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Vital Signs

Fall 2005

Sandwich Generation: Don’t Be Afraid to Seek Support

Middle-aged Americans often bear a double burden— tending to an aging, increasingly dependent parent while still rearing their own children. In an era in which more people delay childbirth and more parents live into old age —and, thus, become subject to chronic, debilitative diseases—the so-called Sandwich Generation is booming.

“People in the Sandwich Generation have one arm reaching out to their parents and the other reaching down to their children,” observes David Reuben, M.D., chief of geriatrics at UCLA. “It’s a difficult tightrope to walk, and it doesn’t leave much for themselves.”

In fact, notes Brandon Koretz, M.D., UCLA geriatrician, often these adults try to do too much, neglecting to seek help where necessary and failing to recognize what the stress is doing to their own lives. He emphasizes the importance of finding other family members and/or professionals to share in the responsibilities, and seeking support from others who are going through the same experience. “If you burn out in this role, you take everyone down with you,” Dr. Koretz says. “Your own health suffers, your children suffer, and your parent suffers.”

Researchers are increasingly recognizing what is known as chronic stress paradigm in caregivers who, over a period of time, begin to develop biochemical abnormalities as a result of their constant strain. “It’s often difficult to distinguish between chronic stress and clinical depression,” says Anand Kumar, M.D., director of geriatric psychiatry at the Resnick Neuropsychiatric Hospital at UCLA. People who try to take on too much end up dealing with their own physical and psychological problems as well as their parent’s, thereby compromising their ability to provide care.

“Caregivers in these scenarios are the unidentified patients,” he says. Caregivers should set priorities, allocate a certain amount of time for each responsibility, and realize that they can’t do everything.

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