|
The
Sandwich Generation
...................................................................................................................
In this and
the next Resource Note, I plan to address two societal issues
that arise from the roles members of our multi-generations
are playing. Today, I'll share resources concerning
the "Sandwich generation," a phrase coined by Carol Abaya,
MA. On Maya's web site, The Sandwich
Generation, she gives these definitions of the individuals
in this cohort.
"Traditional:
those sandwiched between aging parents who need care and/or
help and their own children.
Club Sandwich:
those in their 50s or 60s, sandwiched between aging parents,
adult children and grandchildren. OR those in their 30s and
40s, with young children, aging parents and grandparents.
(Term coined by Carol Abaya)
Open faced:
anyone else involved in elder care.
(Term coined by Carol Abaya)"
You may read some
of Ms. Abaya's columns on the subject at http://www.globesyndicate.com/sand.shtml.
As noted last week,
family members from three to four generations have lived together
and cared for one another throughout our history; so, why
this phenomenon of the "sandwich generation?"
What is different? Three changes in our behavior are
possibilities for the "sandwich generation": (1) Women
are having children later in life; (2) More women are in the
work force; and (3) Our parents are living longer. Add
to this, our mobile society, which often leaves only one sibling
available to assist aging parents. This is the case
in my family, and I shall never be able to thank my bother
and sister-in-law for their loving care of my parents.
Read this November, 1999 article by Tom Anderson, published
in the USA Today Magazine, "Taking
a Bite Out of the Sandwich Generation," and pass the reference
on to friends, family members or clients. A
"Midlife
Mommies"web site just said good-bye for a bit; however,
you can still access many of its pages; such as the one that
addresses today's topic,
The Administration
on Aging of the U.S. Department of Health and Human Services
offers some great information for family caregivers.
Following are specific references at this site:
The
American Association for Retired Persons (AARP),
published this interesting report "In the Middle: A
Report on Multicultural Boomers Coping With Family and Aging
Issues " that you can read or download in full at http://research.aarp.org/il/in_the_middle.shtml.
Another
useful organization and site is Family
Caregiver Alliance.
References
Although I did
not find any references to the "sandwich generation" in OT
SEARCH, here are some recent citations concerning family caregivers.
Chen, T-Y,
Mann, W.C., Tomita, M. & Nochajski, S. (2000).
Caregiver involvement in the use of Assistive Devices by frail
older persons. The Occupational Therapy Journal
of Research, 20(3), 179-199.
ABSTRACT: The population of persons over age 65 years is increasing,
and with this trend there is an increase in number of older
persons with disabilities, or frail elders. The importance
of supportive environments for home-based frail elders has
been recognized. Supportive environments include the
presence of family caregivers and appropriate assistive devices.
Assistive devices (AD) offer the potential to decrease frail
elder's need for personal assistance, and could reduce some
of the burden expressed by caregivers. The inclusion
of family caregivers in treatment planning and its implementation
is a component of occupational therapy practice. Occupational
therapists are also recognized as the lead professional in
the provision of assistive devices. However, there has
been little research on the involvement of family caregivers
in the use of assistive devices. The purpose of this
study was to examine the relationship between caregiver involvement
and the use of, and satisfaction with, assistive devices by
frail elders. Interviews regarding assistive devices
were conducted with 20 frail, cognitively intact elders who
had a primary caregiver in their homes. Results indicate
that elders regard assistive devices as very useful in saving
time, conserving energy, reducing frustration, and providing
a feeling of security. Caregivers were involved in the
use of assistive devices when the device was first acquired
(early caregiver involvement) and made suggestions for using
the devices. They also encouraged, instructed, and assisted
with the use of devices later, as necessary. There was
a relationship between early caregiver involvement and involvement
at the time of the interview (late caregiver involvement).
Verbal encouragement and caregiver's use of assistive devices
to help perform tasks were strongly associated with both device
use and satisfaction. The results reinforce the importance
of caregiver involvement with assistive devices used by frail
older persons.
Elliott, T.R. &
Shewchuk, R.M. (1998). Recognizing the family garegiver:
integral and formal members of the rehabilitation process.
Journal of Vocational Rehabilitation, 10(2), 123-132.
ABSTRACT: Radical and emerging changes in health care service
delivery systems and steady increases in the number of chronic
health conditions have shifted more responsibility to family
caregivers of people with disabilities. These caregivers
essentially operate as formal health care providers who receive
little or no recognition, support, or preparation from health
care systems. In this article, major societal and psychological
issues in caregiving are discussed. We also explore
interventions to prepare and assist caregivers that effectively
integrate them into the rehabilitation process. (C)
1998 Elsevir Science Ireland Ltd.
Hersch, G.I.
(1991). Perspectives of the Caregiving Relationship
by Older Adults and Their Family Members. Bloomington, IN:
Indiana University. (dissertation)
ABSTRACT: The intent of this study was to investigate
the affective dimensions of the caregiving dyad of adult child/grandchild
and frail parent/grandparent by employing qualitative methodology.
