“The Sandwich Generation” Challenges of Caring for.ppt

“thesandwichgeneration”:challengesofcaringforparents,children,andyourself,dr.katherinel.fioridernerinstitutemarch20th,2012,“thesandwichgeneration”,thetermdescribingagenerationofpeoplewhocarefortheiragingparentswhilesupportingtheirownchildrenmerriam-websterofficiallyaddedthetermtoitsdictionaryinjuly2006tendtobeinthe40to65yearsofagegroup,but.,generation,orsituation?,“thesandwichsituation”:genderdifferences,75%ofcaregiversforolderadultsarewomentypicalsandwich-situationmember=workingfemalecaringforbothagingparentsandchildrentypeofassistanceprovidedmenfinancialsupportwomenemotionalsupportanddailytasks,outline,challenges(andjoys)ofmidlifetruthormyth?(i.e.,whatdoestheresearchshow?)areallifeexampletipsandtoolscaringforyourparentscaringforyourchildrencaringforyourself,challenges(andjoys)ofmidlife,psychologicalatransition,notacrisis(formost)questioningthepastandfacingthefuture(“generativity”)increasingpositiveemotionsmorelikelytoacceptwhoyouareandfeelmoreinchargeofsituationsandresponsibilitiesphysicalincreasingbodyfat,highbloodpressure,increasingcholesterol,“thesandwichsituation”:truthormyth?,brody(1981):“womeninthemiddle”themeofcaregivingresearchbutisitreal?debate:istherereallyahighincidenceandprevalenceofthisdemographic?arethesemultiplerolesnecessarilystressful,and/orcouldtheybesatisfying?,demographictrends,peoplelivelonger(moremidlifeadultshavesurvivingparents)peopledelaymarriageandhavingchildrendeclinesinfertility(fewercaregiversavailable)moreadultchildrenarechoosingtoliveathomeduringcollegeyearsproportionofmidlifewomenintheworkforcehasincreased,thesandwichsituation:actualprevalence/incidence?,44%ofmarriedindividualsaged35to44bothlivewithchildrenandhaveatleastoneparentinfairtopoorhealth(marks,1998)33.9millionamericans(16%)providecareforanolderfamilymemberparentcare+dependentchild+working=8%ofamericanwomenandmen(rosenthaletal.,1996),thesandwichsituation:actualprevalence/incidence?,anewyorktimesarticlefrom2008reportedthatthereare20millionamericans(mostlywomen)whoarejugglingresponsibilitiesfortheirownchildrenandtheiragingparentsatthesametime53%ofthosewomenreportedfeelingforcedtochoose(atleastonceaweek)betweenbeingtherefortheirchildrenorbeingtherefortheirailingparentspewresearchcenter:1outof8americansaged40to60areraisingachildandcaringforaparentalthoughthemajorityofadultsarenot“sandwiched,”itwilllikelybecomeincreasinglyprevalentgivencurrentdemographictrends,thesandwichsituation:goodorbad?,holdingmultipleroles:rolestraintheoryvs.roleenhancementtheoryvs.rolecontexttheoryrolecontexttheorycaregivingmasteryforwomenin50sand60s,butnotinlate60sand70sforwomen,caregiving+workcaregivingaloneintermsofpsychologicalwell-beingformen,helptoparentsdistress,butlesssowhencombinedwithemployment;helptoadultchildrenandparentslifesatisfaction(womenlessaffectedbymultipleroles,eitherpositivelyornegatively),thesandwichsituation:goodorbad?,insum,psychologicalhealtheffects(negativeorpositive)aresmallcaringforparents,inparticular,canbeanunexpected,unpredictable,andfrustratingstressoritisanonnormative,unanticipateddemandifthesandwichsituationisviewedincreasinglyasnormative,copingstrategiesmaybepositivelyinfluencede.g.,havingastrongsenseofsupportandcarefromcommunity,usingacceptancestrategies,focusingonpositiveoutcomesbutrecentresearchshowsthattheremaybenegativehealtheffects(chassinetal.,2010),thesandwichsituation:goodorbad?,thenot-so-goodfeelingsofbeinginthesandwichguilt,resentment,fearandanxiety,angerandfrustration,confusion/ambivalence,depression/sadnesstornbetweenloveandresentment,betweendutytoparentsanddutytospousesandchildren,betweenwantingtodotherightthingandnotwantingtochangetheirlivesthegoodfeelingsofbeinginthesandwichhonor,respect,pride/joy,lovethewiderangeofemotionsiscommonwhencaringforanagingparentandbeing“sandwiched”,a“reallife”example,thesandwichgeneration,tipsandtools:caringforyourparents,maladaptivefunctioninginadultrelationshiplikelystemsfrommaladaptivefunctioninginearlierrelationshipforgivenessmustbeconsciouseffort(self-awareness,personaltherapy,activereflection)rolereversalemotionalturmoildisappointment,anger,guiltanxietyoverparentsmortalityandworryabouttheirownmortality,tipsandtools:caringforyourparents,makingdecisionaboutcarelocationputtheminthedriversseatletthemparentyoubringintheexpertsifhiringaprofessionalprovider,getreferences,andcontactthem!ifyoudonthavemoneytopayforprofessionalhelp,anddontfeelcomfortableaskingfriends