March 18 • 01:02 PM

Advice for 'sandwich generation'

March 11, 2009
More and more these days we hear about the "sandwich generation." This is defined as the generation of people who are involved with the simultaneous demands of caring for their own children as well as their aging parents. How can these competing demands be met?

According to Alex Johnson in his article 'A Generation Caught Between Two Others' there are 20 million Americans who are 'sandwiched' between the demands of their children and aging parents. The typical solution is shown by the word 'sandwich'—the children end up taking a large share of the responsibility. In 2006 there were 32 million Americans who were caregivers to their aging parents. Thus, it is not surprising that caring for aging parents was cited as the number one concern in the minds of Baby Boomer financial services clients.

While the children of aging parents end up taking much responsibility it is often unintentional. Senior citizens generally do not want to be thought of as a burden to their children and often experience guilt and remorse when they believe that they may become so.

Therefore, in order to avoid misunderstandings and relieve the burden on both the children and the aging parents it is wise to plan ahead. A prudent plan will help everyone understand and deal with the difficulties that can arise in the aging process. Or, if the responsibility has already arisen, getting the right professional help can mitigate the difficulties and provide solutions for better care as well as relief from caregiver stress.

First, it is necessary for the children and the parents to have a discussion about the issues that affect the aging parents' well-being. The possibility of additional care must be mentioned and there should be a clear understanding about what the children are able to provide. This becomes essential when the parent is facing the loss of financial or physical independence; the loss of a spouse or close friend; a significant decline in health, etc. Determining the availability of family members in terms of proximity, number of days and hours per month they are free, and the resources that can be contributed will give an idea as to what outside help may be needed.

Second, the parents should compile a list of their personal and financial information. This should include: a list of dependents; a list of service providers such as doctors, dentists, social workers, home and yard helpers, etc.; a list of financial records and passwords; and a list of insurance policies.

Third, the aging parents should have proper documents. This should include: designating current beneficiaries on insurance policies, having a good durable power of attorney and health care power of attorney (with HIPPA compliance releases), and having proper estate planning documents. All documents should be kept in a place where the caregiver handling these issues can access them.

Fourth, there should be an assessment of the parents' medical and social care needs to determine what level of care is necessary now and in the future, and what resources will be used to meet those needs. For some this assessment may be easy; for others it may be necessary to use the assistance of a professional geriatric care manager. This is a person trained to assess needs that accompany the aging process. When working with a geriatric care manager, there is an initial interview and assessment. Then, the geriatric care manager can identify programs and services (whether provided by family members or with outside help) that will meet those needs. For more information on geriatric care managers, visit the National Association of Professional Geriatric Care Managers at:

Fifth, once there has been a determination of medical, social and other care needs, there should be a discussion of which care options would best fulfill these needs. For example, in-home health care, adult day care, assisted living, adult foster care, nursing home or hospice care are all options that can be explored.

Finally, there should a discussion about how the care options and standard of living can be financed. Government programs, existing assets and family resources should be considered. Often a special estate plan will be necessary to prolong and preserve resources while assessing government benefits for special needs. Tax and legal issues can become critical.

With some attention, both parents and adult children can avoid the pitfalls of the "sandwich generation." Working together we can achieve a healthy balance while maintaining a good quality of life, meeting care needs and enjoying fulfilling relationships.

Gerard J. Garno, Esq. is an attorney who owns and operates the law firm of Heritage Elder Law & Planning and is a partner in the law firm of Rickard, Denney, Garno & Associates, with affiliated offices in Washington, Imlay City, Lapeer, and St. Clair Shores. Call 1-877-731-4357 or visit for more information.

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