Why are middle aged adults sometimes described as the sandwich generation multiple choice question?

Recession, coronavirus and shifting demographics are intensifying the pressures on the ‘sandwich generation’ – those supporting both children and parents.

Jo Austin would love to have a PA. At home in Central England, the financial services worker, who’s in her late 40s, wakes up very early to drive her husband to the supermarket where he works. They don’t want to risk him catching coronavirus on public transport because of the disabilities of their son and his girlfriend, both in their early 20s. 

When Austin returns from the supermarket, she’ll log several hours of remote work. At some point her mother, who lives a few miles away and is in her early 80s, will call. They might talk about the online food shopping order she’s placing for her mum, or when her next medical appointment is. There might also be admin calls to make, for instance to her mother’s utilities companies. Every other day, Austin will go and visit her. 

She takes a break from work at lunchtime to collect her husband from his job. At this point her son and his girlfriend might need some help filling in forms or doing other tasks associated with their supported employment programme. By the time she’s squeezed a full day of paid work in between all her unpaid work, Austin will be lucky to have an hour to sit in front of the TV to relax. “It’s a lot of juggling, it’s blooming hard work, it’s exhausting,” she admits. 

There’s another word for it, too. Like so many people in her phase of life, Austin is sandwiched.

In the broadest sense, the “sandwich generation” is the “caught in the middle” generation who have living parents and children. More specifically, the term often refers to middle-aged people who support both their parents and their children, whether financially, physically or emotionally. Multigenerational needs have become even more pressing during the Covid-19 pandemic, with record numbers of adult children moving back home and with elderly parents needing new forms of care. 

The pandemic has put many in untenable positions; people who were already bearing intense loads are facing more strain, stress and precariousness. This pressure is only mounting on the sandwich generation, as support and vital resources are scarce. So, as more millennials become caught in the middle, there’s one major question: how, exactly, do we care for the carers? 

Multigenerational ‘squeeze’ 

Sandwiched individuals, who may or may not be living with the people they’re supporting, look a bit different around the world. In the Philippines, sandwiched women tend to be aged 30 to 35, whereas in England and Wales they’re typically between 45 and 54, like Austin. 

In the UK, about 3% of the population is providing care for more than one generation, whether in the same home or across multiple homes, according to Athina Vlachantoni, a gerontologist at the University of Southampton. It sounds low. Yet while there are ethnic and class differences in life expectancy and household formation, the number of sandwich carers is rising as people generally have children later and live longer.  

In some families, grandparents are playing a key role looking after children so their parents can work (Credit: Alamy)

We’re also seeing more “triple-decker sandwich” or “double sandwich” individuals. This involves, for instance, people in their 60s helping to care for their grandchildren, which allows their adult children to work, as well as supporting their own parents in their 90s. 

Perhaps unsurprisingly, there are gendered differences in sandwiched pressures. “In general, we know women more likely to provide more intensive personal care to older relatives than men, with men providing support for practical tasks including finance and gardening,” explains Vlachantoni. Men are also more likely to provide support as part of a couple. 

Overall, terms like “squeezed” express the heavy pressure on people juggling duties in all directions. But being embedded within multigenerational responsibilities also carries benefits. In particular, healthy grandparents can be a huge boon to working parents. “The role of grandparents has significantly increased over the last decade or 15 years,” says Vlachantoni. “Older parents facilitating especially younger women to stay in the labour market and become more senior and progress is a very important dimension of the sandwich generation.”

In the US, happiness rates are roughly the same between people in and out of the sandwich generation. In the UK, Austin enjoys her life, busy as it is. The family’s finances are stable and they have a three-bedroom house to spread out in. “It is what it is; I love to care for my family,” she says. “Yes, sometimes I’d just love to go and sit in a dark room for a few hours. You just have to get on with it. You just have to adapt. It makes you very resilient to things.” 

But the positive effects of being sandwiched can’t be realised if the stress overpowers the ability to cope. 

The Covid-19 effect 

In the last year, the way Covid-19 has tested government resources and increased unemployment has made family support even more crucial. This is manifesting in increased strain on both time and finances for the sandwich generation. 

Katherine Wilson, head of employment at Carers UK, reports that of carers surveyed by the charity in October, “some have felt they have had no choice but to reduce their hours or give up work altogether without access to their usual formal and informal support”. Formal support includes things like day-care and eldercare facilities, while informal support might mean occasional help from friends, community or other family members. For Austin, pre-pandemic, meaningful support could be as simple as a coffee break with office colleagues when she was having a difficult day.

Many young people have had no choice but to move back in with their parents during the pandemic (Credit: Alamy)

Sandwiched Americans, meanwhile, are feeling the financial pinch more. According to the life insurance company New York Life, caregiving expenses have risen during the pandemic, with caring for an ageing relative now averaging about $1,000 per month. This is partly related to spending more on necessities. Medical expenses have become especially onerous as health insurance in the US is so often tied to employment, which has been plummeting during the ongoing recession. 

