#SandwichGeneration: Caring for Parents & Kids

One GenXer’s notes from the trenches — or, in this case, from the hospital — where she's caring for her sick parent while parenting her kids via text.

By Mary Vassilakos
family sandwich


Sandwich generation issues

Now more than ever, my friends and I seem to be experiencing firsthand what it really means to be part of the “sandwich generation.” I won’t mince words here. If your parents are part of the Silent Generation (born around 1925) or the Baby Boomer Generation (born around 1946) and you have not yet been squished between the needs of aging kids and aging parents, brace yourself. Because it’s coming. 

About 15 years ago, my aunts began relocating to Florida. My parents would visit them every few years. I think my Mom was intrigued by the snowbird lifestyle, but not completely convinced that the benefits of living in Florida outweighed proximity to her grandkids. Secretly, I hoped they wouldn’t do it; I liked inviting them over for Sunday supper. The kids would chat about their week — school, soccer games, friends — and inevitably my parents would share some stories from their past. 

While my parents were becoming an integral part of my children’s lives just as I’d hoped, I’m now viscerally aware of what it feels like to be trapped in between college tours, homework, my own job, and failing knees, COPD, diabetes, mystery bleeds, pacemakers, Alzheimer’s and more. Not that I’d have it any other way. My parents still live independently, but with each hospital stay, I know those days are numbered. 


The thing is, it will happen to you: Your parents will  age and it will  impact your life. While I’m in the throes of it (as I write, I'm at a hospital waiting for a doctor to come talk to me about my dad’s dodgy heart), here are some tips I can share with you:

1. Be an advocate

Nothing is more important than having a presence at appointments and in the hospital. It’s heartening for your parent and can be helpful for the physician too. If you can't physically be there, ask your parent to FaceTime you in. 

2. Pick a lead caregiver

Forget cooks in the kitchen, there’s nothing worse than too many bodies in a small hospital room or doctor’s office. Truly internalizing what a doctor is saying and plotting next steps is like a bad game of telephone operator when all the siblings want to “help.” Divide and conquer both appointments and medically related tasks.

3. Educate the doctors

Yes, you need to educate yourself about the side effects of your parent’s medications, but you may also need to educate the doctors, nurses, attending physicians, etc., about your parent. As my father sat in his hospital bed mumbling and unable to unlock his phone or tell you what year it was, I had to explain to the nurses that while this could be normal for some 80-somethings, my dad is normally quite lucid. This prompted his medical team to go through all nine of the drugs he was on to “keep him comfortable,” and discontinue most of them. The next day, dad and I were back to playing cards on his hospital bed.  

4. Be prepared

Keep a copy of all the meds your parents need to take in your phone or wallet. Check in with them after their appointments to see if anything — for example, the dosage — has changed. Similarly, keep a list of every specialist they see and know their wishes in case they go unconscious. Resuscitate? Intubate? Sorry, but it’s super important.

5. Centralize

If possible, keep all appointments within the same healthcare network so that all your parent’s x-rays, medicines and CT/MRI scans are accessible no matter which doctor they see. This is critical as it can eliminate duplicate tests and expedite a hospital admission should it be necessary. 

6. Get a timeline

If your parent is in the hospital, ask when they will go to see the doctor (some have rounds in the morning, others at lunchtime, others after work — and some keep it a total mystery). Also, ask when your parent may be discharged and what needs to happen after that. Home or rehab? Is at-home rehab an option? If your visit does not coincide with the doctor’s rounds, write your questions on an index card with your name and phone number on it, and hand it to a nurse to keep in the file for when the doc shows up.

7. Be a pain in the ass...

Ask questions as if your  life depended on them. Why this  test? What are you looking for? What are the potential outcomes? Will this operation cause executive functioning issues? This may seem like common sense, but when your parent has just passed out and doctors are scrambling around, someone needs to ask rational questions. Write down the answers, because, mark my words, you will forget them. You will also likely need to refer to these notes in subsequent appointments. Furthermore, write down the name of every nurse and doctor that attends to your parent. Little details such as knowing names can be humanizing in a very dehumanizing atmosphere.

8. ...but not too much of a pain in the ass

I probably should’ve started with this one. Yes, some doctors and nurses have the bedside manner of a troll, but they are your best hope at getting your loved one home. In my experience, the nurses have been the real heroes: Ninety-nine percent of the time, they are patient and kind while standing on their feet for 12 hours per day cleaning and treating your parent. Take the time to acknowledge and appreciate them. After all, when was the last time someone over-appreciated you? 

9. Don't forget the other half of the sandwich

While you may feel like you’re the parent to your parents at this point, try to maintain some perspective. Have dinner with your kids whenever you can (or squeeze in a breakfast), send random texts to check in and let them know what is happening (if it’s age-appropriate). And, most importantly, try to get some sleep and proper nutrition for yourself. This may not necessarily be the sandwich you would’ve ordered, but it’s the one you were served. I promise that if you use even some of this advice, it will go down easier.

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