The first time I encountered the moniker ‘The Sandwich Generation’ is when my colleague Kristin Hodnett wrote about these folks in an article for my company/publication/brand. I was interested in the economic wellbeing of female upstarts in the (also a moniker) Gig Economy. Turns out the females who really needed my concern are those of the sandwich generation — women who are caregivers for both young children and ill parents. Because I have recently become a caregiver for an ill parent, I immediately identified with these folks.
Upon further investigation the Sandwich Generation also (and mainly) claims women from 40–59 who are caring for aging parents while still financially responsible for adult children who cannot sustain themselves since the economic downturn. In each situation, one of the ‘pieces of bread’ is not behaving as their ilk has in the past. Yet they’re not entirely to blame, which is what makes this an unfortunate cultural phenomenon for all and virtually unbearable for the middle of the sandwich.
I’ve often imagined a familial joy one might garner from a household that brings so many generations together. More love, more participation, interest, activity, community. You know, what we see on sitcoms. If the obvious must be stated: reality is starkly different from what you see on TV. Throw in financial hardship, anticipatory grief, anxiety, panic disorder, caregiver stress, caregiver burden, and layer upon layer of familial emotional psychodrama hardened and crusty from the years but lava hot in the middle, topped like whipped cream with resentment for whichever party could have avoided this or could fix it (the kid who won’t leave his parents’ basement, or the father whose alcoholism and addiction catapulted him penniless into early dementia). That’s probably more like reality.
In a study conducted by the Pew Research Center, 75% of respondents under age 40 said that taking care of elderly parents is a responsibility. In this same study, respondents in the sandwich generation actually reported their level of happiness to not be any different. So maybe those sitcoms are not wrong — not entirely. Community, family, togetherness — these have a much more positive impact than isolation, which is shown to potentially shorten lifespan.
Isolation. This is a key factor in caregiver burnout, characterized by The Cleveland Clinic as ‘a state of physical, emotional and mental exhaustion. It may be accompanied by a change in attitude, from positive and caring to negative and unconcerned. Burnout can occur when caregivers don’t get the help they need, or if they try to do more than they are able, physically or financially. Many caregivers also feel guilty if they spend time on themselves rather than on their ill or elderly loved ones. Caregivers who are “burned out” may experience fatigue, stress, anxiety and depression.’
What can cause caregiver burnout? Overwhelming demands. Some caregivers place unreasonable burdens upon themselves, in part because they see providing care as their exclusive responsibility. Some family members such as siblings, adult children or the patient himself/herself may place unreasonable demands on the caregiver. They also may disregard their own responsibilities and place burdens on the person identified as primary caregiver. In turn, the primary caregiver often feels they “a lack of money, resources and skills to effectively plan, manage and organize their loved one’s care.”
So, even if you have family and community, quite often, they dissolve into coffee once there is a ‘primary caregiver’ identified. Once good and isolated and burdened with the entirety of the responsibility, the primary caregiver finds they are not equipped with proper resources, information, knowledge, or tools to actually perform this role. It’s as if the primary caregiver is a sacrificial lamb of the family. They are offered up in a foolish half-hearted attempt at blind faith — ‘if we give you the soul of our sister, then this whole thing will be okay, right? For the rest of our lives we’ll just whisper behind her back how she’s never been okay since this whole thing but it will never rise to full-throated concern, kay?’
The sad thing is, it actually works.
Here’s my question: if you are the lamb, and you don’t want to be the lamb, and you see it happening and identify it, can you stop it?
Can you stop and turn things around with sheer will? Can you ask for help loud enough that, in the words of Bob Dylan, ‘someone thinks they’ve really found you?’
Or, is the responsibility not actually on you to ask for help? Is it society’s responsibility to anticipate you? Is it our elected representatives’ responsibility to enact policy that supports you? Is it the health care system’s responsibility to see you as an at-risk person, as a patient as well as the one in the hospital bed?
I’m done with sacrificial lambs, and I’m done with people who offer up sacrificial lambs. Everyone who is silent, who watches what is happening and does not stop the sacrifice, is complicit.
Who are the sacrificial? Who needs help? The isolated and the stressed, studies find.
What determines who is stressed, or what causes stress? The human response to a stressor has two parts. First, a stressor is appraised by the person — ‘how do my abilities match up to its demands? Can I take this on?’ The answer is yes if the person determines they have control over the stressor, or, they see the stressor as temporary. If the person determines they do not match up to the stressor, they employ coping mechanisms — perhaps the strongest of which being a social support network. In times of stress, both acute and chronic, social support has been shown to lower blood pressure, strengthen immune response, and decrease the secretion of stress hormones. Social support has been shown to prolong life in breast cancer patients (Spiegel, 1993), reduce the risk of suicide among HIV-positive men (Schneider, Taylor, Hammen, Kemeny, & Dudley, 1991), and reduce the risk of a second heart attack (Case, Moss, Case, McDermott, & Eberly, 1992). In contrast, social isolation has been associated with higher death rates in a number of large-scale prospective studies of the general population (e.g. Berkman & Syne, 1979;House, Landis, & Umberson, 1988).
Isolation — or the degree to which someone feels isolated — is the number one key factor in how stress will effect them, even to the level of how likely they are to be for whom the bell tolls.
Isolation is the key factor, and isolation is something that we can influence. This is encouraging! However, the sacrificial lamb thing comes from bystanders allowing someone to be isolated. If an isolated person has access to globally activated allies, there’s a chance in hell they can transcend.
