Aging Parents Helping Adult Children: The Experience of the Sandwiched Generation

Author(s): Berit Ingersoll-Dayton, Margaret B. Neal and Leslie B. Hammer

Source: Family Relations, Vol. 50, No. 3 (Jul., 2001), pp. 262-271
Published by: National Council on Family Relations
Stable URL: http://www.jstor.org/stable/585878
Accessed: 28-05-2017 02:04 UTC

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 Aging Parents Helping Adult Children: The Experience of the
Sandwiched Generation*
Berit Ingersoll-Dayton**, Margaret B. Neal, and Leslie B. Hammer

The help that elders provide to their adult children has received limited attention in the caregiving literature. To address this gap,
data were drawn from two samples of caregiving couples: 63 focus group participants and 618 survey respondents. Survey results
indicated that help from aging parents is associated with a complex pattern of benefits and costs. Focus group data identified the kinds
of help provided by older parents (i.e., financial, emotional, child care, and household tasks) and illuminated why caregivers experience
such help as a mixed blessing. Suggestions are offered for practitioners who work with caregivers.

A dults who juggle work and family responsibilities are
particularly vulnerable when they are caring both for
children and for aging parents. Most of the early re-
search focusing on this "sandwich generation" (Brody, 1985;
Miller, 1981) has highlighted the negative aspects of caregiving.
In general, the major conceptual framework that has guided care-
giver research is a stress and coping model (Biegel & Schulz,
1999). Recently, however, gerontologists have expanded their
purview to examine the potential benefits of providing care to
elders (Scharlach, 1994; Walker & Allen, 1991). One relatively
underexplored benefit is the help that elders provide to those who
care for them. In this article, we examine the provision of help
to working couples in the sandwiched generation by the aging
parents for whom they provide care. In so doing, our research
builds on previous efforts that highlight the benefits of caregiv-
ing and illuminates reactions to receiving help from aging par-
ents.
Benefits of Caregiving
The literature on the benefits of caregiving augments the
stress and coping perspective by characterizing caregiving as an
experience that is rewarding as well as stressful. In a study on
caregivers of depressed older adults, Hinrichsen, Hernandez, and
Pollack (1992) identified a number of caregiving difficulties, in-
cluding problematic relationships with the older care recipients,
the pressures of competing responsibilities, and strained rela-
tionships with other family members. Nonetheless, these re-
searchers also uncovered several benefits associated with care-
giving, such as enhanced relationships with elders, improved
family relationships, and a sense of gratification associated with
being helpful. Similarly, in a study of caregiving daughters and
their older mothers, Walker and Allen (1991) discovered a con-
tinuum of caregiving relationships ranging from conflictual to
rewarding. The rewarding caregiving relationships were char-
*This paper was presented as part of a symposium, "Dual-earner couples in the sand-
tween
wiched generation: Findings from a national study," M. B. Neal and L. B. Hammer (co-
chairs), at the 52nd annual scientific meeting of the Gerontological Society of America,
November 1999, San Francisco, CA. Funding for this research was provided by the Alfred
P Sloan Foundation (Grant 96-10-20) to Margaret B. Neal and Leslie B. Hammer, co-
principal investigators. The authors would like to thank David Morgan for his consultation
and assistance with the focus groups; Jo Isgrigg, Krista Brockwood, and Emily Huang for
their help with recruitment of focus group and survey participants, script and instrument
design, and data collection and analysis; and Anne Martin-Matthews and Carolyn Rosenthal
for their helpful comments on an earlier draft of this article.
assistance was exchanged between older adults and their chil-
dren, they found that the majority of adults aged 50 and older
**Address correspondence to: Berit Ingersoll-Dayton, School of Social Work, The
reciprocated emotional support and sick care with their children.
University of Michigan, 1080 South University, Ann Arbor, MI 48109.
Key Words: caregiving, help-giving, intergenerational exchanges, reciprocity.
(Family Relations, 2001, 50, 262-271)
acterized by dyadic exchanges between the daughters and moth-
ers that were mutually beneficial. In contrast, the conflictual re-
lationships were characterized by a self-focused orientation and
minimal reciprocal exchanges between mothers and daughters.
Walker and Allen found that the daughters in these conflictual
relationships often had competing responsibilities (e.g., employ-
ment and children) that may have contributed to the strain. A
study by Scharlach (1994) focused specifically on the problems
and benefits experienced by employed caregivers. On one hand,
he identified a number of problematic aspects of caregiving, such
as managing the elder's difficult behavior, lack of free time, and
sadness about the elder's declining abilities. On the other hand,
Scharlach noted several rewarding aspects of caregiving, includ-
ing a sense of satisfaction derived from repaying elders for their
previous care, enjoyment from spending time together with the
elder, and appreciation for help provided by the elder. To uncover
the benefits of caregiving, each of these studies used qualitative
methods and asked open-ended questions about the caregiving
experience. Our study combines qualitative and quantitative
methods to focus on one benefit identified by this previous re-
search: the help provided by the elder to the caregiver. In so
doing, we shed further light on the rewards and costs of caring
for an aging parent.
Our study draws on literature that examines exchanges be-
tween adult children and their elderly parents. Bengtson and his
colleagues (Bengtson & Roberts, 1991; Bengtson & Schrader,
1982) provided a comprehensive framework for understanding
intergenerational relationships in later life. Within their intergen-
erational solidarity framework, functional solidarity is a key do-
main. Functional solidarity focuses on the exchange of assistance
and support between older people and their children. Geronto-
logical researchers have become increasingly interested in un-
derstanding ways in which older people are engaged in such
exchanges. For example, Lee, Netzer, and Coward (1994) ex-
amined the extent of advice and tangible assistance (e.g., finan-
cial help, household chores, and transportation) exchanged be-
elderly parents (a minority of whom needed care) and the
adult children with whom they had the most contact. Lee et al.
determined that there was a moderately significant relationship
between the help given to the elders and the help that the elders
provided to their children. Similarly, when Ingersoll-Dayton and
Antonucci (1988) investigated the extent to which support and
Indeed, older adults sometimes play a pivotal role in assist-
ing their adult children and grandchildren. Lillian Troll (1983)
described grandparents as "family watchdogs" who monitor the
status of their families and provide help as needed. Researchers

