Family playing football

Sandwich generation

PUBLISHED: 16 December 2019 | LAST UPDATED: 4 October 2023

Juggling the responsibilities of family life can be a strain at the best of times. With the  added pressures of caring physically or financially for loved ones, it’s easy for your own to-do list and important self-care routines to take a back seat while you’re looking after those around you - this is a common issue for many today who are in a ‘sandwich generation’.  

Who are the sandwich generation?

As we’re seeing more people starting families in their 30’s and 40’s, we’re seeing an increase in people becoming sandwiched between caring for their own children and grandchildren, as well as their elderly parents. 

People in this sandwich generation are usually aged between 40 and 70 with elderly parents needing regular care, and school-aged children or young adults that still need financial support. A study in the USA found that 48% of adults provide some sort of financial support to their adult children, and 25% support their own parents at the same time. 

Family dynamics around the world

In some cultures, looking after both your parents and your children is a normal part of life. China, Korea and Japan all follow the Confucian tradition of "filial piety." This puts the family before everything else and teaches that elders must be respected. It’s accepted that as parents grow old, their children will look after them, unlike western cultures where carers and care homes are often used to provide round-the-clock care to elderly parents when their children can’t be there. 

Traditionally, in India and Nepal, once a couple marry, they live with the husband’s parents and look after them as they grow old. This is known as a patrilocal living arrangement. This style of living is also common in the Mediterranean, and multiple generations live together under one roof, which allows for a form of care to be available almost all of the time.

As the global population ages, many countries are looking at how to manage the care of their oldest citizens. France and China have both recently passed legislation that means grown-up children must visit or stay in contact with their parents or face charges or a fine. 

Cross-border carers

If you’re balancing roles as a parent and a carer to your parents, you’ll know how stressful it can be; potentially more so if you’re all living under one roof. But, what if you have the opposite problem? What if you live on the other side of the world?

As more and more of us move to live overseas, we’re seeing a rise in sandwich generation ‘cross-border carers.’ Whether you moved away to chase a career, or your parents retired to their dream destination, many of us are living with family spread around the world. 

It’s an issue many expats are thinking about. Research conducted earlier this year by Vitreous World, based on expats living and working abroad, showed that aging parents needing support was one of the top reasons expats would consider moving back to their home country, selected by 24% of respondents.  

So how do you manage when parents in another country start needing more of your time and care? We’ve put together some tips to help.

Coping as a Cross-Border Carer

Plan ahead 
Needing a little more care and support as we get older is to be expected, so your parents may well need some extra help, and even more so as they get older. 

Talk to your parents while they’re still fit and healthy about plans or wishes they have for their later years and discuss how you’ll be able to help fulfil them. Ask them to think about where they want to live: in their current home, a smaller place, somewhere with extra support or in a care home? While these conversations can be uncomfortable, they’ll really help you all further down the line. It will also help to have conversations long before they’re needed about any end of life plans or wishes they have, such as their funeral wishes and their financial situation. 

Keep communication open 
Feelings can get fraught in any family situation, but especially when there are a lot of you with multiple lines of communication, various sources of income and numerous responsibilities being shared. Keeping communication central and involving everyone can help to avoid conflict and quickly diffuse any situations that do arise. 

Feelings of guilt and resentment can be felt by any carer but being physically distant from your loved one can make these feelings even more pronounced. A study in the USA found that nearly 30% of distant caregivers felt so inadequate that they didn’t identify as caregivers, despite changing their schedules, missing work and taking leaves of absence to oversee care.

Maintaining regular communication with your parents can help to reduce stress or feelings of guilt. Catching up regularly can mean you know how they’re feeling day to day and won’t have too much to catch up on since you last spoke. Using video calling means you can gain a deeper insight into how your parents might be feeling – especially if they’re keen not to worry you. 

You can also encourage your children to keep in touch with your parents, no matter how old they are. Intergenerational relationships are good for us all, especially older people. You can find some more detailed suggestions on how to keep in touch with your loved ones here.

Ask your parents if they’d like to share their medical information you by the doctor. This will help keep you in the loop and it can be reassuring to know there’s nothing to worry about. If possible, ask a trusted friend, family member or neighbour to accompany your parents to their medical appointments and to fill you in with how it went afterwards. 

A little extra reassurance 
Our virtual doctor service allows our customers to arrange a video or phone appointment at a time that suits them. So, if your parents have one of our plans, they can speak to a doctor quickly from the comfort of their home. If you’re worried about your parents, why not find out more about the Virtual Doctor Service and how it could help you and your family, here

And if you or your parents are ever unsure about their diagnosis, our Second Medical Opinion service is on hand to help all our customers. A dedicated doctor will be on hand to review their diagnosis and manage their treatment and care, right through to recovery. With your parents’ consent, the doctor can also share information with you, so you’ll know exactly what care they’re getting.  

Play to your strengths 
If you have siblings, you’ll all want what’s best for your parents but may only be able to commit to certain types of support. Agree to what you can each contribute both financially and in a more hands-on way. 

If you’re not able to take a hands-on approach, you could agree to take on some of the more administrative jobs involved in looking after your parents. These could involve ordering their grocery shopping online and arranging for it to be delivered, booking their appointments, or arranging for maintenance to be done on their house. 

Ask others for help 
With your parents, make a list of people who will be happy to help, including their relationship to your parents, their contact details and notes about how specifically they can help. Maybe they’re a neighbour who’s happy to pop round a few times a week, or maybe it’s the details of a professional care agency that can help with everyday living. Share the list with everyone involved in your parents’ care so they know who they can contact.

Be realistic and don’t over commit. There are only so many hours in a day and if you know you’ll be unable to do something, be prepared to say no. If your children are grown up, why not ask them to take on some of the caring roles you provide for your parents. All you can do is your best, and it’s important to acknowledge that and accept help when you need it. 

Looking after yourself 
Outside of your role as a carer, it’s crucial to get some ‘me time’. Mindfulness encourages us to live in the present moment and helps us understand that worrying about something won’t fix it. You can find out more about the benefits of mindfulness, here

Remember that when you’re taking time for yourself, whether it’s meeting friends, working-out or having a lie-in, you’re recharging mentally and physically. Without this time, you wouldn’t be able to provide the emotional, physical and administrative support that you do. 

The information in this article is correct at the time of publishing.