'Sandwich Carers': People Caring For Both Young And Old Are Struggling With Mental Health

Some 1.3 million people, or 3% of the general UK population, are parents who also looks after elderly, disabled, or sick relatives.
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More than a quarter of “sandwich” carers – those who look after disabled, sick or elderly relatives and dependent children – say they experience symptoms of mental ill-health.

Some 3% of 16 to 70-year-olds – 1.3 million people – were sandwich carers in 2016/17, a rise from 1.25 million in the previous year, latest figures from the Office for National Statistics (ONS) show.

A rise in life expectancy combined with people having their first child at an older age are factors behind this pattern of caregiving, and women make up more than two thirds of those providing more than 20 hours of care per week.

But 27% of sandwich carers are more likely to report mental health struggles – including anxiety and depression – compared with 22% of the general population.

Additionally, a higher amount of care given leads to a higher prevalence of poor mental health, with more than a third of carers who give at least 20 hours of care each week experiencing mental ill-health. They also report lower levels of life and health satisfaction.

This is compared with 23% of carers giving less than five hours each week.

Women, who account for 62% of all sandwich carers, are more likely to feel restricted by their role when providing at least 20 hours of care a week, with nearly half of those feeling unable to work.

While most sandwich carers are “doing alright” financially, one-in-10 are finding it “very difficult” to get by.

Hugh Stickland, at the ONS, said: “With an increasing ageing population and people deciding to have children at an older age, more people across the UK may soon find that they are part of a new ‘sandwich generation’.

“The well-being of sandwich carers is varied, with parents who spend less than five hours a week looking after older, sick or disabled relatives seeing slightly higher health and life satisfaction compared with the general population.

“However, those who spend more time caring show lower levels of health and life satisfaction, and are more likely to experience symptoms of depression or anxiety.”

Case Study

Sarah, a doctor and mother-of-five, has been caring for her mother in law, Shirley, for 12 years. 

Now 93, Shirley, who suffers from dementia, immobility and heart problems, is bed-bound and sees carers four times a day, with two people needing to take care of her throughout the day.

Sarah left her job around seven years ago to care for Shirley full-time.

Things such as ensuring Shirley has enough to drink with her medication, coordinating between her different carers, and making sure meals are prepared for her are among Sarah’s day-to-day tasks.

Her youngest children are aged 10 and 12 and live in the house along with her third child, who is 18. Her eldest two, in their 20s, have moved out.

“Sometimes it feels I’m being pulled in two different directions at once,” she told HuffPost UK.

“You try to be as orderly as possible to make sure that people know when I can do different things, but particularly if grandma’s unwell, I can’t do two things at once. So you always feel like you’re trying to balance one against the other and feeling that one or other hasn’t had enough attention.

“There’s not quite enough hours and time in the day.”

Given that 27% of all sandwich carers report mental ill-health, Sarah says she is not surprised at the figure, adding that she sometimes wonders whether she is making an impact.

“At times it can be difficult, particularly at times if you feel your contemporaries are doing things which look like they’re more ‘important’ and if they do exciting things, presenting at international conferences or presenting things, doing things that look worthwhile,” said said.

“And then you think ‘I’m here, I’m looking after an old lady, she’s quite happy and that’s good, she probably wouldn’t be happy if she was in a nursing home’. You feel you’re not making much of an impact. Which is not true because you’re doing quite a lot for a small number of people. But it is easy to think ‘what have I achieved, I have achieved nothing’, which is not true.”

Although Sarah has support at home by way of her husband and children, who are familiar with the circumstances, she says there is not enough external support and carers who are on their own would find it a challenge to get time off.

“Often the local events that are put on – you can go to free cinema screenings, but if you’re caring for someone that’s housebound, it’s not that helpful. For carers on their own, they might struggle with time off.”

Helen Walker, chief executive of Carers UK, said that given the combined pressures of work and caring responsibilities, it is “no surprise” that so many sandwich carers report symptoms of mental ill-health.

“It is vital that the government provides ambitious proposals for the funding and delivery of adult social care in the upcoming Green Paper – proposals that better support older and disabled people, giving the sandwich generation the ability to better manage work and caring responsibilities,” she added.

“It must ensure that they receive practical and financial support to care without putting their own lives on hold.”