The other day I was discussing Personal Care Home options with Sue, an adult child of one of our new clients. Her mother was about to be discharged from a hospital to a care community. An important consideration for Sue was to choose a facility that would be convenient to visit her mother regularly. Our staff was able to help Sue to feel good about her choice of a care community that will allow her to visit her mother en route home from her job, and still get home with enough time to have dinner with her family.

Sue’s goal and challenge of having dinner with her family caused me to reflect back to when my wife, Marcia, and I were active caregivers, visiting our now-deceased parents, while also raising our two youngest teenage children. When I described myself to Sue as a survivor of The Sandwich Generation, I couldn’t be sure if the tear in her eye was an emotional indication that The Sandwich Generation was resonating with her personally, or if reflected extremely compassionate pity for our children being forced to survive on only cold cuts and PB&J. The Sandwich Generation image might help some people to understand the emotions of caregiving, but it might seem to others to be only a description of a second-rate menu of convenience for a busy cook’s family.

I explained to Sue that The Sandwich Generation is a label for Baby Boomers who are responsible simultaneously for the care of their children and parents. Members of The Sandwich Generation live through the everyday challenges of being in the middle of competing demands from both ends of the family spectrum. So even if, on a busy night, Sue’s family is served pizza instead of BLTs or tuna melts, she is included as a member of The Sandwich Generation.

Carol Abaya, who has copyrighted the term The Sandwich Generation, has categorized three different types of Sandwiches:

“Traditional Sandwiches” are those who are between aging parents who need care and their own children.

“Club Sandwiches” are those in their 50s or 60s who are between aging parents, adult children and grandchildren, or those in their 30s and 40s, with young children, aging parents and grandparents.

“Open Faced Sandwiches” are those who are otherwise involved in elder care, which can include those of us who once had more bread in our sandwich as a family caregiver.

I can’t recall exactly when I first heard about The Sandwich Generation, but I’m guessing it wasn’t until sometime early in the 21st century that the term became relevant to me. Wiki attributes the first use of the term to a 1981 article by Dorothy A. Miller. I appreciate the creativity of both ladies, Abaya and Miller, but the Sandwich metaphor doesn’t quite cut it for me.

I think of a sandwich as being two pieces of identical but otherwise mostly inconsequential bread, with the primary subject being the substance filling the middle. Think about it. When you order a BLT on rye, which is most important? How many restaurants first advertise the bread they have available, then list the filling options? “I’ll take the whole wheat sandwich. OK, sure, put some turkey with mayo inside the wheat.” And I’ll bet you have never said: “Give me the BLT with a slice of rye and a slice of whole wheat.”

Usually the parents’ and children’s caregiving needs are very different from each other, not at all like two pieces of sandwich bread from the same loaf. Marcia and I sometimes felt toasted after caring for our parents and children; and our time together was sliced pretty thin while all that caregiving was in the middle of our marriage. So, maybe the Sandwich image works better for me if I think of our caregiving roles as being like the Sandwich bread. Because it rarely seemed that the caregiving needs of both our parents and children were easy to manage between us, we were more like a Dagwood Sandwich, hard to handle with caregiving needs stacked high.

If you aren’t nauseated from trying to imagine whether your caregiving experience is more like a bologna and cheese on wheat than liverwurst on rye, maybe you have an appetite for a few caregiving facts which are commonly attributed to the Pew Research Center: 1 of 8 Americans aged 40 to 60 is both raising a child and actively caring for a parent; and an additional 7 to 10 million adult children care for their parents from a long distance. A July 2012 caregiver profile by the Pew Research Center shows that while caregivers come in all varieties, they are likely to be college educated women between the ages of 30 and 64.

It’s not surprising that Pew’s research found caregivers to be more inclined than non-caregivers to have issues in relation to blood pressure. The Pew research did not factor a caregiver’s diet into the study. But Pew’s suggestion that caregivers report having symptoms of extra stress is not hard for me to swallow.

Don’t you agree that it’s pretty hard to digest and enjoy even the best sandwich without a cold beverage to help wash it down? Maybe Keystone’s role as an Elder Law firm is better understood as a Coke than as Abaya’s Open Faced Sandwich. Things go better with Coke!

Dave Nesbit
Attorney

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