Strength for the Sandwich Generation

by Kristine Bertini

Author Kristine Bertini Isbn 9781598843644 File size 1MB Year 2011 Pages 144 Language English File format PDF Category Family and Friendship This comprehensive instructive and entertaining book is full of information and resources for middle aged adults faced with the complexities of raising children while caring for elders Utilizes instructive case examples to expose the intricacies of challenges like simultaneously caring for children and elders Contains a bibliography of more than

Publisher :

Author : Kristine Bertini

ISBN : 9781598843644

Year : 2011

Language: English

File Size : 1MB

Category : Family and Friendship

Strength for the
Sandwich Generation

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Strength for the
Sandwich Generation
Help to Thrive While
Simultaneously Caring for Our Kids
and Our Aging Parents

Kristine Bertini

Copyright 2011 by Kristine Bertini
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, except for the inclusion of
brief quotations in a review, without prior permission in writing from the
Library of Congress Cataloging-in-Publication Data
Bertini, Kristine, 1955–
Strength for the sandwich generation : help to thrive while simultaneously
caring for our kids and our aging parents / Kristine Bertini.
p. cm.
Includes bibliographical references and index.
ISBN 978–1–59884–364–4 (hard copy : alk. paper) — ISBN 978–1–59884–365–1
1. Sandwich generation—United States. 2. Middle age—United States—
Psychological aspects. 3. Middle-aged persons—Family relationships—United
States. 4. Caregivers—United States. I. Title.
HQ1059.5.U5B375 2011
646.70 8—dc22
ISBN: 978–1–59884–364–4
EISBN: 978–1–59884–365–1
15 14 13 12 11

1 2 3 4 5

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This book is printed on acid-free paper
Manufactured in the United States of America

For my husband, William J. MacKilligan
There is no one I would rather be sandwiched with . . .

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ONE: Introduction: Multigenerational Caregivers


TWO: Midlife Challenges


THREE: Our Children


FOUR: Our Parents


FIVE: The Self and the Importance of a Plan


SIX: Finances


SEVEN: Creating Meaning in All Stages of Life


EIGHT: Conclusion


Afterword: The Author’s Story


Appendix A: Resources


Appendix B: The Caregiver’s Creed






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This book could not have been written without the grand presence of
my father, George E. Bertini. He is the greatest caregiver of all the ages.
I salute you, Dad. I bow to him and all the other kind souls who care for
loved ones against all odds and with the deepest love imaginable.

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Introduction: Multigenerational
When we think of a sandwich, the best part is what is found in the middle.
The filling between two pieces of bread might be rich roast beef, tuna,
vegetables, cheese and ham, or any number of main events prepared to
delightful perfection. We look forward to what falls between the two slices
of bread, and the sandwich is noble for its ease of preparation and ability to
be modified to every preference. Yet we do not often spend much time
thinking about the sandwich, or the fillings. We take the sandwich for
granted. And that is not unlike our failure to appreciate the Sandwich
Generation, millions everywhere all around us, caregivers that are a staple
in society today, sustaining families and fulfilling so many basic needs, with
no fanfare.
Of late, more attention has been given to the phenomenon of the Sandwich
Generation: individuals who have come to midlife and find themselves
“sandwiched” between their children and their aging parents, nurturing,
providing for, and filling what can seem like nonstop, too numerous, and
maybe even overwhelming needs of both their offspring and their elders,
most often while carrying career demands and household chores, to boot.
The Sandwich Generation is the filling, the variable that often keeps the
family together, nourished in every way, and running. These individuals
come in all shapes and sizes and from differing backgrounds and histories
and have varying philosophies. While their differences may be profound


