Sandwich Generation

Many years ago, I was part of what is called a “sandwich generation,” an expression generally used to describe people who are in middle age and have responsibility for the care of their children and their older parents. When I was in my 30s and 40s, I had two young children and an elderly mother (she was 77 when my youngest child was born). My mother was a widow, and had dementia beginning in her mid-70s. I worked full-time, and needed to arrange childcare and manage my household, at the same time that I hired home health care aides for my mother and managed her home care. We lived in different boroughs of NYC (she in Brooklyn and I in Manhattan) and my weekly visits were often a time and emotional drain.

My two older siblings had moved to Florida, so the primary responsibility for my mother’s care-giving and management was mine. I never resented this, it just seemed the way things needed to be.

My mother spent the last two years of her life in a coma in a nursing home, not requiring much care from me, although weekly visits were sometimes challenging, given the ongoing responsibilities I had for my own children. She died at 84. My children were still quite young then, and barely remember her.

I thought my sandwich days were over, and for many years they were. But now things have changed and I seem to be in a different type of sandwich.

My sister is older than me and has had dementia for about eight years. She lives in Florida and has been in “memory care” for two years. Her care is managed by her four children, all of whom live near her in Florida. I visit two-three times each year, and stay in contact with her children to learn about her health status. I hope this contact also helps support them in their loving care for my sister. It’s difficult for them, and me, to see her as she is now.

My husband has several health conditions, including pulmonary fibrosis, requiring constant supplemental oxygen, and a heart condition that puts severe limits on his energy and activities. I manage all his care and household needs, and he has an aide who comes to our home for several days per week, giving me time to see friends, shop, and do some of the cultural and other social things I had looked forward to in my retirement.

Our children are now happily married; they have their own children, good careers, and supportive spouses. At some point I may need their assistance with caring for my husband, but not yet.

I am fortunate to be relatively healthy. I go to the gym regularly, and my engagement in several hobbies and other activities helps me to maintain good cognitive functioning. But that is no longer true of some friends I have known for years. As I have gotten older, so did they.

One had a knee replacement and expects to have the other knee replaced soon. Another is staving off knee replacements by periodic injections. Both of them experience pain often, and have limited mobility. A friend who I made late in life was well when she had to start taking care of her husband with dementia.  When he entered a care facility she anticipated being free to do things without being the primary caretaker. He lived in the facility for about a year, and she was diagnosed with cancer within a few months of his death. She died about a year later. I still miss her.

I have two friends from college who were my roommates after we graduated, and we had wonderful, sometimes a little wild, times as single women in Manhattan in the late1960s and early 1970s. We often laughed about being able to blackmail each other! They both stayed in New York, and I have been in contact with them for over 60 years, even after we married and had children. Both became widows in the past few years, and now one has kidney and multiple organ failures and is on dialysis three times weekly. The other has disc and joint degeneration, must use a walker for mobility, and has too much walking fatigue to engage in activities outside of her home. 

So what kind of sandwich am I in now? Maybe it’s an open-faced sandwich, with just one piece of bread on the bottom, me, and with the food piled on top and around the sides. I am no longer in the middle of the sandwich, as I no longer have pressures or responsibilities for generations older and younger than me. I just have concerns about family and friends who are my age peers and have started to have health challenges.

I am trying to figure out what is happening!  Thankfully, some of my friends are well and I enjoy being with them and doing things together. But I can’t help wondering how long that will last. Are the serious declines of aging coming for all of them? For me? When will that be?

I feel growing concerns, and losses, from those I have known for many years, who are my age and have always surrounded me. And it’s not just their declines that sadden me. I fear losing the support they always gave me. As I experience my own changes, I sense that I will need them more than ever.