The term, “sandwich generation” refers to people who need to take care of both their children and aging parents at the same time. The National Institutes of Health (NIH) estimates there are around 2.5 million sandwich caregivers in our country.

Those who are doing it know how difficult it can be. Over time, a University College London (UCL) study shows, this kind of double-duty responsibility jeopardizes the mental and physical health of sandwich caregivers.

The research involved analyzing data from approximately 2,000 sandwich caregivers and 2,000 non-sandwich caregivers in the United Kingdom taken from the UK Household Longitudinal study between 2009 to 2020.

Sandwich caregiving can be physically exhausting, emotionally draining and expensive.

Also known as “Understanding Society,” the UK Household Longitudinal Study follows the lives of individuals and households in the United Kingdom over time, which enables the researchers to analyze changes in social and economic factors, as well as family dynamics.

The team tracked the mental health of both non-sandwich carers and sandwich carers using the General Health Questionnaire which assesses issues such as concentration, sleep and feelings of emotional strain. Physical health was also measured, using the Physical Component Summary, and covered aspects such as mobility, pain and limitations in daily tasks. The study focused on the period before, during and after becoming a sandwich-carer and then used statistical models to compare the two groups — sandwich carers and non-sandwich carers. The research team found:

  • People between the ages of 30 and 49 were most likely to be sandwich carers.
  • Parents who became sandwich carers experienced a significant decline in mental health. This was especially true for those who dedicated over 20 hours per week to caring for their parents compared to non-sandwich carers.
  • Sandwich carers' decline in mental health lasted for several years.
  • Physical health also declined among those sandwich caregivers who devoted over 20 hours of attention per week to an aging parent.
The authors emphasize that it's important to recognize the effect sandwich caregiving has on individuals and to support those affected. “Our study highlights the significant mental and physical health challenges faced by sandwich carers,” lead author, Baowen Xue of UCL Epidemiology & Health Care, said in a press release. “These individuals, who balance the demands of caring for both their children and ageing parents, often experience a decline in their well-being. It's crucial that we recognize and support the unique needs of this growing group to ensure their health and resilience.”

People between the ages of 30 and 49 were most likely to be sandwich carers.

Sandwich caregiving can be physically exhausting, emotionally draining and expensive, according to Mental Health America, an organization that advances the mental health and well-being of people living in the U.S. through public education, research, advocacy and public policy. It offers these tips:

  • Be honest and direct about your feelings. Approach caregiving conversations with as much patience and grace as possible, and let your other family members know that their help is both wanted and needed.
  • Share what you are going through with others. You can do this in whatever way feels right to you — with a support group, a therapist, a trusted friend or in a journal that no one will ever read. Putting your thoughts and feelings into words is a great way to start processing them.
  • Make sure you're attending to your own needs. Although your child and parent may need you, you're in a highly emotional situation and deserve to take care of yourself.
  • Try not to be too hard on yourself. You are in a uniquely challenging situation, and doing the best you can looks different each day.
  • Acknowledge all that you have done. Know that if you've fallen short on some things here and there, following through on the big things is what matters.

The study is published in Public Health.

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