Strength for the Sandwich Generation

in terms of culture, finances, education, and emotional resources, they have
many things in common in their role as multigenerational caregiver.
It is significant that more than 50 million Americans are considered to be
middle-aged. This number constitutes at least one-fourth of our population.
This group of Baby Boomers “earns most of the money, pays the bills
and makes many of the decisions. Thus, the power in government, politics,
education, religion, science, business, industry, and communication is often
wielded not by the young or the old, but by the middle-aged” (p. 231).1
During midlife, many people come to terms with their life, and they
solidify their self-identity during this developmental period. Traditionally,
at midlife, individuals have often found their life partner, may have been
divorced, have solidified their professional life, and have had children.
Others are less traditional; they may have decided not to wed, have children, or focus in one area of employment, but they also have developed
a strong sense of who they are in the world. Still others may enter midlife
without having come to terms with their life path, and they may not yet
have solidified or embedded their identity.
Erik Erikson, a pioneer in research on the stages in the life cycle, identified the period of midlife as one in which individuals develop either
generativity or stagnation. He described the person who has a strong sense
of creativity, is successful, and is making a mark on the world with the
term “generativity.” This person is also concerned with the next generation, and Erikson called the virtue associated with generativity “care.”
Love is given without expectations of a specific return and is connected
to the generations to come. Too much generativity, however, can lead to
overextension, which creates unhappiness in that the individual has no
time for himself because he is so busy. According to Erikson, individuals
who do not develop generativity will experience a sense of stagnation.
These people can be self-absorbed, be unconnected to others, and tend to
offer little to society. Too much stagnation may lead to a failure to create
any sense of meaning, a state that Erikson called “rejectivity.”2
This book details the challenges one faces at midlife as an individual. It
also explores the many challenges of the multigenerational caregiver, who
is trying to nurture and care for both children and aging parents. Sandwiched
between one’s children and one’s elders, the midlife individual may reach a
healthy generativity or may burn out or stagnate. The challenges at midlife
may be huge, so this book offers hope, and a concrete plan of action, for
the overwhelmed caregiver.
Much like the traditional sandwich, whose filling is the best part, midlife
can be the best part of one’s life journey. Midlife is not the beginning, when



we are struggling with basic trust, autonomy, competence, and identity
issues. Nor is it the end, when we face the impending demise with either
wisdom or despair.3 Midlife and multigenerational caregiving can be that
middle place, and as spicy, sweet, or mild as we choose to make them. This
book is designed to help the caregiver focus on what is good during what
can be a stressful period of life and find joy.
Interestingly, the Sandwich Generation is now officially registered within
the National Special Events Registry, which marks a national observance
annually each July 1–31. According to the Pew Research Center, just over
one of every eight Americans aged 40 to 60 is both raising a child and caring
for a parent, in addition to between 7 and 10 million adults who are caring
for their aging parents from a long distance. Projections from the U.S.
Census Bureau indicate that the number of Americans aged 65 or older will
double by 2030, to 70 million. Currently, more than 42 million women fall
into the range of the Sandwich Generation.4
The tasks of multigenerational care for the midlife individual may seem
overwhelming. There can be children of varying ages still in the home—
from youngsters to adolescents and even young adults—who make up
one side of the sandwich. On the other side, there are aging parents, who
come with their own complex set of needs. Many elderly people have
physical and mental challenges that they do not have the resources to
cope with on their own. Thus, each side of the sandwich needs help from
the filling to survive and succeed. The midlife individual, in the middle,
attempts to be all things to both sides, children and aging parents, to make
the sustenance work. At the same time that the midlife person is managing
her own life, relationships, and profession, she may also be attending
sports events for her children, helping with homework, making meals,
and putting a finger in the dike of the typical daily crises of the children.
While doing this, she may also be caring for one or both parents: scheduling and providing transportation to doctors’ appointments, attending to
the demanding needs of the demented parent, and providing assistance
with physical needs that ranges from cutting toenails to dressing, bathing,
giving medications, making meals, and feeding.
Americans have come to expect longer lives; thus, more midlife individuals have parents who are still living, and more of these parents are contending with chronic diseases from Alzheimer’s and arthritis to cardiac
conditions, diabetes, osteoporosis, and hearing or vision loss. In addition,
women are deciding to have their children at later ages, so their parents
are older at the same time that their children are younger than was the case
in years past. Many midlife women are also choosing to adopt; thus, they


Strength for the Sandwich Generation

are parenting into later life. Most women in the Sandwich Generation work
outside the home, making it even more challenging to balance both work
and the needs of their children and parents.5
According to Charles Pierret, up to 33 percent of 45- to 56-year-old
women are caring for both their children and their parents. He noted that
only a little more than 1 percent of this group has both parents and children living with them, so the care provided to elders often also involves
time-consuming travel.6
The financial resources used to support and care for both children and
elders must also be considered. Monetary outlay can be considerable.
Younger children living at home require new clothes, braces, driver’s education, and tutoring and need monies for extracurricular activities and a
multitude of other routine expenses. As these children get older, college
payments loom and are more significant now than ever before, with tuition
skyrocketing at the same time more and more careers are demanding
degrees. Financial support of an elder may also be significant if the elder
has not planned for retirement, for chronic disease care, or for simply
living as long as we do today. The midlife caregiver may find himself
paying for a parent’s groceries, home cleaners, medical care, insurance,
prescriptions, home safety devices, and general upkeep. Some elders
may require in-home assistance, and if the caregiver is working, this also
must come out of the family budget.
Living arrangements for the elderly parent may be in question. Does the
adult daughter choose to have the parent(s) come to live with her? How
will this impact the dynamic of the primary relationship with her partner
and with the children still at home? What about space? There are certainly
pros and cons for having the elderly parent come to reside with the family
that need consideration.
This book maps out a guide for those at midlife who are struggling with
these considerations and more. It offers a plan for sanity while balancing
the challenges of being a multigenerational caregiver and gives concrete
suggestions on how to nurture oneself while caring for loved ones. It
addresses the complexities of caring for parents with whom one may have
had a negative life experience, and it explores ways to manage life with a
demented parent.
This discussion begins by exploring the tasks at midlife and the psychological impact of reaching the middle of our years. It is crucial that one
has in place the foundation for identifying the strengths and weaknesses
of the self at midlife before the caretaking of others can be fruitful. Unless
the self is wholly recognized and nurtured during the middle years, the assistance to others will be filled with resentment and will be ineffective.



