The Sandwich Generation: Caring for Kids, Aging Parents, and Yourself

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:09):
welcome to the Hope Table. I'mErin Brinker. Well, I am very
pleased to welcome back to theshow a regular guest and friend
of the show, Dr. Ashley Zucker.
She is Kaiser Permanente,Southern California's child,
adolescent, and adultpsychiatrist. She's assistant
area medical director for mentalhealth and SCPMG, Southern
California Permanent PermanenteMedical Group Wellness, San

(00:31):
Bernardino County, and theregional lead for child and
adolescent psychiatry. Dr.
Zucker, welcome back to theshow.

Dr. Ashley Zucker (00:40):
Thank you so much for having me back.

Erin Brinker (00:43):
So we have talked about all kinds of mental health
issues, and specifically todaywe are going to talk about the
sandwich generation, that isthe, that is, the parents who
have teenagers or young adultswho are caring for their, their
kids, but also caring for theiraging parents, and that is a
really tough place. People feelsqueezed, you know. How

(01:06):
prevalent is that here? May isMental Health Awareness Month,
and you know, talk to me aboutthat age group.

Yeah, I mean, the sandwich generation is
definitely a struggling agegroup, I would say, for sure. I
mean, it's really kind ofgetting a lot of just workload
and stress, kind of from alldifferent directions, right? So,
obviously, you've got what youhave to deal with in your
day-to-day at work, but thenit's everything that you're
trying to manage at home, and socertainly, if you're trying to

(01:37):
manage, you know, your ownchildren and your own family,
plus also trying to manage, youknow, your parents or other
caregivers, or being a caregiverfor, you know, folks older than
yourself. Then that's just a loton any one person. So I just
think of all of the stressesthat aid that age group really,
or that age band, really has todeal with, and you know, I got

(01:59):
to give them a lot of credit anda lot of grace. I'll say that,

you know, it's interesting, because, and I, and
I, my mom passed away about 10years ago, and as, as, and my
children were in their 20s,early 20s, and, and late teens,
and I have to tell you, it was,it was, it was very strange. I
was used to parenting my kids,but parenting my mother, as she
was, her health was declining,and I hate to call it that, but

(02:25):
it's what it felt like wasreally a strange dynamic.

Yeah, absolutely. Yes, it feels very
bizarre to have the tableshifted in that way, right? To
be parenting or caring for theperson who parented and cared
for you for so long,

and they don't necessarily appreciate that
they're being parented.

Definitely not.

So, from a mental health perspective, how.. how is
this.. you know, how is thisuniquely challenging?

Yeah, I mean, I think you.. you called out
just one big piece of it, isthat it's just a total shift in
the.. in the relationshipdynamic. You know, the parent is
used to being the parent and tosuddenly essentially become the
child, I think it's just so, sochallenging. I mean, if you
think about, you know, how howyour mom probably felt too, like
that's very difficult for her toall of a sudden feel like she

(03:11):
sort of lost her autonomy,right? And so she's navigating
that change in her own life,where she's no longer able to
care for herself, and obviouslyyou know older generations have
different abilities depending ontheir cognitive abilities to
understand kind of what'shappening in that space, but
certainly it's this just theimpact it can have, you know, on

(03:34):
the caregiver in terms of thisis the person I looked to for
care and for support and now I'mthe one caring for them, that's
a big, you know, just mentalshift, so that can certainly
have a big impact,

you know, and for some, for her, she, uh, she had
a disease that took her prettyquickly, she, you know, last two
months of her life were in ahospital, and then she was on
hospice for four days, and thenshe was gone, for other people,
I've, you know, friends of minehave had their maybe it's
dementia, maybe it's cancer thatkeeps being going into
remission, and then coming back,and it's this long waltz with

(04:11):
the inevitable that is, it isreally difficult, and it's
exhausting. You know, how do youcare for yourself while you're
caring for your kids, becausethey still have needs and caring
for your parents as they arewinding down their life, you
know. How do you deal with that?

Yeah, I mean, I think it's, it's definitely
challenging, and I don't thinkit's appropriate to say
anything, but to recognize that,you know, if we were to say,
"Oh, it's easy if you just do x,we would be lying. So, right, I
don't agree with that. So, Ithink one piece is just
acknowledging that that's adifficult place for any human
being to be in. I think there'ssomething powerful about just

(04:51):
acknowledging the situation,doesn't mean you have to love
it, but just, you know, beingaware that this is very, very
challenging, and I think thatall. Also leads to just being
willing to reach out for helpand to look for support for
yourself, and you know, in anyway that that is available to
you, and so I think of just interms of how you take care of

(05:13):
yourself is one, recognizing thechallenge, and two, being
willing to share in thechallenge, right, a lot of
people are sort of embarrassedby the fact that they might not
be able to manage it or tohandle it, and so they're afraid
to ask for help or afraid toadmit that it's just too much
for them.

You know, I have to think some of that is
cultural too. You know, thatthat's in some cultures that's
the kind of thing that you keepin a family, and why can't you
manage it? I did it with my mom,or whatever, and so there's
there's outside expectationsthat really define how they
think you are supposed to befeeling or reacting, or what
you're supposed to be doing, andsometimes those, those
expectations make thingsinfinitely worse.

Absolutely, absolutely, yeah, there's a lot
more pressures, right, that comefrom those expectations,

so what are the most common emotions you hear
from people caring for kids andaging parents at the same time,
and they don't necessarily haveto be sick parents, they could
be just maybe that mom movedback in with you because she
needs a little extra carebecause she fell, or she, you
know, maybe is starting to havesome cognitive decline. So, what
are some of the most commonemotions you hear from people?

