Kathy L. is a 46-year-old mother of three living in North Carolina. Five years ago, she moved her family to her hometown in order to care for her aging parents, but for the past year and a half, the family has devoted a lot of time and resources to caring for her husband’s aunt, suffering from dementia. Her children were 15, 11 and 9 when the aunt came to live with them last summer.
Initially, the plan was to care for the aunt in their home for 12 weeks, after which her long-term care insurance would kick in to cover the cost of an assisted living facility. But after 8 weeks, the family decided to pay out of their own pocket to move him into accommodation.
“Our family has reached a breaking point,” Kathy L. told HuffPost.
“Patients with dementia can often become aggressive because they are confused or scared and don’t know what is happening,” she explained. While her two older sons were able to handle the aunt’s tantrums, her youngest child struggled. Kathy L. said her 9-year-old daughter “cried every day and was terrified to say or do anything that would make her angry.”
Additionally, her husband obtained power of attorney for his aunt, handling her finances, clearing out and selling her house.
Despite these challenges, Kathy L. says the experience of providing this care has not been entirely negative. “I also feel very honored to be able to help,” she said. “There are many layers of feelings involved. »
People like Kathy L. who find themselves in the dual – and sometimes competing – roles of simultaneously providing care to children and the elderly are sometimes referred to as the “sandwich generation.”
With an aging population and declining fertility rates globally, more and more families are at risk of finding themselves in this situation.
A research group at the Max Planck Institute for Demographic Research (MPIDR) in Rostock, Germany, led by Diego Alburez-Gutierrez, recently published a paper titled “Projections of Human Kinship for All Countries.” Using data from the United Nations World Population Prospects 2022 report (the most recent year available), researchers were able to make probabilistic predictions about what families of the future will look like.
An important finding is that family networks – measured by the number of a person’s biological relatives – will shrink. (Although researchers understand that family can mean much more than the people who are biologically related to you, for the purposes of this research they did not include other kinship relationships such as spouses, in-laws, adopted children or LGBTQ family structures).
People will have fewer living relatives on average. “At every age, we see that as we move into the future, families are going to get smaller,” Alburez-Gutierrez told HuffPost.
For example, a 65-year-old woman in 1965 might be expected to have 41 living parents, whereas a 65-year-old woman living in 2095 would only have 25. Factors in this change include delay of procreation and the decline in fertility. rates. Some countries have already seen their birth rates decline, while others may experience this trend in the years to come.
Another trend shaping demographics, researchers say, is that families are becoming “more vertical,” Alburrez-Gutierrez said. “That means you’ll have fewer lateral relatives – siblings, cousins - and because people live longer, that means you’ll have more genealogical generations going on at the same time.”
In other words, you’ll probably have fewer siblings and cousins, but you’ll be more likely to meet your great-grandparents.
One finding that was striking, he said, was that “the probability of a newborn having a living grandparent, say in the Global North, will be 100 percent in the years to come.”
Also, “in Europe, it will be increasingly common (for a baby) to have up to six living great-grandparents at birth.”
Researchers have also found growing age gaps between generations within families, leading people to become grandparents (and great-grandparents) at older ages. For example, if you have a child at age 20 and that child has a child at age 20, you become a grandparent at age 40. But if you have a child at 40 and then your child has a child at 40, you won’t become a grandparent until you’re 80. Rising life expectancy means you’re more likely to witness the birth of grandchildren – and great-grandchildren – but these growing age gaps mean you’re more likely to be frail or disabled when you meet them.
These demographic changes have advantages and disadvantages.
One of the great benefits of increased longevity is that we are more likely to meet, spend time, and form relationships with our grandparents and even our great-grandparents.
Ellen Carbonell, a professor of social work at Rush University, explained that the role of grandparents in the United States has changed over time.
“Today, grandparents’ roles are more diverse than ever,” Carbonell told HuffPost. In addition to their “traditional roles as family historians and providers of love, support and wisdom,” Carbonell explained, grandparents are more likely to play the role of child care providers.
