In a modest home in west Philadelphia, John Adeniran lives with his wife, two young daughters—a toddler and a newborn—and his mother, Elizabeth, who has Alzheimer's disease. “I always knew I would take care of my mom because I am close to her and have the patience to handle it,” says Adeniran, who is one of seven children. “But I underestimated how much juggling there would be once my wife and I started a family.”
When Adeniran's second child was born, his mother-in-law came to help out, and Adeniran asked his sister in Virginia to host their mother for a few weeks. Elizabeth, who was diagnosed in 2015 and is now 68, needs help with bathing, dressing, and meals. Adeniran's father, who is 71 and a pastor, lives nearby and visits Elizabeth regularly when he's not overseas doing missionary work.
Elizabeth began exhibiting signs of dementia when Adeniran was in high school. He knew then that he would most likely care for her, so he chose to major in computer science in college because it offered the opportunity to work from home. “Without working remotely, I don't know how I would be able to help with my kids and take care of my mom,” says Adeniran, now 26 and a data analyst.
Anica Leon-Weil, 38, says caring for her daughter and her mother, who has Alzheimer's disease, has had unexpected benefits. “Despite being pulled in different directions, I have learned to overcome challenges even when I didn't think it was possible and developed greater self-confidence because of it,” says the single mother and therapist, who lives in Santa Cruz, CA. “It also has allowed my 1-year-old daughter to develop a closer relationship with her 80-year-old grandmother.”
Leon-Weil and Adeniran are part of the “sandwich generation,” a term coined in 1981 by social worker Dorothy Miller to describe adults caring for aging parents and young children. Today, an estimated 11 million Americans make up this generation. About 61 percent are women, and the average age is 41, according to a 2019 report funded by the National Alliance for Caregiving and Caring Across Generations. About 20 percent care for someone with Alzheimer's disease or another form of dementia. And roughly a third said they endured great emotional stress, especially those whose parents live with them. A fifth reported a high level of physical strain. Eighty-five percent of sandwich caregivers say they want more information on at least one caregiving topic, including how to manage stress.
“As people wait longer to get married and start a family, they get squeezed even more,” says psychologist Merle Griff, PhD, author of Solace in the Storm and host of the podcast Caught Between Generations.
To help others in a similar situation, Leon-Weil started an Instagram page called “The Sandwiched Caregiver”, where she chronicles life as a therapist, a single mom, and an only child caring for a mother with severe dementia. “I wanted my experience to have a greater purpose,” she says, noting that her father died years ago.
Leon-Weil, other caregivers, and neurologists share advice on how to reduce the stress and increase the enjoyment of caring for loved ones.
Understand the Challenges
Sandwich caregivers face unique demands. On a given evening, they could be doing homework with their children, then helping parents with their medications before bedtime, or booking babysitters for when they visit their parents in assisted living facilities.
“There's such an emotional component to caring for my daughter and my mom,” says Leon-Weil. “Sometimes I'm overwhelmed with feelings of guilt and grief. When I'm with my mother, I feel like I should be spending time with my daughter. Now I've found ways to include my daughter when I'm with my mom so they develop a closer relationship.”
Look for a Job with Flexibility
More than 76 percent of sandwich caregivers are also employed, according to the 2019 report. For many, this entails significant adjustments to their work schedules, including arriving late, leaving early, taking leaves of absence, transitioning from full-time to part-time hours, turning down promotions, or even opting for early retirement. Like Adeniran, some sandwich caregivers seek out hybrid or remote work.
Carlos Olivas, 56, worked full- time for several years at production companies in the entertainment industry. Now he works part-time for an agricultural manufacturer in Sacramento, CA, so he can care for his father, who has Alzheimer's disease, and his adult daughter, who is severely depressed and has attention deficit hyperactivity disorder. “I was up-front with my boss about taking care of my dad and daughter, and my boss allows me to stay home when I need to.”
Brenda Burk of Wyomissing, PA, eventually left her part-time job in food services for the local school district to care for her son, Hunter, who has Duchenne muscular dystrophy, and her mother, Ruth, who has severe depression and Alzheimer's disease. Brenda's brother, Allen, also had Duchenne muscular dystrophy. He died in 1995 at age 28.
Through an online support group for parents whose children have muscular dystrophy, Burk, who is 53, learned that she could get paid for caring for her son. The three-month process involved getting approvals and signatures from Hunter's doctors, securing consent from the health insurance company, and finding a home health care agency that works with family caregivers. “I had to apply to the agency for the job and take a caregiver's test to be certified,” says Burk, who now gets paid $14 an hour to care for Hunter. Before the end of this year, though, Burk must apply to the state for financial assistance because her insurance company won't cover her as a paid caregiver once Hunter turns 21 in December.
Enlist Friends and Relatives
Never hesitate to ask for help, says Neha M. Kramer, MD, assistant professor of neurological sciences and palliative medicine at Rush University Medical Center in Chicago. “It can come from anyone, including family members, neighbors, and friends. Identify people who can offer support and have strengths you need,” says Dr. Kramer. “Arranging meals or providing companionship can make a significant difference. Be specific about your needs and communicate them clearly to those who are willing to pitch in.”
Every Friday night, one of Burk's daughters stays with her son and mother while Burk and her boyfriend enjoy a night out. The daughters also help when their mother needs a mental break. When Leon-Weil's mother moved to an assisted living facility in 2023, Leon-Weil prepared to sell her parents' home. She relied on friends to watch her daughter, Ella, while Leon-Weil packed boxes and sorted through her parents' belongings.
In the early stages of his father's dementia, Olivas lived in Santa Barbara and asked aunts and cousins who lived near his father to check in on him. That's how he found out that his father wasn't paying his bills. He learned from his father's dentist that his father was neglecting his oral health. Soon thereafter, Olivas returned to Sacramento and moved in with his father. At one point, Olivas' younger brother flew from North Carolina to Sacramento to lend a hand but ended up being more of a burden because of his untreated alcohol use disorder. “I ended up caring for three people—my dad, my daughter, and my brother,” says Olivas, whose brother died a few years later.
Guard Your Well-Being
Protecting your mental health is crucial, says Dr. Kramer. “If you can't go out for coffee with friends, talk to them on the telephone or via video. Even short interactions with other people can help boost your morale,” she says.
Leon-Weil joined an Alzheimer's Association support group that meets in person or virtually each month. She also connected with Working Daughter, a national online group for women that meets weekly to discuss how to juggle demanding careers with caring for children and parents. “When I joined these groups and started connecting with others like me, I felt a positive shift in my emotional health,” she says.
Olivas is grateful to be caring for his father, who has become prolific at painting and drawing since his diagnosis of Alzheimer's disease. “My father continues to parent me and show me how to take care of him and my daughter,” says Olivas, who has unexpectedly also become his dad's manager. His father's artwork is in a local gallery, and Olivas has been asked to speak about his father's “second career.” Olivas has created some merchandise, including a calendar, using the artwork to show that people living with Alzheimer's disease can sometimes flourish. “I always say that my dad has been teaching me my whole life how to care for people,” says Olivas. “I'm fortunate that I can reciprocate that care.”
Adeniran leans on his faith and the example of caring set by his parents. “Meeting the needs of my mom and daughters, at different points of the spectrum, is both challenging and beautiful,” he says. “It's a delicate balance, but many times throughout the day, caring for them brings me joy.”
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