Sandwich generation: ‘Working, raising their own families and caring for elderly parents’

Brian Doyle was a firefighter paramedic with Dublin Fire Brigade when his father, Michael, was diagnosed with vascular dementia. For the next seven years, until Michael died in 2019, he and his two sisters helped with his care. In the early stages they reacted as problems arose, but later on they rostered themselves to do a night a week to support their mother, Adrienne.

As he was already working about three nights a week in his shift pattern, that meant another night away from his wife and three sons, “so that was tough”. However, despite the full-on nature of his job, he says he was lucky because he got great support both from management and colleagues who would swap shifts. Although annual leave was rostered over the winter months, he was allowed to rearrange his leave if necessary.

“If there was a crisis, Dad had an issue or a fall, I was able to get away because somebody would come in and work for me. The culture in there was that we would look after each other.”

Being a paramedic, he was perhaps unusually comfortable in disclosing his father’s medical emergencies when they arose. However, as is typical, he didn’t identify as a family carer. “I was just looking after my dad. It was only when I started working for [advocacy organisation] Family Carers Ireland [FCI] that I realised ‘I was one of them’,” he laughs.

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Now, aged 56, he is a carer again. “We have started the [dementia] journey with my Mam who was diagnosed in May of this year, but we have kind of known for probably the last year that was where she was going.” At age 86, “she is very forgetful but physically good; she is very independent”. The family worry she might wander if left unsupervised.

I am lucky that the two employers I have are very flexible and understanding. You make up the time

—  Brian Doyle, family carer

This time around, he is combining his caring role with two part-time jobs – one with the FCI, and the other as a research assistant with the Royal College of Surgeons Ireland, filling up his week. Unlike when in the fire service, he can work remotely from his mother’s house in Ballinteer, Dublin, when it’s his turn to provide cover. But there is also the unexpected to deal with.

“I am lucky that the two employers I have are very flexible and understanding. You make up the time. A lot of family carers would say you more than make up the time.” Anyone who is supported well by an organisation, he adds, will show loyalty to that employer out of gratitude.

Difficult choices

A manager is just about to go into a crucial meeting announcing redundancies at her workplace when she gets word that her elderly mother has had a fall and is being taken to hospital. What does she do? Stay to make her contribution at work, or rush to her mother’s side?

In this case, one of the experiences shared with UCD researchers for the Carewell project (carewellproject.com), the manager went to the meeting because she felt obliged to, says project co-investigator Majella Fahy. You can imagine how conflicted this manager was at the time, but the chances are colleagues were unaware of her dilemma because home carers tend to be invisible in the workplace.

We’re talking here about those providing unpaid care for somebody who has a chronic illness, disability or age-related frailty, as opposed to parenting. The so-called sandwich generation may be juggling both. Yet companies who flaunt their “family-friendly” credentials generally have employees with young children in mind, not those with caring responsibilities at the other end of the age spectrum. Equally, statutory entitlements for maternity, paternity and parental leave have improved significantly in recent decades, while there has been far less progress for those left holding their parents’ hands.

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Enabling older people to remain living in their own home for as long as possible is an aspiration for both families and the State. But this usually requires an escalating level of finely balanced supports. Inadequate hours of HSE homecare are supplemented with private services by those who can afford them, and family members fill the gaps. But just one no-show or unexpected crisis can send the house of cards tumbling.

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Between 2016 and 2022, the number of people providing regular unpaid care increased by more than 50 per cent, from 195,263 people in 2016 to 299,128 in 2022, according to the Central Statistics Office (CSO). The ageing profile of our population is the main reason for that upward trend. With the 2022 Census showing 57 per cent of unpaid carers (excluding 4,800 aged under 15) were in work, up from 51 per cent and 49 per cent in 2016 and 2011 respectively, clearly the employee-carer overlap is growing too.

What strikes Fahy from extensive interviews conducted for Carewell is “the incredible pressure and stress” this overlap can create. She recalls one woman who with her sister was caring for their mother, who had progressive dementia, talking about “the mental load” in trying to keep all the plates spinning. “She was going in and trying to negotiate with her mother, address her needs and keep her in her home as long as they possibly could.”

It is the sort of scenario that is going to become more prevalent, says Sue O’Grady, marketing manager with FCI (familycarers.ie). “Now is the time to future proof workplaces because so many of the sandwich generation are working and caring – raising their own families and caring for elderly parents and grandparents.”

FCI runs a Caring Employer programme to increase both awareness and support offered to carers. It started it in 2019, not long before Covid-19 hit, but she believes the pandemic speeded up the discussion around caring.

“We were all at home and it is very difficult to hide what goes on behind closed doors when mum with dementia could have strolled in on a Zoom call.”

We want to keep family carers working so they avoid isolation and the dangers of falling off a financial cliff by having to give up work, says O’Grady. But it is also in employers’ interest not to lose workers – hiring and retention are big challenges.

