Sandwich Generation Caregivers: Struggling Between a Rock and a Hard Place (Blog 6/3/25)

Did You Know About the Sandwich Generation?

If you’re wondering where the term “sandwich generation,” came from, it’s been around since the early 1980’s. Coined by two women, (Dorothy Miller and Elaine Brody who first introduced the term in the areas of social work and gerontology) it initially referred to adults (primarily women in their 30s) caring for their own children and their aging parents simultaneously. Over the years, the term has broadened as the faces of family caregivers have changed to include both men and women, primarily ranging from 35 to 55 years old. Similarly, the population of people being cared for has expanded to include not only elderly parents and young children, but older children, grandchildren, and grandparents as well. However, the concept remains that the caregiver is “sandwiched” between caring for at least two of these generations at one time.

Needless to say, caring for one generation at a time is challenging enough. But caring for two or more generations simultaneously, comes with heightened levels of stress, overwhelm, anxiety, and financial challenges. Keep in mind most of these caregivers also work in addition to their family caregiving responsibilities. This adds another dimension of struggles to their daily activities. Perhaps a guest on our ieadvocate podcast said it best when she referred to her role of being a sandwich generation caregiver as more like a “panini.” A powerful metaphor for sure!

To get a clear picture of some of the difficulties faced by sandwich caregivers, let’s take a brief look at the real-life responsibilities of a caregiver, Tina. Although the circumstances you are about to read about are real, the caregiver’s name has been changed to protect her privacy. If you are currently a family caregiver, or have been one in the past, you may have experienced similar situations during your journey. Think about what you did or would do if you were in Tina’s dilemma – struggling between the rock of her job and the hard place of doing what’s best for her family.

Emotional Stress

Tina is a divorced mom of a 13-year-old son in junior high school. She is a senior executive at a large company in New York City and commutes from her home in New Jersey to work. In addition to her son, Tina also cares for her aging mother who has a terminal illness and lives with Tina as well. Today, Tina was scheduled to kick off the company’s Global Executive Leadership Summit that is being held at a hotel near her Manhattan office.

When Tina awoke this morning, she was exhausted after having been up through most of the night tending to her mom who was running a fever. As she started to get ready for her day, she realizes that her mother’s condition has gotten worse. Her fever is dangerously high. Before she can even think about her next move, she gets a call from the health aide she hired to care for her mother during the day. The aide informs Tina that she has food poisoning from dinner out the night before and can’t come to work today. To round out this spectacular morning, Tina’s son informs her for the first time that he is being bullied by a group of boys at school. The thought of going to school today triggers an anxiety attack. 

This scenario illustrates one of the major challenges of sandwich generation caregivers – emotional strain. Indeed, juggling between the pressing needs of aging parents and children often leads to the sandwich (or “panini”) caregiver experiencing burnout and guilt. (“The Impact of Family Caregiving on Mental Health and Well-being,” American Psychological Association.) 

Financial Challenges

In this situation, Tina has hired professional health care staff to care for her mother during the day while she is at work. This brings up another area of caregiver stress – financial concerns. The most current data indicates that the average cost of in-home nursing care in this country is between $3175 and $5853 per month (based on $30.00 per hour). Of course, these numbers can vary across states and depend on the range of services that need to be performed. Tina is fortunate because she can afford to hire in-home health care support for her mother. However, this is not the case for most sandwich caregivers. 

Many are dealing with having to pay not only the expenses of caring for an elderly parent, but daycare for a pre-school aged child as well. According to findings in a new report, Care.com 2025 Cost of Care Report, US families are spending 22% of their household incomes on childcare expenses. Interestingly, the US Department of Health and Human Services has established 7% of household income as the affordability benchmark for childcare costs. There is a huge gap between desired affordability and actual costs for childcare services. Trying to bridge this gap can have a critical financial strain on sandwich caregivers and their households.

Food for Thought

By now you are probably wondering how Tina handled her dilemma. Right? Wait for it…Okay, what Tina decided to do to address her challenging situation is not really our point. Our point is that in this country, as many as 11 million sandwich generation caregivers can easily find themselves facing similar circumstances on a consistent basis. Keep in mind that this blog highlights only a few of the many difficulties that sandwich caregivers face in their day-to-day roles of caring. Others include recurring stress from job and family responsibilities, draining of personal time to care for their loved ones, and lack of sufficient self-care. These can lead to serious health consequences for the caregiver and can negatively affect the people they care for as well. 

Our purpose in writing this blog was to raise awareness regarding the level of daily stress working sandwich caregivers are susceptible to as they try to meet their work responsibilities, care for their elderly parents and their children. The impact of these conflicts is felt by their employers in the form of absenteeism, presenteeism and attrition. As our elderly population continues to grow and our professional health care staff continues to diminish, decisions of employees to switch to part-time roles or leave their work to fill the void seem inevitable. Clearly, we need a systemic approach to address this caregiving crisis that involves stronger leave policies, more employee-centric workplace cultures and practical solutions that will work for the long-term.

Until the next blog!

Thank you for being here, for reading and for caring!

References

• Mental Health America, Caregiving and the Sandwich Generation, (2025).

• Pew Research Center, More than Half of Americans in their 40s are sandwiched between an aging parent and their own children, (April 8, 2022).

Seniorliving.org, The Sandwich Generation, by Barbara Field, (Updated Jan 31, 2025)