From Dr. Jane's Notebook

Challenges of the Sandwich Generation

Life is truly an amusing series of cycles that echo the notion, "turnabout is fair play". Who would think, as children, that one day we would be caring for our parents just as they have cared for us. When we are young, our parents help us walk and talk. They attend to our every need. When they are old, we help our parents walk and talk, and we attend to their every need. Eventually, everything from food, housing, clothing and even diapers goes in reverse for those who live long enough. Many in the sandwich generation agree that while its not so easy being in the middle of the sandwich, its also not easy to lose the bread. While some middle-aged kids complain, others care for their aging parents with extraordinary love. To them, the opportunity to care for their parents in their elder years is indeed an honor.

What’s the secret of surviving your parents’ aging? Here are a few thoughts on the subject.

Distinguish between life and death. Unfortunately, death is inevitable and it is often preceded by illness, pain, and a great sense of loss. When the pain felt by the care-giving loved one is so great, we enter into a state of anticipatory mourning. We feel torn between our desire that our loved one not suffer, but we also feel guilty for any thoughts that resemble the wish for a hurried death. Sometimes we begin the mourning process upon learning that the diagnosis is terminal. Unconsciously, we may shut down our feelings as a way to cope with the pain.

Address your fears about your own aging process. When our parents lose various capacities, a great sense of helplessness sets in. They feel helpless and embarrassed, and because we can’t fix their problems, we too feel helpless. This often leads to fear that someday we will be in a similar condition, which then leads to anger and frustration. Many care takers have described the irrational feeling of wanting to "shake them out of it". We are sure they could try harder to be well and feel better "after all we’re doing for them..."

3. Apply the golden rule. Even loving family members are often not nice to those who are in firmed. We talk about them rather than to them. We make decisions for them rather than with them. We over-estimate their disabilities and under-estimate their capabilities. But then, we often think that babies don’t understand what’s going on either. All too often, we equate intelligence with language and the ability to communicate. Immigrants for whom English is a second language get the same treatment. But consider how you’d feel if you became hard of hearing or lost your ability to speak; would that make you less intelligent?

4. Set an example for your children. Now is your opportunity to train your children in how to treat you a couple decades down the road. Teach them to be tolerant. Teach them to be loving and kind. Teach them to include seniors in decision making. Teach them to be respectful. All of this is taught by your example and through dialogue about these issues. Its never too early to start this discussion. There’s a bumper sticker around town that reads, "Be nice to your children, they’ll be picking out your nursing home".

Parents: Be nice! Unfortunately, there is one sure-fire way to upset relationships. When aging parents become frustrated and angry at their plight, they often take out that frustration on their children. When this is the case, its not so easy to be nice. For this reason, I implore aging parents to appreciate the care they receive from their children. If taking care of a parent feels more like punishment than a good deed, both parent and child lose out on the opportunity for great final memories of a loving relationship.

Facing the reality of aging and death is not easy. However, as humans live longer, we will have to learn more about achieving excellence in this area. We need to learn how to handle this stage of life skillfully and well. Like so many other stages of life, the more we learn, the fewer mistakes we’ll make and the less we will regret. I predict the need for a whole new set of family life education skills in the 21^st century. Perhaps they’ll be called skills for guilt-prevention

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