Sandwich caregivers are an often ignored segment of family caregivers; however, these individuals significantly contribute to the home care of their loved ones. Burning the Candle at Both Ends: Sandwich Generation in the U.S., a November 2019 report by the National Alliance for Caregiving and Caring Across Generations, illustrated who the sandwich caregivers are and the challenges they face on a daily basis. We’ve included many of their insights in this article.

Who are sandwich caregivers, and what do they do?

Sandwich generation caregivers, more commonly known as sandwich caregivers, are individuals who provide care for an older relative while also parenting a minor child in their home. According to the report, at least 11 million people fall into the category of sandwich caregivers, with the majority being females in their forties. 31% of sandwich caregivers are millennials, and 49% are a part of Gen X.

Sandwich caregivers care for loved ones with a variety of conditions and illnesses. The most common is aging and frailty, followed by wounds and surgery, mobility issues, mental illness and diabetes. In addition, 20% of caregivers care for someone with Alzheimer’s or another form of dementia as their primary or co-morbid condition.

Caregivers dedicate an average of 22 hours a week to their care recipient. Three out of five caregivers perform medical and nursing tasks that a nurse or home health aide would typically provide. These tasks include injections and colostomy care. About half of caregivers perform these tasks with little to no prior training, and about 15% say it is difficult to accomplish them. Thankfully, some caregivers have help – about half report that they receive some support from other unpaid caregivers and a quarter hire aides or nurses.

Effects of sandwich caregiving

Providing care to both an older relative and a child causes a variety of mostly negative effects on the caregiver. Although caregivers do what they do out of a sense of love and commitment to their loved ones, it often takes a heavy toll on them. The study showed that family caregivers often neglected their own medical needs and health conditions in order to focus more of their time and attention on their care recipient. As a result, a third of caregivers surveyed reported high levels of emotional stress and resulting conditions such as depression and anxiety. In addition, a fifth of respondents reported physical strain, such as back pain from lifting their loved one.

Caregiving often is a financial stressor for families of sandwich caregivers. The report estimates that, on average, caregivers spend almost $7,000 per year on caregiving out of their own pockets. In addition to the financial burden, many caregivers work jobs that don’t provide benefits, such as paid leave, that could help them manage the responsibility. This leads caregivers to leave jobs or make less career progress than their non-caregiving counterparts.


Caregiving is a big responsibility, but luckily there are some steps you can take to lighten the load. Here are some tips that can help:

  1. Ask for help

Family members, friends and community members may be willing to assist with some of your caregiving tasks if you ask them! Consider asking a friend to pick up groceries and medications once a week or asking a family member to drive your care recipient to the doctor on occasion.

  1. Hire help

Many professional services can assist you and your loved one. Home health care companies like Maxim can provide skilled and unskilled care services, depending on the needs of your loved one. Many also offer personal care and companionship services. If home care doesn’t feel right for you, residential care facilities, assisted living, and nursing homes can provide various support and healthcare services to fit your needs.

  1. Take time for yourself

Burnout is incredibly common among sandwich caregivers, so taking time for yourself should be a priority. Even if you cannot take a day off, little activities like taking a hot bath, drinking a cup of tea in a quiet room, or doing a 15-minute yoga or meditation practice can help you stay centered and better equipped to provide compassionate care.


Caregivers often report feeling under-informed about caregiving topics and how to care for themselves while caring for others. Fortunately, having access to helpful information can help reduce these feelings.

Here are some resources that can help:

Well Spouse Association

  • The Well Spouse Association advocates for and addresses the needs of individuals caring for a chronically ill or disabled spouse or partner. The association offers peer support and educates health care professionals and the general public about the unique challenges caregiving spouses face every day.

Family Caregiver Alliance

  • The Family Caregiver Alliance has provided support services to family caregivers of adults with physical and cognitive impairments, such as Parkinson’s, stroke, Alzheimer’s and other types of dementia, for over 40 years. FCA provides assessment, care planning, direct care skills, wellness programs, respite programs and legal/financial consultation vouchers. They also offer one-on-one support through their FCA CareNav TM digital platform.

AARP Caregiving Resource Center

  • The AARP Caregiving Resource Center provides expert articles and guides on caregiving, taking care of yourself, legal and financial advice, senior housing, end-of-life care, benefits and insurance and care planning and organization. In addition, they host an interactive caregiving community forum.

How Maxim can help

If you are having difficulty balancing caregiving with your other responsibilities, Maxim may be able to help. We offer skilled and unskilled care options for adult and pediatric patients with a variety of conditions. Our team of nurses, therapists and home health aides work with patients, families and physicians to implement effective care plans. We take pride in providing excellent customer service and ensuring our patients maintain a fulfilling daily life while under our care. Contact your local Maxim office for more information about which services are available in your location.