262 Family Relations

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have documented the extensive help given by older adults to formance, and work performance; and do these effects differ by
their grandchildren (Baydar & Brooks-Gunn, 1998; Fuller- the adult child's gender?
Thomson, Minkler, & Driver, 1997) and adult children with dis-
abilities (Fullmer, Tobin, & Smith, 1997; Seltzer & Krauss, Methods
1994). In addition, older adults provide assistance to adult chil-
dren during times of crisis. For example, Greenberg and Becker
Sample
(1988) identified numerous ways in which healthy older parents
help their adult children, including the provision of child care, This study is part of a larger longitudinal research project
temporary housing, loans, and advice. Taken together, these stud- in which data were collected via focus groups and two waves of
ies portray the elderly as actors rather than passive recipients in a mailed national survey. The sample for the study described
the help-giving process and highlight the contributions of the here consisted of two groups of subjects: participants in the focus
young old and healthy elderly. With a few exceptions (Dunkle, groups and respondents to the first wave of the national survey.
1985; Pruchno, Burant, & Peters, 1997), the help provided by Both the samples for the focus groups and for the survey had
older adults who are also in need of help has been relatively five selection criteria. First, both members of the caregiving cou-
unexplored. ple spent a minimum of three hours per week caring for a parent,
Researchers have only recently concentrated their attention stepparent, or parent-in-law. The type of assistance provided to
on mutual help giving within the caregiving context (Ikking, parents could encompass a wide array of activities, including
Tilburg, & Knipscheer, 1999; Kahana & Young, 1990). In ad- transportation, shopping, hands-on care, assistance with finances,
dition to the studies mentioned earlier that examined the benefits home maintenance, and emotional support. Second, the couple
of caregiving (Scharlach, 1994; Walker & Allen, 1991), two oth- had been married or living together for at least 1 year. Third,
ers have particular relevance to our study of sandwiched-gen- one person in the couple worked at least 35 hours per week, and
eration couples. Based on a sample of employed caregivers, the the other worked at least 20 hours per week. Fourth, there were
first study found that sons-in-law received more assistance from one or more children 18 years of age or younger living in the
their parents-in-law for whom they were caring than did daugh- home at least 3 days a week. Fifth, the couple had a combined
ters-in-law (Ingersoll-Dayton, Starrels, & Dowler, 1996). Based household income of $40,000 or greater. This criterion was stip-
on the same sample of employed caregivers, the second study ulated because of the specific interest of the project's primary
determined that caregivers who provided more help to their par- funder, the Alfred P. Sloan Foundation, in middle- and upper-
ents and parents-in-law also received more help from these elders income families. According to the Bureau of Labor Statistics
(Starrels, Ingersoll-Dayton, Dowler, & Neal, 1997). In addition, (1995), this criterion represented about half of all U.S. house-
this second study indicated that the relationship between provid- holds at the time of data collection in 1994.
ing support to and receiving support from the elder was almost Focus group participants. Seventeen focus groups were con-
twice as strong for caregiving sons as for caregiving daughters. vened in the Portland, Oregon, metropolitan area in the summer
In sum, the two studies suggest that elders who are receiving of 1997. Participants responded to a series of open-ended ques-
care also provide help to their adult children caregivers; however, tions concerning the impact of caregiving demands on work, the
the receipt of assistance from aging parents appears to differ for
impact of work on caregiving demands, and factors that helped
caregiving sons and daughters.
or hindered their ability to combine work and family responsi-
bilities. Each of these focus groups was tape recorded and sub-
These findings point to an important direction for under-
sequently transcribed. The average number of participants per
standing gender differences in caregiving stress. A growing body
group was four. Participants included representatives of 38 dual-
of literature indicates that men experience caregiving more pos-
earner couples in the sandwiched generation. For 25 couples,
itively than women (Brubaker & Brubaker, 1992). Specifically,
both members attended. An additional 13 couples were repre-
male caregivers report less depression than their female coun-
sented by one member, yielding a total of 63 individual partic-
terparts (Fitting, Rabins, Lucas, & Eastham, 1986), less role con-
ipants. A $20 incentive per individual was provided for partici-
flict (Young & Kahana, 1989), and less caregiver strain (Fred-
pating in the focus group. (Additional details concerning recruit-
riksen & Scharlach, 1999). Based on the recent studies of em-
ment procedures for the focus groups are described in Hammer,
ployed caregivers discussed above, one explanation is that men
Neal, Morgan, & Isgrigg, 1999).
may be receiving more assistance from the elders for whom they
Participants in the focus groups had a mean age of 42.5
are providing care than are their female counterparts. Our studyyears (SD = 7.0) and had been married or living together for an
contributes to this intriguing area of inquiry by examining the average of 16.2 years (SD = 5.6). Men comprised 43% (n =
different experiences of caregiving sons and daughters vis-'a-vis 27) of the sample, whereas women comprised 57% (n = 36) of
the help they receive from their aging parents. the participants. The average number of children aged 18 or
In this study, we explored the experiences of couples who younger living in participants' households was 2.0 (SD = .7).
are sandwiched among competing responsibilities to work, chil- The average age of the children living at home was 10.1 (SD =
dren, and elders by addressing three research questions: 4.7), and the average age of the elder for whom they provided
the most care was 72.6 (SD = 8.4). In addition, the participants
1. What kinds of help do sandwiched-generation adults re- in our sample provided an average of 8.0 hours of assistance per
ceive from the aging parents for whom they are providing care? week (SD = 6.9) to the parent whom they helped the most. In
2. What is the extent of the help received from these aging many cases, married couples in the focus group discussed the
parents, and does the quantity and nature of help differ by the same parent(s) or parent(s)-in-law; however, in some cases, the
adult child's gender? husbands and wives provided care to different elders (e.g., the
3. What are the effects of receiving help from aging parents wife cared for her mother, the husband cared for his mother.)
on the adult child's relationship with the parent, caregiver per- Among the husbands, 42% of the people for whom they provid-