Overall, however, sandwiched Americans are more likely to be supporting young adults than elderly parents, something that has intensified during the pandemic. In July 2020, 52% of 18- to 29-year-olds were living with their parents – the highest proportion recorded since the Great Depression.  In the UK, more than half of those who moved house during the pandemic were aged 16 to 29, and they were largely moving in with older relatives, according to preliminary research by Vlachantoni and her colleagues on Covid-19-affected living arrangements. It’s not clear how long they’ll stay – Vlachantoni points out that these shifts were out of necessity rather than choice – but early evidence shows that such changes “were associated with a rise in stress”. 

The carers of the future 

In addition to immediate impacts on sandwiched people, Covid-19 could have more far-reaching effects. A key question is how its economic impact will delay young people’s progress toward important life and financial milestones, which will feed into their ability to function independently later on. “Resources accumulated throughout the life course are pivotal for people’s later life. And when I’m saying resources, I don’t just mean money. I also mean partnership, having children and investing in occupational pensions and property,” says Vlachantoni.

Accumulating these resources was already challenging pre-pandemic, amid more precarious work, higher housing costs, potentially less generous pensions and greater longevity. And Covid-19 has had crushing effects on employment, education, indebtedness and dating. It may well take longer for young adults to reach the milestones associated with less dependence on parents. Thus, a number of parents may need to help their adult children for longer, and in more complex ways, than society might have envisaged. 

“In the US right now, older adults are on average better off financially than younger adults are. So, they don’t always need as much financial support as these young adults, the millennials, who were hit hard with the Great Recession and really struggled to get their financial footing,” says Kim Parker, director of social trends research at the Pew Research Center. “And now we’ve got a new generation of young adults who are coming of age in a pandemic, and having moved back in with their parents.” 

Covid-19 is also pushing millennials into the sandwich generation faster than might be expected. In the US, millennials now make up more than one-third of multigenerational caregivers – and this rate has been growing much faster during the pandemic than for Gen Xers and Baby Boomers. In other words, the pandemic has accelerated the slide into the sandwich, and with fewer of the resources that helped previous generations out. As well, the general trend of smaller family sizes means that there will be more only children in the future, with no sibling support as they look after ageing parents. 

Reducing the squeeze 

At the moment, in the absence of strong state support, sandwiched women are often left to pick up the slack. For instance, Vlachantoni and colleagues have written that in China, “the state remains predominantly dependent on the family for the delivery of care for older people and infant/toddlers”. Women have been encouraged into the workforce, but public nursery provision remains inadequate, so grandparents often take the place of public services. While China may provide a stark example of this trend, it’s visible in many other countries as well.

In China, family members are expected to take on caregiving duties for both young and old (Credit: Alamy)

When it comes to transferring these services from the family to the state, we already know what will help. Subsidised childcare and eldercare, as well as paid parental leave, will ease the burden on the sandwiched. In recognition of the important role of grandparents in caring for grandchildren, often at the expense of their own employment, some form of grandparental leave could be useful as well. 

On the employers’ side, enabling adjustable work patterns would be helpful, as evidenced by Austin, who deals with her many duties by keeping her schedule as flexible as possible. She’s fortunate to have excellent relationships with her colleagues and an employer that supports flexible work; she works a nine-day fortnight, fitting slightly longer workdays into a slightly shorter time span. “There are people at work I exasperate because I’ll move meetings,” she acknowledges. Telling people about her caring responsibilities helps. “I think if people know, they’re more understanding and accommodating.” 

One small silver lining of the pandemic has been the normalisation of flexible and remote work for those in the knowledge economy. If this continues post-pandemic, carers may find it easier to remain employed. “We know that flexible working is really valued by carers and we want to see this offered to carers from day one of starting a new job,” says Wilson of Carers UK. 

Certain policies would be especially impactful in specific countries. Carers UK is calling for larger carers’ allowances and five days of paid carers’ leave for working carers. In the US, the lack of public healthcare clearly affects the health and finances of all parts of the sandwich. In South Africa, small, mobile childcare units – for instance inside food markets where many women work informally – could provide affordable spaces for women to leave their children. 

The problem is that while investing in social-care infrastructure now would have many benefits, it may be a challenging proposition for governments whose coffers have already been crunched by the pandemic. 

“I’ve always found that effective policy tools are the ones that give individuals real choice,” reflects Vlachantoni. Having more options would help carers maintain their varied family ties while preserving their financial, mental and social wellbeing – especially those who have less income security than Austin. Undoubtedly, the sandwiched could use more support as they themselves support others – and as they pave the way for the sandwich individuals of the future.