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Caught in the Middle

May 9, 2009 | by Leah Abramowitz

Pulled between responsibilities towards one's children and one's aging parents, "the sandwich generation" have their own dilemmas.

Mrs. L.'s children are grown up and living lives of their own, and her husband is nearing retirement. She should be able to finally slow down and relax, and focus on nurturing her own intellectual and spiritual pursuits. She can volunteer at the local hospital or partake in a wide variety of courses from -- computers to Jewish history. Her time is now her own.

So why does Mrs. L. look so bewildered, so harassed, so worn out? Why does she go to sleep at 2:00 A.M. feeling nothing's been accomplished? Why are her nerves strained to the limit and she fights with the butcher, the switchboard operator and especially her long-suffering husband?

Mrs. L. is in fact holding down many jobs. Now that her children are grown up she balances new relationships with daughters and sons-in-laws; she becomes the adviser on household affairs and "chief babysitter at a moment's notice." She is expected to fulfill community tasks, because after all, she has "so much time."

Mrs. L. is also the daughter and daughter-in-law of aging parents, and the only living relative (who cares) of an elderly maiden aunt -- who never knew she existed before the age of 80. This morning, for example, this aunt has to be taken to an eye doctor, so Mrs. L. makes the appointment, goes over to dress the stubborn aunt (who won't take a home helper) and is just about ready to leave for the eye clinic, when her mother-in-law calls up on Mrs. L.'s mobile to tell her the refrigerator is dripping.

When she gets to the eye doctor, they're kept waiting for an hour. The aunt is restless and it takes considerable skill to keep her calm until their turn arrives. The doctor tell s them that the aunt needs new eye drops (she'll have to get to the pharmacy somehow today before taking care of that dripping fridge). Mrs. L. explains everything three times to the aunt as they go back home.

She sees that everything is in order before leaving auntie, and arrives home just in time to hear that her own mother, who's suffering from Alzheimer's, has burned the pots again, and her father is out of his wits. "A man of 88 shouldn't have to deal with problems like this," says her father, arousing only guilt feelings in the only one of his daughters who lives within visiting range.

Mrs. L. goes over to comfort him and clean the pots. She also discovers that the bedding is wet. She changes the sheets quickly before her father notices another crisis and wonders how they will deal with incontinence that is becoming more frequent in recent weeks.

While she is at her parent's house she gets a call from her son, Gary, to ask if she could look after the twins tomorrow because Aliza has a dentist appointment.

"How will I ever build a relationship with my grandchildren if I'm always busy with old people?"

She loves looking after the twins, but she's promised to take her father to a new senior citizen facility tomorrow to give him some relief from the constant stress of living with a mentally impaired wife. Mrs. L. also plans to use the time to break in a new caretaker for her mother who hopefully won't steal, talk all day on the telephone and treat her mother caringly. Regretfully she turns down her son's request, feeling terribly frustrated. "How will I ever build a relationship with my grandchildren if I'm always busy with old people?" she asks herself.

Mrs. L. represents a segment of the population called "the sandwich generation," "dor habeiniyim" in Hebrew, somewhere in the middle, pulled between responsibilities towards one's children and grandchildren on one hand and to aging parents, grandparents and various elderly members of the extended family on the other.

As people live longer and today's mobile society finds offspring often living miles and even continents away from their parents, the problems of how to look after the aging third generation is becoming a very prevalent and pressing question to so many families. Some sandwich generation members are responsible for three or four sets of elderly relatives

The example of Mrs. L. is played out all over the world in different variations, and involves both practical and ethical questions. The dilemma of choosing between "what we want to do" and "what we ought to do" is nowhere more prominent than in the field of multi-generational responsibilities. Middle-aged women (and men too) are more and more torn by the divergent messages that they receive from society and their own conscience. On one hand Western culture today proclaims, "Do your own thing." Women are encouraged to choose their own goals in life, develop their own potential, and give prominence to their private lives.

On the other hand we've been nurtured on the age-old adages, "Honor your father and mother" which means giving precedence to the needs of the older generation. Many people also want to assist their parents who brought them into the world, sustained them, provided their every need and gave them unconditional love. Even in cases where one's childhood wasn't ideal, where a parent was missing, withdrawn or abusive, the Jewish religion still admonishes us to provide for their care, if not from love then from obligation.

For most the desire to do for our elders is much more prominent than the other alternative, but clear-cut guidelines are needed. Do we leave a sick husband to look after a sicker parent? Can we let the doctor tell a dying patient what his condition is? How do we react to a paranoiac parent who refuses to let us help him? Do we give a diabetic patient the food he craves, even insists upon?

These are questions that leading rabbis have dealt with over the generations. Even though each case is and requires a "psak" -- a response according to Jewish law -- from one's own spiritual leader, the halacha, the body of Jewish law, has many practical and well thought out answers for questions of these sorts. Jewish law includes many quite "modern" approaches to intergenerational dilemmas that show deep psychological insight and take into account extenuating circumstances.

For example, even though adult children should listen to their parents, they are released from this dictate regarding choosing a spouse or a profession. All those mothers who are trying to get their sons to be lawyers or doctors and their daughters on the stage can try to influence them but they can't claim the 5th Commandment as a clinching argument. Parents cannot keep a child from making aliya to Israel, or choosing where he wants to learn. Similarly if a parent requests something which will be harmful to him (e.g. a diabetic who requests forbidden food), the son or daughter should not give it to him.

Married women are exempt from caring for their aging parents if they have family responsibilities in their own homes; but their husbands (the sons-in-law) are encouraged to allow their wives to follow their natural inclinations in this matter. Sons on the other hand must provide for their parents even if it is at the expense of their own nuclear unit. However they cannot bring their parent or parents-in-law home to live with them without their wives' approval (or vice versa). Similarly parents of means cannot request their sons to support them or spend their children's money for their personal requirements. So when the well off parent asks his son to pick up some medicine for him at the pharmacy the son can definitely ask his dad for reimbursement, but of course in a respectful way.

Parents are cautioned to treat their adult children with respect, not to abuse them physically or verbally, so that they will not cause their children to lose their temper or strike back at their parent. This is learned from the passage, "Do not put a stumbling block in front of a blind man."

Children who realize that they cannot look after their parents with equilibrium are encouraged to hire someone who will do the job for them. Thus a mentally deranged parent will probably do better with a professional caretaker, and the adult child will avoid losing his cool.

The mitzvah of honoring parents calls for empathetic alertness, making oneself available and a great deal of fortitude. A sense of humor helps a lot too. All too easily the adult child tends to justify retreating from the "battlefield" (from caring for the dependent elder), or just the opposite -- smothering the parent's independence with over-solicitude. Worst of all is capitulating into quarrel and strife.

No wonder the Fifth Commandment is among the few that comes with a built-in reward when performed properly (as the Torah states, "…so that your days be lengthened"). After all, the Sages taught that it is one of the most difficult precepts to keep.

To all those Mrs. L.'s and their partners out there, fulfilling too many roles at the same time, torn with guilt feelings and frustrations, uncertain that they are doing the right thing, I'm sure that under the circumstances you're caring for your parents in the best way possible. It also happens to be a very good example that you're setting for your own offspring.

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