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From Making Sandwiches to Being Sandwiched

Three generations of womenWork-life balance for working caregivers may be difficult. But you are not alone – among the 44 million unpaid elder caregivers in the US, 75% are employed.

Sally is 49 year old caregiver to her 90 year old mother with Alzheimer’s Disease. Sally is also the mother of two teenage sons and she works full time supervising a multi-million dollar program. Between her job, taking her sons to after-school activities, and caring for her mother, she has little time for her own hobbies and interests. Lately she feels distracted at work, a problem referred to as “presenteeism.”

Sally sometimes has trouble finding time to exercise and manage her health conditions, being that she is “sandwiched” between the needs of an aging parent and the challenges of raising children. She is part of the sandwich generation, traditionally defined as those who are at the same time caring for an aging parent and raising a child under the age of 18 years. The Pew Research Center has reported that a little over 1 in 8 Americans are both raising a child and caring for a parent, and there are seven to ten million adults caring for an aging parent who lives far away.

Adult daughter with senior father on park bench

Caregivers provide connection and compassion to promote Healthy Aging.

Three generations of Asian women

Although caregiving can be a challenge, many people who are caregivers report a temendous feeling of satisfaction and purpose.

Manager consoling employee

Establishing a work life balance is important for caregivers. So one step is to talk to your employer and let them know your needs.

Among the 44 million unpaid elder caregivers in the U.S., 75% are employed, so Sally is not alone. The average employed caregiver works about 35 hours a week. Although Sally is a caregiver by definition, she might not label herself as such, and simply see her care of her mother as part of her normal family responsibilities. A caregiver is defined as a person who takes responsibility for another person who cannot fully take care of themselves.

Establishing a work-life balance may be even more difficult for those with caregiving responsibilities. Consequently, many working caregivers have to change their job situation in order to make time for their caregiving tasks. Often these changes include reducing working hours, taking a leave of absence, downgrading to a less demanding job, or turning down a promotion. In some cases, working caregivers may lose job benefits by reducing work hours, receive warnings about performance and attendance, retire early, or leave the workforce entirely. All told, not being at work, lost productivity (presenteeism), and replacement costs among caregivers of older persons is believed to cost U.S. businesses $34 billion per year.

Caregiving can take a toll on health. Caregivers report higher levels of depression, anxiety, and lower quality of life. Research has shown that 17% of caregivers rate their health as “fair” or “poor” compared to 10% of non-caregivers.

If you are a working caregiver, here are some tips you can use:

  • Talk to your employer. Let your manager know your needs related to caregiving. Make it clear that you are committed to your job and want to find ways to remain productive. Work with your employer to see if you can change to a more flexible work schedule or work from home.
  • Resist being by yourself and accept help. Find support in and out of work. Join community caregiver groups for emotional support, and seek out local resources for help. Take advantage of resources, such respite care and adult day care, to coordinate caregiving within your family and support network.
  • Talk with your family and friends about your loved one who needs care. Sometimes families can feel neglected, so be sure they understand the demands on your time and are supportive by helping out with chores and other activities.
  • Take care of yourself so that you can take care of others. As often as you can, get enough sleep. Eat sensibly, use alcohol in moderation, and exercise. Take a break when the pressure gets too great, even if it’s just a hot bath or a short walk. Walking with a buddy can cover two needs at once—friendship and exercise.

For additional resources, visit the Caregiving website and Caregiving Resources.


  1. Caregiving in the U.S. 2015. National Alliance for Caregiving Public Policy Institute. Washington, D.C.
  2. Policies and Interventions to Support Working Caregivers. Association of States and Territorial Health Officials. 2016.
  3. The Sandwich Generation: Rising Financial Burdens for Middle Aged Americans. Pew Research Center, 2013.