The book reviews the parenting of children during midlife and the
special joys and trials that are faced as skinned knees are bandaged, proms
are celebrated, and children are launched into young adulthood. Next, the
complications of caring for elders are discussed within the context of
the family. Relational bonds are examined, forgiveness is addressed, and
the creation of a balance between children and parents is explored. Helping
all generations of the family to create joint meaning as days dwindle for the
elder is also discussed.
Embedded in this work is a chapter that assists the individual at midlife
in finding ways to nurture himself and his primary relationships. It spells
out a concrete plan that can help him manage each piece of the multigenerational caregiver package during midlife and offers worksheets on
which to design one’s own individualized plan from the suggestions that
are offered.
A discussion of the life cycle in different cultures provides a new lens
through which to look at how others in the world care for their children
and aging parents. The phenomenon of the need to be loved and cared
for permeates all societies and cultures and provides common ground to
look at the midlife role. A section is included on meaning at each stage
of life and the practice of creating rituals, celebrating, and remembering.
This is an important chapter that assists readers in weaving their world
and families together throughout the generations.
Finally, national and regional resources are identified as potential sources of help for the multigenerational caregiver.
This author is a midlife caregiver to multiple generations. Some days it
seems hard to simply survive. Some days there is a joy that is unimaginable, although this may last for only a brief second until the next task
appears. I write this book from a combination of research and my own
experiences to assist the many others who are experiencing much of the
same exhaustion and delight that I do. My hope is to help others expand
the moments of delight so that they overpower the exhaustion and to
coach others to give in to the exhaustion when it is needed and care for
the self.
Here is my brief story. I am 55 years old, clearly at midlife. I work fulltime as the director of busy health and counseling clinics at a midsized
university. I am an author. I am married and have young stepdaughters, ages
10 and 11. I have two elderly parents who live in our home with us. My
mother is 78 and has Alzheimer’s; my father is 82 and is sharp as a tack,
but he has been in and out of the hospital with a multitude of illnesses,
including a broken hip. Adding to the family constellation are our three
Ragdoll cats. So, you see, I understand. While your life story may differ


Strength for the Sandwich Generation

from mine in significant ways, the underlying context of being a caregiver
remains consistent between you and me. We are universal in our roles,
and creating the most gracious and loving way to be who we are is my
heartfelt goal for this book.
I am up in the morning at 5:30; my husband (a saint) does the morning
duty with the children and gets them their breakfast and off to school or
camp as I head out the door to work. I never leave without seeing them
or kissing them good-bye, but I do not have the luxury of sitting at the
breakfast table to enjoy the morning with them, which is a great regret
of mine. My father and mother rise later on their side of the house, and
Dad prepares breakfast for Mom, cuing her to wash up, bathe, and eat.
During each day, Dad tries to take Mom out for a ride or visit. My dad is
an amazing fellow who has the patience of an angel, as my mother cannot
be left alone, experiences paranoia, and must be cued to do any task. Dad
tires easily, and Mom does not nap, a common trait of Alzheimer’s
patients, so it is challenging. Dad refuses home help, as he is proud. I am
afraid for him, for them, all the time.
During the day, I call to check in. Work is a blessing; it is my respite.
My profession is exciting and rewarding, and the days are full. In the early
evening, my workday at the clinic begins to wind down, and I get ready to
propel myself home. I am the evening “everything-for-everybody.” If I
am lucky, I get home before the kids, change into my scruffies, set the dinner table, and start the meal. Mom wants to help, which doubles the time
of any task. She places silverware helter-skelter; stands in the center of
the kitchen, her favorite spot, so I have to walk around her; and wants
me to look at a picture of her childhood for the 18th time that evening.
Dad has gone to the computer room to play solitaire for a bit of respite,
very much deserved. I understand his choice in computer games. Within
a few minutes, the door crashes open with joyous kids, dirty from the
playground and filled with stories of the day, both talking at once and
vying for my attention. “Kristine, Kristine, Kristine, Kristine!” How many
times can a child say my name in a minute? My husband fumbles in the
door behind the kids and looks disheveled and faded from his day. I know
I am the one on prime duty. I start the laundry and clean the litter boxes
while the dinner cooks, and the kids trail me from room to room, saying
“Kristine, Kristine!” My mother also follows and tries to “help.” It’s about
now that I want to hop a plane for the islands. I take a deep breath. We say
grace and eat. Dinner is a lovely time; the kids take center stage on the
nights they are with us, and my parents enjoy their interactions with them.
We share our day, and on special nights, we all have a scratch lottery
ticket and share stories about what we would do if we won.



