The Caregivers

By Amy Dickinson

Last Thursday I sat at Thanksgiving dinner with my extended family, buried in food and conversation and enjoying the soporific effect of the sweet potato-marshmallow casserole. With the kids at the card table, the elders sprinkled around the periphery, I couldn't help noticing that my generation had become the core of our large family. Try as we might to delay the growing-up process, by marrying and having children late, my sisters, cousins and I have finally graduated from the kids' table. While that has its advantages (uncontested second helpings of pie, for instance), it also confirms us as members of the "sandwich generation," so called because we are wedged between the needs of growing children and aging parents. More than likely, within the next few years my sisters and I will join 22 million other American households that provide care for their older relatives.

According to the National Alliance for Caregiving, a "typical" caregiver is a 46-year-old woman, married and working, who spends around 18 hours a week caring for her elderly mother. Caregivers normally provide transportation and do grocery shopping and household chores in addition to assisting with the more basic aspects of daily living, such as bathing, dressing and feeding.

Researchers say family caregivers too often exhaust themselves, their relationships and their finances in caring for an older relative--caregivers spend about $1.5 billion each month out of pocket, for instance. The strain is often made worse by the fact that families aren't prepared for the role of caregiver. In addition to coping with the sadness of a loved one's illness, they simply don't know what to do or where to turn to relieve the burden. Ken Dychtwald, Ph.D., gerontologist and author of Age Power, suggests that the most vital thing a caregiver can do is find a trusted adviser--"a person, not a pamphlet"--to help lead a family through the thickets of health care, financial and emotional questions. "Families should assume that they're grappling with a situation that will only get worse," he says, and they should do what they can to prepare themselves.

Fortunately, the aging of the baby boomers is also creating a boom of services (many of them free) for people thrust into the caregiver's role. Geriatric-case managers can offer all kinds of practical assistance to a family in need, from coordinating home health care to providing financial and emotional counseling. The local Office of the Aging, or Eldercare Locator (800-677-1116), can assign local case managers for families who live at a distance. Two particularly helpful Internet sites are www.AgeNet.com and www.aoa.gov

Even without professional help, family caregivers can give themselves a break by farming out some tasks. Kathy Paddock, a bookkeeper, assists 40 elderly clients and their families by helping them manage their household finances and insurance forms; she visits some of her clients in nursing homes and keeps in touch with their family members by phone. Paddock says she loves her work and has grown close to her clients and their families, "but no one should have to do this alone." Caregivers must also take care of their own personal, health and financial planning. As I couldn't help noticing this Thanksgiving, we recent graduates of the kid's table aren't getting any younger ourselves.

For more about care for the elderly, see our website at time.com/personal You can also e-mail Amy at timefamily@aol.com