‘Sandwich Generation’ struggles to care for kids, aging parents

Feb. 02--Once a week or more, Ann Ipock makes the hour-and-15-minute drive from her Wilmington home up to Jacksonville to look after her 85-year-old parents.

Her mother has dementia and now lives in an assisted living facility, but Ipock drops in to monitor her care, to visit, to provide a back rub and to bring little presents.

"Maybe just a lollipop or some lotion," Ipock said. "She really appreciates it."

"She repeats things over and over," Ipock added of her mother. "You can be gone for, like, 15 minutes, and she'll say, 'You haven't been here for ages.'?"

Ipock's father still lives at home and is relatively fit, but he still needs rides to doctors' appointments and other errands.

Ipock counts herself lucky. Her brothers and her two sisters all live nearby and help share the caregiving duties. "If we didn't have the support system, things would be tough," she said.

To complicate matters, Russell and Ann Ipock's daughter, a classical flutist with a graduate degree, moved back home a few years ago when she couldn't find work in her field.

The daughter eventually retrained as a nurse, married and moved to the Charlotte area. For a while, though, the Ipocks were members of one of the fastest-growing groups in America: the so-called Sandwich Generation.

Social worker Dorothy A. Miller is widely credited with coining the phrase back in 1981, to describe middle-age adults who were caring for aged relatives while still looking after adolescent children. Or else, grown children who had moved back in.

A changing demographic

Richard Ogle, chairman of the psychology department at the University of North Carolina Wilmington, knows the phenomenon all too well. He and his wife, who have three children, brought in his mother-in-law to live with them for the last three years of her life.

"It's not like it was a hundred years ago," Ogle said, "when people didn't live very long with a chronic illness."

The U.S. Census Bureau estimates that the number of Americans ages 65 or older will double by the year 2030, to more than 70 million. Many of these will have Alzheimer's disease or other forms of dementia or some other debilitating condition. And many of them will be cared for by their families.

According to a 2013 survey by the Pew Research Center, about 15 percent of middle-age Americans are financially supporting both a parent or other aged relative and a child.

Many others are providing varying degrees of care for an older relative. According to the Pew survey, nearly four in 10 of the respondents said that their parents and their grown children rely on them for emotional support. By some estimates, as many as 60 million people may be engaged in what's known as "informal" caregiving, checking in on parents and grandparents.

Most of these Sandwich Generation caregivers are between the ages of 40 and 59. As Americans live longer, however, increasing numbers of people in their 60s and even their 70s are caring for an aged relative, said Stacey R. Kolomer, a professor in the School of Social Work at the University of North Carolina Wilmington.

"People spend a lot more time in post-retirement," Kolomer said, "often 20 or 30 years or more."

Several sources have identified an emerging "Club Sandwich" Generation, people caring for grandchildren as well as supporting parents and children.

In much of the world, that's normal, Ogle said, "but we don't do a good job of handling 'normal.'?" For one thing, Americans are having fewer children, which leaves fewer family members to call upon. Also, many of those children move far away from home, leaving perhaps one or two siblings with the responsibility for caring for a declining parent.

Stressed

The recent recession added to the burden, Kolomer said. The Pew study found that 48 percent of middle-age adults provided financial support to a grown child in the past year, up from 42 percent when a similar study was conducted in 2005.

The result, Kolomer said, is a lot of stress.

"It's going to be harder than you thought," said Jane Marks, who runs SandwichCaring.com, an advice website. Marks thought she knew about the problem from her term as executive director of the West Virginia chapter of the Alzheimer's Association, but then she wound up caring for her mother while her children were still young.

"It's one thing to read about it, but another thing to be the Sandwich Generation," Marks said.

If a parent has dementia, the burden grows, said Sheryl Zimmerman, a Kenan professor of social work at the University of North Carolina at Chapel Hill.

"Medical events, such as falls, occur without warning, and it's not always clear whether medical care is needed," Zimmerman said. "A parent with dementia may be fine one moment, and wandering outdoors the next, or else leaving the burner on the stove, and the caregiver may not know the event occurred until after the fact."

The Pew study found that adults with a senior parent and a dependent child reported that they often felt pressed for time nearly twice as often as their non-Sandwiched contemporaries.

Spending a lot of time in that pressure can lead to full-blown depression, said Ogle, who sees such cases in his part-time practice as a psychologist.

Left to fester, that pressure can also cause fatigue, weaken individuals' immune systems and lead to frequent, sometimes serious illnesses, Kolomer said.

She, Marks and Ogle all agree: Sandwiched caregivers need to make some time for themselves.

"Even an hour or two off-duty does a lot to relieve the stress," Ogle said. "It doesn't have to be a lot. An hour or two hours every day or so, if it's consistent, can do more good than a three-day weekend."

A British study showed that caregivers fared better if they scheduled in a little time for bridge club, bowling or some other favorite recreation, Marks said.

Finding help

But how to get that time?

"These people need to know it's OK asking for help," Kolomer said.

Caregivers need to research what resources are available out in the community, she added.

Respite care (in which an agency looks after an older adult for a short time) or adult day care are useful options, Kolomer said. In the Wilmington area, Elderhaus Inc. provides services at its facility near Greenfield Lake, allowing family members to run errands or handle other matters, while seniors engage in a variety of activities, including a walking club or even surfing the Internet. Available services include aide-assisted showers.

Alzheimer's North Carolina Inc. has nearly a dozen support groups in New Hanover, Brunswick and Pender counties, Zimmerman said. These groups can offer tips, a sympathetic ear and a chance to vent. (For a complete directory, visit www.alznc.org.)

