What is the sandwich generation, and why is caring for both children and ageing parents so exhausting? Read about the signs, causes and ways to ease the load.
You are getting your child ready for school when your phone rings: your mother's blood pressure has gone up again. In the afternoon you are in a meeting at work, but your mind is on your father's hospital appointment. In the evening, while helping your child with homework, you are also working out who will look in on your parents tomorrow. If this picture feels familiar, you are most likely part of what is known as the sandwich generation. The term describes adults squeezed between two generations: caring for their own children on one side while taking responsibility for parents who are ageing or in need of care on the other. In this article I look at what this two-directional caring load does to mental health, how it relates to family structure in Turkey, and the practical steps that can help you protect yourself during this period.
What Is the Sandwich Generation?
The term usually refers to adults between their late thirties and their fifties, though the age range varies from family to family. These people look after children who still need financial and emotional support on one side, and on the other, parents whose health problems are increasing, who live alone or who need help with daily tasks. Often a full-time job and their own marriage or relationship come on top of this.
Caring is not only physical work. Keeping track of hospital appointments, remembering medication times, paying bills, dividing tasks with siblings, attending to a parent's mood, making it to a child's school meeting and fitting all of this into one calendar create a mental load that is invisible but heavy. This load is often normalised with the phrase "that's what families do", and the person's own needs are pushed to the bottom of the list.
It is important to note that this is not a diagnosis; it is a life stage and an accumulation of roles. However, when this period goes on for a long time and is not balanced with support, it can have serious effects on mental health.
What Are the Psychological Signs of Being in the Sandwich Generation?
The strain of this period can show itself in different ways. Common signs include:
- Constant tiredness: Not feeling rested even after sleeping, starting the day without energy.
- Guilt: Feeling that you neglect your parents while spending time with your children, and your children while you are with your parents.
- Irritability and angry outbursts: Overreacting to small things, then blaming yourself for it.
- No time for yourself: Constantly putting off seeing friends, hobbies and your own health check-ups.
- Anxiety and a state of alertness: Flinching every time the phone rings, wondering "Has something bad happened?"
- Tension in the relationship: Having no time alone with your partner and arguing often about how responsibilities are shared.
- Physical complaints: Headaches, sleep problems, stomach complaints and muscle tension.
- Feelings of loss and anticipatory grief: The sadness of seeing that your parent is no longer who they used to be.
These signs alone do not mean a mental disorder, but when they intensify they can turn into caregiver burnout. I covered this topic in detail in my article on caregiver burnout.
Why Does This Load Feel So Heavy?
Roles demanded at the same time
Parent, child, spouse, employee, sibling... Each role has its own expectations, and these often arise at the same moment. When the mind has to keep setting priorities, decision fatigue and burnout can become unavoidable.
Reversal of roles
It is an emotionally demanding shift when the parent who once looked after and protected you now needs your care. This process can bring sadness, compassion, anger and helplessness all at once. Some parents find it hard to accept help, which can lead to power struggles between the adult child and the parent.
Old family dynamics coming back to life
The caring process can bring unresolved family issues back to the surface. Someone who felt they were not seen enough in childhood may experience complicated feelings while caring for their parent now. Old rivalries between siblings, or the feeling that "the responsibility always falls on me", can also become more pronounced in this period.
A tendency to self-sacrifice
From a schema therapy perspective, people with strong "self-sacrifice" or "subjugation" schemas constantly put other people's needs ahead of their own. They find it hard to ask for help, struggle to say "no" and may see resting as selfishness. In this period of caring for two generations at once, such tendencies markedly increase the risk of burnout.
Uncertainty and unpredictability
An older parent's health can change unpredictably. Someone who manages on their own today may need intensive care tomorrow after a fall or a sudden illness. This uncertainty leaves the caregiver living in constant "standby" mode. Planning becomes difficult, holidays are postponed and asking for time off work becomes a habit.
Financial pressure
When children's education costs, a parent's health expenses, transport, care support and adaptations to the home all add up, the financial burden can become a serious source of stress.
Being in the Sandwich Generation in Turkey: Family Structure and Cultural Expectations
In Turkey, the care of older parents is mostly provided within the family, especially by women. Questions such as "Are you going to put your mother in a care home?" can make seeking professional support look like disloyalty. These cultural values preserve strong family bonds on one hand, but on the other they can make the caregiver's burden invisible.
The double load on women: In many families, the daughter or daughter-in-law takes on work, childcare and the care of ageing parents largely on her own. This can lead women to put their own health and careers on the back burner.
Division of labour between siblings: The sibling who lives in the same city usually takes on most of the daily care, while siblings who live far away contribute with money or by phone. Over time this imbalance can turn into resentment.
Migration and distance: Adult children who have moved to big cities or abroad may carry constant worry about parents left alone back home. Coordinating care from a distance, frequent journeys and the guilt of "I can't be there with them" create a separate burden.
Cost of living: Rising living costs in 2025–2026 make both raising children and caring for older people harder financially. Paying for care support or taking time off work may not be an easy option for many families.
A parent moving in with you: When a parent moves into your home for care, it directly affects the household routine, privacy and the couple relationship. My article on extended family and boundaries may also give you some ideas on setting limits.
