Squeezing the life out of me…. Living the sandwich generation

IMPORTANT: This blog is not a substitute for therapy, but provides evidenced-based education for the purposes of self-help, or to compliment the therapeutic process. ​ ​This blog is non-monetized.

By: Juli Fyfe, Registered Psychotherapist

Does this sound familiar?

Your kids are finally grown, perhaps at university, or even back home in a full-time job.

You’ve found your stride at work and feel like now is your time to restart living your life!

Suddenly, you realize your aging mom or dad needs a lot more care and you are the person they rely on heavily. It might start small with running errands or paying bills and then, over time their dementia takes away who they used to be and your find yourself parenting your loved one.

This is the reality of many of us in the ‘sandwich generation’.  It doesn’t help that our health care system is difficult to navigate, and it can be a challenge to get the resources mom/dad really need.  

If this is you, you are not alone!

Our Canadian population is aging rapidly and most patients with dementia (including Alzheimer’s disease) are cared for in the community, primarily by family members (the spouse of the loved one, or their children).  Family caregivers of a person with dementia tend to give selflessly of themselves, and as a result, they are susceptible to a host of health problems themselves.  

One of the most prevalent problems are depressive symptoms (like insomnia, a loss of interest in usual activities, difficulty concentrating, increased irritability, unexplained physical aches and pains). 

The paradox of caregiver burnout

Did you know that caregiver exhaustion and depression are directly correlated with poor health outcomes of the care recipient?

The mental health of the care-giver is believed to impact the mortality of the care recipient in three possible ways:

  1. Impacts on the quality of care provided (there may be neglect and abuse).
  2. There may be a weakened social bond between the care giver and recipient. Care-givers report feeling lonely, isolated and have less of a connection to the care-recipient. This weakened bond alters the immune systems of both the caregiver and recipient making them susceptible to infections and higher mortality rates.
  3. Finally, it is possible that care-giver stress levels, with at negative affect (more specifically, the feelings of anxiety, sadness, fear, anger, guilt and shame, irritability, and other unpleasant emotions) and increased cortisol levels (our stress hormones) can be transmitted or shared with the care recipient. We call this behavioural mimicry, and it impacts the recipient mortality.

What about caregivers that no longer seem to care? 

I hear the administrators of administrators of long-term-care homes complain that family members dump their parent at the home and vanish. They may wonder how the adult children can do this. I sense that by the time the aged parent is admitted, the adult children are completely burned out, feel overwhelmed and might even be experiencing symptoms of depression. Caregivers do not get enough support at all. But what can you do when you are that caregiver ?

It’s time to really take care of yourself. 

YOU need radical self-care too.

Mindfulness-based interventions can increase the quality of sleep, decrease depressive symptoms, and increase feelings of overall gratitude.

Mindfulness can help you take note of the moments when you experience the positive benefits of carrying for your loved one. You may even appreciate the ability to give back to the person who raised you. You might feel a sense resilience when you are appreciated by your loved one.

Other themes of positivity include developing patience, a positive outlook and bonding with your loved one.  We can try to accept that who they are with dementia, is not the same as who they were before.

You may also want some 1:1 personal treatment through psychotherapy. Many of the Dig A Little Deeper therapists can help you recognize triggers, emotional patterns, and help you process these emotions so that you can stay healthy too.


Further Resources

References

Cheng, S. T., Fung, H. H., Chan, W. C., & Lam, L. C. (2017). Short-term effects of a gain-focused reappraisal intervention for dementia caregivers: A double-blind cluster-randomized controlled trial. The American Journal of Geriatric Psychiatry, 24(9), 740-750.
Cheng, S. T., Mak, E. P., Fung, H. H., Kwok, T., Lee, D. T., & Lam, L. C. (2017). Benefit-finding and effect on caregiver depression: A double-blind randomized controlled trial. Journal of Consulting and Clinical Psychology, 85(5), 521.
Cheng, S.-T., Mak, E. R. M., Lau, R. W. L., Ng, N. S. S., & Lam, L. C. W. (2016). Voices of Alzheimer Caregivers on Positive Aspects of Caregiving. Gerontologist, 56(3), 451–460. 
Lwi, S. J., Ford, B. Q., Casey, J. J., Miller, B. L., & Levenson, R. W. (2017). Poor caregiver mental health predicts mortality of patients with neurodegenerative disease. Proceedings of the National Academy of Sciences, 114(28), 7319-7324.
McCabe, M., You, E., & Tatangelo, G. (2016). Hearing their voice: A systematic review of dementia family caregivers’ needs. The Gerontologist, 56(5), e70-e88.
Paller, K. A., Creery, J. D., Florczak, S. M., Weintraub, S., Mesulam, M. M., Reber, P. J., … & O’Hara, M. (2015). Benefits of mindfulness training for patients with progressive cognitive decline and their caregivers. American Journal of Alzheimer’s Disease & Other Dementias, 30(3), 257-267.
Peacock, S., Forbes, D., Markle-Reid, M., Hawranik, P., Morgan, D., Jansen, L., … & Henderson, S. R. (2010). The positive aspects of the caregiving journey with dementia: Using a strengths-based perspective to reveal opportunities. Journal of Applied Gerontology, 29(5), 640-659. 
Stirling, C., Andrews, S., Croft, T., Vickers, J., Turner, P., & Robinson, A. (2010). Measuring dementia carers’ unmet need for services-an exploratory mixed method study. BMC Health Services Research, 10(1), 122


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Picture of Juli Fyfe, H. BSc. MACP

Juli Fyfe, H. BSc. MACP

Registered Psychotherapist Juli is a therapist with DALD, and has a particular interest in Eating Disorders, Borderline Personality Disorder, helping support caregivers, who have family members with Alzheimers Disease, any type of cancer or Rare Disease, and general mental health disorders.  ​Visit Juli's bio to learn more, or book a free consult with her. 

3 thoughts on “Squeezing the life out of me…. Living the sandwich generation”

  1. I am glad that you come up with this kind of article. I appreciate this a lot and I found it very informative and worth reading. Thanks for posting.

    Reply

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