6 Tips for the Sandwich Generation: How To Make Difficult Choices

Caring for aging parents is tough. Raising children is tough. And when you’re caring for both at the same time, well that’s a whole other level of challenging. According to an AARP report 44 percent of women ages 45 to 55 are in the difficult position of caring for at least one parent and one child under the age of 21.

tips for the sandwich generation

If you are one of those women, living in the sandwich between two generations, the choices you have to make can often feel like false choices. Go to your child’s sporting event or visit your sick parent? Visit your mother in hospice or your father in memory care? Go on a business trip or stay home on “death watch”? Sleep at home and have breakfast with your family or sleep at the hospital with your parent? Answer the ringing phone from a hard-to-reach doctor or watch your son blow out his birthday candles? Take a vacation or stay home and be the dutiful daughter? How do you choose?

I faced all of those scenarios in the last few years. Choosing wasn’t easy and didn’t always feel like a choice. I often felt caught between two competing demands. But ultimately, everything we do is a choice.

Recently, I spoke with Denise Brown on her Caregiving.com podcast about how to make those seemingly impossible choices. Here are my top tips for the sandwich generation and how best to make decisions.

6 Tips for the Sandwich Generation


1 Know your value system. In order to choose between two competing priorities, you need to be crystal clear about what you value. There are many different ways to parent: attachment or free-range, strict or lenient, electronics or not. There are just as many ways to “daughter.” None of us approach our family life in the exact same way – and that’s okay. We all have different value systems and therefore none of us will make the exact same choices. I hate missing even one of my kids’ soccer games, but I did, many times, when my parents were sick and in crisis. That’s because I value talking to my kids more than I value showing up. And so facing too many demands on my time, I would rather skip a game where I would watch my kids play but not talk to them, and visit my parents during that time instead. I could talk to my kids later, if not in person, then over the phone or via text. Likewise, I would skip hospital visits if I knew my parent would be asleep the whole time. I didn’t need credit for showing up; I needed connection.

Someone else might value showing up. They might choose to attend the game and then visit their parents later when their kids were decompressing. They might choose to go to the hospital every day even if their parent wasn’t going to be awake or conscious. And that’s okay too. Make your decisions based on what you value most. If you are honest with yourself, your choices will feel simpler.

To help you identify what matters most to you, download the Finding Balance Worksheet here.


2 Ban the word “should.” I’ve written about this before, and I will write about it again because I cannot stress enough how harmful the word “should” is. Any thought you have that starts with “I should” is someone else’s value system playing in your head. There are no shoulds. You cannot make good decisions if you base them on what other people think you should do. They do not know all that factors into your decision, nor do they need to.

When I chose to take my family on vacation without my father, even though I knew he was lonely, it may have looked to outsiders that I was heartless, or selfish, or uncaring. I knew there were people who would judge me for my choice but I couldn’t worry about that. I knew that I had been good to my father. And I knew I would continue to do so. I also knew that my children had felt the impact of me caring for my mother and that they needed me to be their Mom and nothing else for a week. I knew my husband needed me to put him first for a few days and I knew all that he did for my father behind the scenes. I knew my father would be well cared for by the assisted living staff while I was gone. I knew that I had made arrangements for my father to receive daily phone calls while I was away. I knew that I needed to relax and have some fun and that doing that would make me a better caregiver. I also knew I did not need to explain any of that to anyone who thought I should do something else because I have banned that word from my vocabulary. And you know what? I had a great vacation with my kids and husband, and my father was just fine.

3 Accept the fact you are not a supreme being. But what if while on that family vacation, something had happened to my father? What if he had gotten sick, or fallen, or died? Would that have been my fault? Would I have been able to prevent it from happening? Highly unlikely. Because despite the fact I’d like my husband to refer to me as the goddess, I am not a supreme being. My thoughts and actions do not control anyone’s fate but my own.

As caregivers, we are warriors. People rely on us. We get sh*t done. We shoulder so much more than we ever thought was humanly possible. But we do not control other people’s fate. We need to remember that and chill out a little more. Not every decision we make is life or death.

4 Avoid hyperbole. My mother spent the last three months of her life in a hospice home and I spent lots of time there with her. It’s where I wanted to be…mostly. But I also wanted to be home. I wanted to be with my kids. I wanted my normal life back. Sometimes, when my mother was sleeping, I went into the woods outside the home and cried. Why did I always have to sacrifice for my parents? Why could I never catch a break? When my kids, or my husband, or my boss would call and I was in one of those moods, I couldn’t make decisions. Should I go home for dinner and leave my mother for a few hours? Should I go to a client meeting or stay at the hospice home in case my mother needed me? I’d become paralyzed facing fairly simple choices. What difference did a few hours make, at least in the early days of my mother’s stay? They didn’t. But when I thought in hyperbole, “I always…” or “How come I never….” Small, simple decisions became enormous and complex. If you find yourself thinking that way, ask yourself if your thoughts are true or if they would be more accurate minus the words always and never? When you lower the stakes by removing the hyperbole, your decisions become a lot simpler.

5 Be pragmatic. My mother was diagnosed with Stage 4 ovarian cancer on the same day my father was diagnosed with dementia. Immediately following the diagnoses I scaled back at work. I canceled business trips, reduced my hours and workload, and got backup support to help me with my client load. I had a lot to sort out, like medical treatments, living arrangements, and estate planning. Back then, I used to travel cross-country once a month for meetings but I skipped the first month, and then the second. I was too busy to travel and I was worried my mother might die while I was away. But when month three came around, my mother’s health seemed to have plateaued. She had been steadily declining, and then she leveled off. Did it make sense to skip the trip if nothing was going to happen while I was gone? But what if she got worse while I was away?

In order to make my decision, I needed to avoid that “what if” thinking and be as pragmatic as possible. The Merriam-Webster definition of pragmatic is, “dealing with the problems that exist in a specific situation in a reasonable and logical way instead of depending on ideas and theories.” That’s exactly what caregivers need. The facts were I needed my job because I need to earn a living, I had business to handle in California, and my mother had been declining but was currently stable. I took the trip. If I had depended on ideas and theories I would have second-guessed myself into a frenzy. Something bad could have happened while I was away. But I made my decision based on a specific situation, not a million possible scenarios.

6 Know there are no perfect answers. When we are caregivers, we make a lot of decisions – a lot of really important decisions. We make medical, financial, and emotional decisions all the time. And we often make those decisions under stress and with fear and time constraints. I had to find both of my parents places to live in five days — and they couldn’t live together because they had different needs. I looked at as many facilities as I could in those five days, and then I signed leases. The night I signed and paid the deposits, I had a nightmare. I dreamt my mother’s primary care doctor called me and told me I had made a mistake and that I should have chosen a different facility. That same dream featured a dinner party, a pile of mulch, Central Park, and a biker gang. Clearly I was stressed – worried about whether or not I had made the right choice. But here’s the thing: there are no perfect choices in caregiving. You will make decisions and they will be okay. There will be other options. There may even be better options. So what? There are no perfect decisions in caregiving. The only truly bad decision is to make no decision at all.

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3 comments on “6 Tips for the Sandwich Generation: How To Make Difficult Choices”

  1. Carla Reply

    Sharing this but had to stop and let you know I never thought about how I’ve stopped MUSTurbating (thank you Albert Ellis :-)) and already shed those shoulds would help me as I enter this sandwich time!

  2. Sherry Macdonald Reply

    I am not a good caregiver but I guess you do what you have to. The decision making is probably the hardest part so sorry you had to go through all that.

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