Through open-ended, semi-structured interviews, focus groups,
and participant observation, the intergenerational dynamics
impacting the frail parent-adult child relationship and its
effect upon family coping strategies were examined. The investigator
engaged in the hermeneutic process with respondents from 11
families, culminating in a joint construction for both the
caregivers and care receivers. Utilizing the constant comparative
method of joint coding and analysis, six major patterns of
meaning delineated by the caregivers emerged. These
were: the characteristics of caregiving, stress and coping
strategies, preparation for caregiving, relationships, understanding
of caregiving, and the meaning of caregiving. For the
care receivers, four major themes were identified independence
vs. dependence, life satisfaction, value of reminiscence,
and the bipolar view of the caregiving situation. The patterns
and the subcategories were then organized into stages of
caregiving for both respondent groups. A case study format
was used to present the emic construction of each family regarding
the experience of care involvement. .Findings from the study
indicated that where affective ties were strong, caregiving
responsibilities were felt less negatively. In addition,
the long-range and more helpful approaches to coping with
caregiving consisted of seeking spiritual support, reframing,
gaining confidence in one's problem-solving skills, and finding
meaning in the caregiving. For the care receivers, their
method of coping with the loss of independence was derived
from recognition and satisfaction with past endeavors and
resolution of the present situation, A conceptual framework
was offered as a graphic portrayal of the dimensions of caregiving
impacting the quality of the dyad relationship. Implications
for future research and policy formulation dealing with both
professional and family caregivers were discussed.
Howard, K. &
Singleton, J.F. (2001). The forgotten generation:
The impact a grandmother with Alzheimer's Disease has on a
granddaughter. Activities, Adaptation & Aging,
25(2), 45-57.
ABSTRACT: When a parent assumes the caregiving
responsibilities of someone with Alzheimer's disease, the
relationships between family members, as well as the family
roles, may be altered. The caregiving role is generally
assumed by the female within the home; a daughter or daughter
in-law. The children of the caregivers are affected
as their mother becomes involved with the caregiving responsibility
of their grandparents with Alzheimer's. The leisure
patterns of the family are affected as the grandparent's behavior
and daily care affect the everyday routines of the family.
The focus of this research was to gather information to generate
new insights about how granddaughters were affected when their
grandmothers had Alzheimer's disease. Information was
collected by interviewing six granddaughters. The themes
that emerged from the granddaughters' stories included problems
with social interaction and feelings of embarrassment due
to the grandmothers' behavior. Stress and tension, feelings
of guilt, feelings of sadness, feelings of frustration and
anger also emerged. Avoiding the caregiving situation,
participating in activities, the need to possessing information
about Alzheimer's disease and the importance of support
were other themes that emerged. These themes formed
the foundation for a model that illustrates the interaction
of the themes on the granddaughters in this study.
McGrath, W.L.,
Mueller, M.M., Brown, C., Teitelman, J. & Watts, J.
Caregivers of persons with Alzheimer's disease: An exploratory
study of occupational performance and respite. Physical
& Occupational Therapy in Geriatrics, 18(2), 51-69.
ABSTRACT: This qualitative study explored the impact of caring
for a family member with Alzheimer's on the caregiver's occupational
performance and the perceived influence of respite on occupational
performance. Five caregivers participated in semi-structured
interviews including the client-centered Canadian Occupational
Performance Measure. The caregivers described (a) the desire
for respite that would be mutually beneficial for the caregiver
and the care receiver; (b) the importance of engaging in occupations
that provided a mental break from caregiving; and (c) prioritization
of occupations for which they would use respite. The
findings emphasize the need for client-centered interventions
to promote caregiver occupational performance.
Morris, A.L. &
Gainer, F. (1997). Helping the caregiver: Occupational
therapy opportunities. OT Practice, 2(1), 36-40.
ABSTRACT: Mrs. Stewart Cares for her mother, who has Alzheimer's
disease, but she is considering placing her in a nursing home
because she can no longer leave her alone while she goes to
work. She is unaware that there is an adult day center
not far from her house where her mother would not only be
well supervised but would engage in activities to enhance
her remaining function. Mr. Williams prepares all of
his grandfather's meals, which makes it virtually impossible
for him to take a vacation or even stay late at the office,
and he is becoming resentful. If he were aware of the
local Meals-on-Wheels, much of this burden would be relieved.
Mrs. Gomez has been taking care of all of her husband's personal
care needs since he had a stroke, and she is exhausted.
If she and her husband had access to low-priced assistive
technology equipment, he would be more independent and feel
better about himself and she would have more energy to help
him with other activities.
Steinfeld, E.,
Tomita, M., Mann, W.C. & DeGlopper, W. (1999).
Use of Passenger Vehicles by Older People with Disabilities.
