According to the U.S. Census Bureau, 35 million Americans are 65 years and older, with almost half older than 75. An aging population comes with benefits and challenges. Many older Americans are in good health, are still participating in their communities, and are choosing to “age in place,” which for many translates to living at home and being cared for by their adult children. With the rise of this home caregiving and other assisted-living options for seniors, a new wealth of living options has allowed seniors to choose between living independently with family, a professional caregiver or both.
Independent living in designated retirement communities is one option for seniors. These communities allow seniors to live on their own and manage all aspects of their lives with ease, but also offer the conveniences and camaraderie of community living. Additionally, these communities cater to the lifestyles and interests of older adults. But make no mistake, these are NOT “old folks homes;” they are active and vibrant communities.
Assisted-living communities offer options for seniors as they are lifestyleadaptive and often combine residential housing features of independent living with added assistance of personal health care. These settings cater to senior who desire independence but may need help with daily activities such as grooming, bathing and dressing, but not around-the-clock care.
Skilled nursing facilities are meant for older adults who needs aroundthe- clock nursing care. These facilities are licensed and regulated by the state department of public health and must meet federal requirements. They are staffed by licensed professionals.
The fastest growing segment of services for aging adults — and one that is most often used by the so-called “sandwich generation” is home health care. Home health care services are very individualized and vary according to families’ needs. Many home health care services offer caretakers the opportunity for respite, companionship, overnight assistance, help with chores, and help with daily activities for seniors. Additionally, many home health care companies provide physical therapy, nursing services and at-home counseling. All of these services allow the aging adult not only to remain in a familiar place, but also a greater opportunity for independence.
Even with all these options for aging adults, oftentimes their care ends up in the hands of their adult children. In the past, families lived together or in close proximity. This multi-generational living arrangement was considered part of being a “normal” or traditional family; parents raised their children, and then as children became adults, there was a natural shift to the adult children taking care of their aging parents. According to the National Caregivers Library and a report by the Pew Social trends organization, as America ages and as a generation of young adults are struggling to achieve complete independence, more adult children are providing support and care for older relatives. Today, the term frequently used for those adult children trying to take care of their aging parents is the “sandwich generation.”
Interestingly, social researchers suggest that most sandwich generation participants have median incomes of more than $100,000 and support their young adult children as well as their parents, both emotionally and fina - cially. Sandwich generation adults share the joys and rewards of having family close by, but as our population lives longer and with the complexity of today’s world, being members of the sandwich generation present a ubiquitous set of challenges. Some of the challenges include juggling work and personal life with that of parents and adult children. A common theme expressed by this generation is that they constantly feel pressed for time and rushed to fit in all work and daily family responsibilities.
FINANCIAL SUPPORT
Many sandwich generation adults believe they have a responsibility to provide for their parents financiall . Statistics show that one in four sandwich generation adults give their parents financial support, and the support is more than just a short-term commitment. Many who have given financial assistance to an aging parent share that the money was for ongoing expenses and they expect it to continue. An interesting note, however: This generation of aging adults over 70 who are in need of care is much more financially stable than previous generations, and when questioned about their personal finances say that they have actually given financial support to their grown children in the past year and feel that they are much more in need of personal care and emotional support than the financial component.
EMOTIONAL SUPPORT
Although many aging adults do not feel they need the financial support and commitment of their adult children, they feel strongly that they do need help with dayto- day living and emotional support. Often, it is the fear of loneliness and isolation that is a major contributor to depression in the aging adult. It is amazing how powerful 30 minutes of daily communication with another person can be in the health and wellness of aging adults. Pets are also a huge source of emotional support for the aging adult and can contribute to an enhanced quality of life. The “sandwich generation” may face logistical, financial psychological and/or physical challenges. Experts say that it is always important to remember that caretaking is not going to go perfectly. You are not going to please everyone all the time. There is no formula or algorithm for being a successful caretaker for aging parents or adults, nor are all adult children going to understand or appreciate your efforts all the time.
THINGS TO CONSIDER WHEN CARETAKING:
1. Time management and logistics: Juggling the demands of parents and adult children with dinner and work can all require a great deal of time and energy;
2. Financial impact: Budget and plan on things like home health aides, home renovations, medical equipment and even adult daycare for a parent who may be suffering from dementia. Also take into consideration time from missed work as you are trying to meet the needs of parents;
3. Career and caregiving: Pay attention to the impact on your professional life; you may miss work or have to pass up promotions to maintain the level of care you are able to offer to a parent or aging adult.
