services to help you customize your sandwich so everyone in the family can enjoy it. From finance to health to personal care, there’s always room for support. We identify the most applicable, effective community services, networks and partnerships. Then we make those connections happen. We make sure that our clients and their families or caregivers understand not only what the options are but how to start using them right away.

What does your customized sandwich look like? What other ingredients would you like to add to your sandwich?