By Susan Smith Nash, Ph.D. Jacilla was off to a good start with e-learning. Things were to suddenly change, however, when she assumed primary responsibility for the care of her 75 year-old mother, who suffered from arthritis, diabetes and cognitive impairment.
When Jacilla was able to bring her aging mother from the Philippines to live with her at home with her two teen-aged girls, she was thrilled. Later, she was worried and wondered if she had taken on more than she could hande. Her mother's health needs required a great deal of time, and, instead of being the outgoing, happy woman Jacilla remembered, her mother was often withdrawn or argumentative, and she seemed confused.
To make things even more complicated, Jacilla's two teen-aged children started to act out shortly after the arrival of Abuelita, their grandmother. Maritza, who was taking classes at the community college, became very withdrawn, and then suddenly announced she was thinking of getting married, although as far as anyone knew, she wasn't really dating anyone. Violet, who was in high school, started skipping classes. Bickering about inconsequential things, spending time in waiting rooms and driving to clinics, and taking more time grocery shopping and on errands started to characterize Jacilla's life.
It was a classic "Sandwich Generation" dilemma and Jacilla was caught in the middle. Before her mother's arrival, Jacilla had dreaded the impending empty nest that would occur when her daughters moved out. Now she had a "cluttered nest" (Riley, 2005), and it was more stressful than Jacilla had ever imagined.
The one place of refuge was her coursework. It was a lifeline. By taking courses, Jacilla could feel as though she were making progress toward her dream of becoming a licensed registered nurse and having a nursing degree in the United States.
Now, in her "cluttered nest," Jacilla considered dropping out, but she had worked too hard and was too close to achieving her dream. Jacilla had worked as a nurse in the Philippines, but needed American credentials — a degree, licensure. Thankfully, after speaking with her advisor and searching for information in discussion boards dedicated to individuals taking care of aging family members while simultaneously caring for children, Jacilla decided to continue her education.
"It was a relief to find out I wasn't alone," she said. In fact, she shared many things in common with others.
Characteristics of Sandwich Generation "Cluttered Nest" Caregivers
- 34 million adults (16 percent of population) provide care to adults 50+ years (AARP, 2004)
- Of those caring for someone aged 50+, the average age of family caregivers is estimated at 47. (FCA, 2005)
- Most caregivers are women, and they are working either full time or half-time outside the home. (FCA, 2005).
Estimates of the number of long-distance caregivers in the U.S. who are caring for an older relative range from 5.163 to nearly 7 million. Long-distance caregivers are generally defined as living more than one hour from the older adult needing assistance. (AARP, 2004)
The amount of time spent caring increases substantially as cognitive impairment worsens. Among people 70+ years old, those with no dementia receive an average of 4.6 hours per week of care, while those with mild dementia receive 13.1 hours of care weekly. For persons with severe dementia, hours of informal care received rises to 46.1 hours per week. Similarly, nearly one-quarter (23 percent) of caregivers of someone 50+ with some type of dementia provide 40+ hours of care per week compared to 16 percent of those helping someone 50+ without dementia. (FCA, 2000)
Bringing the Statistics Home
At age 46, Jacilla realized that she was was fairly typical. The fact that she was working full time, made her also similar to almost half the people who were caring for older relatives.
The responsibilities were very stressful, and as Jacilla investigated more deeply and started to communicate with others in the same situation, she started to realize that if she did not do something to balance her life, she would start to suffer health consequences herself. Further, she ran the risk of "pay it forward" consequences as her daughters felt alienated and her marriage suffered.
Granted, it was every person's responsibility to deal with the stress, but as primary caregiver, Jacilla was feeling the brunt of it.
Thankfully, Jacilla's mother had some savings and a small income from investments. She was aware that she did suffer from cognitive impairment, and trusted Jacilla with her financial affairs. Plus, she encouraged Jacilla to continue her education and to obtain nursing credentials in the United States.
Success Strategies for E-Learning in the Cluttered Nest
- Make studying a priority.
- Budget high-quality time for studying.
- Fine-tune your time management skills. Identify your tasks and break them up into management chunks.
- Practice effective goal setting. Take a moment to pat yourself on the back when you achieve each of your goals, including the small ones.
- Involve the family, and make your degree a team effort.
- Encourage other family members to take online courses as well.
- Strive to achieve a calm, predictable environment. Schedule naps and quiet time for the elderly person.
- Maintain a separate study where you can study without interruption.
- Invest in a laptop with wireless card, and a wireless connection in your home. If there are tasks that do not require a great deal of concentration, try to do them in the same room as your family member.
- Find large-print books and books on tape that she or he can read or listen to.
- Find church activities, library reading rooms (large-print section), eldercare day care or activity groups to provide outings for your family member.
- Find activities for the relative. This might include gardening or light household tasks (folding clothes, etc.) so that he/she feels useful.
- Find activities for the relative that can be shared with the younger family members.
- Anticipate "crunch times" in the school term and find support/additional care options during that time.
Implementing the Strategies
Many of the suggestions and strategies are easier to talk about than to implement. Many elderly fall prey to depression and anxiety, especially if they suffer from cognitive impairment. It is important to find activities where they can feel useful. It is also important to find ways to alleviate boredom, and to keep a healthy lifestyle that includes exercise and good nutrition. This applies to the entire family, and family members who may have been neglecting their diets or exercise may find that living with a person who must exercise and eat healthy foods can be a great example.
Make the entire family a part of the degree plan. Involve the family in your educational activities. Celebrate the highs, discuss the lows. One of the realities is that by modeling positive behavior — continuing education, and concern for the elderly, families will learn the values and the behaviors that will allow them to thrive.
References
AARP (2004). National Alliance for Caregiving and AARP. Caregiving in the U.S. Bethesda: National Alliance for Caregiving, and Washington, DC: AARP, 2004.
Family Caregiver Alliance. (2005) A 20-Year Partnership in Caring. San Francisco: Family Caregiver Alliance, 2005.
Family Caregiver Alliance. "Selected Caregiver Statistics"
http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=439 retrieved 28 Feb 2008.
Riley, L. D., and Bowen, C. D. (2005). The Sandwich Generation: Challenges and Coping Strategies of Multigenerational Families. The Family Journal, Vol. 13, No. 1, 52-58 (2005).
http://tfj.sagepub.com/cgi/content/abstract/13/1/52
Spector, W. D. et al. (2000) The Characteristics of Long-Term Care Users. AHRQ Publication No. 00-0049. Rockville: Agency for Healthcare Research and Policy, 2000.
Winnett, A. (2006). "Sandwich Generation and Family Stress" Effective Communication.
http://www.hodu.com/blog/2005/08/sandwich-generation-and-family-stress.html