— It was challenging enough for Joy Robison to care
for her terminally ill mother while she lived only a few
minutes away. But when her husband accepted a job in
Minnesota last May, she had to fly back and forth to
Pittsburgh every couple of weeks, or pack her two young
children in a car and drive across the country to be
with her mother.
very thankful and very lucky I could spend the time in
Pittsburgh I did with my mother," said Robison, 41.
mother, Mary Robison, 76, died of cancer in October at
home in hospice care. Robison’s father, Jonathan, 71,
also is in poor health, which meant that most f
caregiving responsibilities fell to the couple’s only
fulfilling her responsibilities to her aging parents,
Robison was often unavailable to her own family due to
exhaustion and physical absence. Not only did she pile
up a hefty amount of credit card debt traveling, the
freelance designer also lost income while tending to her
mother’s needs and spending hours on the telephone
with nurses, social workers and family members.
emotional and financial stress experienced by Robison
and her husband, Ian Hargraves, 48, has become so common
that social scientists describe their demographic as the
"sandwich generation." Typically between the
ages of 40 and 59, these adults are raising children and
caring for aging parents at the same time they are
struggling to keep up with their own expenses and save
workers who counsel families in crisis say the
population of sandwich-generation families is on the
rise with no signs of slowing down in light of parents
living longer and more of their adult children waiting
until they are older to start their own families, which
could add up to a looming crisis for the next generation
to the latest research by Pew Research Center in
Washington, almost half of adults in their 40s and their
50s have parents age 65 or older and are either raising
a young child or financially supporting a child age 18
or older. And about 1 in 7 middle-age adults provide
financial support to both aging parents and children.
Pew survey was conducted three years ago with 2,511
adults nationwide, but the number of affected families
has been growing for more than a decade, said Stefanie
Small, a clinical social worker at Jewish Family &
Children’s Services in Pittsburgh.
population of sandwich families has increased over time,
particularly because children are getting married later
and parents are having children later," said Small,
a 16-year veteran social worker who began working
closely with Robison and her mother before the illness
disabled the older woman.
Family & Children’s Services handles care
management. Since Robison could not be around all the
time, it was reassuring to her that social workers were
visiting her parents once a month to talk about their
situation and answer insurance questions.
her father already suffering from multiple sclerosis,
Joy knew as an only child, she was better off planning
ahead for her mother’s terminal diagnosis," Small
said. "The emotions I see caregivers experience
most often is guilt and a lot of resentment, because
often the child becomes the parent.
if the older adult and their adult children had
discussed what they all wanted and needed when everyone
was healthy, you rarely have a crisis because they
of the conversation involves the costs involved in the
long-term care and if the parent will move in with the
caregiver or maintain a separate home. Robison obtained
a power of attorney from her mother to make medical and
financial decisions on her behalf.
thing that is problematic with the sandwich generation
is they reject the title of caregiver," Small said.
"They see themselves as being good children. But
they are caregivers and they don’t take advantage of
all the services available for caregivers, such as
private duty in-home care. These are paid people who do
personal care, transportation and companionship."
management is not covered by health insurance. As a
nonprofit, Jewish Family & Children Services charges
$75 an hour. Private care management companies often
charge $100 or more an hour.
get a lot of spouses taking advantages of these
services," Small said. "A lot of children feel
they must do these things themselves."
financial pressure faced by caregivers in the sandwich
generation often takes a heavy toll on their ability to
Fertig, a vice president at Fragasso Financial Advisors,
said a 50-year-old head of household earning an average
salary of about $50,000 is unlikely to be able to put
aside enough savings to retire at age 65 if sandwiched
between raising children and supporting parents.
they’ll have to work longer or redefine what
retirement is going to look like," Fertig said.
"That could mean living on less or going into some
kind of part-time work to continue some type of income
stream in pseudo-retirement."
recommends asking a financial adviser to lay out what
the retirement picture looks like if they put a specific
amount of money in a retirement account on a regular
basis. Then see how those numbers would improve if they
were to add 10 percent more.
realize what sacrifices they need to make now or later
in retirement," Fertig said. "It’s not an
easy topic to bring up. There’s a lot of emotion
involved. But sometimes seeing the financial projections
on paper can be an ice-breaker."
Stoltzfus, a manager in the office of work, life and
engagement at Johns Hopkins University in Baltimore,
said one aspect of her work is helping university staff
and faculty members navigate challenges while they are
care for aging family members.
responsibilities can include transporting parents to
doctor’s appointments to staying up late at the
emergency room the night before work. Sometimes
employees have to negotiate with their managers for more
caregivers also pay for some of the caregiving needs to
be met," Stoltzfus said. "Not only are they
not able to make more money, they are spending more in
new career opportunities come along, many caregivers don’t
have the emotional capacity or time to take on more
challenging roles, even if it would mean more pay.
Lower-income workers might not be able to take extra
shifts or work overtime.
caregivers may be hesitant to reveal this aspect of
their life, Stoltzfus said.
they are seen as someone with a lot of personal issues,
they may not be given important projects and
opportunities," Stoltzfus said. "But by not
being forthcoming, they could lose out on some
opportunity for support because they may have a
sympathetic manager or team. They may also miss out on
benefits offered by their employer for caregivers."
said some companies offer referrals and counseling
through employee assistance programs. Others may offer a
home-care providers for a limited number of days. Some
also pay for consultations with aging-life-care
professionals who can help a family map out what needs
to happen in terms of long-term care.
services may be offered at larger companies, she said.
"But small companies can offer flexible work
schedules and telecommuting, which can be just as
helpful to caregivers."
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and Hargraves have two children — a son, 9, and a
daughter, 6. Hargraves works at the Mayo Clinic in
Rochester, Minn., as a service designer. Robison is a
freelance designer of print and brand strategy work.
her job gives her flexibility, it was difficult to build
a clientele in Minnesota when she was always in
Pittsburgh or preparing to make another trip.
worked through both my children’s babyhoods,"
Robison said. "But I feel this health care
challenge was way more difficult. With parental health
care, there’s a 24-hour aspect of not being able to
make plans and know you won’t have to change plans.
You’re in crisis mode all the time."