The Sandwich Years: Caring for a Parent While Raising Kids

You are in the pharmacy line on your lunch break, picking up your mother's prescription, texting your daughter about a ride, and taking a work call you should not be taking. None of these three things is a crisis. The feeling is not drama. It is that there is no version of today in which somebody is not getting a reduced version of you. Researchers call this being in the sandwich generation.

The name is bland. The research is not, because the obvious explanation turns out to be wrong.

You Are in the Majority, Which Is Its Own Information

A quarter of US adults are in the sandwich generation, defined as having a parent aged 65 or older plus either a child under 18 or an adult child they support financially. That comes from a Pew Research Center survey of 8,750 adults conducted in early September 2025.

In your forties it is the normal condition, not the exception: 54 percent of Americans in their forties are sandwiched, against 45 percent in their fifties, 25 percent in their thirties and 10 percent of those 60 and older.

It is also not a new emergency. The overall share has grown only modestly, from 23 percent when Pew last measured in 2021 to 25 percent now, though the figure for people in their fifties rose more sharply, from 36 to 45 percent, partly because more of them still have a living parent over 65.

The Hours Are Not the Problem

This is the finding that should change how you think about your own week.

Lianlian Lei, Amanda Leggett and Donovan Maust analyzed national data on adult children caring for an older parent and compared the sandwiched with the not-sandwiched. Sandwich caregivers provided a similar number of care hours to their older relative: 77.4 hours a month against 71.6, a difference that was not statistically significant.

What was different was everything else. More of them worked for pay, 69.4 percent against 53.9 percent. Far more reported substantial financial difficulty, 23.5 percent against 12.2 percent. More reported substantial emotional difficulty, 44.1 percent against 32.2 percent. And they scored higher on caregiver role overload.

So it is not that you are doing twice the work. The same work is landing on a life with no slack in it, alongside a job, with money pulling in two directions and a sense of being required in several places at once. That distinction matters, because if the problem were hours the answer would be a calendar. It is not a calendar.

Two further studies sharpen this, in a direction most articles on this topic avoid. When researchers compared sandwich generation caregivers, parent-only caregivers and child-only caregivers, burnout was significantly higher in the first two groups than the third, and the sandwich group did not separate from the parent-only group. A 2026 replication with 415 caregivers found the same grouping. The elder-care role appears to be doing most of the work here, and the familiar claim that doing both at once is worse than either alone is not well supported.

That 2026 study found something more useful than a ranking. In the sandwich group, the predictors of burnout were positive and negative relationship quality. Not hours, not tasks. The relationship. It was a convenience sample recruited online, so hold it lightly, but it points therapy at something specific.

Both Things Are True at Once

Articles on this subject reach for the language of crisis, and the data contradict them.

Sandwiched adults are more likely than other adults to say they are very satisfied with their family life, 48 percent against 43 percent. Among people in their forties the gap is wider: 49 percent against 38 percent. In earlier Pew work, sandwiched adults were about as happy with their lives overall as everyone else, but noticeably more likely to say they always feel rushed, 31 percent against 23 percent.

Short of time, not short of meaning. That is a different problem than the one the word burnout usually implies.

Pew's February 2026 report on family caregiving holds both halves together. Among people regularly helping a parent with errands, housework, personal care, finances or health care, 56 percent said it had a positive impact on the relationship with their parent. On their own emotional wellbeing, 39 percent said negative, 28 percent positive and 33 percent neither. It is genuinely split, and anyone quoting only the 39 percent is turning a divided population into a verdict.

The split is not even. Forty-seven percent of women said caring for a parent had a negative effect on their emotional wellbeing, against 30 percent of men, and men were likelier to report a positive effect, 36 against 21 percent. That gap most likely describes who does which parts of the work rather than who copes better.

In Arizona, among people caring for someone with dementia, 32.3 percent are also caring for a child, according to 2023 Behavioral Risk Factor Surveillance System data compiled by the Alzheimer's Association. That describes Arizona dementia caregivers rather than Arizonans generally, and it lines up with the national picture, where nearly one in three caregivers is also raising children under 18.

What Actually Helps

There is real evidence here, with real limits, and it is worth separating the two.

The strongest result comes from REACH II, a randomized trial of 642 dementia caregivers across five US cities. The intervention ran twelve in-home and telephone sessions over six months, addressing depression, burden, self-care, social support and the care recipient's behavior. Clinical depression among caregivers in the intervention group was 12.6 percent against 22.7 percent in the control group. Roughly half the depression, in six months. It was a dementia caregiving trial specifically, which is not everyone's situation, and there was no significant difference in nursing home placement. A version was later adapted for delivery through Area Agencies on Aging, which is worth knowing because your county may run something like it.