2001, Vol. 50, No. 3 263

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ed the most care were their own parents, and 58% were parents-
in-law. Of the wives, 69% of the people for whom they provided
the most care were their own parents, and 31% were parents-in-
law.
Survey respondents. As with the majority of the focus group
participants, sampling was accomplished via the use of a CATI
(Computer-Assisted Telephone Interviewing) system. A list of
telephone numbers of households throughout the contiguous
continental U.S. composed of one or more adults aged 30
through 60 was purchased. Trained interviewers contacted and
screened potential participants by telephone for eligibility based
on the criteria identified above.
This sampling procedure resulted in a sample that was na-
tional in scope, although by using a targeted list of telephone
numbers, some members of the population were not represented
(e.g., persons with unlisted numbers).
A total of 741 households contacted met the criteria for par-
ticipation, except for income. Of these 741 couples, 624 couples
agreed to participate in the study or to consider participating,
and they were mailed survey packets. Surveys from both mem-
bers of 360 couples (57.7% of 624, 48.6% of 741) were returned.
Twenty-two couples (6.1%) who completed surveys no longer
met the study criteria, however. Of the remaining 338 couples,
309 (n = 618 individuals) met the income criterion. These re-
sulting 618 husbands and wives then serve as the sample for the
survey described in this study.
Survey data were gathered from both members of each cou-
ple. The majority of spouses were White (95% of husbands and
94% of wives). The average age of the husbands was 43.5 (SD
-6.3), and the average age of the wives was 41.5 (SD 6.0).
They had been married for an average of 17.9 years (SD 6.6)
and had an average of 1.84 children (SD = .78) aged 18 or
younger living in their homes.
Whereas most husbands and wives reported on the same
parent, in some cases spouses described different elders. Because
we did not ask respondents to provide the name of the parent
for whom they were providing the most care, we estimated the
proportion of couples who cared for the same parent by using
age and gender of the parents to determine their identities. Using
this technique, we estimated that about 70 to 80% of the couples
were reporting on the same parent. Therefore, data collected for
husbands and wives are reported separately. Most of the elders
cared for by the couples were women: 71 % of the husbands and
77% of the wives were caring for a female parent or parent-in-
law. Husbands lived an average of 55.1 miles (SD = 287.2) from
the elder and wives lived an average of 27.9 miles (SD = 104.6).
These standard deviations were high because a number of care-
givers lived hundreds or thousands of miles from their parents.
The average age of the elder for whom husbands provided the
most care was 72.8 (SD = 8.7), and the average age of the elder
for whom wives provided the most care was 71.8 (SD = 8.9).
In general, the elders for whom both husbands and wives pro-
vided the most care were in fair health. Husbands provided an
average of 5.1 hours (SD = 6.8) of care per week to the elder
for whom they provided the most care, whereas wives provided
an average of 6.8 hours (SD = 7.3) of care per week. (For ad-
ditional details concerning the sample and survey procedures,
see Neal, Hammer, Rickard, Isgrigg, & Brockwood, 1999.)
Survey Measures
Four types of help from the parent for whom the adult child
was providing the most care were examined with respect to three
264 Family
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outcome measures. In addition, several control variables were
considered.
Types of help. Four kinds of assistance provided by the par-
ent to the adult child were identified through the focus groups,
and the following four survey items were developed:
Even though parents may need help, they sometimes provide
help as well. How often does the parent provide the follow-
ing types of help to you? (a) financial assistance (money);
(b) emotional support (someone to talk with); (c) help with
watching/caring for your children; (d) help with household
tasks.
Respondents answered each of these items using a four-point
scale (1 = never to 4 = frequently).
Outcome measures. The three outcome measures included
quality of relationship with parent, performance as a caregiver,
and working less effectively because of concern or upset about
parent(s). First, the quality of relationship with parent measure
was derived from Lawrence, Tennstedt, and Assman (1998), who
adapted four items from the positive affect index used by the
University of Southern California Longitudinal Study of Three-
Generation Families (Mangen, Bengtson, & Landry, 1988):
"Please indicate the extent to which you and this parent: (a) are
emotionally close, (b) can exchange ideas, (c) have similar views
about life, and (d) get along together" (1 = not at all to 4 =
very). The internal consistency reliability for this measure was
.87 for wives and .83 for husbands in our sample, similar to the
Cronbach alpha of .85 reported by Lawrence et al. (1998) in
their sample of family caregivers. Second, performance as a
caregiver was measured using a single item: "How would you
rate your overall performance as a caregiver to the parent or
parent-in-law you're helping the most?" (1 = extremely poor to
6 = excellent). Third, the effect of parent care on one's work
was measured with a single item used as part of our ongoing
program of research (Neal, Chapman, Ingersoll-Dayton, & Em-
len, 1993): "In the past month, how often have you worked less
effectively because you were concerned or upset about your par-
ent(s)?" (1 = never to 5 =most or all of the time).
Control variables. Several variables identified by previous
research as related to positive and negative outcomes of care-
giving (Ingersoll-Dayton et al., 1996; Neal et al., 1993) were
included as control variables: caregiver's years of education,
number of hours the caregiver worked in paid employment per
week, age of caregiver's youngest child, elder's relationship to
caregiver (parent, parent-in-law), number of hours of care per
week provided to the aging parent whom the caregiver was help-
ing the most, the number of miles this parent lived away from
the caregiver, and a measure of the parent's need for help with
activities of daily living (ADLs). This latter measure was com-
puted by summing the caregiver's ratings of help needed by the
parent in accomplishing each of 14 ADLs (0 = no help needed
to 3 = totally dependent on others); thus, scores ranged from 0
to 42. These 14 ADLs included five types of personal help (e.g.,
bathing, dressing, eating) and nine types of instrumental help
(e.g., shopping, cooking, laundry). Finally, perceived adequacy
of the caregiver's and the parent's annual household incomes
were included as control variables. These two items were adapt-
ed from a single item developed by Stewart and Archbold (1996)
that focused exclusively on the caregiver's income. Our respon-
dents indicated, separately for themselves and for the parent for
whom they were helping the most, which of four statements
described their ability to get along on their income: 1 =We (or
Relations
Table 1
Comparison of Personal Characteristics and Caregiving Responsibilities of Husbands and Wives
Husbands Wives