I was once told that doing something that doesn’t work over and over
again expecting a change is a sign of insanity. Well, by the time dinner
is over, I must be insane—because every night the same things happen.
After the kids clean their places and go to start their homework, the men
sit at the table and talk. Mom “helps” by again standing in the middle of
the small kitchen, so I have to continually move around her with dishes,
garbage, and glasses. Every night I say (I should just make a recording),
“Mom, could you clear the table for me instead of standing in the middle
of the room?” And she gets hurt. And I feel badly. And she remains in the
middle of the room. And I want to really get on that plane.
I then get my parents’ bed ready for nighttime and put out my mother’s
nightgown. I tell her it’s time to get on her nightgown, and every night she
says she doesn’t have one. So we go and find it—placed out for her, as
always, on the bottom of her bed.
Then it’s time for the kids’ homework and baths. I don’t know about
you, but if you really want to feel dumb, try doing a 10-year-old’s math
homework. I have a doctorate and can’t figure out their math. In some
ways, this gives me a break because then they take the math to their father.
Otherwise, we do spelling, English, social studies, and special projects.
With luck, no one has a meltdown (including me). During this time, I also
fold laundry, make school lunches, check work email, make bedtime
snacks, and return necessary phone calls or pay bills. Family games come
next: kids’ choice. This ritual is a good one, and we all have fun unless
someone is overtired and cranky (again, including me). Then I have a
scheduled hour with Mom in front of the television while she drinks
a glass of cream sherry and I drink three glasses of wine. (Well, give me
a break!) By now, it’s nine o’clock, and I escort Mom back to her side
of the house with Dad. I look at the cats and say, “Sorry, I just can’t play
tonight.” They give me a dirty look.
Back at our side of the house, we all say prayers, and I go to my bedroom and collapse. I don’t think I’ve looked at my husband all night and
remind myself to kiss him in the morning. The kids stay up later than I
and read or watch television; sometimes they crawl into bed with me,
and we talk or read together, but I am usually the first one asleep. I wake
up the next morning with Dorie, the stuffed fish from Finding Nemo that
forgets everything, under my arm.
So you see, I do understand. And I generally love my life. My plan for
this book is to create a way for you to love yours, too.

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Midlife Challenges
She throws herself face down into the hammock and tries to curl up into a
ball and become as small as she can. The tissue she grabbed on her way
out of the house is soaked and ragged from her tears. She lets herself
cry, deep sobbing tears that make her nose run. She can feel the breeze
under her bottom from the hammock, and it feels good as she tries to settle
into the rhythm of the wind and her sobs.
The house is full. Her husband is in the kitchen, preparing dinner for
nine. She had made the week’s menu out and posted it on the refrigerator,
done the grocery shopping (two full carts, pulling one and pushing the
other), set the table, run errands, and made sure the kids were washed
for dinner and one child ready to head out to soccer practice as soon as
his plate was clean.
The meltdown was inevitable, even welcomed. On her drive home from
work, she had known it was coming; it would be just a matter of when and
what might set her off. On the front lawn, her in-laws had been sitting with
her parents, enjoying each other’s company. She had served them iced
drinks (she kept thinking that one of them might notice that she was running
in and out of the house and say they were all set, but no). Out of the four
parents, only one of them could still hear, so there had been a lot of shouting, saying “What?” and repetition. Her father uses a walker and her
father-in-law is in a wheelchair, so movement of any sort is a challenge,
and it takes time to get anywhere. Both mothers are still spry and maneuver
well, but with their aging has come a sense of entitlement, and they do little

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