Yeah, I mean, I think probably anxiety would
be the most common emotionitself, but I think just all of
the reactions that we can haveto those situations, you know,
there's just the stress of itall. Stress isn't necessarily an
emotion, but I think it's anexperience that people certainly
have in those situations. Ithink it's the anxiety of trying

(06:46):
to be able to manage it all andkeep up with everything, and
you're worrying about, am I, youknow, am I doing it right for
any one person, right? Am Idoing the right thing for my
kid? Am I doing the right thingfor my parents? Am I doing the
right thing at work? And howwill I get it all done? And so I
think that really just piles upinto that, that anxiety, but
certainly it can also lead toother, you know, difficult

(07:07):
emotions. It can lead tosadness, and it can certainly
lead to anger. There's a lot ofguilt that can be associated,
you know, with that kind ofposition that you're in, partly
guilt that you feel like you'renot able to accomplish
everything, or maybe that you'refailing other people, but
sometimes you know to your pointabout especially people who may

(07:27):
have a prolonged illness orthings like that, there can be a
lot of guilt about feelingfrustrated or angry about the
situation, and then you feel badthat you feel frustrated with
the situation, so then you feelguilty, and you start to kind of
tear yourself apart. So, I mean,then the range of emotions is
really the whole gamut. I can'tsay there's just these emotions,

(07:50):
but those are the biggest onesthat I think of.

So, I'm curious about how adolescents in a home
react to grandma or grandpa.
It's usually grandma, but movinginto the house to be cared for,
and what that means for them andtheir schedule, and you know,
what are you seeing in yourpractice?

Well, I think it's variable, you know, every
family is a little bitdifferent. There are some
adolescents who might actuallyenjoy it, because maybe it takes
a little bit of the attentionand the pressure off of, yes,
they can, you know, do theiradolescent separation and be
more with their peers than withtheir, their family, so there

(08:30):
may be some that actually likeit, and then I think there can
also be, you know, someteenagers that maybe are
resentful of it, they feel liketheir whole world has been kind
of upended. This isn't the lifethat they're used to, or you
know, maybe having grandma orgrandpa on the home means that
they also have to take on someof those caregiving
responsibilities, and they maynot like that either. So, I

(08:54):
think it again, it can bedifferent for different people,
but you know, a lot of teenagersare going to be very
self-focused, which isdevelopmentally appropriate, and
it's annoying, but it's okay.
Yes, but yeah, adding anotherperson to the mix can be very
frustrating for them, becausethat's not what they're about at

(09:16):
that moment in their lifetime.

Do you recommend when families are facing these
kinds of questions. I mean, it'sa big deal if mom has been, or
dad, if your parents have beenindependent, and all of a sudden
they find themselves having tomove back, move in with you, and
you're moving things around, andmaybe a bedroom shifts, or maybe
you know, I imagine that kind ofdisruption is really, it can

(09:40):
really make an impact on afamily. Do you see a lot of
families coming into counselingfor that, or should they?

They probably should, but I think it's.. it
really depends on again thesituation. So, it's so, so, so,
so hard to generalize. But whatI would say is, first and
foremost, I think it's aboutcommunication. Yeah, and so if
the communications nothappening, and then there
becomes really this sort of, youknow, distress level in the
family where people areconstantly arguing, or you know,

(10:10):
not getting along, and then it'sstarting to really impact, you
know, other people's emotions orother people's well-being, or
just how they're able tofunction in their day to day, so
maybe that's school for the kidsor work for the adults, those
are the things I start to thinkabout, where you might really
need to seek out some moreprofessional therapy type of
help when it's really reachingus, you know, a level where it

(10:33):
feels like I just can't managewhat's happening, you know, in
the dynamics of the family atthis point,

you know, it's interesting when I get
overloaded, and I can't imagineI'm the only one, but when I get
overloaded, I tend to get tunnelvision, so I'm really just
focused on that next deadline,I'm focused on that next thing I
have to do, and I don'trecognize that I'm tired, I
don't recognize that I'm hungry,I don't recognize that I'm
snapping at everybody, I don'trecognize that I'm not sleeping,

(11:02):
you know, and that is it. Iswhen I get on the backside of
it, it's like, oh, I go topeople, oh, I'm so sorry, but
you know what is what is thatkind of emotional overload due
to a family dynamic, and how dothey work through

it? I mean, you described that, what
happens, right? So people getsnappy, they get irritable,
they're less pleasant with eachother, you know. Home becomes a
less pleasant place to be forall of those that are there, and
so it can really impact familydynamics, where home, which
maybe once was the sort ofrelaxing safe space, can now
become the very difficult andstressful space, and so I think

(11:42):
that, that can, you know,certainly be be a challenge, you
know, I think again it's reallyimportant to have that like open
dialog, open communication fromfrom the beginning, right? so if
you have, you know, let's say aparent moving into the house,
you know, having that dialogwith the family members, you
know, what might this look like?
What are some things they'reworried about, but I also think,

(12:03):
you know, to just to step backfrom it, it takes, you know,
each of us kind of recognizingsome of those signs that you
described over what things looklike when you're getting
overloaded, and being able toalso, you know, even say to
maybe your spouse or yourpartner or your kids, like, hey,
if you start to notice thesethings, can you just like remind

(12:23):
me that maybe I need to like eatsomething?

Yes, yes, maybe you have a safe word, right?
Somebody yells sloth in themiddle of dinner, you know
that's a safe word, right? Thereyou go, so you know, let's dig
into trauma a little bit,because you know, with a parent
moving in, maybe there's trauma,if history of trauma in the

(12:52):
family, maybe there are thingsthat you know that, because you
haven't been living in the samespace, are buried deep within
you, things that start bubblingup, memories, or just emotions
if you don't have the actualmemory of what happened, and so
that adds a level of complexityto your ability to give love and
care for your aging parent. Whatadvice do you have for people

(13:13):
who are in that boat?

Yeah, I mean that's certainly a very tricky
situation to be in, and I thinkif you know there are things
that are really being triggeredor coming up for you, especially
if they're trauma related. Thoseare probably things that are
going to make sense to, youknow, maybe talk with a
therapist about. That might notbe stuff that's just about, you
know, having an open dialog atthe dining room table. It may be

(13:38):
a little bit more, you know,detailed or personal or nuanced,
and so you know, reaching out tosomebody outside of the family
may actually be the betteroption in that type of
situation.

So, how would you, how would you recognize, because
I'm thinking, you know, asyou're, as you're reacting
strongly to something thathappens, and you get to the
point where you're like, why isthis bothering me so much? What
is, what is this? Where is thiscoming from? You know, and if
you're self-aware, you askyourself those questions. Dang,

(14:13):
I'm being rude. Why? You know,how you know what are.. what are
some other early warning signs.
What can.. how do you preparefor that?

