Are You Part of the Sandwich Generation?

A survey of social workers who provide services to Sandwich Generation women found that this group is ill-prepared for the challenges of caring for older relatives. Sandwich Generation women are defined as those women ages 35 to 64, who are "sandwiched" by the needs of their children and aging parents.

Commissioned by the New York Academy of Medicine (NYAM) and the National Association of Social Workers (NASW), the report, "Not Ready for Prime Time: The Needs of Sandwich Generation Women, A National Survey of Social Workers," explored the challenges faced by some 42 million American women who are sandwiched by the needs of their own children and their aging relatives, at a time when women are having children later and their parents are living longer. The squeeze is expected to intensify, as one in five Americans will be 65 or older within the next two decades.

"As our society’s demographics shift, older women will increasingly find themselves shouldering heavier caregiving burdens, but they don't have to do it alone," said Pat Volland, director of NYAM's Social Work Leadership Institute. "Unfortunately, there are barriers to seeking help, because women think they should be self-reliant and able to handle it all. And they often don’t know that health professionals like social workers can help with daily stresses."

In addition to the survey of social workers, 41 Sandwich Generation women were asked to keep a journal for two weeks about their experiences to provide anecdotal support to the social work survey. They wrote about the kinds of tasks they would like help with and they explained why they didn't seek more support.

"What this research reveals is that many of the things social workers can help with—managing and relieving day-to-day stress and helping to navigate the maze of health and social services that their older relatives need—are precisely the things that women say would most relieve their anxiety and unhappiness," said Dr. Elizabeth Clark, executive director of NASW.

The 1,400 social workers surveyed said:

  • Sandwich Generation women are not prepared for many aspects of their aging relatives' care.
  • They are least prepared to deal with the cost of their aging relatives' care.
  • The majority of these women underestimate the financial, emotional and physical toll of providing care for aging relatives.
  • Sandwich Generation women delay getting help because they feel they should be able to shoulder caregiving responsibilities on their own.

Many social workers ease caregivers' burdens by providing care management or care coordination for aging relatives. This includes making referrals to health and social services, arranging transportation and food delivery, advising on financial management and benefits, and even acting as a liaison for long-distance care.

A New Web Resource: Help Starts Here.org

The National Association of Social Workers has developed an online resource for Sandwich Generation women and others who are looking for information, advice or a connection to a social worker for themselves or their aging parents. Find out more on the Help Starts Here website.


The National Association of Social Workers (NASW), in Washington, D.C., is the largest membership organization of professional social workers with 150,000 members. It promotes, develops, and protects the practice of social work and social workers. NASW also seeks to enhance the well-being of individuals, families, and communities through its advocacy.