Nearly a quarter of U.S. adults care for children as well as their aging parents, according to a 2021 Pew Research Center study, defining them as the “sandwich generation”—a set of adults squeezed by significant financial pressures and time constraints. Of this group, close to 75% are adjusting their retirement goals to provide caregiving and financial support to both groups in need, The data, from a 2025 Athene survey, further showed 44% of “sandwiched” adults are cutting expenses, 34% are delaying retirement and 22% are spending their retirement savings.
What’s more, 9% say they no longer expect to retire at all.
Such setbacks to future plans are only compounded by the emotional and physical stresses levied by current caregiving demands.
And mental health experts, who are often “sandwiched” themselves, are increasingly sounding the alarm for the Sandwich Generation to seek out ways to cope.
There are ways for singles and couples who are caring for children and aging parents to reduce stress, take care of themselves and encourage sharing responsibilities with co-parents, siblings and paid assistants. Coping mechanisms minimize negative impacts on physical and mental health for everyone, including older parents as well as children receiving care.
“Ideally, families will talk about caregiving needs in advance so there are clear understandings about preferences, resources, and roles. It helps everyone anticipate what may come down the road. Communication is key. It can reduce the chance of a breach between siblings or adult children and caregiving staff,” says Dr. Elizabeth Cassanos, a Santa Rosa-based psychologist.
Caregivers who partner with other adults who are uncommunicative should talk to a mental health professional to recognize signs of exhaustion.
“You can’t take care of yourself if you don’t know what to watch for. Think of the signs associated with burn-out, fatigue, trouble sleeping, upset stomach, weight changes, headaches, depression, irritability, and losing interest in the things you enjoy. Also be mindful of prolonged periods of isolation and bouts of substance use,” says Dr. Joseph Habis, lead physician and co founder of Prima Health Group in San Rafael.
Members of the Latino community can experience unique sources of stress. These include worries about undocumented status, language barriers for themselves and family members, and struggles to care for parents who live outside the U.S. Latinos can also experience difficulty with finding caregivers who are culturally sensitive and communicate effectively with Spanish-preferring older adults. A number of Latino nonprofits in the North Bay offer advice and resources for caregivers facing these obstacles.
“There are a lot of emociones encontrados, mixed emotions, and guilt for those of us who can’t be home with our parents who live in another country. We are also concerned about raising our children far away from our parents, or where we grew up. There are ways to address this, like sending grandchildren to visit grandparents when possible. At times, we can also ask family members and neighbors to ensure elderly parents are looked after,” says Argelia Gómez.
Gómez is a behavioral health manager for Canal Alliance, a San Rafael nonprofit that serves the Latino community of Marin County. Gomez says Canal Alliance supports Latinos and immigrants in Marin County with everything from English language classes to referrals for affordable childcare centers.
“We’re here to make life easier and determine how to serve Latino residents better,” says Gómez.
What being “sandwiched” means
In past decades, the term “sandwich generation” referred to people in their 40s and 50s who provide financial support and caregiving to adult children and older relatives. Today the term is more expansive. This is because the age range of people “in the middle” is broader. The “sandwich generation” can include individuals from their 70s to their early 20s. It can also include those who provide significant care for children of all ages, whether or not those individuals are the parents of the children. Further, it can include those who are caring for adults with moderate to severe physical or intellectual disabilities.
In April , Athene Holding Ltd., a West Des Moines retirement service provider, announced results of a survey it conducted of people between the ages of 40 and 59 who are caregivers for adult children and older relatives. It found 73% of respondents had adjusted their retirement goals to continue caregiving. For 34%, this meant delaying retirement. For 22%, it meant using retirement assets to support their family. For 9%, it meant not planning to retire.
Worries about retirement add to the list of issues that caregivers face, but typically the physical and emotional toll of caregiving is a more immediate problem.
“You can lose yourself in the role of caregiver. It’s important not to try to do it all by yourself. Find ways to check in with yourself, to recharge. Resources include being part of a strong friend group, religious community or cultural organization, maintaining regular activities or, if needed, seeking therapy,” says Cassanos.
Such actions are challenging for those who are suffering from loneliness , a concern heightened by the COVID-19 pandemic. Political differences can also cause rifts in family and friend groups, making it difficult for caregivers to reach out for support.