Yeah, I mean, I think it's.. you're right,
some of it takes someself-awareness, which some
people are better at, thatbetter at than others,
certainly. But I think it'sreally knowing sort of what's
your kind of baseline, so tospeak. So, if you're noticing
things like, you know, obviouslychanges in your mood, but
changes in your sleep, orchanges in your eating, or just

(14:46):
changes in your energy level,you know, those can be some kind
of subtle warning signs, thatirritability piece, that snappy
piece, that's a big warningsign, but often we don't really
see it in ourselves when it'shappening, it's usually. To the
people around us that notice itbefore, before we do, right,

right,

so I think it's really about just knowing,
like, I just don't feel likemyself, and I know that's a very
vague way to put it, but there'sjust something to being able to
differentiate between, you know,what's a normal just stressor,
what's a normal, just difficultday, right. We're not going to
all feel perfect and happy allthe time, but if it's really,

(15:27):
you know, perpetuating formultiple days, even weeks in a
row, that's really a biggerwarning sign that, you know,
something else is going on,besides just like a bad day.

It could be depression that you're not
aware, it just all of a sudden,you look at yourself and say,
you know, it's been a coupledays since I took a shower, and
you know, I hurt all over mybody, and I don't know why.

Yeah,

you know,

yep, yep, exactly.

So, I want to talk about in something that is in
the news right now a lot, andthat is parental estrangement,
you know where a, it's usually achild, a young adult child will
decide for whatever reason thatthey're going to go, no, no
contact with their, with theirparent or a sibling, but in this

(16:15):
example, we'll talk aboutparents, and then maybe that
parent comes back, maybe youguys reconcile, and that's when
the parent moves back in withyou, but you know, talk to me
about parental estrangement, andwhat you are, what you are
seeing, and what, what you thinkcauses that, and I'm, I'm
particularly interested in, youknow, are people too quick to

(16:35):
pull that no contact trigger?

Yeah, I mean, I think it's such a challenging
space, I think. Part of whywe're probably seeing it a
little bit more is a good thing,and part of it is not. Not that
I'm a proponent of estrangement,that's certainly not what I'm
getting at, but I think there isa recognition of being able to
recognize when we need to setboundaries and protect

(17:00):
ourselves, and so I think thatthat part can be good in sort of
recognizing, like, this is notserving me, this is not
something that's, you know,helping me to be successful in
my life, and so I need to stepback from it, or I need to build
boundaries around it. I thinkwhere it gets, you know, really
into that sort of yuckiness orbad places that a lot of people

(17:24):
don't know how to build thoseboundaries and maintain the
relationship, so sometimes itbecomes easier to just cut the
relationship off, and of course,that, that's, I don't think
anyone actually wants that,maybe in some rare situations
where, like you mentioned, some,you know, significant trauma or
things like that are involved,and then that's kind of a
different story, but sometimespeople just want to avoid the

(17:47):
conflict or trying to navigatethe space, and so the just total
cut off can be a bit easier in asense, and I think that's part
of why we're seeing a little bitmore of that. I think also just
culturally, you know, familiesused to like always live in the
same area, at least if theydidn't even live in the same

(18:08):
household, right? There's a lotof multi-generational families
that, you know, were much moreprevalent than maybe they are
today, and so being able to cutoff from people in some ways is
easier than maybe historicallyit had been..

I, I wonder, you know, this aversion to
discomfort is, is, I think, aproblem in lots of areas, you
know, you see it in theworkplace, where young people,
especially, because they havebeen protected, that the that
there, there's a real aversionto discomfort, and I think you

(18:46):
know that concerns me, and Ithink that breaking through that
discomfort with somebody,working through that with
somebody, now everybody'sdifferent, so if somebody is
abusive, that's a differentstory, so we're talking about
people, general people who arenot abusive, that that real
intimacy comes from workingthrough some of that together,
and so I think young people areare cheating themselves out of

(19:09):
that.

Yeah, yeah, I think so. And I think to your
point, it's the like thediscomfort, the avoidance of the
conflict, the I wasn't everreally maybe taught how to
navigate spaces like this, youknow, if people have not had to
have those sort of difficultjust relationships in their
life, or you know, I shouldn'tsay difficult relationships, but

(19:32):
difficult experiences withinrelationships, I guess I would
would say, or you know, ifthey're not as used to even just
the socialization, right? Wetalk a lot about, you know, what
COVID did to folks, butcertainly, you know, if people
are having more and more oftheir relationships in a digital
space, you know, then navigatingreal-life space can sometimes be

(19:53):
more challenging if you haven'thad those experiences before,
with having to, you know, workthrough conflict with another
person.

And it is an overall lack of feeling
safe to get your own needs met,that I think, and I'm not a
psychiatrist, and I don't playone on TV, but you know, it
seems to me that that people areafraid to have those meaningful
conversations, and not that youneed to talk about every little

(20:20):
discomfort that you ever have.
Nobody wants that, but if you,you know, if there's something
really bothering you, you know,you can't, you'll, you won't be
able to have a good marriage orother kind of relationship if
you can't talk through thingsand get to the other side. And
the same thing with parentalrelationships, or sibling
relationships, or workplacerelationships,

yeah, absolutely. If you're, you know,
just sort of constantly avoidingthat discomfort, then you never
learn how to navigate, how tonavigate that space, right? So,
you know, I think we, you know,can think about how we sort of
have, like, the helicoptergeneration of parenting in the,
you know, very like protectivesort of parenting, where you're

(21:04):
trying to keep your kid fromdifficult or uncomfortable
situations, which in theorysounds wonderful, right, to be
able to protect your, you know,your children from that, but
then when they never learn howto navigate it, then we can
sometimes end up in these spacesthat are, you know, extremely
challenging.