“It’s no longer just a matter of ‘babysitting’ their grandchildren to give parents free time, but many grandparents regularly care for their grandchildren,” Carbonell said.
Since grandparents are on average older when their grandchildren are born, they are also more likely to be retired.
“The role can be easier and more enjoyable without the competing tasks that come with the job. This greater flexibility can be seen in grandparents who move to be closer to their out-of-state children and grandchildren so they can be more involved in their daily lives,” Carbonell said.
These benefits assume good health, which is not a guarantee and becomes less likely as the grandparent ages. Older grandparents may also lack financial stability.
“Many have been unemployed or underemployed for years, or have contributed financially to the care of others, leaving them particularly cash-strapped during their grandparenting years,” Carbonell said.
When a grandparent requires financial support or caregiving, the burden may fall on family members who also care for the children, creating a “sandwich” dynamic.
These dynamics can both play out at the same time within the same family. Kathy L., for example, was able to turn to her mother to help care for her children, while also caring for her own father and her husband’s aunt. Aspects of his situation were both emotional and logistical.
With so many generations living at the same time, we are increasingly witnessing what Alburez-Gutierrez calls the “big sandwich” and Carbonell the “club sandwich” of a generation that takes care of its parents, its children and his grandchildren. Such a burden can take a heavy “physical, emotional and financial toll,” Carbonell said. In other words, increased longevity may mean more caregivers, but also more caregiving responsibilities.
“The increased availability of grandparents and great-grandparents in the future, which we think is likely to happen, does not necessarily mean that there will be more sources of informal care within families,” said Alburez-Gutierrez. “Actually, it might be the other way around. We will impose an even greater burden on the current generation.”
Grand-sandwich or club-sandwich caregivers, Carbonell explained, can put their own needs last and delay preventive health care. Sandwiching also creates an unstable network that can collapse in an emergency.
“Without built-in safeguards for care delivery,” Carbonell continued, “we can see how the fragility of an overburdened care system can be pushed beyond its capacity to cover care needs. »
The ramifications of these demographic changes extend beyond individual families.
With fewer living relatives within each generation, caregiving duties will fall to fewer people, increasing their responsibilities. It will also mean that more families will turn to public and private institutions to provide care to their family members who need it.
“One of the challenges will be that even in countries that have taken into account the aging of the population and introduced measures to try to address it in terms of restructuring pension systems or changing the retirement age, retirement, they always assumed that there would be a “constant pool of informal support” to provide care, Alburez-Gutierrez said.
Grandparents step in to fill the child care void. Kathy L. and her husband step in to care for her aunt. Without this unpaid work, our society could not function. If the shrinking and aging population forces us to outsource more of this work and pay for it, it will require a huge financial investment.
Carbonell pointed out that caregiving, whether for children or the elderly, often falls to women. When they take time off work to care for family members, they lose both seniority and years of accumulated pension or social security contributions.
Paid caregivers are also typically women, many of whom are immigrants, and pay for this work is often low, leading to high turnover.
As it stands, the system is fragile and the combination of increased longevity and falling birth rates continues to add to the stress.
“This country does not have a comprehensive long-term care system, especially for the elderly. It is crucial that this issue is investigated and addressed quickly, as an increasingly aging population will need care for which there is currently no plan,” Carbonell said.
While these are serious concerns, a “sandwich” situation in which your children see you caring for elderly family members can also be a source of meaning and reflection.
“As difficult as it was last summer, I think our kids saw what it’s like to take care of your family,” Kathy L. said.
“Our 15-year-old once saw us cleaning up our aunt’s tracks…and he said, ‘Wow, I can’t wait until it’s my turn to do that for you guys.’ And I was struck by two competing feelings: one, I hope you never have to do this for me, and two, I’m so grateful that you’re automatically expected to do this.