The Sandwich Generation: Managing stress and anxiety while caretaking for others amidst COVID-19

The Sandwich Generation is a term frequently used for individuals who find themselves simultaneously responsible for caring for their children and their parents. Typically, the transition from child, to adult-child, to parental caregiver is a fluid process in which the child and older adult develop and accept their new roles within the family system. The child who once sought physical, emotional, social and financial support is now the caregiver. The caregiver – whose primary identity for decades has been to love, nurture, guide and support their children – now finds themselves in a place of dependency: needing physical, social, emotional, and in some cases financial support from their loved ones. The varying emotions that ensue as both parties reconcile their new roles and identities (denial, worry, fear, sadness, and anger) eventually will be accepted. The dynamics within the family system will change, a new normal will be created, and the identity of caretaker and dependent will ultimately shift. Ideally, the adult child will have the opportunity to reciprocate the affection, nurturance and emotional bond that was instilled in them by their parent.

An unanticipated casualty to this transition from child to caregiver has been the worldwide pandemic of COVID-19.  Almost overnight the terms older adult and elderly have been plastered all over the internet, television and news outlets with a picture of an active individual at the ripe old age of 65.  For many families, 65-year old adults have children in their 30’s and 40’s, and grandchildren in elementary school. Suddenly middle-age adults with young children are faced with the mortality of their parents, and the risks associated with contact with others. Social distancing prevents us from providing the love and nurturing we have always known, causing fear and isolation, vulnerability and panic.

What is the typical response to fear and anxiety? Control. But we cannot control what we don’t understand, and  – in the case of many who have found themselves a part of The Sandwich Generation for the first time in the past few weeks – we cannot understand family roles that have not been negotiated. So, how do we provide support to our older loved ones while still caring for our children? Consider these tips:

  1. No one likes a lecture. No matter how old they are, they are still your parents. There is a hierarchy and power dynamic. Lecturing them on expectations about social distancing and the importance of staying inside will only lead to anger and feelings of disrespect. Instead, make it easy for them to stay home. Drop off meals and groceries, offer to pick up their prescriptions or other essentials, and educate them on the technology that will allow them to interact with others: telehealth programs, FaceTime, and meal and grocery delivery. If this does not work and your loved ones are insistent that they want to continue to engage with the world then you have to accept what you cannot control and focus on what you can.
  2. You are NOT a superhero. You cannot be all things to all people, all the time. Focus on what you are able to accomplish in a given day and triage based on necessity and importance. Making sure your children and the older adults in your life are fed and safe is a necessity.  Ensuring that your children completed all assignments, stayed off electronics, finished the crafts for the neighborhood art display, and managed to create two homemade meals because your parents are meat and potatoes people and your nuclear family decided to go vegan last year is, in fact, not a necessity.  Prioritize and practice some flexibility. Remember to grant yourself some grace in the moments when you cannot be the superhero you want to be.
  3. Really consider what social distancing means to you. There is a spectrum to the concept of social distancing by which some refuse to leave the home and order in groceries, where others are engaging in the world without any disruption to their normal routine. You have to consider, without fear of judgement, what is best for you and your family. Mind you, I am not suggesting that you do not adhere to state guidelines or mandated safety precautions, but ask yourself, where on the social distancing spectrum would alleviate the most amount of anxiety for you and your family?  For example, while you may know in theory that isolation for your 65 -year old parents would ensure their physical safety, and this is comforting; would the physical detachment increase anxiety and depression for you, your older loved one, or even your young children?  If the answer is, yes, then maybe it would not be emotionally healthy to practice a complete isolation but a hybrid approach: two weeks of social isolation coupled with only social engagement among family.  If this sounds reckless then daily FaceTime interactions with all parties might be a better option.  The point is, you know yourself, you know your children, and you know the relationship you have with your parents. You decide on what healthy social distancing looks like among your family without fear of judgement. This is a very stressful time for the world.  Talk about it.  Let your colleagues know that it is difficult to take the noon conference call because that is smack in the middle of lunch for your kids who are now home.  If a deadline appears unreasonable, apologize and ask for an extension. The current world does not have it together; you don’t have to, either.
  4. Find time for you. There is no definitive end to COVID-19 and while we might begin to find a new normal, it is important to ensure that you are maintaining a sense of self at the end of all of this.  Take time, even if it’s only 20 minutes, to do something that you enjoy.  Read a book, take an online yoga class, go for a walk, complete the Paint by Number craft that has been hiding in your closet.  Releasing energy both physically and emotionally is a great way to decrease anxiety and reduce stress.

Author: Ashley Morgan Soukup, MA, LMFT