Yes, yeah, you know, I, I think we may have
talked about, you know, kind ofhow Gen X grew up versus how
later generations, and nowwe're, you know, the teenagers
are, are what is that, Gen, GenY, so that our Gen Z, rather,

(21:43):
you know, that we were kind offeral, and the Gen X were, and
you know, we had to work throughthe difficult conversations, we
had to get ourselves intotrouble, we had to work through,
because we were five miles fromhouse on our bikes, and we
didn't have phones or anythingback then, and so if we got it
ourselves into trouble, we hadto get ourselves out if there
was was conflict with our friendgroup, friend, friends, you

(22:04):
know, our friends, friend group,then we had to work that out
too, and you know, for some theyended up fighting physically,
some of them they would, youknow, scream and yell at each
other, some of them they wouldjust work through it, but we, we
got to figure out how to do thatwhile we were young, and it's
uncomfortable, and sometimesnoses were bloodied, but you

(22:26):
know, we didn't. We have robbedour children of that experience.

Yeah, if you didn't learn how to navigate the
playground, right? Yeah, thatcertainly makes the rest of life
very challenging,

indeed. Indeed, so you know, we're you know,
switching back to, to this kindof sandwich generation. It
strikes me that it's an, youknow, when you're caring for
your ailing parents, it's agreat opportunity to teach your
kids about empathy. You know,talk about the adolescent
experience through that,

through, through managing your parents,
your

yes, through the sandwich generation experience.

Yeah, I mean, I think it's, it's just
challenging for everybody. Idon't know a better way to say
it, but I think you know youcan, or you are at all points in
your life really a role modelfor your children, right? And so
when you are kind of workingthrough that. I think it's also

(23:23):
in some ways amazing opportunityto show your kids how to
navigate maybe a difficultrelationship or just maybe a
difficult situation, and also toshow them that it doesn't have
to be perfect, right? Like maybeyou fight with your parent who
you're caring for, but at theend of the day, you still love
each other and care for eachother, and you know, do the

(23:44):
things that you need to do foryour parent, and they can kind
of see that that conflictdoesn't necessarily mean that
you know a relationship isnon-existent, or there there
isn't, you know, somethingdeeper and more meaningful
behind just, you know, a littletiff, or a little, you know,
argument about something minor,so I think there's that kind of

(24:06):
space in there to really thinkthrough, like, how can you know
I sort of show and live what Iwant my own kids to be able to
deal with, and I think it's alsookay to show them sometimes you
don't handle it great, right,like none of us are perfect, so
sometimes we mess up, but thenwhat do you do after the fact? I
think that's really where the,you know, the kind of

(24:27):
educational moment comes intoplay, to be able to show your
kids, like, the expectation isnot that every one of us is
perfect, it's, you know, what wedo after the fact that really
matters.

Do you have any now? I understand about HIPAA
and being careful of identity.
Do you have any stories aboutthe sandwich parents and their
families, kind of how theymanaged and how they overcame,
and and lived through that withgrace?

Yeah, I mean, I can think of lots of different
exams. Examples or differentvariations on it, you know, I
can think of several patients,actually, that that I've had
that are that are teenagers thatare put in that position of
really having to help care forthe, you know, the elderly
generation that's kind of movedinto the house because their

(25:17):
parent is off at work, you know,trying to have an income for the
family, and so then theresponsibility of care really
falls on the adolescent, andthat's very challenging for
them. So I've certainly seen alot of patients have to navigate
through that, and then trying tonav, they're trying to navigate
their, their own life and theirown, you know, school or

(25:40):
whatever they're trying to workthrough, too, and so you can
see, though, those challenges,you know, sometimes it's not so
graceful as you go through it,but you know, a lot of times
after the fact, people aregrateful that they got that
time, you know, with their maybetheir grandparent or their,

(26:00):
their other loved one, so therecan be that sort of plus side. I
also have seen patients that,that really struggle after the
loss of maybe that oldergeneration that they were caring
for, so definitely seen a lot ofpeople who, you know,
grandparent moved in with them,and now grandparent is gone, and

(26:25):
they really don't know how tonavigate that space, or they're
just dealing with a lot ofgrief, which is 100% normal, but
just really difficult. So, youknow, it kind of plays out in a
lot of different ways. I seeother people who find great
meaning in caring for, you know,for older generations, and kind
of being in that space, and I'veseen people that are sort of

(26:48):
forced into that position wherethey're kind of forced to care
for their parent, and it's notsomething that they want to do
or are particularly happy aboutdoing, but I have seen it really
kind of turn things around interms of just their appreciation
for their parent in a, in adifferent way, and to be able
to, you know, really alter maybewhat wasn't a great relationship

(27:11):
before actually becomes a verypositive

one. Oh, that's interesting, as they spend that
time together and, and, and arein a vulnerable position
together, because it's all veryvulnerable, yep,

very, yes,

wow,

Unknown (27:27):
yeah,

so as a parent, so maybe I'm I'm doing the work
like I'm going to work duringthe day, and and my will just
say 17 year old son or 17 yearold daughter is helping with
grandma. What are some earlywarning signs that, that I could
see in adolescence that it'sbecoming more that they than
they can handle? What do I needto look out for to make sure
that they're okay?

Yeah, I mean, it's not all that different in
adolescence. I think what'strickier is that, you know, one
big warning sign isirritability, and if you know
any adolescents, you know

they're pretty irritable,

irritable, so if there's a big shift in
worsening, I should say, of theirritability, or it's looking
different than sort of thatnormal teenage leave me alone
kind of stuff, that's certainlya warning sign if they're really
starting to withdraw or isolatea lot more, and that's very
different than, like, hey, Iwant to go hang out with my

(28:23):
friends, and I don't want to behome with you all. That's like,
I just want to be in my room inthe dark all the time, and I
don't want to engage with peoplein a way that's different than
they used to do, right? So,you're always looking for these
changes, I think, is part of, isreally the key piece of all of
it, is, is there something verydifferent than historically how
they sort of reacted orresponded to things. I mean,

(28:46):
other things can be, again, likesleeping, the eating, if their
grades are starting to decline,that's certainly a big warning
sign that something's going on.
And so those are things that Ithink parents should kind of be
on the lookout for.

What do you do when grandma's parenting style
is very different from your own,and all of a sudden grandmas is
reacting to your child in a waythat you find pretty negative,
that they think is quite normal,but you find negative. How do
you deal with that?

