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Economic and sociological factors have transformed the way we care for elderly family members over the past sixty years. We celebrate economic and social progress, but many caregivers pay heavy costs for that progress.

Most of us have living parents or grandparents that have survived heart attacks or cancer. Cardiac and cancer patients usually died too young to experience frailties of old age until modern treatments for those conditions emerged over the past sixty years. Today, coronary artery bypass, angioplasty, and various cancer treatments allow people to live long enough to experience physical and mental deterioration that their ancestors never imagined.

Post-World War II prosperity permitted couples to marry young, live on one income, and raise children soon after marriage. In today’s weaker economy, many married couples delay marriage, depend on dual incomes, and delay parenthood until early middle age.

Society has traditionally expected adult children to care for their aging parents and grandparents. However, the combined effects of parents living long enough to wear out their minds and bodies, working families’ dual income dependence, and couples starting families later in life are causing social pressures that pinch adult children between caregiving responsibilities for their parents and their own children. Sociologists call such pinched adult children the “sandwich generation.”

These economic and sociological changes leave elderly couples to care for each other until neither spouse can safely and adequately serve the other spouse’s health care needs at home. Even when the younger generation can participate in the older generation’s home healthcare, the younger generation’s employment and childcare responsibilities stretch many caregivers to the breaking point.

Family caregivers must be realistic about their limitations and the care recipients’ physical requirements. Depression, sleep deprivation, malnutrition, physical and emotional fatigue, and physical injury plague many overextended caregivers. When caregivers exceed their physical and psychological breaking points, their own health crises jeopardize the people they are trying to protect.

So should we conclude that all caregivers should wave the white flag and admit their aging family members to nursing homes? Realistically, that may be the healthiest and safest solution for many families, but other alternatives exist.

Growing concern for our aging generations is attracting more home healthcare and respite care providers than ever before. For those people who cannot afford home healthcare, Indiana’s Area Agencies on Aging (information about Area Agencies on Aging appears online at http://www.iaaaa.org/) coordinate a Medicaid solution known as the aged and disabled waiver (A & D waiver) to help pay for home healthcare. Other creative solutions are opening around the state such as adult day care facilities that provide structured supervision of mentally disabled adults while caregivers shop, work, or participate in children’s school activities.

Caregiving is not for the faint of heart. Caregivers need not be superheroes, nor should they try to give superhuman care. Generally, wise caregivers care more effectively than sacrificial caregivers do. Caregivers need to be strong and healthy, but most importantly, caregivers must be realistic.

Jeff R. Hawkins and Jennifer J. Hawkins are Trust & Estate Specialty Board Certified Indiana Trust & Estate Lawyers and active members of the Indiana State Bar Association and National Academy of Elder Law Attorneys. Both lawyers are admitted to practice law in Indiana, and Jeff Hawkins is admitted to practice law in Illinois. Jeff is also a registered civil mediator, a Fellow of the American College of Trust and Estate Counsel and the Indiana Bar Foundation;  a member of the Illinois State Bar Association and the Indiana Association of Mediators; and he was the 2014-15 President of the Indiana State Bar Association.

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