Scale/Item M SD M SD n t
Caregiver's education (years) 14.69 2.78 15.08 2.61 308 -2.46*
Caregiver's income adequacy
(1 = low, 4 = high) 2.82 .71 2.70 .77 305 2.92**
Hours employed per week 49.46 11.38 38.01 9.70 307 12.95***
Youngest child's age 10.43 5.02 10.43 4.99 309 .08
Relationship to elder
(0 = parent, 1 = parent-in law) .42 .49 .31 .46 297 2.38*
Elder's income adequacy
(1 = low, 4 = high) 3.06 .90 2.98 .95 288 1.43
Elder's ADLs (range = 0-42) 8.27 10.56 9.42 10.33 273 -1.92
Hours helps elder per week 5.10 6.83 6.78 7.28 266 -3.34***
Distance from elder (miles) 55.05 287.20 27.94 104.60 297 1.61

Note: ADLs = activities of daily living.

*p .05. **p s .01. ***p s .001.

parent) can't make ends meet; 2 = We have (parent has) just
enough, no more; 3 = We have (parent has) enough, with a little
extra sometimes; and 4 = We always have (parent always has)
money left over. Table 1 lists means, standard deviations, and
the results of paired-sample t tests for husbands and wives with
respect to these control variables.
Analysis Strategy
data for each of the three outcome measures. The control vari-
ables were entered as a block in Step 1. To determine their pre-
dictive power over and above the control variables, the help-
receiving variables were then entered as a block into Step 2.
Finally, to help us interpret the results from these analyses, we
returned to the content analysis of the focus group data and re-
examined the sections in which participants described the help
they received from their parents.

Our study integrates qualitative data from the focus groups

and quantitative data from the mailed survey to understand the Results
experience of working men and women who have children and
Our integration of the focus group and survey data is pre-
care for aging parents at the same time and who receive help
sented in three sections: focus group findings informing survey
from those parents. Qualitative and quantitative methods have
items, survey results, and focus group findings explaining non-
unique strengths that when combined can build on each other.
intuitive survey results.
Morgan (1998) described a number of ways in which qualitative
and quantitative methods can complement one another. Two are Focus Group Findings Informing Survey Items
particularly relevant to our study: (a) using qualitative research
Participants in the focus groups talked about the overwhelm-
to identify the relevant domains of a content area that can be
ing stress they experienced as they juggled the multiple demands
subsequently examined by quantitative research and (b) using
of employment, caring for children, and caring for aging parents.
qualitative data as a follow-up to quantitative research to illu-
Expanding on Miller's (1981) "sandwich generation" metaphor,
minate the quantitative findings.
one couple described themselves as "a triple-decker sandwich."
To address our first research question concerning the kinds
Despite these demands, there also were references to the
of help provided to sandwiched-generation couples from the ag-
benefits of caregiving. One of these benefits was the reciprocal
ing parents for whom they were providing care, the first author
nature of some caregiving relationships. For example, a self-
content analyzed the data from the focus group transcripts. This
employed daughter with two children described the give-and-
analysis involved reading the verbatim transcripts and coding
take quality of her caregiving relationship with her mother:
each of the instances in which participants talked about receiving
help from the parent or parents-in-law for whom they were car- Sometimes you even feel like, well, you're exhausted emo-
ing. This coding process enabled us to identify the different types tionally after one conversation. But then the next one, they'll
of help aging parents provided to the sandwiched-generation par- have some insight for you about dealing with your kids or
ticipants. something. So it's still, you know, it's still a really dynamic
To answer the second research question that concerned gen- and giving-both-ways relationship.
der differences in the extent of the help received from these
A mother of two boys who worked at two different part-time
aging parents, we used the findings from the focus groups to
jobs also portrayed this kind of reciprocity. She and her mother
create items asking how often each type of help was received
both depended on each other for support:
from the parent to whom the adult child was providing the most
care. These items were included in our survey instrument. Once We rely on Mom, but it's kind of a two-way street, because
the quantitative survey data had been collected, we examined the she hates being alone. She can stay the night by herself, but
frequency distributions of the types of help provided and com- she doesn't want to. Especially in the summer, she'll go
puted paired t tests. every other night just because she wants to have them (the
To examine the third question that concerned gender differ- children). They'll spend the night or work for her during
ences in the effects of receiving help from parents, we used both the day or whatever. But that does help us out, too, because
data from the survey and the focus groups. First, hierarchical you don't have the sibling problems as much. You just know
multiple regression analyses were conducted using the survey that they're kind of taken care of.