Oh, that's a really tough one, for sure.
Yeah, I don't know that I havethe perfect answer for that one.
I definitely have a lot ofpatience where I see that, that
they're, and sometimes it's evenamongst like spouses where they
have different parenting styles,but yeah, you throw, you know,
grandma and grandpa into themix, and yeah, it's just, it's
just very challenging, I wouldsay. I mean, a lot of parents

(29:38):
certainly express a great dealof frustration with, hey, I'm
trying to, you know, enforcethese rules or these boundaries,
or, you know, I'm trying toexercise these things that we've
talked about in our, you know,in our appointment, but then
I've got Grandma coming behindand undoing all of it, right,
and so that can certainly bevery, very challenging.

Of that,

I mean, I think again it's about
communication, but that's easyto say, very hard to do. So I
wonder, how do you caveat inthere?

How do you set boundaries in your own home with
your parents, dealing with yourchildren?

Yeah,

you know, it's, it's because I, you know, mom
moves, mom and dad move back inthe house, all of a sudden
you're 16 years old again,right?
But you're not, you're 45

Yeah, yeah. I mean, sometimes it's just being
like, you know, hey mom, I loveyou. I know you're trying to
help, but you know, I really amtrying to do things this way,
and I would love if you couldhelp support me in, you know,
navigating this, and you couldback me up in terms of how I'm,
you know, how I'm parenting, ormaybe it's we seem to have a

(30:50):
different approach to this. Canyou help me understand your
approach, and maybe we can findsome common ground, because I
feel like we're sendin differentmessages to

Sally, you know, maybe some ways. Oh,
sorry to interrupt.
No, go ahead.
That's fantastic. I'm wonderingif Sally, depending, let's say
that she's 17, because that wasthe example, yeah, would Sally
need to be a part of thatdiscussion?

Not necessarily. I think she could,
but she certainly doesn't haveto be, and in some spaces maybe
she shouldn't be, maybe it's a,you know, just a parent to
parent, parent to grandparentconversation that's had without
Sally in the room, just to say,you know, hey, I've really been
struggling with navigating thisspace with Sally, and I'm

(31:37):
feeling, you know, that we'resending her mixed messages, and
I want us to get on the samepage and be on the same team.
Let's talk about how we do that,right? Sally doesn't have to be
a part of that conversation.

So, what is this?
You know, Mom and Dad are one ofthem moving into your house. How
does this impact a marriage?

Yeah, that's a tough one too. I think it can
be very stressful on a marriage.
Certainly, I mean, it's just ifanyone in a relationship is
stressed that impacts the otherperson in a relationship, of
course. You know, sometimes,too, this happens not only in
these situations, but you know,even if you're really stressed

(32:18):
out at work, you know, you can'terupt at work, so you erupt at
home, where it's safe with yourloved ones, right? And so
sometimes things get taken outon our spouses that you know may
not be fair to them, and so Ithink that's something to just,
you know, really be aware of. Ithink it's, you know, really

(32:38):
important that people sit downand talk through with their
spouse, with their partner,before the parent moves in. You
know, what are some things thatwe're worried about, or what are
some ways that we're going tomake sure that we don't lose our
relationship in this? Maybe it'slike you talked about the safe
word for dinner - sloth meanstime out, and let's go meet in

(33:02):
the kitchen and talk thisthrough without grandma, you
know. So, trying to, I think,trying to think ahead in some
ways can be very helpful.
Obviously, you can't predict allof it, and so I think also
making sure that you're reallycarving out that time to stay a
couple is important too, so it'skind of like what you had to do

(33:24):
when the kids were little, likeyou got to carve out date night
and time for yourselves, andthat can be really hard to do,
but it is really importantbecause you don't want your, you
know, relationship to suffer atthe cost. You really need your
partner in this with you,because it's going to be
challenging for all involved,you know.

You know, I think about when the kids are little,
and that is the most difficultand stressful time in a
marriage. And this sounds likethis is this is kind of on par
with that. That's that's a lot.

Yeah, yeah, it can be sort of part two, I
guess, act two of thatsituation, but maybe you learn
something from going with it,going through it with your kids,
like what really helped at thatpoint, probably not a bad thing
to maybe spend some timereflecting on that, and that
might help you anticipate wheresome of those stressors might
be, or might come from, and whatyou might be able to do to work

(34:16):
through

it, so How do you know when you've hit your limit,
like you are, you're atcapacity, and that maybe it
might be time for dad or mom togo in assisted living or
something, where there's morememory care, or somewhere where
that they can be there 24/7 andpart of navigating that, as is
the guilt that goes along withit. Can you talk about that a

(34:39):
little bit?

Yeah, I mean, I think first and foremost about
safety, right? When we're reallytalking to when it's gotten to
that place where you just can'tnavigate, I think one, there's
the place that you just can'tnavigate because of the just the
stress of it all, or just beingoverwhelmed by it, but there can
also be a point where you'retrying to do everything
possible. You just can'tmaintain that safety in that

(35:03):
space for, you know, the personthat you're caring for, and I
think if you can reflect on thesafety, that can help a little
bit with some of the guilt. Ithink everybody, you know, wants
to be able to stay in their homeor to keep their loved one in
their home and not necessarilyhave to, you know, put them in a
facility or utilize a facility,but recognizing, you know, this

(35:28):
is no longer a place where I cankeep them safe, and so, for you
know, their good and theirwell-being, it's really time for
me to look into what are someother resources where I know
that my loved one will be fullycared for in a way that I just
am not able to do it, and so Ithink that again it's like,

(35:48):
where's that safety piece issometimes helpful in alleviating
that that guilt, and I thinkalso just recognizing, you know,
what are the other options forhelp, maybe there's like home
health that can come in and carefor a parent for, you know, a

(36:08):
certain amount of time a week,or things like that, but if you
really maximized out all thosepossibilities, maybe it's, you
know, really appropriate to belooking at another place for
your, your loved one to be.

