A national profile of sandwich generation caregivers providing care to both older adults and children
- 25 November 2022
- journal article
- research article
- Published by Wiley in Journal of the American Geriatrics Society
- Vol. 71 (3), 799-809
- https://doi.org/10.1111/jgs.18138
Abstract
Background: Many U.S. caregivers provide care to the generation above and below simultaneously, described as "sandwich" generation caregivers. We seek to provide the first national estimates characterizing sandwich generation caregivers and the older adults for whom they care. Methods: We used the 2015 National Study of Caregiving (NSOC) and National Health and Aging Trends Study (NHATS) to compare individual (demographic, socio-economic, health, and caregiving characteristics) and caregiving-related experience (financial and emotional difficulties, caregiver role overload and gains, supportive services, employment and participation restrictions) between sandwich and non-sandwich generation caregivers. The analysis included adult child caregivers with or without any minor child under 18 years (n = 194 and 912 NSOC respondents, respectively) providing care to n = 436 and 1217 older adult NHATS respondents. Results: Of all adult child caregivers, 24.3% also cared for a minor child (i.e., sandwich generation caregivers), representing 2.5 million individuals. Sandwich generation caregivers provided similar care hours to older care recipients as non-sandwich caregivers (77.4 vs. 71.6 h a month, p = 0.60), though more of them worked for pay (69.4% vs. 53.9%, p = 0.002). Both sandwich generation caregivers (21.0% vs. 11.1%, p = 0.005) and their care recipients (30.1% vs. 20.9%, p = 0.006) were more likely to be Medicaid enrollees than their non-sandwich caregiving counterparts. More sandwich generation caregivers reported substantial financial (23.5% vs. 12.2%, p < 0.001) and emotional difficulties (44.1% vs. 32.2%, p = 0.02) than non-sandwich caregivers; they also reported higher caregiver role overload (score: 2.9 vs. 2.4, p = 0.04). Their supportive services use was similarly low as non-sandwich caregivers except for seeking financial help (24.8% vs. 14.7%, p = 0.008). Conclusions: Besides caring for minor child(ren), sandwich generation caregivers provided similarly intense care to care recipients as non-sandwich caregivers and had higher labor force participation; they experienced more caregiving-related financial and emotional difficulties and role overload. Policymakers may consider supportive services that address their unique needs and roles.Keywords
Funding Information
- National Institute on Aging (1K99AG075145, 3K01AG056557‐04S1, 5R01AG056407, K01AG056557, P30AG053760, R01AG054004, U01AG032947)
This publication has 24 references indexed in Scilit:
- Disability and Care Needs Among Older AmericansThe Milbank Quarterly, 2014
- The physical functioning and mental health of informal carers: evidence of care-giving impacts from an Australian population-based cohortHealth & Social Care in the Community, 2014
- Socioeconomic and demographic factors modify the association between informal caregiving and health in the Sandwich GenerationBMC Public Health, 2014
- The impact of being the intermediate caring generation and intergenerational transfers on self-reported health of women in IrelandInternational Journal of Public Health, 2013
- Norwegian sandwichesEuropean Journal of Ageing, 2010
- The association between membership in the sandwich generation and health behaviors: A longitudinal studyJournal of Applied Developmental Psychology, 2010
- Prediction of institutionalization in the elderly. A systematic reviewAge and Ageing, 2009
- Informal Caregiving: Dilemmas of Sandwiched CaregiversJournal of Family and Economic Issues, 2009
- Working sandwiched-generation caregivers: Prevalence, characteristics, and outcomes.The Psychologist-Manager Journal, 2008
- Potential and Active Family Caregivers: Changing Networks and the ‘Sandwich Generation’The Milbank Quarterly, 2000