2001, Vol. 50, No. 3 265

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These descriptions of mutual help-giving within the caregiving Table 2

relationship suggested that our focus group data could provide a Correlation Coefficients for Help Received From Aging Parents

fruitful means for addressing the first research question concern- Types of Help Received

ing the kinds of help that sandwiched-generation couples receive Emotional Child Care Household Tasks
from the parents and parents-in-law for whom they are caring. Husbands
Based on our content analysis of the focus group transcripts, we Financial .24*** .26*** .20***
identified four distinct kinds of help. Each type of help is de- Emotional .30*** .24***
Child care .49***
scribed below with illustrations drawn from the focus groups.
Household tasks
Financial help. Focus group participants talked about re- Wives
ceiving money from the aging parent for whom they were caring. Financial .22*** .31*** .23***
A woman, who worked in a bank and was the mother of a 2- Emotional .46*** .24***
Child care .44***
year-old, helped her husband provide care for his mother. She
Household tasks
described how her parents-in-law, "take us out to a nice dinner
and pay for it. They'll give us money to go home with." Another *p - .05. **p - .01. ***p ? .001.
woman, a budget analyst with one son, had a frail mother who
required extensive personal care. She described how she and Table 3
other family members received financial reimbursement from Help Received From Parents by Their Adult-Child Caregivers

their mother when they provided personal care for her. Frequency of Receiving Helpa
(n = 298)
If you just go visit her, you're visiting her-but if you're
Husbands Wives
there and you're doing the suctioning of her throat, and Kinds of Help M (SD) M (SD) t
changing her diapers and feeding (she's got the tube), if
Financial 1.89 (.94) 1.92 (.90) -.53
you're doing all that stuff, you're getting something for it. Emotional 2.64 (.97) 2.83 (1.00) -3.09**
That's out of her estate-that's something she set up ahead Child care 2.32 (1.02) 2.32 (1.00) -.32
of time. Household tasks 1.56 (.80) 1.61 (.83) -1.40

a I never, 2 not often, 3 = sometimes, 4 = frequently.

Emotional support. The receipt of emotional support from
their parent was described by caregivers in two distinct ways.
One form of emotional support was expressed in terms of en-
joying the companionship of that parent. For example, the wom-
an who worked in the bank and cared for her mother-in-law also
was involved in caring for her own mother. She described this
relationship with her mother as extremely supportive: "My
mother is my best friend. I couldn't handle not talking to her at
least once or twice a day."
Another form of emotional support was described in terms
of receiving helpful advice. A computer specialist with two chil-
dren talked about the self-doubts he experienced as the sole care-
giver for his cognitively-impaired mother. His wife's parents, for
whom the couple occasionally provided support, were more cog-
nitively intact than his mother and could provide him with much
appreciated advice. In his words, "It's nice having . .. her folks
around because then you can, 'Well, what do you think of this
and this and this?'. . . . Her dad's a retired minister, so he's gone
through some of these things before." Advice from his parents-
in-law helped provide this man with perspective and direction
that facilitated his ability to care for his own mother.
Help with child care. Participants talked about how much it
helped them to have their parents care for their children. A med-
ical secretary with one daughter lived near her parents and her
in-laws and helped provide care for her father-in-law. Both sets
of parents enjoyed spending time with their granddaughter. This
arrangement was a great relief to the secretary, who explained,
"I don't have to worry about (my daughter) because I know she's
in good hands. Because she gets passed around ... she spends
a lot of time with my parents and his parents. She's lucky she
has two sets of grandparents." Another woman who owned her
own business and had two daughters described a similar arrange-
ment with her father, who lived with them: "Actually, he's a
help around the house, or being, he's a warm body there when
the kids ... If I'm not home, he's there. So I don't have an
empty household ever, really. That helps."
Help with household tasks. Older parents also helped their
*p .05. **p ? .01. ***p? .001.
adult-child caregivers with cleaning, laundry, and cooking. A
postal clerk with two children described how her mother's dizzy
spells required trips to the doctors and management of these
medical visits. Nevertheless, her mother offered tangible assis-
tance around the house: "Even at 79, she's slowing down a lot,
she realizes that. But she still ... there's lots of times when I'll
come home for lunch and she'll be there cleaning up the kitchen
or folding clothes or something." Another woman had three chil-
dren and was employed by a hospital elder-care service. Her
mother-in-law had Alzheimer's disease and needed considerable
care. This focus group participant explained that, despite her
mother-in-law's limitations, she "still cooks too, even though she
still gets in her 'moods,' but she loves to cook big old dinners
still."
In sum, analysis of the data from the focus groups in relation
to the first research question revealed four distinct dimensions
of help received from parents by their adult-child caregivers.
These included financial help, emotional support, help with child
care, and help with household tasks.
Survey Results
Based on the focus group data, we developed separate items
for each of the four dimensions of help received from parents.
These items were subsequently used in the survey to address the
second and third research questions. Because many spouses were
reporting on the same parent, their data were not independent.
Therefore, we analyzed the data for husbands and wives sepa-
rately. For both husbands and wives the four help-received items
were correlated (see Table 2).
The second research question asked about the extent to
which dual-earner sandwiched-generation couples received help
from the parent for whom they were providing the most care
and gender differences in the amount of help received. In gen-
eral, our findings show that a substantial proportion of caregivers