It's really hard, so I, you know, have had family
members who, a couple, where,where one of them got
Alzheimer's, and he was adamantthat he didn't want to go into
home, and it wasn't until itwas, it was genuinely dangerous
for him to be at the house,because he would light a burner
and walk away, or, you know, dosomething else, where he just,

(36:40):
he just couldn't remember, andit was, you know, walk outside
the front door, or maybe want todrive somewhere, or then it
becomes scary, but his, his wifejoined a support group for
caregivers, because that, thatwas really helpful to her, and I
think they helped her get to thepoint where she recognized,
yeah, I no matter what I do, I'mnot going to be enough.

Yeah, yeah.
No, I think again, it's thatreaching out piece, right? So
support groups, I think, are agreat resource for people who
are in that kind of sandwichcaregiving generation, because
nobody else understands it ifthey haven't really lived
through it. But you can alsolearn a ton of resources from
support groups as well, right?

(37:22):
So, and sometimes the resourceis just recognizing, yeah, it's
time to move on to this nextstep, you know. So, I think
those things are reallyimportant to make sure that
you're reaching out to otherpeople who maybe are going
through it or have gone throughit before, and that can be, you
know, really helpful,

certainly in alleviating the guilt, because
she loved her husband, and shewanted to be there for him, and
take care of him, as she hadpromised to do, and she had
reached a point where everybodyaround her was also saying, you
can't do this anymore, becausewe could see the toll on her,
there's a tremendous toll forthe caregivers,

yeah, yeah, absolutely. It's, I think, it's
just very difficult to be inthat space where you know you've
probably had a loved one thatsays, like, when I get old, just
make sure you don't, you know,put me in a home, or you know,
they've made these comments, butthen the reality of the
situation is that's the onlysafe place for you to be. Yes,

(38:21):
and I think that managing thatguilt is so, so difficult, and
that's where getting thatsupport from others is really
important, so that you, you canhave that reassurance that what
you're actually doing is reallyin the best interest for
everybody, and that you know asmuch as you feel guilty about
it, you really shouldn't,because you are doing what's in,

(38:43):
you know, what's best for all.

So, let's talk about perfectionism, you know,
for the perfect being the enemyof the good. You know, how does
that find its way? Like, you'vealways been super bomb, you've
shown up, you go to all thegames, despite working full
time, you, you know, that youget the daughter to the school
to get, or get to the shop toget her prom dress early. You

(39:07):
make sure she has her nails doneand her hairs down. I'm thinking
of all the little things that,Bob, that moms do for teenagers,
you know. How does, how doesthis kind of load impact the way
parents show up for theirchildren,

yeah. I mean, I think it's certainly for
someone who's a perfectionist,it can be very, very challenging
because they feel like they'refailing, right? And that's
where, yeah, you know, sort ofterrible sense of self and that
guilt can all come from whereyou're like, I used to be able
to do all these things, oreverybody expects me to be able

(39:42):
to manage all of this, and I'm,you know, kind of ruining the
image that others around have ofme, but I think the reality is
that most of us are prettyunderstanding that no one person
can do it all, and that youshouldn't have to, and you know.
Being able to recognize thatyou're not going to be able to

(40:02):
keep all the balls up in the airall of the time is something
that I think needs to be sort ofbetter stated throughout life,
not just when you're at thislike sandwich generation, right,
but the parenting piece of beingthe perfect parent too, you
know, I think that's a very, weput a lot of pressure on people
to have this perfectionisticoutlook, or from the outside

(40:28):
looking in looks perfect, right?
But when, in fact, you know theperfect person may actually be
quite unhappy, and so I thinkit's recognizing that no one of
us can be absolutely perfect,and that we can only do what we
can do, and sometimes you haveto prioritize, and sometimes you
have to let some things fall,you know, or fall off,

you know. It's interesting talking about being
the perfect parent. Sometimes Iwonder, you know, parent parents
are so focused on being theperfect parent for their kids,
they basically turn them intotheir kids' staff, so that they,
that they, you know, haveflipped it, so that they now
work for the children, becausethat child's happiness, quote
unquote, becomes the mostimportant thing, which is a

(41:12):
terrible thing to do to a child,and the terrible thing to do to
yourself.

Yeah, absolutely. I think it's, you
know, so important that you, youknow, maintain your yourself
through it all. I think you'reright. People kind of fully give
of themselves to their children,which is wonderful in theory,
but you're actually notnecessarily doing the best thing
for your child if you're notstill able to have your own life
and have your own world, right?
I mean, what are you teachingyour kids if all they see is

(41:39):
that I should just give all ofmyself to the next person and
not do, you know, what they wantto do for themselves, I don't
think any of us would tell ourchildren to do that, but you
know, do it for them, right?

Do you know? Have you read the book, The Shel
Silverstein book, The GivingTree?

Yes, of course.

Okay, people love that book, and I gotta tell you,
it makes me so profoundly sad,because the child, as he's
growing up, just takes, takes,takes, takes, takes until the
tree is nothing but a stump. Thetree has nothing left, and
that's not that, that's not thestandard, you know.

Yeah, I just heard somebody else talking
recently about the story, sayingthe same thing. It's, you know,
used to always be sort of, oh,it's this beautiful book, and
then you sort of really stop andthink about it, and yeah, you're
really supposed to destroyyourself to just give everything
to someone else. I don't knowthat that's the message we want

(42:40):
giving our children,

and it's unhealthy for everyone. If you love your
kids, you, you have boundaries,and you help them have
boundaries, right?

Right. Yep, absolutely. And how does it
serve your kid if you're just astump now, right? Like,

right,

you gave everything, and now there's
nothing left that's not verygood either.

No. So, how does caregiving, so sorry. What do
kids often notice when parentsthink they're hiding stress?
Like, how transparent should yoube with your kids about your own
stress? Should you be talkingabout what you're going through
with them, since you're kind ofdoing the journey together?