,turntovolunteerschurches,seniorcenters,4hclubs,hscommunityserviceorganizations,collegesthattrainnursesandsocialworkers(likeadelphi!)letvolunteerssortmail,gogroceryshopping,dolaundry,paysocialvisits,helpthematmealtime,drivethemtoappointments,tipsandtools:caringforyourparents,beproactivetrytoinvolveparentinday-to-dayhouseholdtasks/chores,evenifverysimplewipingofftableafterdinner“supervising”thechildrenscheduled/spontaneousactivitieswithgrandchildren“specialmoment”eachday,separatefromchildren,tipsandtools:caringforyourparents,ifparentisinanassisted-livingcenterornursinghome,gettoknowotheradultchildrenwithfamilymembersthereuseonlinetoolstogethelpwithhealthcareissuese.g.,webmdoffersa“askthedr.checklist”takeadvantageofassistivetechnologyifinsurancecompanysaysno,askdoctortowritealetter,tipsandtools:legalintervention,legalinterventionmaybecomenecessarywhenparentscannolongerhandletheirownfinancialandpracticalaffairsmentallycompetentparents(capableofmakingdecisionsandunderstandingconsequences)bankaccountheldjointlywithadultchildlivingtrustortrustaccountwithautomaticinheritancepowerofattorneydeclarationoflegalincompetenceguardiancontrolswardspropertyandpersonadultsshouldspecifyinadvance(i.e.,inawill)thepersontheywanttoactasguardianincaseofbecomingmentallyincompetent,tipsandtools:caringforyourparentswithdementia,dementia:developmentofmultiplecognitivedeficitsincludingmemoryimpairment12+illnesseswithsimilarsymptomsbutdifferentcauses(alzheimersmostcommon)ratedoublesevery5yearsafterage75,with8.5%ofpeopleages85to89affected;milddementiaaffectsalmost30%afterage90researchershavefoundthatapersonwhoprovidescareforsomeonewithdementiaistwiceaslikelytosufferfromdepressionasapersonprovidingcareforsomeonewithoutdementia,caregiverburden,tipsandtools:caringforyourparents,tocopewithimpendingloss:stayinthemomentmanageyourownfearsaboutdeathanddying(counseling?)manageyourownfeelingsaboutthepastexpressyourloveoften,ifyoucanremembertosaywhatneedstobesaidnowbewithyourparentwherehe/sheiscelebratesmallthingsreminiscefindjoy,tipsandtools:caringforyourchildren,talkwithchildrenandpreparethemneedforsupportfutureplansandadjustmentlovefinancialwoes:beingfrugal,cuttingcosts,andteachingchildrenavaluablelesson,tipsandtools:caringforyourchildren,takemomentsouttoexpresshowmuchyouloveandvalueyourchildren(“specialmoment”eachday)sitwithchildatbreakfasteverymorning(routine)sayawordofpraiseeachmorningputanoteinyourchildsbackpackhavedinnerconsistentlyatthesametimeeverynightwhenpossiblehelpwithhomework(dontnag)assignchores,andgivepraisewhentheyaredonehaveaconsistentbedtimehourandsitwithchildwhenhe/shegoestobed,caringforyourchildren:warningsigns,pre-school/elementarykids:withdrawndepressedisolated(cantgetthemtoopenup)regressive-thumbsucking,soilinganxious-clingy,poorsleep/eating,irritablefrequentfighting/aggression/actingout,caringforyourchildren:warningsigns,middleschool(andbeyond)sleepingpoorly,nightmaresdepressed/withdrawnavoidance(schoolbus,lunchroom,absenteeism)anxious-pacing,nightmaressubstanceabusesomaticcomplaints:headaches,stomachaches,visitstothernofficeoftenfrequentfighting/aggression/actingout,1-800-lifenet,tipsandtools:caringforyourself,dontbeamartyrself-pityisunhelpful(negativitydoesnotchangethesituation,onlydepletesenergy)donotdoitalone;askforhelp!why?canprovideanopportunityforrelief(respite)thepersonwhoisaskedwillfeelneededcaregiverwillfeellessisolatedrecipientofhelpmaybenefitfromhavinga“fresh”helperletgoofunreasonablyhighstandards,ifnecessaryreturnfavors(ifyoucan)andgive“thankyou”s!,tipsandtools:goodnewsaboutaskingforhelp,researchshowsthatcaregiverswithadequatecommunitysupportreportmanydimensionsofpersonalgrowth!moreempathic,caring,understanding,patient,compassionate,closertopersontheyarecaringfor,moreappreciativeofowngoodhealth,tipsandtools:caringforyourself,takerespite:yearlyvacation,plusweeklyanddailyrespitenurtureyourpartnerestablisharoutinebutexpectinterruptionaskemployerformoreflexibleworkschedule,possiblyleaveprovisionsfamilyandmedicalleaveactof1993counseling,onlinesupport,self-helpgroups,tipsandtools:caringforyourselfdepression,caregiversareatparticularriskformildtoseveredepressionsymptoms:changeineatinghabits(unwantedweightgainorloss)orsleeppatterns(toomuchsleepornotenough);feelingtiredallthetimelossofinterestinpeopleand/oractivitiesthatoncebroughtyoupleasurebecomingeasilyagitatedorangered;feelingthatnothingyoudoisgoodenoughthoughtsofdeathorsuicide,orattemptingsuicideongoingphysi