“This is where certain professionals can help. Therapy can help the caregiver work through stressors and family conflict. A licensed clinical social worker or therapist can help you identify resources for elderly adults living with dementia,” says Cassanos.
It is also possible to consider options for multigenerational living.
“Living with elderly parents can be a gift. Depending on the situation, it may include sharing in the burden of household tasks, including caring for children. They may also share cultural traditions or family history, which can be meaningful and enjoyable for the whole family,” says Cassanos.
Gómez, whose mother is a member of the sandwich generation, says adult children can help alleviate stress.
“I have checked in on my grandparents. I’ve done translation for my mother. I’ve helped her with errands, like shopping. This gives her more time for herself,” says Gómez.
From worms to apps
In one of the research labs at the Buck Institute for Research on Aging, Dr. Gordon Lithgow, a professor at the Novato-based institute, is studying Caenorhabditis elegans, a tiny worm. The idea is to find drug-like compounds to increase the animal’s life expectancy. The species lives in temperate soil and is already long-lived.
“We’re screening 100,000 compounds to see which ones can increase the life expectancy of this nematode even further. The compounds assist the animal by preventing chronic disease. Treatments that include these compounds could be beneficial for people dealing with chronic stress,” says Lithgow.
Lithgow says the compounds it is testing should be beneficial for mice.
“We’re not sure the compounds will work for people yet. That will require double-blind clinical trials. Once we identify the compounds that may work, existing or new companies will want to develop those compounds as anti-aging drugs.” says Lithgow.
Lithgow adds there are many non-pharmaceutical ways people can “turn on” the body’s defense system.
“Swimming, saunas, walking and meditation all help. Yet it can be challenging to engage in such activities if your work and caregiving responsibilities leave you no time,” says Lithgow.
Armand Braun, M.D., a psychiatrist at Kaiser Permanente in Santa Rosa, says sleep deprivation is a common struggle for caregivers experiencing stress. Those who suffer from this issue should work with a health professional to develop a plan about how to get enough restful sleep.
Braun says caregivers should avoid blame for failing to get a full night’s sleep. Instead, they should allow themselves periods of rest during the day in such situations.
Sleep deprivation creating stress is particularly difficult for women in perimenopause or menopause. Hormonal shifts can interrupt sleep because of symptoms like hot flashes.
“Often people experiencing trouble with sleep start out using over-the-counter medications. These medications are “dirty” because they do not provide a person with deep, restful sleep. A patient should work with a clinician to identify the behavioral activity or prescription medications that may help them,” says Braun.
Lingering effects from the COVID-19 virus can add to sleep issues. This is because they create a complex medical presentation creating stress. Concerns like mental fog and fatigue, particularly on the job or while caregiving, can increase stress.
“People entering middle age may not easily fall into deep sleep [as they did when] they were younger. It helps to figure out what helps you get into a good sleep. Ideas include a shower before bed, a meditation session, white noise, putting away the smartphone, or using “night shift” or “twilight” features on the phone,” says Braun.
A multitude of apps can help caregivers manage stress through different approaches such as journaling, mood tracking and challenging negative thoughts. The list includes Calm and Headspace, which Kaiser Permanente offers to its members for free. Other apps that address the stress include Youper, Wise, MindDoc and Earkick.
Individuals considering apps should research what each app does and whether it has features that are helpful for them or loved ones.
For example, Earkick offers an “AI therapist” chatbot. A caregiver might not be comfortable with having a child under 10 use this service, but might consider it for themselves. Calm offers relaxing “sleep stories” that lull listeners before bedtime. A caregiver might consider playing a sleep story targeted to children for their child. Later they might play a sleep story for adults to themselves.
Take it from a doctor—or an educator
North Bay healthcare providers have a number of general and region-specific suggestions for caregivers. The first is caregivers should be cautious about using homeopathic remedies to relieve stress.
“Some medicines may have value even if they’re not FDA-approved. But they could have side effects that might make things worse, like causing someone to frequently have to go to the bathroom. Some natural remedies contradict prescription and over-the-counter medicines,” says Habis.
Habis says caregivers should talk to a homeopath about natural medicines and let their primary care physician know they are taking the substances. That way a patient gets an understanding of how the medicine is working from both providers.
When it comes to resources for older adults, a caregiver should come to a hospital, nonprofit, senior center or private in-home respite company to ask about programs and eligibility.
