Late one afternoon at the end of April, I was walking our dog
out along the mudflats. It was a short break from the stress of
long work hours that had started a month earlier when my mother had
fallen in her home. I'd dashed up there to find her shaken and
badly disoriented, and for the next week I visited regularly to
check on her and my father. All through April, I never quite got
back on top of everything - work, travel, family,
Professionelle.
So there I was, taking a little me-time, fresh air and exercise.
I turned for home and in the distance saw a figure hurrying my
way… as he drew closer I could see it was my son… soon I
could tell he was carrying a phone… when we were finally in
earshot, he panted, "Call Dad. It's urgent. Grandad's been rushed
to hospital."
If I laughed, there was more than a hint of hysteria in it. Sure
enough, the first half of May made April look a downright
breeze.
Sandwich generation
Eldercare. If you're lucky, it may never come calling. Maybe -
as we'd all hope - your elderly relatives will be hale and hearty
right up to the day they peacefully die in their sleep; or maybe
your siblings will pick up the strain. If you're a bit lucky,
eldercare will wait to come into your life until after your
childcare stage is all done and dusted. If you're unlucky, however,
you'll join the "sandwich generation", caught between children who
are still heavily dependent on you, and parents who start needing
you more and more.
Key demographic, economic and career trends all point to the
"sandwich" risk rising for all of us, and for it coinciding with
years when we are still fully employed. Think about it. We're now
having children later, after our careers are established. In NZ, if
our children go on to University, we remain financially responsible
for them longer than we used to. Our parents, who have been retired
for decades, are living to ever greater ages, while we ourselves
are retiring later.
Just how fast the ranks of the elderly are growing is shown in
the numbers below, which are for the combined populations of NZ,
Australia, US, Canada, Europe and Japan:
% of the developed countries' populations >60 years old
- 1950 12% [100m people]
- 1998 19%
- 2025 28% [>500m people]
Sandwich statistics
It's a significant phenomenon: in the USA, 44% of American baby
boomers are "sandwiched". In Canada, a 2007 Ipsos -Reid
survey found a third of 45-60 year olds were caregivers to elders
and 44% of those surveyed supported children too.
You won't be surprised to read that the hours of care fall
disproportionately on women. An AARP (USA) study reported that the
typical unpaid family caregiver is a 46 year old married woman, who
works outside the home. In Canada, national statistics show
middle-aged women (45 to 64 years old) devote almost twice as much
time as men do to unpaid caregiving. Within that age group,
working women spend 26.4 hours a month caring for an aging parent,
compared to 14.5 hours for employed men.
I can't find NZ statistics on "sandwiched" adults or the gender
split of care, but a teara.govt.nz study in 2010 by Alison Gray
found that among mid life adults here:
- Almost 80% gave parents emotional support (phone calls, visits,
sharing leisure time)
- Almost 70% helped parents around the home
- Almost 50% helped parents with shopping and health visits
Stress and Strain
There are only about 110 waking hours in a week and it's hard to
invest 10 or 15 hours of them in eldercare without other things
giving way. Carers may cut back on work hours, and use
holiday leave and sick leave on caring duties. Some even quit work
altogether. Relationships with spouses can suffer and so can the
carer's health because of the stress of the situation.
"Caregiving in the USA" reveals that the toll on caregivers'
health appears to increase over time. The rate of caregivers
reporting that their health is fair or poor is 23% among 5+ year
carers vs 15% for newer carers. Also, a larger share of female than
male caregivers report declining health as a result of giving care
- this is consistent with findings by the American Psychological
Association that women do suffer more stress in these situations
than men. (That's why it's really important to "put on your own
mask before assisting others", as the airlines always tell us!)
Flummoxed
I'm sure I'm not the first person to be blindsided by parents'
sudden ill health. Don't get me wrong; I want to help them,
from motives of both love and duty, but gosh it's been hard. I've
tried to analyse why it was so tough to deal with and have come up
with three main reasons that applied for me:
- Babies you know about for several months beforehand, but a
parent's fall or heart attack gives you no warning. It drops into
your lap regardless of everything else that's going on. And to
complicate matters, you have no idea if it's a short term emergency
that will go away, or something systemic you have to reorganise
lives around. If you overreact you undermine independence and waste
money. If you under-react you risk the situation deteriorating, to
say nothing of the guilt trip you're eventually going to
suffer…
- People at work were disinterested - or perhaps, more
charitably, unsure of what to say or do. Again, babies are a known
commodity but how many people have you heard talking about caring
for their elderly parents? My experience was that there was a bit
of initial concern, and then nothing. No follow-up queries about
how things were going, no interest in revisiting deadlines, and
seemingly, no sharing among the managers of the news of my
situation
- I had no frameworks or reference points on what to do, how to
feel, what to prioritise. I was literally swamped. That's why
I chose the picture of the Japanese tsunami woodcut for this
article.
What I've Learned
Look on this next bit as an early report back from the front
because I'm certain I have much more to learn! From my own
experiences so far I've found:
- There's more support available than you realise - you just have
to be in a bad way for it to emerge! For instance, I had no idea
doctors would do house calls in NZ, in fact I had never even heard
of a district nurse doing rounds in this country. Turns out they
do. And there are mobile X ray units and physiotherapists who will
come to your house if you are in too much discomfort after a fall,
say, to make it to a clinic
- There's a whole industry geared to elder care in the form of
home help and personal care, some of it funded publically and some
of it not. The trick is finding names of organisations and then
figuring out how to get plugged into the 'system.' It can be like a
merry-go-round.
- It pays to plan ahead. I was surprised, when I looked back, to
find that I had in fact done some planning. There had been signs of
my parents' faltering health for the last three or four years (one
of them was no longer able to drive for example) and I had pushed
and cajoled them to move back to Auckland from their down-country
home. They are now 12 minutes drive away, in a small bungalow with
a small, very low care garden, all on the flat. So much more
manageable than a five hour round trip!
- You need to practise self-forgiveness. For the first time
ever, I missed a work deadline because of the hours involved in
visiting my father and I was too exhausted to communicate this
properly to my colleagues. It led to a stuff-up and my
default reaction was to berate myself and feel even worse.
From others who've been through more of the challenges of
elderly parents' failing health, I've gleaned the following (and
please add your own advice in the comments below):
- It can be very hard to get your relatives to accept they need
some help. Expect a lag between their deterioration eg in mobility
and their acceptance they need extra help to cope with it
- Don't let your elderly relatives make you feel guilty. You will
be doing your best.
- Have sisters to share the burden with. (Ha! I'm an only child,
bit late to go back and change that…)
Coming to a desk near you
Even if it's true that 80 is the new 60 - and that seems a
little optimistic - there are going to be a lot more 85+ year olds
around in NZ over the coming decades as the graph below from
Statistics NZ makes clear. The big jump starts in less than 10
years from now.
Eldercare may not yet be bracketed anywhere near as closely as
childcare with the issues of flexibility and work life integration
but surely we are going to hear more and more about it as these
numbers work their way through. Unmanaged, it's a threat to
productivity and to careers; well-managed, it supports valued
employees at a sensitive but important phase in their lives.
Professionelle was born of the realisation that we all go
through similar life and work chapters and yet often wrestle with
the issues alone. I have felt alone and unsure with my parents' ill
health and would love to hear from others who are managing this
stage of the juggle - or who are managing employees with this
challenge - so that we can share ideas and advice with the
wider Professionelle community.