If their daily load gets too overwhelming, carers tend to change work commitments themselves: by taking a demotion, working fewer hours or dropping out of the workplace altogether. FCI believes that, with the right supports, “you can do both, sustainably”.

Family carers save the State €20 billion a year. Our healthcare system would literally collapse without what they do

—  Sue O’Grady, Family Carers Ireland

So what supports are available, and what else do carers need? Under the 2001 Carer’s Leave Act, workers are entitled to at least 13 weeks of carer’s leave, up to a maximum of 104 weeks. But, as David Joyce, equality and developmental officer with the Irish Congress of Trade Unions (ICTU) points out, you generally have to take huge chunks of time. (Shorter periods are allowable with employer-employee agreement.) “You basically end up out of the workforce and you end up on carer’s benefit, which is not pay-related.”

The transposition of the EU Work Life Balance Directive into Irish law is ushering in more statutory supports. Five days of unpaid leave a year to provide care “for a serious medical reason” became an entitlement last July. Another element of the Work Life Balance Act, yet to be introduced, is the right to request flexible working arrangements for caring purposes. The Workplace Relations Commission is developing a code of practice for this, a process in which the ICTU is involved.

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“For people in this situation, it could be a key component in reconciling their work and caring,” says Joyce. While the juggling of such responsibilities “is not something we have people banging our doors down about, it is an issue that is bubbling there, I would say, under the surface”.

Bringing the issue out into the open is what FCI’s Caring Employer scheme is all about and why the organisation is also a partner in the Carewell project. From a State and society perspective we have to start valuing care more, says O’Grady. “Family carers save the State €20 billion a year. Our healthcare system would literally collapse without what they do.”

The Chartered Institute of Personnel and Development (CIPD) Ireland (cipd.org) also believes workplaces have to be much more conscious that many of their employees have caring responsibilities. These “can impact on performance, and that is how it often becomes apparent”, says its director, Mary Connaughton. “It can also have a negative impact on mental health and workplaces can support that by [offering] flexibility and the opportunity to talk about it.”

With many companies pushing to reduce or even eliminate working-from-home practices that were a necessity during Covid, CIPD hears about people not wanting to go back into the office. However, often there is not enough investigation into the reasons for individuals’ resistance, she says. If their caring at home has been hidden, they may need an opportunity to talk about it.

Connaughton believes management should be able to provide for people in exceptional circumstances and explain to others why new rules aren’t being applied to all; that there will be exceptions, based on very clear need and provided it can fit work requirements.

Fahy says that in looking at the health and wellbeing of carers in the workplace, it was no surprise to find flexible working arrangements are helpful. Facilitating mindfulness sessions at lunchtime might tick an employer’s “wellbeing” checklist, but “the truth is that in terms of helping carers to look after their health, you have to create some space for them. They are saying the way you do that is [by] ‘giving us flexibility’.”

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Formal flexible working arrangements are one thing, but she sees how informal flexibility and supports are more effective. “They are simple things which, unless they are thought about, are difficult to ensure they are there in practice.” For instance, reassurance from a line manager and/or peers that workers who also have caring roles have the licence to take time off or be late into work, and make the time up later, can bring huge peace of mind for them. When accompanying somebody to medical appointments, says Fahy, “they need to be able to take a half day, or make up the work. In some awful situations, people are using a lot of their annual leave, particularly when a crisis occurs.”

The caring employer

When Sharon Daly took up a new post of health and wellbeing programme manager with Irish Rail in November 2020, she started to explore staff needs through informal discussions. In the context of health, she expected people to talk about weight, blood pressure and stress, but the strain of combining paid work with caring was a topic that surprised her.

“This different area piqued my interest; it hadn’t come up for me before.” In a company-wide survey for all 4,500 staff, she included a question about caring, accompanied by a definition of it, so there would be no confusion with parenting. Some 48 per cent of respondents said they were carers.

A small bit of flexibility can make a huge impact on somebody’s life and the goodwill we get back is absolutely phenomenal

—  Sharon Daly, Irish Rail

“I was bowled away by this, I didn’t think it would be that high,” says Daly. She advised senior management that “we need to do something here”. The first step of that was to sign up for the FCI’s Caring Employers programme. Irish Rail’s participation was launched in June 2022, with chief executive Jim Meade being very open about his own caring experiences.

“That act in itself had a knock-on effect within the organisation,” says Daly, with more people feeling it was okay to speak up. One employee, for example, told her he was empowered to approach his manager and had been able to swap shifts to facilitate his caring responsibilities.

“A small bit of flexibility can make a huge impact on somebody’s life and the goodwill we get back is absolutely phenomenal.” She acknowledges that managing flexibility is not straightforward, as no one size fits all. “The trains have to keep running so it has to be case by case.” But the company is trying to back managers in supporting carer colleagues in whatever way is possible.

“They appreciate so much that they are acknowledged and given this flexibility in their hour of need,” she adds. “You don’t choose to be in this situation; any one of us can be a carer in the morning.”