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Role Reversal and the Sandwich Generation

Posted by Valerie Henderson on Jul 16th 2020

According to the Family Caregiver Alliance in San Francisco, more caregivers are hospitalized due to burnout than medical conditions. The reason is clear: Caregivers put themselves last. If you lucked out in the parental lottery, your mom and dad placed your well-being first for many years. They put food on the table, provided you with a safe place to sleep, and carted you to school and activities. Naturally, many adults feel a strong desire to return the favor by caring for their own parents at the end of their lives: Serving them meals, providing a cozy place to live, and taking them to medical appointments and family events.

We love a caprese panini. Or a tuna melt. Or even a simple turkey club. (Now we're hungry.) But one sandwich is a bit tougher to swallow: Being stuck in the middle of raising children while caring for your own parents.

If you lucked out in the parental lottery, your mom and dad placed your well-being first for many years. They put food on the table, provided you with a safe place to sleep, and carted you to school and activities.

Naturally, many adults feel a strong desire to return the favor by caring for their own parents at the end of their lives: Serving them meals, providing a cozy place to live, and taking them to medical appointments and family events.

But doing all of that while also raising one's own family and possibly even working full-time comes with a big price tag. According to the Family Caregiver Alliance in San Francisco, more caregivers are hospitalized due to burnout than medical conditions.

The reason is clear: Caregivers put themselves last.

Put on your own mask first

Just as airline passengers are instructed to don their own oxygen masks before helping people around them, caregivers need to look after themselves first. Signs of overload include feelings of guilt, anger, and resentment, and those negative emotions aren't helpful to anyone.

D. Helen Moore, MD, a gerontologist at the University of South Florida, says that "Even the most dedicated workers need an occasional vacation, and this is especially true of caregivers. A burned-out caregiver cannot provide quality care."

We know that taking an actual vacation is an impossible feat for most caregivers (and, well, most Americans in general in the current climate), but geriatric social worker Suzanne Alexander recommends a few preventative measures that can have the same effect.

  • Divide and conquer. Periodically step back, take a deep breath, and pause for a moment to truly assess what your loved one's needs are today and in the future. Write everything down, prioritizing and dividing tasks according to what you must do personally and what you can delegate. "Maybe it's important for you to take Mom shopping, but it's not so important who takes her to the senior center," Alexander says.
  • Turn inward. Alexander then recommends making a list of your own needs, starting with the personal. "Protect the time you have with your spouse and children. If you get on a (metaphorical) treadmill, it's easy to find every minute scheduled, with nothing left for you. You need to find something that feeds you, like a walk, reading, solitude, dancing, exercise, and schedule that in."
  • Reach out. "The American character is 'I can do it by myself.' If people offer help, let them do so. Offer specific things they can do, whether it's vacuuming, cooking, or watching your loved one so you can have some time to yourself."
  • Call in the reinforcements. If, in addition to practical help, you find yourself in need of human contact, invite two friends or relatives over at the same time. Let one cook and look after your loved one (and even your kids) while you and your other companion talk, take a walk, and savor your freedom; then take a walk with your other friend when you come back.
  • Just say no. Set reasonable expectations, and don't try to be all things to all people. Learn to say "no" in cases where you used to say "yes." Don't have time to contribute to that bake sale? Let someone else whip up the snickerdoodles. Hate being a part of a book club? Consider the chapter closed.
  • Be mindful of destructive habits. "Watch out for destructive ways of coping such as drinking too much, misusing medication, or overeating." Alexander advises. "Seek medical advice or treatment if you are experiencing changes in your health such as blurred vision, stomach ailments, or high blood pressure."
  • Ask HR. If you're employed, find out if your company has an employee assistance program (EAP) you can use for counseling and other support programs. You may qualify for benefits under the Family and Medical Leave Act, which provides up to 12 weeks of unpaid leave to care for a family member. And in states like California, working caregivers can receive up to 55% of their wages for six weeks of leave per year.

Still not enough?

As Beth Witrogen McLeod, who shared her touching story of simultaneously caregiving for both of her parents, relates, "Despite its many rewards, including sharing love and developing inner strengths, caregiving can be overwhelming. When caregivers expecting to do this work for the short term find themselves in it for the long haul, self-care is often left out of the equation."

McLeod says that she fell into a clinical depression for a full year after her parents' deaths. "Although I did everything I could to give them the best possible care, I never budgeted time for myself. I didn't realize that by ignoring my physical and mental health during two years of intensive caregiving, I was setting myself up for a breakdown that would take another two years to recover from."

If you get to a point where you feel incapable of continuing on in your current situation, you may need to hire help from a home health agency or consider placing your loved one in residential care. Never lose sight of the importance of your own health, especially if you're raising kids of your own.

Suzanne Mintz, former president of the National Family Caregivers Association, says "We remind caregivers that your whole life is not caregiving. You are separate from the person with the illness. You choose to be there because of your love or sense of duty, but as an individual, you have a right to wellness and to love yourself. When you have to be a caregiver, you have two choices: You can fall apart or you can find inner strength."

Having written for companies ranging from MTV to the Winter Olympics, Valerie Henderson spearheads Carewell's communications and PR efforts. A resident of majestic Park City, Utah, Valerie enjoys four of the things her region is most famous for: hiking, independent film, a giant family, and incredibly weak beer.

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