Sandwich Generation Squeezed by Downturn

Need to earn more money and also support aging parents is causing boost for in-home care industry.

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This recession is hard on everyone but takes a particularly brutal toll on the sandwich generation. According to, nearly half of the people providing some form of in-home care for their parents also supported them financially. Average out-of-pocket spending is more than $5,500 a year. Caregivers are worried that they will have to provide additional support because of the weak economy and retirement funds that have been badly hurt by the stock market's decline., an ad-supported web site that provides advice and support to family caregivers, says the economy is hurting the retirement plans of both generations. "For baby boomers that are caring for their parents, the caregiver role affects their marital relationship and physical health, and now, because of the stock market crash, it's having an even greater impact on their finances," CEO Andy Cohen said. Those same financial pressures are, however, causing record demand at Senior Helpers, a franchise provider of in-home care providers. Their offices are seeing families forced to seek paid care for aging relatives because the family can no longer afford to provide unpaid care. Caregivers who already work are seeking added hours or second jobs; family caregivers who don't work are being forced back into the labor market.

For families turning to in-home care, Senior Helpers President Peter Ross urges people to make a careful and thorough assessment of their in-home needs. Beyond selecting a properly trained person to take care of their family member, it sometimes is even more important to make sure the two people are a good match in terms of personality and temperament. Ross says an in-home assessment is a standard requirement for a Senior Helpers' placement, and he advises consumers to ask lots of questions, to get a contact list of other customers from their care provider and to make sure they understand exactly what is covered by the service.

Senior Helpers does not provide medical home care, which generally would be covered by Medicare (see its extensive online help  for caregiving) . Senior Helpers, by contrast., offers two types of non-medical care -- home care and companion care. Home care includes assistance with eating, bathing, getting dressed and other activities of daily living. Companion care would include medication reminders, meal preparation, helping with errands, and the like. Home care is often provided by a registered nurse or other licensed care professional, while companion care does not require such professional training. Hourly fees run from $15 to about $23, Ross says, with the variation depending on required skills and where the home is located; rates are higher in larger cities.

Ross says families should make sure their potential caregiver has been properly screened by their employer. "That should be the number one question that families ask," he says. "Families have to be involved," he adds. "They have to be in contact with the caregiver and company, and their parent." He recommends frequent visits, including unannounced stops, to make sure things are going well.

The National Private Duty Association,  a trade group, provides model ethical and business guidelines for in-home care, as well as a care locator. Geriatric and elderlaw care groups can help here as well.