266 Family Relations

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received help from their parents. The receipt of emotional sup-
port was particularly pervasive among both husbands (60.9%)
and wives (68.8%), followed by the receipt of child care (re-
ported by 46.2% of husbands and 47.4% of wives), financial help
(30.7% of husbands and 30.6% of wives), and household tasks
(14.9% of husbands and 17.2% of wives). Husbands and wives
reported receiving similar amounts of tangible assistance (the last
three types of assistance) from their parents. Husbands, however,
indicated that they received significantly less emotional support
from their parents than did their wives (t -3.09, p ' .05; see
Table 3).
Table 4 pertains to the third research question and portrays
the relationship between receiving help from parents and the
three dependent measures for husbands and wives: quality of
relationship with the parent, performance as a caregiver, and
work effectiveness. This table shows the unique variance ac-
counted for by the help-receiving variables beyond that due to
the control variables. For two of the three outcomes, quality of
relationship with the parent and performance as a caregiver, the
pattern of results was straightforward. For both husbands and
wives, receiving certain kinds of help from their parent was sig-
nificantly associated with relationship quality and improved per-
formance in the caregiving role, over and above the control var-
iables. Among the four help-receiving variables, emotional sup-
port emerged as the single significant predictor of a good rela-
tionship with the parent for both husbands (13 = .45, p ' .001)
and wives (13 = .62, p ' .001). For performance as a caregiver,
emotional support also emerged as the only significant predictor,
but just for husbands (13 = .26, p ' .001). For wives, none of
the help-receiving variables was significantly associated with
caregiving performance.
For the worked less effectively because of concern about
parent(s) outcome, the pattern of results was more complex. The
four help-receiving variables provided significant predictive
power over and above the control variables for husbands only.
For husbands, interestingly, receipt of more financial help from
the aging parent (13 = .22, p ' .01) and more household help
(13 = .14, p ' .05) were associated with working less effectively
because of concern about parents; however, the aging parent's
provision of help with child care (13 = -.27, p ' .001), was
related to working more effectively. In contrast, for wives, the
four types of help did not explain a significant proportion of the
variance beyond that explained by the control variables. Within
the block of help-receiving variables, however, help with child
care emerged as a significant predictor (13 = .16, p ' .05) such
that the receipt of more help with child care from the aging
parent was associated with working less effectively because of
concern about parents. In sum, these findings indicate that the
provision of help by aging parents influenced work effectiveness
differently for men and women.
Focus Group Findings Explaining Nonintuitive
Survey Results
Some of the survey findings concerning the effects of re-
ceiving help from an aging parent were somewhat perplexing.
Although receiving emotional support from the parent was as-
sociated with positive feelings about relationship quality and per-
formance as a caregiver, receipt of the other forms of support
were not consistently beneficial. Specifically, receipt of all three
of the tangible kinds of help (i.e., financial, help with child care,
and help with household tasks) were related to more frequent
2001, Vol. 50,
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reports of working less effectively because of concern about
one's parents for either husbands or wives in sandwiched-gen-
eration couples. By returning to the qualitative data from the
focus groups, we discovered patterns that helped us to interpret
the nonintuitive findings concerning the three forms of tangible
help.
Receipt of financial help. Comments made in the focus
groups indicated that receiving financial help from aging parents
could be problematic. One member referred to the receipt of
money from a parent as "this whole big sticky area-'Mom, you
don't need to pay me.' " The previously mentioned woman who
worked in a bank and received money from her parents-in-law
also talked about her discomfort with accepting this financial
assistance: "I don't want them giving us that kind of stuff all
the time ... because they'll think we depend on them, and I
don't want that." These remarks suggest that the receipt of mon-
ey was, for some caregivers, associated with feelings of depen-
dency, indebtedness, or guilt. Such reactions are consistent with
the clinical observations of Lustbader (1991), who conducts ther-
apy with older adults and their families. She noted that the need
to depend on others often results in feelings of anger, frustration,
and guilt.
Furthermore, this interpretation provides a helpful way of
understanding the reactions of the men in the survey, for whom
working less effectively because of concerns about their par-
ent(s) was associated with the receipt of financial assistance from
the parent whom they were helping the most. Perhaps men are
especially vulnerable to feeling guilty about receiving financial
help from parents who need care. This guilt may result in greater
amounts of worry or concern about one's parents while at work,
thus leading to working less effectively. Men also may experi-
ence such assistance from their aging parents as an implicit crit-
icism of their ability to provide for their families. Greenberg and
Becker (1988) found that when elders provided financial help to
their adult sons, they were more distressed than when they pro-
vided this help to their daughters. They reasoned that older par-
ents are more uncomfortable with dependency on the part of their
sons. Our results in conjunction with Greenberg and Becker's
findings suggest that, for employed male caregivers in the sand-
wiched generation, the acceptance of financial help may serve
as a symbol of their dependency and inadequacy, influencing the
effectiveness of their work.
Receiving help with child care. Although several focus
group participants talked about how much they appreciated their
parent's provision of child care, their remarks also highlighted
aspects of this care that were problematic. A general contractor
with three daughters talked about how his mother-in-law helped
his family by caring for the children. Nonetheless, he explained
that along with this help came a considerable amount of unso-
licited advice.
She has nothing else to do with her life but to go to work,
and maybe kind of tell us what we should do with our lives
[laughter], and how we should raise our kids and this and
that.... She always felt that she needed to be part of what
is our business. You know, "Our business is her business".
This description of the intrusiveness associated with an aging
parent's provision of help with child care highlighted the poten-
tial for negative fallout.
As indicated by our survey findings, women may be partic-
ularly vulnerable to the negative effects of receiving help with
child care. They reported working less effectively because of
No. 3 267
 Table4

Block1:ntrvaibes

Block2:heprivdabs'

*pc<.051

'Helprcivdoas1=n,4fquty.

eRlationshpdrc0=,1-w.

bPerfomancsgivd1=xtlyp,6.

aQulityofrenshpcd1=,4v.

HierachlRgsonfCvOutmVbpdFAiPare

dPercivaquyofnms1='tk,4lwh.

cWorklesftivyda1=nw,5mhorklesfctivydunabp.

