As a new parent with aging parents of my own, the realities and complexities of the so-called ‘sandwich generation’ hit close to home. The sandwich generation is a real and growing phenomenon. Many families are doing double duty, providing care for both young children whilst also looking out for their aging parents, often at the expense of their own well-being. In my case, I have two parents in their mid-seventies, a two-year old daughter (with another on the way), and an extended family that includes two sets of aging in-laws. It’s a lot to manage, even with the resources and support I have. I’m fortunate to have the means, the knowledge, and the family network to make this work—but I know many people do not. For many, the cracks in our healthcare and social support systems are all too easy to fall through. Caregivers themselves often need care, and without adequate support, the toll on mental, emotional, and physical health can be overwhelming.
My father lives with dementia, while my mother is his primary caregiver, navigating the nuances of providing day-to-day support for someone whose needs are ever-changing in the context of her own aging. This caregiving arrangement is all too familiar in the context of increasing longevity and an aging society. I see it not just in my family but also in my research, where informal caregiving—often provided by spouses or adult children—is becoming the backbone of contemporary care provision. Women disproportionately shoulder this burden, a reflection of both the longer life expectancy of women and deeply-rooted gender roles that often persist into older age.
Thinking about what the next five, ten, fifteen, or twenty years will bring is a daunting task. My parents’ needs are not static, and they will change dramatically over time. We’re already considering questions like whether they can continue living in their home, how to make their living situation safe, and what kind of support we’ll need as my father's care need increase in complexity. And it’s not just about them—I also have a young family of my own. My two-year-old is deep in the heart of toddlerdom, and we’re about to welcome a new baby into our lives in just a couple of months. Balancing the needs of two generations—one just beginning their journey through life and the other reaching the later stages—has made me acutely aware of the challenges faced by this ‘sandwich generation’.
In my professional life, I see firsthand how these cracks in care provision can swallow people and families whole. I supervise a PhD student, Lucy Kervin, whose research focuses on older adults without advocates—those who do not have family or friends to step in, to help them navigate the labyrinthine healthcare system, to fight for their needs when they cannot. The outcomes for these individuals are often much poorer: delayed or missed medical care, untreated health issues, and an overall decline in quality of life and in some cases premature mortality. They are people who need help but are left to fend for themselves in a system that is not set up to catch them when they fall.
This brings us to the broader policy implications of an aging population. As we live longer, the expectation that families will simply absorb the increasing care needs of older relatives is both unrealistic, unfair, and inequitable. Informal caregiving is essential, but it should not come at the cost of the caregiver’s own health, financial stability, or ability to thrive. We need policies that support caregivers—paid leave, respite care, financial assistance, and access to community resources that can lighten the load. We also need better systems for those without family support, to ensure that every older adult has access to the care and dignity they deserve.
As I reflect on my own situation, I recognize my privilege. I am fortunate to have the capacity—financial, emotional, and logistical—to care for my growing family and my aging parents. I have resources, knowledge, and support systems that many do not. But this should not be the exception. Everyone deserves to grow old with dignity, to receive care without burdening their loved ones, and to live in a society that values them at every stage of life. As we move forward, we must address these issues, not just for our aging parents but for ourselves, our children, and the generations that follow. Our policies must evolve to reflect the reality of an aging society—one that supports caregivers and ensures that no one, at any stage of life, falls through the cracks.
About the Author
Theodore D Cosco joined the Oxford Institute of Population Ageing in 2016 as a Research Fellow. Dr. Cosco is a Chartered Psychologist (British Psychological Society) trained in applied social research methods (MSc 2011, Trinity College Dublin) and epidemiology (PhD 2015, University of Cambridge), and Assistant Professor of Mental Health and Aging in the Department of Gerontology, Simon Fraser University. His research interests include resilience, mental health, and the interface between technology and healthy ageing.
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