New Hanover County'sDepartment of Aging and the Cape Fear Area Agency on Aging offer a number of useful services, such as Meals on Wheels and Senior Meals on Wheels, Kolomer said.

"Never say never," Marks advised. Some people swear they'll never put their loved ones in a nursing home, but a time may come when some level of nursing care is needed for the family's safety, if not the parent's. Elderhaus's PACE program offers an in-home alternative to nursing care, with medical and supervisory care offered at home. Medicaid-eligible seniors may be able to receive this service for free.

One of the best things families can do, Kolomer said, is talk about some of these issues well in advance, while seniors are still in good health. Topics might include long-term health insurance, end-of-life directives and having such documents as a health-care power of attorney and a full power of attorney ready in advance.

"Nobody likes to talk about these things," Kolomer said. "It's painful. But it's important."

Ben Steelman; 343-2208

Their stories -- Susie Parker

It may not take a village, says Susie Parker, but it certainly takes a caring neighborhood to survive the Sandwich Generation.

"Listen, I'm burning that Sandwich Generation candle on both ends, buddy," says Parker, 53, who took her parents into her Lansdowne home 14 years ago, and also shared it recently when her son Justin, 27, and his wife, Stephanie, moved back in. "The stress really is something, but the folks on my street, my friends and neighbors, have been phenomenal.

"Truth is, the American family just isn't set up for or prepared to take care of parents who now are living into their 90s. We're learning as we go."

Parker has come full circle with her parents -- father Barbe, 89, a retired West Virginia coal mine executive, and mother Maxine, 89. When they moved in 14 years ago, they actually were stress-reducers.

"Now it's like having two toddlers around, but who don't learn anything new," says Parker. "In fact, things are going backwards."

It's now necessary for her to work from home -- she co-owns and manages the Secure Harbor Retirement Planning agency. Justin makes the outside sales calls.

"Until recently, I could go out and make sales calls," Parker says. "Mom was a fabulous cook and kept the house. Dad took care of the lawn, and the pool, and knew finances, and took care of all that. They took care of the dogs if I needed to be away.

"But it wasn't long ago I noticed they were losing weight. What happened was Mom just stopped cooking, which created a problem because I am the all-time 'take-out' queen. So I've learned in a hurry how to cook. Then one day I gave Dad some receipts and he said, 'I don't know how to do that anymore.'?"

Now, at least, she knows what not to expect, and what she must deal with herself.

Parker also is somewhat of a poster child for the products and services Secure Harbor is selling: financial protection vehicles not just for the elderly but also for their boomer children.

"Our company specializes in the senior market -- final expense, Medicare supplement plans, fixed annuities, prescription drug plans, life insurance," says Parker. "You can talk about a lot of good products to help people with their families, on both ends, but I think the No. 1 thing is health-care coverage, especially with the Medicare supplement for our parents."

Her business is doing better recently, and Justin and Stephanie have moved into a rental home in Wilmington.

They'll be nearby, however, and join the neighbors in reducing Parker's worries about her elastic environment.

"Yep, that's me," she says. "Right in the middle of the Sandwich Generation."

-- Phil Fuhrer

Valorie Hatten

Valorie Hatten, 51, had been caring for her mother-in-law, Albertha Hatten, 78, in three-month shifts, sharing time with her husband's sister, who lives in Savannah, Ga.

Valorie, who works at the Senior Resource Center, and her husband, Marcell, 52, a retired Marine, live in Navassa. Their second son, Manzell, just went off to college at Campbell, where he is studying computers and is going "to learn how to find the hackers," says Valorie.

"My mother-in-law's dementia was getting worse," she says. "I am blessed to be working where I am because it helps to know about all the support and services that are available for seniors and their caregivers. I do worry about people in situations like ours who don't know the assistance that's available."

As her mother-in-law had setbacks, it was hard on the family.

"It was like having two seniors at home, one a high school senior and also my mother-in-law," Valorie says. "Manzell used to joke that years ago, even if he was outside playing, his grandmother would call him in to find the TV remote for her. Last summer, though, it was sad when he realized that when you gave her the remote she didn't know what to do with it."

Also tough was the five-hour drive to Savannah: "The traveling wasn't good for her, with her walker and all. We spent a lot of time picking out the really good rest stops to stop at along the way. That was a test all its own."

The setbacks and the travel ended peacefully when Albertha died just before Thanksgiving.

Albertha's passing has left more than memories. She has left lessons for Valorie and Marcel as members of the Sandwich Generation.

"Having to assist with Albertha's care has better prepared me for the care of my parents whenever that time comes," says Valorie. "Thank God my parents are still mobile and able to take care of themselves, being 81 and 82. The experience has been a blessing. Yes, our family will miss her but we all know she's in a better place and she no longer has to suffer."

Valorie and Marcell are prepared to do what's necessary a second time, which is automatic for a strong marriage of 26 years that bloomed on Castle Street.

"I was standing on the corner across the street from the old Ebony Club and I saw him over there, and he was so handsome," says Valorie. "One of my girlfriends double-dog dared me to ask him over and get his name. And I did it. The rest is history, as they say, and with all that comes with it."

What's the penalty for losing a double-dog-dare bet?

"Fortunately, I never had to know," Valorie says with a laugh.

-- Phil Fuhrer

Michelle Reid

Michelle Reid, 48, has a lot to juggle: two children at home; a 91-year-old mother coming to live with them; a husband who is gone, unlikely to return and unable to provide any financial support; and one recent weekend her washer/dryer inadvertently got sold in an estate sale.

"I've learned to multi-task," says Michelle, inching her way toward the ordering window at a drive-thru restaurant. "Give me an 8-count grilled chicken, plus a tall lemonade. And light on the ice."