Take a teacher in her mid-forties, a mother of two, whose father needs daily care after a stroke, so she stops by her father's home every day after work. Her brother lives in another city and sends money. After a while she notices that she is becoming impatient with her children, arguing constantly with her husband and unable to do anything for herself. This picture shows that the problem is not a personal inadequacy but an unsupported burden.
How Do You Protect Yourself in the Sandwich Generation?
1. Make the load visible
For a week, write down everything you do related to care and responsibilities: appointments, shopping, phone calls, homework, housework. This list shows both you and your family the real size of the load and makes conversations about sharing it more concrete.
2. Hold a family meeting
Have an open conversation with your siblings, your partner and, if possible, your parent. Who can take on what, and when? Financial contribution, physical support and emotional support can be shared in different ways. Even a sibling who lives far away can take on tasks that can be done remotely, such as tracking appointments, ordering medication or handling paperwork.
3. Learn to ask for help
Asking for help is a sign not of inadequacy but of sustainability. Look into options such as neighbours, relatives, friends, municipal home care and elderly support services, social services units in your province and paid care support. For decisions about your parent's medical needs, always rely on the assessment of the doctor treating them.
4. Work with guilt
The feeling of "I'm not doing enough" is very common among caregivers. Ask yourself: "If a friend were in my situation and doing all of this, would I tell her she wasn't doing enough?" Guilt is often a measure not of what you do, but of ideals that cannot be met.
5. Make small but regular spaces for yourself
A twenty-minute walk every day, coffee with a friend once a week, watching a series you love... The time you set aside for yourself is not selfishness but an investment that protects your ability to care. Put these slots in your calendar like appointments.
6. Involve your children in an appropriate way
Explain, in a way suited to their age, why their grandparents need support. Giving small tasks can help them feel they are contributing to the family. Take care, however, not to place adult responsibility on children.
7. Don't neglect your relationship as a couple
Plan regular time alone with your partner, even if it is brief. Review responsibilities together and express your appreciation for each other. Tension in the relationship during this period can be turned from mutual blame into looking together at a shared problem.
8. Set boundaries
Instead of trying to keep up with everything, decide on priorities. Shortening some family visits, saying "I can't do that this month" to some expectations, or temporarily lowering your standards for housework will protect you.
9. Talk about the future in advance
While your parent's health is relatively good, talking about needs that may arise later is a difficult but protective step. Where would they like to live, under what circumstances would they be open to support, and how will financial and legal matters be handled? These conversations make it easier to respect your parent's wishes and reduce the pressure of making hurried decisions in a crisis. Don't try to finish the conversation in one go; spreading it over several calm talks gives everyone a chance to express their feelings.
To be able to care for others, you first need to protect your own resources. This is not selfishness; it is sustainability.
When Should You Seek Professional Support?
Carrying caring responsibility is demanding, and some tiredness is expected. However, the following signs may indicate that you need support:
- If constant exhaustion, hopelessness and lack of motivation have lasted for weeks
- If sleeplessness, changes in appetite and physical complaints have become pronounced
- If you have angry outbursts towards your children, your partner or your parent that you find hard to control
- If you cannot enjoy anything and feel emotionally numb
- If anxiety shows itself with symptoms resembling panic attacks
- If thoughts of harming yourself or "I can't bear this any more, I want to be free of everything" cross your mind
If you are having thoughts of harming yourself or ending your life, call 112 (Turkey's emergency services) without delay or go to the nearest emergency department.
How Is the Sandwich Generation Load Addressed in Therapy?
Individual therapy can be one of the rare places where a caregiver finds a space of their own. Topics often worked on in this process include:
- Making room for feelings: Expressing feelings such as guilt, anger, sadness and exhaustion without judgement.
- Cognitive restructuring: Examining thoughts such as "I have to do everything" and "If I ask for help I'm a bad child" within a cognitive behavioural therapy framework and developing more balanced perspectives.
- Schema awareness: Noticing how self-sacrifice, subjugation or unrelenting standards schemas make the caring load heavier.
- Boundary-setting and communication skills: Being able to talk about needs openly and respectfully with siblings, your partner and your parent.
- Problem-solving and planning: Organising daily and weekly responsibilities realistically.
- Working with anticipatory grief: Understanding feelings of loss linked to a parent's declining health.
If difficulties with your children are also in the foreground, my article on parental burnout may offer an additional perspective. For people who find it hard to leave the house because of heavy caring responsibilities, sessions can also be held online.
Frequently Asked Questions
Who is included in the sandwich generation?
It generally covers adults who support both their children and parents who are ageing or in need of care. These people are mostly middle-aged, but those who had children late or whose parents became ill at an early age can also belong to this group.
Is it normal to feel guilty while caring for my elderly parent?
Yes, this is a very common feeling. Guilt is often a reflection of love and a sense of responsibility, but if it is fed by unrealistic expectations it can wear you down. It is important to notice this feeling and also to be able to see what you are doing.
Is getting professional care support disloyal?
No. Getting professional support can ensure that your parent receives safer and better-quality care while also preventing you from burning out. When deciding, you need to weigh your parent's needs, their health and your own resources together; on medical matters the doctor's opinion is decisive.
What should I do if my siblings do not take enough part in the care?
First, try to put together a concrete breakdown of the load and share it with your siblings at a calm moment. Stating your needs and suggestions clearly rather than blaming is more constructive. If necessary, it is also possible to get support from a neutral professional in family sessions.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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