A Fresh Pickle for The Sandwich Generation: The New Economic Realities of Eldercare

Perhaps you’ve heard of the Sandwich Generation, those millions of Americans caught between the costs of raising kids and also taking care of dependent, aging parents.  Saving for college versus more meds for Grandma—those kinds of choices have always made life in the “sandwich” a daunting challenge.  However, we face a new set of economic realities that will put adult children in an even more difficult place:  a fresh pickle in a sandwich already tough to chew.

There are actually two major social forces now pressing together in American life with tectonic intensity.  They are opposing trends that are already sending shock waves through existing economic models for eldercare. And they are going to touch everyone’s life who has aging parents—Sandwich Generation or not.

Let’s start with the good news—a trend towards longevity. Our parents are living longer—way longer. In fact, adults over 80 are the fastest growing segment of the population. However, most will spend years dependent on others for the most basic needs.  That brings up a not so good reality:  You may well wind up caring for your parents longer than you did for your children.  So you will need access to more financial resources than in the past to ensure the dignity of life your aging parents deserve.

Unfortunately, that brings us to the second major—and opposing—trend: receding government assistance in eldercare programs.  Traditionally programs such as Medicaid have taken over when the resources of the aging parents were exhausted.  The financial status of their adult children was not taken into the equation when assessing eligibility for parents.  When Mom and Dad’s savings were gone after the initial “spend down” phase, Uncle Sam stepped in to pay the bills.

However, addressing a colossal national debt is now forcing the Federal government to look hard at a new source. You guessed it: adult children.

As Jane Gross explained in the New York Times New Old Age blog, “The staggering cost of long-term care and the explosion in the number of people who will need it has prompted a second look at ‘filial responsibility laws’ as a way to deal with the impending crisis.” She went on to describe how 30 states already hold adult children legally responsible, at least on paper, to pay for necessities like food, clothing, shelter and medical attention for indigent parents.
So whether through family loyalty or future laws—adult children today can expect to be held more financially responsible—and for a much longer time—than the preceding generation for the needs of their aging parents.
These new economic pressures aren’t going away. So what can be done?

Clearly, adult children will have to actively build their eldercare acumen in regard to costs, benefits, and levels of care.  There has never been a broader range of options and competition has created some remarkable values—if you know where to look. As you embark on your adventure in self-education, allow me to offer you a very useful mantra to repeat over and over:  cost containment and self-preservation.  Never let that pair of ideas stray from your criteria and you will steer a wise course.

Cost containment forces the question:  Do I know how much the total cost is now and can I predict what it will be in the future?  Unplanned medical expenses are one of the major causes of bankruptcy for otherwise financially viable families. Rather than attempt to purchase separate services a la carte and cobble them together —look for service packages that are inclusive of meals, health services, and even housing if needed—at a capped rate.  You know when you write that check each month what the amount will be.

Self-preservation means—to use an air travel analogy—you keep your own oxygen mask on before you attempt to secure a family member.  Americans have never been busier to make ends meet and the emotional stress and physical wear of serving as a primary caregiver is not in the best interest of your family.  For example, family members who become caregivers for memory patients run a high risk for stroke and heart attack themselves.  Your family, employer and parents need you at your best.

So, for both cost containment and self-preservation, be prepared to entrust your aging parents to a professional care giving environment when aging parents lose the capacity for independent living.  Your spouse and children shouldn’t have to compromise the best years of your life, when others can do the job for you—and much better.

Surprisingly, it can be much more cost effective than trying to orchestrate a succession of services in and out of your home.  Senior communities that provide assisted living often also provide a range of medical services which can include skilled nursing and even memory care.  So your parents would never be separated due to differing health.

Already an estimated 22.4 million US Households—one in every four—are providing care for a relative or friend aged 50 or older.  If you’re not one of them now the odds say you will be at some point in the future. Now is the time to start learning your options—in order to become something of an expert—in shopping the kaleidoscope of senior services now available, and those on the way.

Trust me, you can do this. Millions of Americans already are.  A good place to start is a local senior care expert who is trained to review your individual case and offer you a range of options.  People in this field are generally quite family focused and can provide a very objective perspective on where the best fits for senior care are for your aging

parents.  The main idea I want to leave with you is: Start this learning adventure today.  Once you’ve gotten the scope of options clearly in mind and mastered a smattering of eldercare jargon—you can be confident that you are equipped to make the right choice.

You can’t make the pickle go away but you can make it a whole lot sweeter.

For more facts on the various options available for aging parents in the local area, please contact Lynda Brislin, executive director at Windham Terrace in Windham, New Hampshire at lbrislin(at)terracecommunities.com.

About the Author
Christine Wirthwein is a senior housing and healthcare consultant, with decades of experience. Wirthwein has been involved with over 200 communities in 24 states throughout the United States and Canada. Having worked in the senior living industry since 1983, Wirthwein understands the vast difference between today’s seniors and the many choices they and their adult children can opt for.  She understands that they’re not only living longer, more active lives but also bring significantly higher expectations to their retirement years.  Her passionate work with seniors and their adult children over the past 27 years equips her to offer incisive perspective on the many—and often complex—options that exist.


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