The Sandwich Generation, ‘Care For the Carers’ – Tuly Rosenfeld

Wednesday, October 18th, 2017

Parents ‘the meat’ in the sandwich

“It’s care that just happens. No one’s really counting it and certainly no one’s paying for it. It comes out of people’s own goodwill and sense of responsibility.”

“The average life expectancy in Australia today is in the mid-80s. A child born today can expect to live to 86 years of age.”

Having children later in life, along with an ageing population is putting a strain on the ‘Sandwich Generation.’

This is nothing to do with what you might be eating. The Sandwich Generation is in fact those of us who are middle aged adults who are juggling the demands of bringing up our children and the needs of our elderly parents.

“We’re getting older. That means our parents are getting older and at the same time, we have children who are still in their 10s and 20s and we’re still involved in looking after our children,” noted Professor Tuly Rosenfeld.

‘Physical cognitive problems and dementia are increasingly likely’

“Also their walking, mobility, and their ability to look after themselves,” commented the professor on the increasing numbers of employed family members who are caring for their elderly relatives.

New research finds that almost half (46%) admit that their commitments to both their parents and children are having an adverse impact to their own health.

And a quarter say the help and care they provide to their parents is impacting the time they can spend with their children.

Associate professor Tuly Rosenfeld is a specialist geriatrician at the University of NSW and Notre Dame. He’s also the Clinical Director of Care Pilot. (

“So we’re sandwiched between the responsibilities and care of our children and increasingly at the same time being involved in the care and providing safety and support for older parents,” Tuly explained, saying it’s a complex matter.

“If you go to the Carers Australia website the dimensions include $60-billion a year in unpaid unrecognised care provided by about 2-and-a-half million Australians.” Tuly noted, saying the immense size of the amount is not coming from government coffers. (

“This is because of everyone’s responsibility, care and love for their folks and their children. That’s something we all do and it’s very difficult to juggle.”

“The more I talk to people the clearer it is that everyone seems to be in this situation. The baby-boomers, that’s us, and we’re all having to juggle children, care, elderly parents, our jobs, our lifestyle and needs.”

Professor Rosenfeld said the Care Pilot survey showed many of the people in that sandwich generation are suffering anxiety, stress, lack of sleep, and financial strain.

Impact of child-bearing older couples

Another consideration is the impact brought about by couples having children later in life.

“I’m one of those and my kids are still relatively young and many people in their early mid and late 20s, even now people in their 30s are having children.”

Although Professor Rosenfeld approved of older couples having children he admitted it’s having a twofold impact with these couples ageing parents now living longer.

But for those who become octogenarians a range of ageing problems are more than likely to surface if they haven’t already done so.

“Physical problems, cognitive problems, dementia are increasingly likely. Their walking, mobility and their ability to look after themselves, and they need to call on help,” Tuly informed, saying that help is usually their family.

Carers physically and mentally exhausted

“And families usually give of it freely and that’s great and it’s wonderful. It’s part of our loving society, however that stress and strain has an impact.”

The professor said one of the biggest messages that came out of Carers Week are the carers who are suffering.

“They need to put up their hands and ask for help.”

These carers are physically and mentally exhausted – running around after their children and at the same time, caring for their elderly parents.

Professor Rosenfeld acknowledged it wasn’t easy for carers to realise and admit they’re struggling to cope. They’ve become institutionalised.

“A lot of the people I see who come to my clinic have been doing it for years and they don’t know there are citizens supports out there.”

How connected are we to families?

“There are people who can give advice. Obviously people can go to their GP who can diagnose and give solutions to the problems their parents are having.”

“But as far as community care goes, one of the issues in Australian society is that community care is not necessarily connected too well to hospitals, doctors and specialists.”

Professor Rosenfeld emphasised the importance of asking for assistance. But are we as Aussies connected to family as much as we’d like to think we are?

Yes, we are! Tuly’s response was a definite yes, and if not more so.

“Most Aussies I see that come to my clinic have been doing all sorts of things that I think are above and beyond what you might expect.”

“Aussies are doing it!” declared Professor Rosenfeld. Again he recited the statistics.

Goodwill and fellowship – ‘It’s bottomless!’ 

“2-and-a-half million Australians, and that’s just the ones we know about, are actually providing care to their folks at the same time as their kids.”

And he repeated the amount of money these people are saving the government.

“It’s bottomless! I think there’s a lot of goodwill and fellowship among Australians for their responsibilities.”

And there’s another statistic Tuly wanted to bring up that he said was quite astounding.

“Of the 1000 people who took part in the Care Pilot survey, it showed that more than three-quarters were having to provide care to parents and their children.”

The survey also recorded 25 percent of the participants admitted the stresses and strains was causing them to suffer lack of sleep, anxiety, and problems such as depression.

The sandwich generation

“This was impacting on their ability to care for their children.” A sobering statistic as far as Professor Rosenfeld was concerned.

“It just shows the impact of what we take for granted that people do for their folks.’

A quarter of the people surveyed were found to be doing more than five hours a week in actual hands on care. This included providing every day personal care.

“So there’s an enormous amount of care being provided by carers in the sandwich generation.”

“It’s care that just happens. No one’s really counting it and certainly no one’s paying for it. It comes out of people’s own goodwill and sense of responsibility.”

‘Ask for support’

Professor Rosenfeld wanted to make it clear there’s a price to pay for all this goodwill and sense of responsibility.

As for all the services available to take care of the carers, a good place to start can be the internet.

“There’s a website called My Aged Care ( This is a government service that provides information, documents, education, as well as a link to services available on the ground throughout Australia,” Tuly revealed, saying there are a host of private organisations.

“Not for profits such as Care Pilot or Catholic Care. Just from a range of services and people need to put up their hand and explore what’s available.”

“They need to ask for support before they get into a situation where the impact is overwhelming and leads to a crisis.”

Professor Rosenfeld warned that making decisions when in a crisis is not the ideal place to be.


Assoc. Prof. Tuly Rosenfeld

Tuly Rosenfeld

Senior Specialist Geriatrician and Physician

Associate Professor Tuly Rosenfeld has a special interest in the assessment of capacity and competency in older people. He has been involved in a large number of matters before the courts. He has been engaged as an expert witness in NSW, other states, and internationally. He has been involved in a range of litigation matters acting for various parties including patients and health care providers. He has published in the area of capacity and decision making as it affects older people.

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