More broadly, a meta-analysis of 78 caregiver intervention studies found improvements across burden, depression and wellbeing in the range of 0.14 to 0.41 standard deviations, with psychoeducational and psychotherapeutic approaches the most consistent. Modest, real, and better than nothing by a clear margin.

Two findings are worth carrying into your own week. A 2025 trial of problem-solving training for dementia caregivers found 60.4 percent showed meaningful improvement in burden or depressive symptoms, and that the likeliest responders were those who started with the highest burden, the most depressive symptoms and the lowest life satisfaction. The most overloaded people were the most likely to be helped, which is the opposite of what people in this position assume about themselves.

And on respite: a small study of 85 dementia caregivers found that achieving their goals for respite time predicted feeling happier with it a week later, independent of how many hours they got. Planning what you do with the break mattered more than the size of the break. The broader respite evidence is weak and at high risk of bias, so treat that as a hint rather than a prescription.

Our pieces on the mental load of modern life and understanding emotional exhaustion cover the texture of this, and always tired, always stressed is about knowing when to stop.

Where to Start in Arizona

If you are considering therapy and the obstacle is that you cannot find the hour, that is worth saying out loud at the start rather than apologizing for later. Telehealth exists largely for weeks like yours.

Worth bringing to a first session: what is unmanageable, which relationship is costing most, and what you have stopped doing that you miss. That last one tends to produce more than the other two.

The Healing Effect works with clients across Arizona, in person and by telehealth for clients located in the state. There is more about this work on our life transitions counseling page, and you can reach us through our contact form.

One final thought on the research, since it rarely says anything this kind. People in this position tend to assume they are doing it worse than everyone else, and that the fatigue is evidence of failure. The data say something close to the reverse: the hours are ordinary, the overload is real, the satisfaction is genuinely high, and the people who arrive most depleted are the ones most likely to get something out of help.

What is the sandwich generation?

Pew Research Center defines it as adults who have a parent aged 65 or older and either a child under 18, an adult child receiving financial support, or both. A quarter of US adults are in this position, and 54 percent of Americans in their forties are.

Is caring for a parent and children at the same time worse than doing just one?

Less clearly than people assume. National data show sandwiched caregivers provide a similar number of elder-care hours to other adult-child caregivers, while reporting substantially more financial difficulty, emotional difficulty and role overload. In two studies that compared groups directly, burnout among sandwich caregivers was higher than among people caring only for children but not distinguishable from people caring only for a parent.

Why am I so exhausted if I am not doing more hours than anyone else?

Because the research points at overload rather than volume: the same work landing on a life with a job in it, money pulling two directions, and the sense of being needed in several places at once. One 2026 study found that among sandwich caregivers, relationship quality rather than hours predicted burnout, though that was a convenience sample recruited online.

Does anything actually help?

Yes, modestly and measurably. In the REACH II randomized trial of 642 dementia caregivers, twelve sessions over six months cut the prevalence of clinical depression from 22.7 percent to 12.6 percent. A meta-analysis of 78 caregiver intervention studies found improvements across burden, depression and wellbeing, with psychoeducational and psychotherapeutic approaches the most consistent. A 2025 trial of problem-solving training found that the caregivers who started out most burdened and most depressed were the most likely to improve.

Is it normal to find parts of this rewarding?

Yes. Among people regularly helping a parent with daily tasks, 56 percent said it had a positive impact on their relationship with their parent, and on emotional wellbeing the responses split 39 percent negative, 28 percent positive and 33 percent neither. Sandwiched adults also report higher satisfaction with family life than other adults. Finding it meaningful and finding it hard are not in competition.

The Healing Effect is not a crisis service. If you are in crisis or thinking about harming yourself, call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours a day, 7 days a week.

Sources:

Pew Research Center. More than half of Americans in their 40s are sandwiched between an aging parent and their own children (a quarter of US adults are in the sandwich generation; 54 percent of those in their 40s, 45 percent in their 50s, 25 percent in their 30s, 10 percent of those 60 and older; up from 23 percent in 2021 and from 36 percent among people in their 50s; composition by decade; family life satisfaction 48 percent against 43 percent overall and 49 against 38 among those in their 40s). Based on a survey of 8,750 US adults conducted September 2 to 8, 2025. Note that Pew's page carries an internal date inconsistency, giving 2026 in one methodology line and 2025 throughout its chart sources; the September 2025 fielding date is confirmed in Pew's February 2026 report below.

Pew Research Center. Family Caregiving in an Aging America, February 26, 2026 (survey of 8,750 adults conducted September 2 to 8, 2025, including 1,193 caregivers; 56 percent say helping their parent had a positive impact on the relationship; emotional wellbeing 39 percent negative, 28 percent positive, 33 percent neither; 47 percent of women against 30 percent of men reporting a negative effect on emotional wellbeing; 10 percent of all US adults are a caregiver for a parent 65 or older).