“There are numerous support groups for caregivers, from informal family and friend support groups that you create yourself to hospital and nonprofit-run programs. There are also programs at senior centers and the like where older adults can do everything from enjoy lunch together to learn how to prevent falls,” says Habis.
Caregivers for children should ask their childcare providers and community nonprofits about help and resources available for families.
Dennise Enriquez is the family and community engagement manager for Marin Child Care Council (MC3). The nonprofit offers a free service for all Marin families to help them find childcare providers near them. It offers vouchers for financial assistance for childcare.
“Marin County also has the Adopt-a-Family program, where families can apply for up to $750 per family financial assistance for rent, groceries and other essential needs. In addition, here at Marin Child Care Council we have workshops on many topics, including infant brain development, computer literacy and “Know Your Rights” sessions for undocumented immigrants,” says Enriquez.
[Photo courtesy Marin Child Care Council]
Throughout the year, MC3 hosts several “Parents’ Cafe” where parents of young children come together to talk about common concerns in a safe and welcoming environment.
“These are very popular with our community and open to all parents,” says Enriquez.
It is a special challenge to reach the members of the Latino community who work in agricultural areas in West Marin.
“There everything is more remote and spread out. There are some services, but not all the services they need,” says Enriquez.
Mayra Perez, the acting interim principal of Madrone High School in San Rafael, says addressing the needs of the Latino community requires listening to parents.
“When you get them to open up, they share their life stories. Many are concerned about working so much that they can’t be home with their children at night. Hearing the stories first-hand helps educators and administrators develop empathy and compassion,” says Perez.
About 15 years ago, Perez learned a great deal by organizing a “school community night”—a meeting between parents, educators and administrators.
“We offered day care and snacks and held the event in the evening. That’s when many people were done with work. As a result, so many families came. Both moms and dads came. That’s notable. Before, when we held events earlier in the day, a lot of dads couldn’t come. Their voices had been missing,” says Perez.
Every parent or guardian has their own concerns. Cesar Granados, controller for the Canal Alliance, is currently working to keep his young son connected to their shared heritage.
“My wife and I are caring for my son, and her mother, who is older. We all live together in a duplex in Fairfax. It’s great having her present. But I’m the only one in the house who speaks Spanish. I want to do more to make sure my son is bilingual,” says Granados.
Working with private care
Even caregivers who are shouldering much of the work themselves can occasionally or regularly use the care of an in-home care provider. The staff of these companies can offer companionship for older adults as well as transportation to doctor appointments or the grocery store.
“I am in this situation myself, because my dad is older. So I’m both a customer and the owner of Right At Home Santa Rosa. A caregiver just can’t be everywhere at all times. We direct our customers to trustworthy caregivers,” says Erica Carlisle.
Right At Home serves residents of Napa and Sonoma counties. The company conducts background checks and makes sure referred professionals receive training as well as instructions about what tasks to perform and care to provide.
“One of the best features we offer is that caregivers write detailed notes. If an older parent has a memory issue and can’t remember everything they did, there are notes from the caregiver to review,” says Carlisle.
Carlisle’s tip for parents and guardians “in the middle” is to make time to spend with children and listen to them, while expecting them to help out.
“Kids should know that there are times other people’s needs come before theirs. They should also get the sense that they can contribute, whether that means helping make dinner or taking out the trash,” says Carlisle.
Shauna Sweeney is the founder of tendercare, a free information-sharing app that makes it easier for caregivers to care for aging loved ones by becoming more organized, more prepared and more connected to vetted resources. Sweeney says technology can play an important part in improving care for older adults.
Sweeney currently splits her time between New York, where she lives, and Marin County, where her aging father lives.
“I developed this app because I was struggling to manage care for my father on my own. This platform helps family caregivers organize critical information, set doctor appointments, connect with vetted professionals such as elder law attorneys, and plan for emergencies. It also especially helps those who don’t live in the same place as their aging parent,” says Sweeney.
Sweeney says the most important thing she has learned about being a caregiver is time is the most expensive currency.
“A caregiver is constantly pulled between their parents and their children, their spouse and their job. Often, they end up at the very end of the list. What I am doing, personally and as a business owner, is resetting priorities. I put myself on the list of people to take care of. I count too. I want other caregivers to have the tools and the opportunity to feel appreciated,” says Sweeney.