Note:Tablrpsundizgcf,wyoetparnhsilmd.ADL=cvfyg

R2.13068
QualityofRenshpPrmcCgvbWkLE

OveralR2.349015 Fchange17.*4230596 R2change.036847

Househldtak.04(6)-1925* Childcare.03(5)712-* Emotinal.32*(45)61-0 Finacl-.02(3)15*9
F3.8*4016752
Distancefromld.0(-8)219 Hourshelpd-.01*(5)2 3 Elder'sADL.0(-3)51748 Elder'sincom.06(9)25-71 Relationshpdr-.17*(3)4098 5 Youngestchild'a.0(4)3-12 Hoursemplyd.0(1)-26478 Caregiv'sncomd.03()518*47-2 Caregiv'sducton.01(5)-43826
B1 (n=250)6481
HusbandWive

268 Family Relations

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concern about their parents when they received help with child
care from their aging parent; their male counterparts, however,
worked more effectively when they received this form of help
from the parent whom they were helping. Our focus group data
suggest that one reason for this gender difference is that women
are more intimately involved in making arrangements for child
care. One woman reported, "The kids are 99% my responsibil-
ity." For these women, receiving help from their parents with
child care may result in more worry about their parents' physical
ability to provide care, the quality of the care, and feelings of
guilt or indebtedness. Such feelings may, in turn, affect the
en's ability to work effectively. On the other hand, because the
men may not feel as responsible for managing the child-care
responsibilities, they may experience fewer negative reactions
when they receive help with child care from their parents. In-
deed, the help provided by their parents may reduce the hus-
bands' child-care responsibilities, thus enabling them to work
more effectively.
Another explanation for this gender difference may be that
women are more involved in ensuring that the needs of both
their aging parent(s) and those of their children are met. One
woman indicated that part of the reason she asked for her moth-
er's help with child care was that it "makes her [mother] feel
needed." This comment suggests that by accepting the intimate
kind of help involved in child care, our study participants some-
times assumed the additional responsibility of caring for their
aging parents' emotional needs that might lead to working less
effectively because of concern about one's parents. Taken to-
gether, the remarks from the focus group participants illuminate
the stresses associated with receiving child care from aging par-
ents, especially for the women who make these arrangements.
Help with household tasks. The focus group participants also
described some of the difficulties associated with receiving help
with household tasks from their aging parents. The experience
of one woman who had three children and ran a craft business
was particularly informative. Her mother's condition had dete-
riorated markedly, but this elderly woman still wanted to be use-
ful. Therefore, the daughter saved her laundry for her mother to
fold:
She folds one load of laundry, then we fold the second load
of laundry. I proceed to do four more loads of laundry
which I have saved because she told me to ... and none
of the rest of the laundry got folded [laughs]. And I said,
"You know, she used to be a help but now it's about like
having four kids instead of three."
This woman's situation demonstrates how involving the aging
parent in household tasks may result in additional work for the
caregiver.
Our survey results indicate that receiving household help
from aging parents has particularly negative repercussions for
men's work effectiveness. Drawing from the focus group data,
we discovered sandwiched-generation husbands who had as-
sumed more responsibility around the house to accommodate
their wives' work schedules. One man who worked with freight
at the airport was described by his wife as "a Dad of the 90s."
She talked about his involvement in household tasks: "He's
home at three, and so he usually starts dinner at four or four-
thirty, and I'm in the door about a quarter after five." To the
extent that husbands are more responsible for household tasks,
the assistance of a parent could play a crucial role in the hus-
bands' ability to balance work and family responsibilities. When
2001, Vol.
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the aging parent's help with household tasks is inadequate (as
illustrated by the older mother who did not follow through on
her promise to fold all of the laundry), managing household re-
sponsibilities becomes even more difficult. These difficulties
may spill over into the work situation, resulting in reduced work
effectiveness among men who are worried about their parent's
ability to assume some of the domestic responsibilities.
Another explanation is that the husbands may have put con-
siderable effort into trying to change the physical environment
to accommodate the aging parent's needs. For example, the gen-
eral contractor with the intrusive mother-in-law had made a sub-
wom-
stantial investment of time and energy remodeling his family's
house to accommodate her needs: "So I went in and redid the
whole place. I mean brand new everything-carpets, appliances,
counter-everything. So we put some money into that place,
moved her over here.. . Well, it only lasted 3 months." When
such efforts lead to inadequate help from the aging parent, men
who are assuming more household responsibility and counting
on this help may become particularly frustrated. Their frustra-
tions may in turn be associated with working less effectively.
Discussion
By examining gender differences in the help received from
aging parents by sandwiched-generation couples, this study
builds on previous research. In so doing, we discovered that a
substantial proportion of caregivers receive help from the aging
parents for whom they provide care. Furthermore, receipt of this
help is associated with both costs and benefits. Receiving help
from aging parents is beneficial in terms of the quality of rela-
tionships reported with those parents and improved self-ratings
of performance as caregivers. Nonetheless, receiving help from
parents is also associated with costs that are related to working
less effectively because of concerns about parents. The following
discussion highlights the major findings, limitations, and impli-
cations for practice.
Our study confirms Morgan's (1998) assertion that qualita-
tive and quantitative methods can be combined to build on each
other's strengths. The analysis of qualitative data from multiple
focus groups of caregivers enabled us to identify four kinds of
help that aging parents provided to their caregivers. Items as-
sessing receipt of help in these areas were then included in a
survey that allowed us to determine the extent and effects of
such assistance. When we discovered that help from parents re-
sulted in a perplexing pattern of effects, we used the qualitative
data to enrich our understanding of this phenomenon.
This research also provides support for Bengtson's concep-
tualization of functional solidarity between aging parents and
their adult children (Bengtson & Roberts, 1991; Bengtson &
Schrader, 1982). In our study, both elders and sandwiched-gen-
eration adult children were providing assistance to each other.
Our findings expand on Bengtson's framework by suggesting
that help received from aging parents may be a mixed blessing
for sandwiched-generation caregivers. On one hand, emotional
support from aging parents emerged as a consistently beneficial
form of assistance. It was the most frequent kind of support
provided by parents and the strongest predictor of relationship
quality and performance as a caregiver. On the other hand, the
three forms of tangible support (i.e., financial, help with child
care, and help with household tasks) were problematic for either