Well, I think parents think they're much
better at hiding things fromtheir kids than they really are.
Kids are pretty smart, they pickup on a lot. They are, so I
don't think anyone should assumethat they're successfully hiding
everything, or maybe anything,from their kids. I do think it's
really helpful to talk itthrough, talk it out loud. I

(43:39):
think it, again, it's rolemodeling for your kid, like,
hey, this is really difficultfor me, and this is what I'm
doing to try to navigate throughit. Or you probably noticed
that, you know, mom's been alittle bit snappier recently,
and I think it's because I'vebeen really stressed out about
that. You know, I think if wecan really think through, like,
what would we want, what wouldwe, what advice would we give

(44:01):
our kids if they were in thatsituation? What would we want
them to do, and then how do weactually role model that for
them? I think that's a reallygreat sort of frame of mind to
have through this. Would youtell your kid, or just keep it a
secret from everybody aroundyou, and don't talk to anybody
about what you're strugglingwith? No, you certainly
wouldn't, right? So that's aframe of mind I find helpful,

indeed. Indeed, the flip side of that is you
don't want the kids to beworried, oh, mom's falling
apart. I don't want toovershare, because you, you
really do have to, you and your,your spouse, if you have one,
have to make sure that the shipis sailing correctly, and your
kids have to see that you arethat you're kind of holding it
together, so how do you walkthat line?

Yeah, it is definitely a balance. Yeah, if
you're just completely fallingapart, and then your kid sort of
feels like they have to becomethe parent, that's not a great
place to be and be in either.
But I think sometimes what canhelp avoid that is the early
sharing, right. I'm reallystressed out. I need to take a
minute, like mom's got to go laydown for five minutes, I'll be
right back, or I've got to walkaway, or you know, showing them

(45:06):
that you're sharing with themthat you're experiencing some
kind of negative emotion ornegative space, and then doing
something with it, and rolemodeling that, I think, is
really important. Sometimes wecan't help but fall apart. So,
again, I don't want people tofeel like they have to be
perfect at this either. Butyou're right, you also want to

(45:28):
create that safe space for yourkid to know that, you know, hey,
I can feel really bad right now,but I'm still going to get you
to school tomorrow, I'm stillgoing to pick you up from this,
or I'm going to get you to thatparty, or whatever it might be,
so you're right, you've got tonavigate that balance there too.
If things are getting to thepoint where you really feel like
you can't, that's another bigsign that maybe it's time, you

(45:49):
know, to seek out someprofessional help, because
that's not where we want anyoneto be.

No, you know, I..
I.. it's. it's one thing to tellyour kid, you know, I'm having a
rough night, I need an attitudeadjustment, give me 20 minutes,
and it's another thing to fallapart completely, and you know,
and not be able to show up atall for your kids,

of course.
Absolutely, yeah.

So, wow, so what role does modeling healthy
coping? We've kind of talkedabout it, but coping play for
kids when you're modeling thathealthy coping skills.

Yeah, I mean, I think it's everything, but
you're, I mean, you're teachingyour kids how to navigate their
own challenging times in theirfuture life. I don't think we
always recognize how much ourkids pick up on it's not just
like, oh, they see it or theyhear it, but how they
internalize it. I think we underacknowledge, I guess I'll say,

(46:55):
and so sometimes I don't thinkwe're thinking, oh, I've got to
role model this out, or I've gotto do this just so, so my kid
could then say, 'Oh, mom, Inoticed when you got really
stressed out, you were able tostep away and take a break. Your
kid's probably not going to beable to, probably not right, but
they are internalizing it, and Ithink that's, you know, part of

(47:15):
what's important to recognize isthere's some, some learning
being being had there that isn'tnecessarily overt, and so just
being able to know that youknow, I just try to take care of
myself is teaching my kid how totake care of themselves. I'm not
telling them how to do it, I'mjust doing what I need to do for

(47:36):
myself, and hoping that that'ssomething that they'll take on,
knowing, oh, well, when I wasgrowing up, this is what you did
when you got upset, so that'sjust normal, you know.

I wonder, you know, we, so we have to give
each other grace, and I thinkthat that having those
conversations is important. Whatabout structure and routine? You
know, they say that for adults,too. Healthy hygiene, sleep
hygiene is about every time,every time, about the same time
every night, you start windingdown, and you have a ritual,

(48:09):
maybe, that you know, you go inand wash your face, and brush
your teeth, and you, you know,feed the animals, and put the
dogs out, or whatever your, yourroutine is, you know, is it
important to keep that structurein place during this, during the
transition to having a parentmove back in with you, what
difference does that make?

Yeah, I mean, I think structure and routine is
super important for people ofall ages. I mean, that's, you
know, our bodies are kind oftrying to always reach that, you
know, homeostasis, or that kindof perfect balance, and the best
way to do that is to have thatroutine and that structure, so
we all kind of know what'scoming, right, all parts of our

(48:49):
sort of being, both our brainand our body. I think when
you're moving into a stressfulsituation, in particular, then
it's even that much moreimportant, because you have to
make sure you're still meetingyour basic needs, and that's
really what you know structureand routine is meant to
accomplish, is that you're ableto take care of the things that

(49:10):
are most important to take careof, like eating, sleeping,
getting some exercise in,whatever it might be, right. So
I think that that's reallyimportant, but at the same time
we can't lose flexibility,right? If we're so rigid in our
routine and our structure, thenwhen something interrupts that
and that creates stress oranxiety, that's not good either,

(49:32):
right? So I think one is havingroutine and structure with
flexibility, and if you'reshifting into a new space, say,
you know, say a parent is movingin, you may have to rethink what
that routine is. That routinemight change, and so, how do you
build in a new routine? Youknow, changing your routine
isn't necessarily a bad thing,as long as you've kind of

(49:53):
established that new one. But Iwill also just throw in the
caveat that it's really goodevery once in a while to have no
routine. No, structure, and justenjoy yourself.