4. Marriage: Double-duty caretakers may see the stress of the situation become a factor in their marriage.
5. Emotional consequences: Family caretakers have high rates of depression and anxiety. Often there is a chronic sense of guilt when people feel as though they are not doing anything well, or meeting everyone’s needs, but they are burning the candle at both ends trying to do everything for everybody.
DON’T WAIT UNTIL IT’S TOO LATE
When it comes to planning for the future, the saying “sooner rather than later” certainly applies. It’s much better to be five years too early than five mintues too late.
It is important to have open communication with aging parents before you become their primary caregiver. Discuss health care and if they have money saved for longterm health care needs. The answer to this question is pivotal to how they will proceed with the planning.
As adults age into their golden years, their right brains starts to have more control over decisions. This part of the brain is often driven by emotion and fear and less with logic and rationality. It is important to try and communicate this with your parents and for you to take this into consideration when their choices and decisions don’t always resonate or make sense to you.
How and when to downsize is also a crucial topic to discuss. Oftentimes, this conversation happens too late, when the decision really isn’t a choice anymore. Aging adults will often feel more empowered if they make these decisions themselves before they are really non-negotiable.
Expectations should be discussed and carefully considered. What are your parents’ wants and needs? How much time, money and emotional capacity do you have to dedicate to taking care of aging adults? Be real with yourself and honest with your parents so the expectations are clear on both ends. And by all means, set boundaries. Be sure that expectations are clear and honest; it may be helpful to write these expectation down so everyone understands and is on board with the level of caretaking necessary and possible.
THE KEYS TO SUCCESSFUL CAREGIVING
It is important for caretakers to accept imperfection and allow themselves and their parents and adult children to be human. The best way to avoid guilt, exhaustion and other challenges is to be proactive. Develop a plan before moving forward. It may be helpful to give forethought and consideration to medical situations that may arise and the likely trajectory over time. This will help everyone create short- and long-term living plans. Openly communicate what each member of the family is willing and not willing to commit to. Again, be realistic with your time; this is not the time for anyone to be the martyr of the family. Everyone’s happiness should be considered and valued in the equation. Remember, there are services available to get in-home help with needs that cannot be met by a family member. No one can do it all by themselves.
We are all different in our needs, commitments and abilities, and as a child and caretaker you are required to only be a loving child and ensure your parents’ safety, but you do not have to do it all. Self-care, as always, is a priority. Exercise, meditation or yoga will help you take time for yourself, stay centered and keep your priorities in check. Rest is critical; that means healthy sleep and downtime.
You must take time for yourself, even if you feel like you can’t. Let people know you’re tired so they don’t take your mood personally.
Siblings all deal with caretaking and parents differently so pay attention to how you treat each other while caring for parents. It may be healthy to have a phone call or meeting at least every two months. These meetings provide siblings an opportunity to regroup and assess the current situation. It allows for discussion of short- and long-term needs. It may be healthy to also involve parents. Be sure to communicate openly and honestly so feelings of guilt, resentment or being overwhelmed are not bottled up and ignored. If everyone is on the same page, responsibilities may not be equal but everyone will be aware of the situation and will be able to contribute in a proactive and helpful way; the help may be with day-to-day living, financial and/or emotional support.
Caretakers of aging parents and adult children know that while double-duty caretaking may be challenging, it is a unique opportunity to bring families together in multi-generational living. It provides the opportunity for all to learn about their core family values, empathy and love.
RESOURCE LIST
Agape Senior
843-782-4033
www.agapehospice.com
Beaufort Medical Equipment
843-379-2800
www.bme4u.com
ComForCare Home Care
843-837-3100
www.hiltonhead.comforcare.com
CrossRoads Financial Group
843-785-9400
www.crossroadsfinancialgoup.wfadv.com
The Cypress of Hilton Head Island
843-689-7000
www.cypressofhiltonhead.com
DayBreak Adult Care Services, Inc.
843-415-3211
www.daybreakcare.com
Griswold Home Care
843-785-6400
www.griswoldhomecare.com/hilton-head
Home Instead Senior Care
843-842-3372
www.homeinsteadbluffton.com
Hospice Care of the Lowcountry
843-706-2296
www.hospicecarelc.org
The Palmettos of Bluffton Assisted Living
843-707-9400
www.thepalmettosbluffton.com
Right at Home
843-815-7890
www.rightathome.net
The Seabrook of Hilton Head
843-842-3747
www.theseabrook.com
TidePointe, a Vi Community
877-519-6848
www.tidepointe.viliving.com