Sandwich Generation Caregivers: Pulled in Too Many Directions


Alzheimer’s caregivers as well as many other types of caregivers are constantly pulled in countless directions. Doctor’s visits, picking up medicine, paying bills, and managing patient hygiene can become a massive undertaking for a caregiver—especially one who still maintains full-time employment. This is consistent with the findings of Sherman and Bauer (2008) regarding the family pressures that exist among caregivers that maintain the dual responsibilities of working in the traditional job sector while providing care for elderly relatives suffering from Alzheimer’s.

What about “my” personal life?

In addition to working and being a caregiver, many of these individuals also have their own families to care for, and that side of life includes additional doctor’s visits, finances, and social activities for the caregiver and their own children. This is what’s called the sandwich generation: where individuals are not only working, but also caught in between caring for aging parents and children at home (Hamill, 1994).

Roots (1998) suggested that caregivers in the sandwich generation face an average of 18 years of caregiving for aging parents. According to the Alzheimer’s Association (2012), 30% of caregivers have children under the age of 18 who are living at home with the caregivers; those caregivers are often called the “sandwich generation” (p. 29) because those caregivers simultaneously provide care for two generations (one older and one younger) while also attempting to continue part-time or full-time work responsibilities.

A recent study by Washington (2014) showed that the demand for caregiving left minimal time for caregivers to spend with their own children and grandchildren to do things such as attending sporting events, dance recitals, etc. Restriction noted by study participants included the lack of time for other family and personal responsibilities outside of the attention needed by the Alzheimer’s patient. Over 80% of respondents stated that there were other demands on their time that conflict with their caregiving duties.

How do I try to achieve a balance with this additional responsibility thrown into the mix?

According to Washington (2014), patient needs place restrictions on the time of the caregiver. Boekhorst et al. (2008) noted that as the symptoms of Alzheimer’s disease progress in the patient, the time requirements that they need for care increase. The implication for the caregiver is additional personal sacrifice of time for work and personal home and family activities while maintaining the dual role of caregiver. The post-diagnosis life expectancy for an Alzheimer’s patient is between four to about eight years in duration (Alzheimer’s Association, 2013). However, because of the usual life expectancy for the patient, the caregiving duties are limited in terms of the time that the caregiver is managing the dual role.

Overcoming the emotional and physical strains of caring for the patient at home will require the caregiver managing the dual roles to reach out to other family members or professional service organizations for support and assistance. This respite care is of utmost importance in order to prevent caregiver burnout.

Small steps such as asking a neighbor for help with the kids or asking a family member to sit with the patient for small increments of time can be a big help. Programs such as the National Family Caregiver Support Program (NFCSP) are available to caregivers, but the caregivers themselves must reach out and take advantage of such programs.

Caregivers must realize that continuing to push their own health to the limits is neither good for themselves nor the patients for which they provide care. Understanding that caregivers are committed to taking care of the patient and neglecting their own health may give the appearance of a noble cause, however, in some cases the sacrifice may have fatal consequences for the caregiver, and the end result is the patient being cared for by another source anyhow.


Alzheimer’s Association. (2013). 2013 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia, 9(2), 1-71.

Boekhorst, S. T., Willemse, B., Depla, M. F., Eefsting, J. A., & Pot, A. M. (2008). Working in group living homes for older people with dementia: The effects on job satisfaction and burnout and the role of job characteristics. International Psychogeriatrics, 20(5), 927-940. doi: 10.1017/S1041610208007291

Hamill, S. B. (1994). Parent-adolescent communication in sandwich generation families. Journal of Adolescent Research, 9(4), 458-482.

Roots, C. (1998). The sandwich generation: Adult children caring for aging parents. New York, NY: Taylor & Francis Publishers

Sherman, C. W., & Bauer, J. W. (2008). Financial conflicts facing late-life remarried Alzheimer’s disease caregivers. Family Relations Interdisciplinary Journal of Applied Family Studies, 57, 492-503.

Washington, K. (2014). Caregiving full-time and working full-time: Managing dual roles and responsibilities (1st ed.). Liberty, IN: WestBow.

Dr. Keith Washington

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Dr. Keith Washington understands the challenges facing working caregivers. His book, “Caregiving Full-Time and Working Full-Time,” aids readers in understanding and managing the role of working full-time while caring for a loved one with Alzheimer's disease.

Caregiving and Working Full-Time

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