The "Sandwich Generation" refers to those people who are simultaneously caring for family members at both ends of the life span--children and elders. The stress associated with being in the sandwich generation can constitute a social problem. Moreover, holding a job in addition to multiple family care responsibilities is a situation that affords its own set of challenges, and it is one that employers are beginning to recognize as a significant concern. At the same time, it is important to recognize that rewards result from caring for both children and elders, and that both the children and the elders can contribute positively to the well-being of the family.

Although being sandwiched between caring for children and elders (specifically aging parents) is not a "typical" situation, no official prevalence estimates exist. Although the U.S. Census details the characteristics of households, it does not include family care arrangements that occur outside of the household, as is the case with most sandwiched people whose aging parents or other elderly relatives tend to live independently or, in some cases, in a care facility. Estimates vary considerably, depending on the population sampled (e.g., the entire adult population, only women, only employees, only caregivers to elders), whether there is an age criterion for "elder" (e.g., 50, 60, 65), whether only aging parents or other elders are considered, how "elder care" is defined, whether there is an age criterion for either the caregiver or the child, or how child care is defined. Generally, taking all of these variables into consideration, estimates ranged from 10 to 20 percent of the population being "sandwiched" in some way.

Several factors contribute to the phenomenon of being sandwiched, thereby fueling the interest of public policymakers, employers, and researchers about this population. These include (a) the aging of the U.S. population, the aging of the workforce, and the increased care needs of an older population; (b) delayed and reduced childbearing in the U.S. population, the resulting increase in the ages of parents of young children, and the decrease in the number of siblings available to share in the care of aging parents; (c) an increasing number of women, the traditional caregivers of both children and elders, who have entered or returned to the labor force and the related increase in the number of families in which both the husband and the wife are working--that is, dual-earner couples; (d) an increase in multigenerational households; (e) rising health care costs and the increased pressures on families to provide care; and finally, (f) growing documentation of the dynamic interplay between work and family demands and the effects on individuals' health and well-being as well as on organizations' bottom lines in the form of absenteeism, turnover, and overall market performance.

In general, research shows that the stress associated with combining work and family care roles is related to negative individual outcomes such as decreased mental health and increased stress and strain, both on and off the job. In addition, work-family conflict is related to negative work outcomes such as increased absenteeism, decreased job satisfaction, and increased turnover. Limited research, however, exists specifically on workers in the sandwich generation. That which does exist reveals higher levels of stress, absenteeism, and decreased mental and physical health among workers caring for both children and aging parents. At the same time, evidence also exists to show that the beneficial effects of multiple roles can buffer this stress.

In the United States, responsibility for addressing workers' and their families' needs is shared among individuals, employers, nongovernmental organizations, and, last, government agencies. This is in stark contrast to most other industrialized nations that view responsibility for addressing workers' and their families' needs as in the public domain, with the government assuming leadership and legislating provisions for family care.

Advocates argue that sandwich generation families need assistance in managing their work and family role demands to alleviate potentially negative associated health outcomes. This requires recognition that work-family stress is a major public health issue related to social problems. Thus, they contend, the U.S. government should assume a level of family support comparable to that of other industrialized countries. Furthermore, employers can help by increasing work schedule flexibility and job autonomy, minimizing long work hours, and training supervisors in family-supportive supervisor behaviors. By providing both governmental and organizational support to families caring for children and elders, improvements in family well-being should result that will ultimately have a positive impact on public health and social problems.

Bibliography:

1) Neal, Margaret B., Nancy J. Chapman, Berit Ingersoll-Dayton, and Arthur C. Emlen. 1993. Balancing Work and Caregiving for Children, Adults, and Elders. Newbury Park, CA: Sage.

2) Neal, Margaret B. and Leslie B. Hammer. 2007. Working Couples Caring for Children and Aging Parents: Effects on Work and Well-Being. Mahwah, NJ: Erlbaum.

3) Nichols, Laurie S. and Virginia W. Junk. 1997. "The Sandwich Generation: Dependency, Proximity, and Task Assistance Needs of Parents." Journal of Family and Economic Issues 18:299-326.

4) Rosenthal, C. J., Anne E. Martin-Matthews, and Sarah H. Matthews. 1996. "Caught in the Middle? Occupancy in the Middle Roles and Help to Parents in a National Probability Sample of Canadian Adults." Journal of Gerontology: Social Sciences 51B: S274-S283.

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