Weekend, exactly, exactly. So, you talked about
self care. You mentioned selfcare, and you know the self care
that you see on the internet isyou're having a spa day, or
you're whatever, retail therapy,

or whatever, you know, and if you've got no
time or space or just anythingfor anything extra in your life.
How do you work that in? Yeah, Imean, I think it's super
important to remember thatself-care does not have to be
something expensive. It doesn'thave to be something that takes
a lot of time. In fact, the bestself-care are things that you
can do in just the littlemoments or little increments,

(50:41):
even throughout your day, sosometimes it's just listening to
your favorite song, or justtakein a five minute break, or
maybe it's just going outsideand taking a walk around the
block, or you know, these thingsthat are just very easy to
access, but again, don't take alot of money, they don't take a

(51:02):
lot of time, they don't take alot of resources, because those
are also the self-care practicesthat you're going to be able to
actually one implement, but two,do routinely, right? If your
only way to take care ofyourself is to go to, you know,
the spa for the day, you're notgoing to be able to do that all
the time, right, right, right,right. You know, how do you find

(51:24):
these things that are easy tokind of implement, you know, any
time of day? I think is are thebest self-care strategies for
sure. There may still be somethat are a little bit more, you
know, time-intensive that arevery important to you, but maybe
mapping out how do I do thoseonce a week, right? But I have
these little ones that I can dodaily, or you know, something to

(51:47):
that effect.

I think that's, you know, you and your spouse
can lean on each other. If yourspouse likes to play golf,
giving him or her space to dothat, and then asking for space
to do your thing in return on adifferent day, you know, if
that, I think that would work,you know, if that's something
that you can lean on each otherfor.

Absolutely, like from, you know, three to
four, you go do whatever youwant, from four to five, I get
to go do whatever I want,

right? Somebody hit some balls, or whatever,

right, whatever it is. Yes, whatever it
is.

So, um for some, for someone listening who knows
that they need support, butfeels overwhelmed, and I'm going
to tell you, like, for me, ifI'm feeling overwhelmed, it's
usually I get that feeling lateat night, or I wake up at
3o'clock in the morning and go,I can't do this anymore, so it's
not exactly the best time to bepicking up the phone and calling
someone, but for someonelistening who knows they need

(52:42):
support but feels overwhelmed,where should they start?

Yeah, I mean, I think there's there are so
many resources out there, so Ithink if it's during the day, if
it's not late at night, likeyou're talking about, I think
being able to even just startwith your primary care doctor
can be a great place, they'llhave a ton of resources, whether
it's connecting you with, youknow, a mental health caregiver,

(53:06):
or you know, a therapist, apsychiatrist, whatever is
appropriate, or they might havejust more like social resources,
or they might be able to evenaccess additional resources,
like, you know, sometimes oursocial workers at Kaiser are
able to connect people tosupport groups or other
resources that might be really,really helpful when it's that

(53:30):
like late at night, which ishonestly the time that most
people struggle. Yeah, whenthere isn't anything available,
that's when I think some of ourtechnology actually can be the
most helpful, so I think of, youknow, there are a lot of apps
out there that can be reallyuseful, that can be things like

(53:51):
they have, you know, relaxationtechniques, or like meditation
videos, or things that you canlisten to, or there are also
places where you can access,like, virtual care, and
sometimes that's at any time ofday, sort of, depending on what
the resource is. So those thingsare accessible at kind of off

(54:12):
hours, but I think also, youknow, recognizing I'm not
starting to do so well atnighttime, maybe I should look
up some stuff ahead of time,yeah. Or right now I'm having a
really difficult night. Tomorrowmorning I'm going to call my
PCP, and like setting a plan foryourself the next day can also
be really helpful.

What if you don't want medication, and so you're,
you're, which you may need, butyour brain isn't there yet, but
you know you don't wantmedication, you say I'm not
going to call because they'rejust going to want to give me
drugs, and I don't want to be onany antidepressant. Is there..
do you.. what do you tell them?

Well, I mean, there are tons and tons of
treatment options that havenothing to do with medication
for our mental health, so that'susually what I talk about. Is
there? There's, you know, a lotof ways that we can really make
a big difference in your mood,in your anxiety levels, in your
mental health, that don'tnecessarily involve medication.

(55:11):
You know, medication has a timeand a place, but that's not
something that everybody needs,and it's not always something
that everybody is interested inor looking for, and so being
able to really explore thealternative options out there,
like talking to a therapist, andthere's, I mean, there's
billions of types of therapythere are, and you could go on

(55:32):
and on with all the types oftherapy, but I think you know,
again, getting connected to thatfirst person, or that first
connection point, and so, like,when I say things like, talk to
your PCP, I don't mean talk toyour PCP about starting meds, I
mean talk to your PCP about, youknow, do they have a therapist
they recommend, or how do youget a therapist appointment, you

(55:55):
know, the beauty of Kaiser isyou don't need to talk to a PCP
at all, you can go straight to atherapist, not everything is,
you know, is set up that way.
So, I think it's also about thetalk therapy part of it, can be
a really, really powerful formof treatment that I don't think
should be overlooked.

Well, that is, that is excellent. So, we are
completely out of time. Dr.
Ashley Zucker, it's always atreat to have you on the show.
How do people find you at KaiserPermanente?

Well, I hide a lot. No, just kidding. I mean,
you can find any mental healthresource. Probably the easiest
way to go is first to go to ourwebsite. So, kp.org is always a
great place to start. You cancertainly look me up there, but
we've just got a plethora ofmental health options, which are

(56:48):
available not just to ourmembers, but actually to
non-members as well. So, I'dencourage folks, whether they're
KP members or not, to start withkp.org because we got a lot of
stuff on there that can bereally, really helpful,
including some virtual webinars,which are accessible to our
non-members too.

Excellent. Well, Dr. Ashley Zucker, thank you so
much for joining, joining ustoday. And I know it's Mother's
Day is in the past, but happybelated Mother's Day. Thank you
very

much.

Same to you. Bye.
Well, that is all we have timefor today. Thank you so much for
spending this time with me. I'mErin Brinker. You've been
listening to The Hope Table.
Have a great week, everyone.

Unknown (57:33):
Bye.

All Episodes

Episode Transcript

Popular Podcasts

Hey Jonas!

Crime Junkie

Betrayal Weekly

.css-15opob5{left:0;position:absolute;top:0.8rem;} All Episodes

.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}The Sandwich Generation: Caring for Kids, Aging Parents, and Yourself

Episode Transcript

Popular Podcasts

.css-r6mb8g{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:1;overflow:hidden;}Hey Jonas!

Crime Junkie

Betrayal Weekly

All Episodes

The Sandwich Generation: Caring for Kids, Aging Parents, and Yourself

Hey Jonas!