the husbands or wives in our dual-earner, sandwiched-generation
sample. Husbands who received more financial help and assis-
50, No. 3 269
tance with household tasks from their parents indicated that they
worked less effectively because of concern about parents, where-
as for wives, receipt of help with child care from parents was
similarly associated with reduced work effectiveness because of
concern about parents.
This unexpected pattern of effects is partially explained by
our focus group data, as well as by previous work. Lustbader
(1991) described how receiving help from others can lead to
anger, frustration, and guilt. Similarly, Thomas (1993) discussed
how such help can be experienced as overwhelming or inade-
quate. Whereas both authors are describing the reactions of older
adults who received assistance from their children, adult children
receiving assistance from their aging parents can be expected to
experience similar reactions. Indeed, our focus group caregivers
described feelings of guilt about feeling dependent, annoyance
over unsolicited help, and frustration when assistance was in-
adequate. In addition to these feelings, there was sadness that
aging parents were losing their capacity to be helpful. As illus-
trated by the daughter who saved laundry for her mother to fold,
caregivers tried to protect their parents' fragile sense of useful-
ness by searching for ways in which the parents could continue
to be helpful despite their increasing limitations. These qualita-
tive data add to our understanding of how help from aging par-
ents can have both costs and benefits for caregivers, especially
for those who are caring not only for parents but also for chil-
dren.
Despite the contributions of our study, this research has lim-
itations that should be addressed in future research. First, our
sample was fairly homogenous with respect to race, as the sur-
vey respondents were predominately White. Second, their in-
come level was relatively high. Future studies that address the
help received from aging parents should focus on minority sam-
ples and caregivers with lower socioeconomic statuses. Perhaps
for these caregivers, help from aging parents will have different
costs and benefits. Third, on average, the elders had relatively
few ADL limitations. Future research on help giving from elders
should include more significantly impaired elders to identify the
different dynamics that emerge in help giving versus receiving.
Fourth, the variance explained in the outcomes measured by the
four help-giving variables was fairly small for caregiver perfor-
mance and work effectiveness. Clearly, future research needs to
explore what additional factors contribute to these outcomes
among sandwiched-generation adult children. Finally, the com-
plex pattern of findings in this study concerning the effects of
help received from the aging parent on work effectiveness sug-
gests that this is an especially important area for further explo-
ration.
Implications for Practice
For practitioners, our research highlights the importance of for their grandchildren in the United States. Family Relations, 47, 385-393.
conceptualizing caregiving as a mutual help-giving process be- Bengtson, V. L., & Roberts, R. E. (1991). Intergenerational solidarity in aging
tween adult children and the parents for whom they are caring.
Adult children often become more involved in the care of their
Bengtson, V. L., & Schrader, S. S. (1982). Parent-child relations. In D. J. Mangen
parents over time (Brody, 1985); however, our research supports
previous findings (Dunkle, 1985; Pruchno et al., 1997) indicating
that even parents who need care may continue to assist their
adult children in a number of ways. Family life practitioners can Biegel, D. E., & Schulz, R. (1999). Caregiving and caregiver interventions in
help caregivers to identify the various psychological or tangible
Boszormenyi-Nagy, I., & Spark, G. (1973). Invisible loyalties: Reciprocity in
ways in which their older parents can serve as a source of help.
According to our research, emotional support from aging parents
is an important resource for adult-child caregivers. In the process
of helping their aging parents with tangible tasks, caregivers may
270 Family
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sometimes ignore the emotional aspect of their relationship with
their parents. In so doing, the caregivers are neglecting a source
of pleasure and sustenance for themselves and for their parents.
Practitioners can help caregivers by encouraging them to share
the tangible tasks of caregiving with others (e.g., family mem-
bers or paid workers), thereby freeing the caregivers to enjoy
time for companionship with their aging parent.
Our research also indicates that whereas some caregivers
appreciate tangible assistance from their parents, such assistance
makes others feel guilty, frustrated, or annoyed. These negative
reactions can result from a feeling that the giving and receiving
of support between the generations is inequitable, a situation that
can become particularly acute for families in later life (Boszor-
menyi-Nagy & Spark, 1973; Sandberg, 1999). By focusing on
the reciprocal nature of the intergenerational relationship, prac-
titioners can assist adult-child caregivers who feel guilty about
receiving assistance from their parents. When caregivers identify
the numerous ways in which they have helped and will help their
parents over time, they may feel less guilty. Practitioners also
can aid caregivers who are annoyed and frustrated by inadequate
assistance from aging parents by identifying more realistic ways
in which their parents can provide help. For example, increased
frailty may result in a parent's inability to make dinner or fold
laundry; however, the aging parent may still be able to tear let-
tuce for a salad or match clean socks. Similarly, practitioners can
help caregivers to recognize emotional support from their parents
as a valuable resource that can be solicited and mutually appre-
ciated. This identification of realistic ways in which aging par-
ents can provide assistance may contribute to enhancement of
the elder's sense of competence, reduction of the caregiver's frus-
tration, and enrichment of their child-parent relationship.
In conclusion, this study advances our understanding of the
help that employed husbands and wives in sandwiched-genera-
tion couples receive from the aging parents for whom they are
caring. Previous research has focused considerable attention on
the stress of caregiving; thus, it is important to explore ways in
which this stress may be reduced. One way involves identifying
and examining the types of help provided by the aging parent
who is the care recipient. Aging parents can potentially reduce
their caregivers' stress by providing emotional support and tan-
gible assistance. Our research demonstrates that although assis-
tance from parents can be beneficial, such aid may also come at
a cost. We hope that others will pursue this area of study to
further uncover the conditions under which assistance from aging
parents can diminish the stressfulness of caregiving.
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Young, R. F, & Kahana, E. (1989). Specifying caregiver outcomes: Gender and
relationship aspects of caregiving strain. Gerontologist, 29, 660-666.
Berit Ingersoll-Dayton is Professor in the School of Social Work
at the University of Michigan-Ann Arbor.
Margaret B. Neal is affiliated with the Institute on Aging and is
Professor of Community Health in the School of Urban Studies
and Planning at Portland State University in Oregon.
Leslie B. Hammer is Associate Professor in the Department of
Psychology at Portland State University in Oregon.
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