Pew Research Center. The Sandwich Generation, January 30, 2013, based on a survey of 2,511 adults conducted November 28 to December 5, 2012 (31 percent of sandwiched adults say they always feel rushed against 23 percent of other adults; overall happiness similar between the groups).

Lei L, Leggett AN, Maust DT. A national profile of sandwich generation caregivers providing care to both older adults and children. Journal of the American Geriatrics Society. 2023;71:799-809 (2015 National Study of Caregiving and NHATS; 194 sandwich and 912 non-sandwich adult-child caregivers; 77.4 against 71.6 care hours a month, p = 0.60; 69.4 percent against 53.9 percent working for pay; substantial financial difficulty 23.5 against 12.2 percent; substantial emotional difficulty 44.1 against 32.2 percent; higher role overload). Author abstract read; full text not accessed.

Owsiany MT, Fenstermacher EA, Edelstein BA. Burnout and Depression Among Sandwich Generation Caregivers: A Brief Report. International Journal of Aging and Human Development. 2023 (sandwich generation caregivers and caregivers of parents reported significantly higher informal caregiving burnout than caregivers of children; the abstract does not report sandwich caregivers exceeding parent-only caregivers). Author abstract read; full text not accessed.

Fenstermacher EA, Owsiany MT, Ju CH, Lohmar S, Edelstein BA. Prediction of burnout and psychosocial differences among sandwich generation and other informal caregivers. Aging and Mental Health. 2026 (N = 415 recruited from an online panel; burnout significantly higher in sandwich generation and parent-only caregivers than child-only caregivers; in sandwich generation caregivers, positive and negative relationship quality were significant predictors of burnout). Author abstract read; full text not accessed.

Pinquart M, Sorensen S. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychology and Aging. 2003 (84 articles; largest differences for depression, Hedges g = .58, and stress, g = .55; larger differences for dementia caregivers than for heterogeneous caregiver samples). Author abstract read; full text not accessed.

AARP and National Alliance for Caregiving. Caregiving in the US 2025, July 24, 2025 (63 million Americans provided care in the past year; nearly 1 in 3 caregivers is also raising children under 18, rising to 47 percent among caregivers under 50; nearly 1 in 4 report feeling socially isolated; 6,858 caregivers surveyed). Figures read from AARP's release rather than the full report.

Alzheimer's Association. Dementia Caregiving in Arizona, fact sheet based on 2023 Behavioral Risk Factor Surveillance System data (32.3 percent of Arizona dementia caregivers are also caring for a child; 39.1 percent socially isolated; 22.5 percent in frequent poor mental health). These figures describe Arizona dementia caregivers specifically, not Arizona caregivers or Arizonans generally.

Belle SH, Burgio L, Burns R, et al. Enhancing the quality of life of dementia caregivers from different ethnic or racial groups: a randomized, controlled trial. Annals of Internal Medicine. 2006;145:727-738 (642 caregivers across five US cities; twelve in-home and telephone sessions over six months; prevalence of clinical depression 12.6 percent against 22.7 percent, p = 0.001; no statistically significant difference in institutionalization at six months; single six-month follow-up noted as a limitation).

Burgio LD, Collins IB, Schmid B, Wharton T, McCallum D, DeCoster J. Translating the REACH Caregiver Intervention for Use by Area Agency on Aging Personnel: the REACH OUT Program. The Gerontologist. 2009;49(1):103-116 (272 dementia caregivers; four home visits and three phone calls; the authors note the lack of a control group and substantial missing data as limitations).

Sorensen S, Pinquart M, Duberstein P. How effective are interventions with caregivers? An updated meta-analysis. The Gerontologist. 2002;42:356-372 (78 studies; improvements of 0.14 to 0.41 standard deviation units; psychoeducational and psychotherapeutic interventions the most consistent). Author abstract read; full text not accessed.

Juengst SB, Smith ML, Wilmoth K, et al. Problem-solving training to improve caregiver burden and depressive symptoms among dementia caregivers. Frontiers in Public Health. 2025;13:1682373 (91 caregivers in responder analysis; 60.4 percent showed clinically meaningful improvement; responders had higher baseline burden, more depressive symptoms and lower life satisfaction).

Godfrey DA, Wong B, Thompson AD, Coleman ME, Sparks C, Utz RL. Respite time-use among dementia caregivers. Frontiers in Health Services. 2025 (N = 85; respite goal achievement predicted improved respite outcomes a week later, independent of the number of respite hours reported). Author abstract read; full text not accessed.

Liu M, Yang Y, Chen Y, et al. Effectiveness and cost-related outcomes of respite care models. The Gerontologist. 2026 (eight studies; four judged at high risk of bias and four with some concerns; findings should be interpreted cautiously). Author abstract read; full text not accessed.