Wednesday, October 8, 2014


Have I mentioned how much I dislike being in the sandwich generation? It is so much. SO MUCH.

In case you're unfamiliar with those in the sandwich generation, it's folks who are adults caring both for parents and children. I'm a double sandwich in that I help a bit in caring for my grandma in addition to keeping an eye on what my parents are up to.

There's someone in my life who has a chronic condition that can be kept in check pretty well with medication. Medications need to be refilled and then picked up from the pharmacy for this to work. Once every now and again an appointment with a doctor needs to be made for more refills to happen. These sorts of resource-management and scheduling tasks are ones I could do with no problem. Many people do these sorts of things for parents and grandparents all the time.

Of course providing care for another adult isn't that simple. If the patient doesn't want to take their medications or if they are too busy to pick up a refill for a week or a month, it becomes the care provider's problem to deal with.

Thus far, I am opting out of managing anyone else's medications for a couple of reasons. Firstly, this person hasn't asked me to help and I am not going to offer. I am a busy person and I don't need to be stupidly signing up for more work than I already have. It's a way of preemptively saying no to work I don't really have time for, to just not offer to help.

Secondly, I want to encourage the maximum independence possible. I am part of an extended family that gets really codependent and way too involved in each other's business. It is healthy for everyone to take care of themselves. It keeps them from playing the victim if they don't get exactly the care they expected (which would inevitably spiral from "please make sure my medication refills get ordered" into "but why didn't you pick up the other 10 things I didn't tell you I needed from the pharmacy that I won't pay you back for despite them being expensive?") and it gives them control over a part of life that it's possible to control. It's rewarding to know you can influence your life. In this case, it's rewarding to know that taking medications improves life so dramatically.

It honestly starts to feel like I'm teaching or parenting every time I set the expectation that, despite it being easy for me to just order refills for someone online, I will let medication management be this person's thing for as long as possible. I am getting really fed up that there are no consequences I can levy if this person does a terrible job taking care of medications and makes noises like "this would never happen if you just took care of me!" I think that's the real trap of being sandwiched between elders and children, caring for both. You have to set boundaries and expectations and clearly divide up jobs, but there are few consequences you as child/grandchild/niece get to give to your elder if they behave badly.

Not that I'm totally convinced that giving misbehavior a consequence is convincing my kid to behave one bit better. Maybe it does but mostly I think that well-timed, brief, loud expressions of my feelings about something she did that was out of line seem to work better. Example: we had a several month stretch where she would get frustrated, be sent to her room "until she was steady," and would get upstairs and immediately start throwing things down at us. Most of the things in the girls' room aren't breakable so it was mostly annoying and irritating. Her consequence was to have to come pick up all the things she had thrown (which entailed much whining and complaining and more throwing of the very same things) and then losing some privilege (TV the next day, story before bed, dessert, TV the next day, a trip planned for the weekend, etc). One day she actually broke a thing and hit me in the head doing it while I stood at the bottom of the stairs listening to hear her actually step into her room. I yelled that I was very upset because she was disrespecting property, that she hurt me by throwing the thing, that it was now ruined and she wouldn't get a new one, if anything else was thrown down the stairs it was going straight into the trash, and that she had lost TV for the week and was also not allowed to play outside of our back yard for the same week.

Since then, she's thrown things down the stairs maybe twice and we haven't made her clean up the things but I did discard them all (I think it was some flashcards or crayons or something). The throwing hasn't been aimed at anyone's head and nothing heavy has been thrown. When she cooled down that first time, we talked about how to use words and explain what was wrong and to use words even if she didn't know what was wrong to say she was upset. Some of that has helped but mostly we established a firm boundary (this behavior is NOT acceptable) and she recognized that no further testing was needed.

Adults though, they know your weaknesses implicitly enough to exploit them and to know that it's hard to keep up a new boundary. Maybe that's just my family, but it is so hard to have my new boundaries poked at all the time. That's really what makes it so hard to be sandwiched, that the boundaries are shifting and the aging parent has to allow more care (and hopefully confess what's really going on) while the adult child has to figure out where to set the boundary for how much care can be given before it's too much.

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