The Occupational Therapy Journal of Research, 19(3), 155-186.
ABSTRACT: The goal of this study was to identify the range
of problems faced by frail older people in using private passenger
vehicles and to identify how assistive technology and selection
of vehicles may reduce those problems. Research activities
included a review of existing research, a review of assistive
technology for vehicle use, four focus group sessions, and
a survey of 101 older people with disabilities. The
findings of the research indicated that frail older people
had significant problems both as drivers and as passengers.
Although they are reluctant to self-report driving problems,
they did report many problems entering and exiting vehicles.
Forty percent of those surveyed reported difficulty getting
their legs in and out. The study identified many ways
that occupational therapists can assist frail older people
and their caregivers in using passenger vehicles. It
also identifies gaps in research, vehicle design, and assistive
technology that need to be addressed.
Tamm, M. (1999).
Relatives as a help or a hindrance -- A grounded theory study
seen from the perspective of the occupational therapist.
Scandinavian Journal of Occupational Therapy, 6(1),
36-45.
ABSTRACT: Family caregivers are the primary source of support
for rehabilitation in the home setting for frail elderly people.
The purpose of the study was to gain a deeper understanding
of how occupational therapists view the family caregivers
and their own role in rehabilitation in the home-care setting.
The investigation was carried out as a grounded theory study.
Interview transcripts from 18 community-based occupational
therapists were analysed according to the constant comparative
method for grounded theory described by Glaser & Strauss.
Six categories formed two higher-order categories -- family
caregivers as a help or as a hindrance. The role of
the occupational therapists in relation to relatives varied,
depending on the part played by the relatives themselves,
but it was better defined and distinct when relatives acted
as a help than when they acted as a hindrance.
The family role
of caregiver is affecting the work world, as discussed in
the following citations.
Buffardi L.C.,
Smith J.L., O'Brien A.S. & Erdwins C.J. (1999).
The impact of dependent-care responsibility and gender on
work attitudes. Journal of Occupational Health Psychology,
4(4, 356-67.
ABSTARCT: On the basis of a survey of 18,120 federal employees
in dual-income households, six 5-stage hierarchical multiple
regression analyses, controlling for 10 demographic variables,
assessed the impact of child care, elder care, and gender
on work-family balance and various facets of job satisfaction.
Elder-care responsibility was associated with lower levels
of satisfaction with perceived organizational support, pay,
leave benefits, and work-family balance, whereas the negative
main effects of child care were limited to leave benefits
and work-family balance. However, child-care responsibility
also interacted with gender: Its negative influence was greater
on women's work-family balance and leave satisfaction. Decrements
in satisfaction associated with dependent care on the "sandwich
generation" were additive, not interactive.
Ponzetti, R.K.
& Ponzetti, J.J., Jr. (1999). Corporate
Opportunities for Intergenerational Linkages: A Human Resources
Perspective. Child & Youth Services, 20(1 / 2),
149-159.
Abstract: The potential impact of dependent care needs on
corporate employers and employees is described. Recommendations
are made regarding the development of effective intergenerational
approaches to meet these needs and reduce their associated
expenses. The roles of human resource personnel, intergenerational
program developers and intergenerational program researchers
in such initiatives are described
Seaward M.R. (1999)
2nd Quarter. The sandwich generation copes with elder
care.
Benefits Quarterly,
15(2), 41-8.
ABSTRACT: The "sandwich generation" refers to the
demographic age group of individuals who are caring for young
children and elder parents at the same time. The increasing
number of employees who must care for children and parents
alike is a trend that is projected to continue. This is a
burdensome responsibility that can cause stress and result
in loss of productivity, accompanied by higher cost, to employers.
The author discusses elder-care services that employers can
offer to enhance productivity and gives case examples of companies
that are making elder-care benefits available to employees.
Spillman, B.C.
& Pezzin, L.E. (2000). Potential and active family
caregivers: changing networks and the "sandwich generation".
Milbank Quarterly,78(3), 347-74, 339.
ABSTRACT: Informal family care giving has been a traditional
mainstay of care for the frail elderly. As the Baby Boomers
approach retirement and old age, it is not clear that society
can continue to rely on informal arrangements. The 1984 and
1994 National Long Term Care Surveys were used as sources
for examining changes over a decade in the population of chronically
disabled elderly, their sources of care, and the characteristics
of family caregivers. The results showed that although the
total number of active family caregivers declined, a constant
number of primary caregivers was looking after recipients
who were more severely disabled. Members of the "sandwich
generation" and full-time workers maintained or even
increased their participation as primary caregivers. The competing
demands confronting these caregivers and the higher disability
levels among care recipients probably contributed to the growing
pattern of reliance on formal care, a situation that is likely
to continue.
Next week, I'll
pull together resources on the growing number of grandparents
assuming the roles of primary parenting of their grandchildren.
|
