The Sandwich Generation

Sue (a pseudonym) partially blames her sister and brother for her panic attacks. The stress of caring for her frail 88-year-old mother creates the anxiety, but Sue believes her siblings aggravate it by their unwillingness to help.

Her sister and brother live out of state and claim hardship or that their lives are too busy when she asks for financial or emotional support. Although Sue’s brother came into town for 10 days last December, he visited his mother only once. He couldn’t stand seeing her deterioration.

“My sister and brother have just dumped this all on me,” Sue says. “They think I can handle it, but I’m drowning.”

Her mother suffers from dementia and needs constant care. But Sue, a retired government employee, cannot afford--and does not want--to remove her mother from her own apartment and place her in a nursing home. Medical insurance pays for home care three partial days each week, but the hours aren’t enough.

“I should have her stay with me but I know my limitations,” says Sue, who lives minutes away.

It’s common for one sibling to bear the brunt of caring for an elderly relative, says Dr. Gary Small, a geriatric psychiatrist and the Interim Director of the Center on Aging at UCLA. “Sometimes geography or an adult child’s personality is a factor. Generally, one sibling is more comfortable in the role.”

But, almost always, the caregiver is a woman. According to the Older Women’s League, a national nonprofit research and advocacy organization, daughters outnumber sons 3 to 1 in caring for their parents. Women, more than any other group, provide the physically and emotionally exhausting tasks of preparing their parents’ meals, administering medicine, managing their finances, driving them to appointments, cleaning their homes and grocery shopping for them. If necessary, their tasks include bathing and feeding their frail elders.

According to the Older Women’s League, the average caregiver to the elderly is married, female and 45 years old. Many women, for the first time in history, can expect to spend close to as much time caring for their parents--an average of 18 years--as for their children. The so-called sandwich generation refers to nearly 2 million women who care for their children and parents simultaneously and often hold down a job.

At first, Small says, caregivers give willingly of their time. Then resentment sets in. Then they start to realize that they may not be that far from their own senior years. “Will there be time for us to enjoy life, now that we have finally paid off our house mortgage and child’s college tuition? What about that trip we’ve dreamed of? There’s this reversal where we become parents to our parents and we’re not prepared for it emotionally.”

Christy, who also does not want her real name used, provided the strength for her mother when they finally decided to place her 95-year-old father, who has Alzheimer’s disease, in a nursing home. Christy’s sister lives locally, but she can’t face making the painful decisions about their father’s care.

“The day we left my dad at the nursing home, my mother and I walked out sobbing,” Christy says. “My sister should have been with us. I feel she has abandoned her burden to me because it’s easier and I’ve always been there.”

Like Christy, Ruth Bromberg, a facilitator in Marina del Rey for Children of Aging Parents, a national support group, was her mother’s primary caregiver before her death, although Bromberg had two siblings.

“I’ll never forget the day my mother sat on her bed in her apartment. Even though she had a housekeeper with her, she said, ‘Please don’t go. I only feel safe when you’re with me.’ Well, that’s the most devastating thing you can say to a grown woman who has another life, yet adores her mother.

“I said, ‘Mom, I can’t stay with you all the time. Do you want me to get a divorce? Do you want me not to see my children and grandchildren?’ And she said, ‘I know, I know, go, go.’ And I went with such a heavy heart.

“My sister was living in Florida. I would call and say, ‘You have to come, I need to get away. You’ve got to stay here for a couple of weeks.’ But she would always have reasons why she couldn’t. She’s a widow, so I could never figure out what held her back. I have a husband but she didn’t and there was no reason she couldn’t come here and stay for a while. So it was really frustrating and sad.”

It’s important to sit down with your siblings and discuss the situation, says Sandra Kessler, Los Angeles coordinator of Children of Aging Parents. “When you don’t make your feelings known, enormous hostility builds up that could evolve into eventual hatred. You are already losing what your parent once was. Added to that is the loss of a relationship with your sibling.”

But what do you do if you’ve talked it through and they still won’t or can’t help?

Then don’t dwell on it, Kessler advises. It’s a waste of energy. “If you are resentful and can’t do the task with feelings of duty or compassion--even duty is acceptable--then go out and scrub floors if you have to and hire someone to do the task.”

* Children of Aging Parents is a nonsectarian support group sponsored by the University of Judaism. For information, call (310) 476-9777, Ext. 215.