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.

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

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?