The Customized Sandwich Generation

Updated: May 6, 2019

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?

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