Israel's sandwich-generation kids are getting squashed under pressure - opinion

The "sandwich generation" is a rapidly-growing group of people that are "sandwiched" between taking care of family members and trying to hold a job.

 THOSE IN the sandwich generation are like a falafel ball squeezed into a pita – struggling to keep it all together.  (photo credit: B'LEV SHALEM)
THOSE IN the sandwich generation are like a falafel ball squeezed into a pita – struggling to keep it all together.
(photo credit: B'LEV SHALEM)

According to the Pew Research Center, 23% of adults in the US are now part of the “sandwich generation,” a rapidly-growing group of people “sandwiched” between caring for multiple generations of family members and trying to hold a job or navigate a career, all with little or no support. 

The emotional, financial and physical demands of being a sandwich generation caregiver can be crushing. Just last week, a piece titled “The Mental Load of Being a Sandwich Generation Caregiver” on Yahoo’s Parenting page highlighted the growing numbers and “rising anxiety” of family caregivers providing hours of unpaid labor – from transportation and doctor visits, to liaising with insurance companies, care facilities and lawyers, while also dealing with the demands of being a parent.”

In the July 26 issue of The New Republic, there is a review of Lynne Tillman’s gripping memoir of her harrowing experience as her mother’s caregiver. “How can an experience so common, one that can be so protracted and draining, both emotionally and financially, have such poor and limited solutions, and so often remain in the shadows?” asks the reviewer. 

In “Leaders: Your Sandwich Generation employees need help,” the author of the Fast Company article writes about becoming her mother’s main caregiver at age 36 while taking care of her own six-year-old just before COVID hit, calling on business leaders to address the caregiving crisis and determine “how for helping our loved ones age with dignity and respect while supporting the caregivers that desperately need help.”

It’s a global crisis

 PEOPLE IN THE 50+ age group receive a third dose of the COVID-19 vaccine at a Clalit Health Care Center in Katzrin on Monday. (credit: MICHAEL GILADI/FLASH90) PEOPLE IN THE 50+ age group receive a third dose of the COVID-19 vaccine at a Clalit Health Care Center in Katzrin on Monday. (credit: MICHAEL GILADI/FLASH90)

Here in Israel, the biblical mandate that a child care for his or her aging parents is deeply rooted in both Israeli culture and the services system. Family members expect – and are expected to – care for their aging parents. In fact, in some situations there is a legal obligation to do so. But like their counterparts around the world, Israelis in the sandwich generation are like a falafel ball squeezed into a pita – struggling to keep it all together. 

Now add to the mix the unique struggles of the English-speaking sandwich generation in Israel, whose members may lack language skills, are unfamiliar with the system, have differing cultural expectations and whose siblings often live across the seas. For this group, the financial, emotional and logistic strain is compounded, especially if they are unable to access those support resources available to their Hebrew-speaking counterparts such as CareGivers Israel, an Israeli nonprofit dedicated to supporting family caregivers, or EMDA, the Alzheimer’s Association of Israel. 

Where to turn?

Our private Sandwich Generation Israel Facebook group is a supportive forum for English speakers caring for elderly loved ones in Israel. The group today has more than 2,000 members (and growing), with daily posts on subjects varying from advice on how to convince a parent to accept help; how to find/hire foreign caregivers; dealing with the National Insurance Institute (Bituah Leumi); communicating with a loved one with dementia; recommendations for doctors; where to purchase equipment; and bringing a parent on aliyah. Some posts are just for venting and an opportunity to get support. Others are simply heartbreaking.

“Both my parents fell last night, at home. They have a button they press to call an ambulance and so they did. They didn’t go to the hospital, but the paramedics helped them into bed. Today they’re barely able to function because they’re all banged up .I live about a two-hour drive from them, and will be able to go up at the earliest tomorrow afternoon. I obviously want to make sure nothing like this happens again, but can’t do that – because they are adults who will walk around and occasionally fall – but... I guess I don’t even know what my question is. Do I convince them to move closer to me? Do I help them get a foreign worker? My father has a helper from Bituah Leumi but he only comes a few hours each week.”

“We need a Manof [patient lift] for my MIL [mother-in-law]. I would appreciate any advice. What do we need to look at? Are there differences between models? Where can we get one?”

“Does anyone have any information about getting a lump sum of money from Bituah Leumi, as opposed to hours through an agency for a carer for an elderly person?” 

“Do people in their 80s need to make an appointment at the Interior Ministry to renew their passports, or can they just show up?”

“Anyone have any info about great hospice facility for a woman with terminal cancer in Jerusalem? Is French hospital better than Hadassah?”

“I’m pretty new to this. A close relative was diagnosed with Parkinson’s and is declining rapidly, so we want to start getting as much relevant information as possible fairly quickly. I imagine that he’s going to need help around the home fairly soon. Is there some sort of starter guide that exists explaining all of our options and the requirements for each of them?”

“Can anyone recommend someone who comes to the house, Jerusalem area, to cut the hair of elderly parents?”

So what's next?

Experts, particularly mental health professionals, agree that family caregivers are in need of long-term support to keep doing what they’re doing, a role that can sometimes span several decades.

On a policy level, social service agencies in Israel are working with government ministries to publicize and address the need for support across all sectors. A July 3 article in The Jerusalem Post, “Caring for the country’s 1.2 million family caregivers of the aged, sick and disabled,” noted that the Civil Service Commission (CSC), which oversees 60 government offices, counts at least 85,000 employees as current or soon-to-be caregivers. The support provided to state workers includes flexibility for those taking care of parents.

Those employees are entitled to 24 days a year as opposed to six paid vacation days, and are allowed to arrive late to work or leave for sudden emergencies. According to the article, the IDF recently adopted a policy to help soldiers and officers who are caregivers. This is a sweeping cultural change that needs to happen, but will unfortunately take time to implement.

In the meantime, I can offer the following advice: take advantage of whatever support is available. We provide a number of suggestions in “The Israeli Sandwich Generation: The Challenges and How to Face Them,” such as hiring a professional care manager. This can go a long way toward relieving the burden and stress by assessing your unique situation, connecting you to resources, and guiding you through the maze of aging in Israel.

The writer is founder and CEO of B’Lev Shalem, a senior care management company in Israel that provides crisis management services as well as aliyah and returning citizens support services for seniors. B’Lev Shalem’s expert care managers ensure maximum independence and quality of life for seniors in Israel, and peace of mind for their families worldwide.