In the United States, from 1900 to 2000, life expectancy increased from 47 to 76 years. Similar improvements in the human life span occurred in other developed countries, such as Japan and Sweden. One consequence of humans living longer is an expanded population of older adults. This remarkable growth in the aging population has resulted in concern about the availability of family caregivers. Researchers consistently report that family members, especially female family members, provide the majority of instrumental and expressive care to their aging loved ones. Due to the social patterns of delayed parenting and increased female labor-force participation, a generation of middle-aged adults are becoming increasingly caught between the demands of child rearing and providing care to their aging parents. This trend, identified as the sandwich generation phenomenon, has become a topic of considerable research interest.
In 1981, Dorothy Miller coined the term sandwich generation to refer to inequality in the exchange of resources and support between generations (Raphael and Schlesinger 1994). Specifically, Miller was referring to a segment of the middle-aged generation that provides support to both young and older family members yet does not receive reciprocal support in exchange. Miller emphasized the unique stressors of multigenerational caregiving and the lack of community resources available to assist the middle generation. Because multigenerational caregivers are most often women dealing with the complex role configurations of wife, mother, daughter, caregiver, and employee, some researchers use the phrase women in the middle interchangeably with the sandwich generation (Dautzenberg et al. 1998).
Despite the importance of the experiences of middle-aged adults and their caregiving responsibilities, some variation in the conceptualization and definition of sandwich generation families exist. Conceptually, some researchers emphasize the demographic implications of this family type, whereas others point to the consequences of this family arrangement on individual well-being and family functioning (Dautzenberg et al. 1998). A number of researchers define this population as middle-aged adults caring for young children (less than the age of 18) and aging parents simultaneously. Other researchers, however, insist this population consists of middle-aged parents caring for aging parents as well as young adult children (18 years of age or older) (Chisholm 1999). Finally, in addition to disagreement over the age of the child or children, there is also disagreement as to whether the youngest generation must be living in the home or not, or if providing financial support to children is sufficient for middle-aged adults to be considered sandwich generation members (Nichols and Junk 1997).
Most likely as a result of this definitional inconsistency, some controversy exists over the prevalence of a middle generation sandwiched between younger and older family members. Elaine Brody (1985, 1990) suggests that due to increased life expectancy and the need to provide care to aging parents, many middle-aged women will inevitably spend time as women in the middle. Brenda Spillman and Liliana Pezzin (2000) reviewed the 1994 National Long Term Care Survey and found approximately 3.5 million individuals, primarily women, were responsible for both an aging parent and a dependent child. In contrast, other researchers, (Spitze and Logan 1990; Ward and Spitze 1998) consider the sandwich generation phenomenon to be a gerontological myth. Because child care and elder care generally occur sequentially rather than simultaneously, some researchers view the sandwich generation family form as an exception rather than the norm (Loomis and Booth 1995). The majority of empirical studies examining multigenerational caregiving have been conducted using samples that are often small and non-representative. As a result, more nationally representative studies, both in the United States and in other developed countries, are needed to assess the likelihood of families experiencing multigenerational caregiving and the impact these responsibilities may have on family relationships and family functioning.
Few international studies have been conducted on multigenerational caregiving. One study conducted by Maaike Dautzenberg and colleagues (1998) examined the prevalence of women in the middle in the Netherlands. Limiting their population-based sample to women aged 40 to 54, the authors found that 29 percent of respondents cared for children in the home as well as parents or parents-in-law. Moreover, these mothers also provided care to adult children living outside of the home and to grandchildren. If a broader definition of care were utilized, 34 percent of the sample would have met the criteria of multi-generational caregiving. Other studies involving small non-representative samples of women from Canada (Raphael and Schlesinger 1994; Schlesinger and Raphael 1992) and Israel (Remennick 1999) also provide documentation of women caring for both aging parents and children of varying ages.
Impact on the Family
Research investigating the effect of multigenerational caregiving on family relationships and family functioning is limited. Laura Loomis and Alan Booth (1995) looked at a national sample of middle-aged married persons to document the effect of multiple caregiving responsibilities on individual caregivers. The authors found that multi-generational caregiving had little to no effect on the dependent variables of psychological wellbeing, satisfaction with leisure time, financial resources, or marital quality. Russell Ward and Glenna Spitze (1998) investigated the frequency of multigenerational caregiving and the impact of these responsibilities on perceived marital quality. Even though women provided more assistance to children and parents than men, marital happiness was shown to increase with age. Berit Ingersoll-Dayton, Margaret B. Neal, and Leslie Hammer (2001) examined the beneficial aspects of receiving help from the aging parents to whom sandwich generation members were providing care. Results indicated that receiving help from aging parents was both positive and negative for sandwich generation members. Emotional support was consistently beneficial, whereas instrumental support (i.e., financial assistance, help with child care and domestic tasks) was problematic.
A small number of researchers have examined the effect of multigenerational caregiving on the well-being of children and adolescents. Jacob Kraemer Tebes and Julie T. Irish (2000) evaluated the impact of support interventions for multigenerational caregiving mothers on the behavior of their children. The authors found that children of intervention participants displayed reduced depression and increased social competence. Sharon Hamill (1994) evaluated parent-adolescent communication among middle generation caregivers and found that strain between caregiving mothers and aging parents was associated with poor communication with adolescent children.
Although researchers disagree about the prevalence of the sandwich generation phenomenon, the demographic trends of delayed parenting and increased life expectancy are irrefutable. In order to accurately estimate the frequency of multigenerational caregiving and analyze the impact of this caregiving arrangement on the family system, a universal definition and more representative sample studies are needed.
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