Nurse Next Door

Sandwich generation balances child, elder care

TORONTO – Within days of learning she was pregnant with her second child, Barb Brzezicki faced the unfolding of an unexpected and harrowing chapter in her family’s life: her mother’s diagnosis with Alzheimer’s disease.

The working mother was suddenly balancing pregnancy with caring for her young daughter and her mother, Stella — starting to drive her to and from appointments in the weeks before Christmas in 2009. What’s more, Brzezicki became sick and ended up on disability, all of which she believed was stress-induced.

By around May or June of last year, Brzezicki realized she could no longer manage on her own and enlisted outside help. Jeanne Ireland, a companion with the home care company Nurse Next Door, has been a presence in their lives for the last eight months.

“I love my mom but I became, `Today we’ve got to do this, and tomorrow we’ve got to do that,’” Brzezicki recalled, sitting in the living room of her home in a quiet west-end Toronto neighbourhood, steps away from her mother’s house next door.

“I wasn’t enjoying the relationship of being a daughter….We totally lost that,” she added, her voice breaking, dabbing away tears.

Brzezicki, who now has a daughter Tola, 3, and baby boy Noah, was laid off from her job in corporate communications due to downsizing, after having worked with the same company for 14 years. She still manages a busy schedule with her little ones and helping care for her mom.

The experiences of the 37-year-old are undoubtedly common in thousands of households among Canadians comprising the “sandwich generation,” and their ranks will likely swell as boomers approach retirement age.

The Desjardins Financial Security National Survey on Canadian Health released last year provides some details about the adults shouldering numerous caregiving and work responsibilities.

Interviews were conducted with nearly 1,800 Canadians. Findings revealed 13 per cent of respondents were assisting their parents with daily domestic and/or psychological needs, while seven per cent were financially supporting their parents and/or kids simultaneously. Of those helping their parents, 47 per cent of respondents said it was a significant source of stress for them.

Nurse Next Door co-founder John DeHart said when they started nine years ago about 75 per cent of the callers were seniors inquiring about how the company could help. Today, DeHart said the same percentage of calls is now coming from the caregiving child, usually the daughter. The average client age is around 75, while the daughter, usually in her 40s or early 50s is often raising kids of her own, he noted.

DeHart admits that even though he owned and ran a company caring for parents, he never thought of the same thing happening to him. He recalled receiving a call “out of the blue” and being told his father had terminal cancer and only two months to live.

“Whether it’s a call like that, or you start noticing (that) your parents, they need that help, they’re starting to become isolated in their home, they’re starting to perhaps not eat well enough because they’re not getting out shopping, then perhaps it’s time to step in because it will affect everyone,” he said from Vancouver. “It’s inevitable that it will happen if you have living parents today.”

Yet too many families don’t communicate about future care needs and “avoid the conversation,” DeHart said.

“We always say if Mom or Dad is around 70 years old, it’s time to have this conversation now because something is going to happen at some point, and the more you’re prepared for it now, the less burdensome it is when it does happen.”

Brzezicki said Ireland is able to help with everything from picking up hair dye for Stella to taking her mother to medical appointments. She has also helped with efficiencies in their daily lives, for instance, by getting pills delivered from the drugstore.

Brzezicki still sees her mother three to four times daily, ensures she’s eaten, has her required medications and everything else she needs. Yet she’s thankful to have a hand in caring for her mother.

“With Jeanne, being able to take my mom out and do the little stuff that I can’t get to, it’s a huge help.”

Care consultant Sherri Auger said most of her clients are adult kids dealing with one or more aging parents or relatives. They typically struggle with issues such as how to give parents advice, determining how much they need to be involved financially, and the dilemma of whether to bring Mom or Dad to live with them or get outside care, she said.”Trying to have a conversation about how to do that is one of the biggest challenges they have,” said Auger, founder and president of Toronto-based Estate Matters, Inc. and Caring Matters, and co-author of “Now What? A Practical Guide to Dealing with Aging, Illness and Dying” (Novalis). “I think especially when someone’s been diagnosed or already ill with something, you feel like you’re taking something away from them, so that guilt weighs really heavily on the children.”

Auger said she first reassures caregiving children they are not alone in their experience and that it is one they will survive. She also recommends setting boundaries, like not getting into the area of personal care, such as washing hair, cutting toenails or feeding their loved one.

She realizes some people may not be able to afford a full-time caregiver and must take on a few responsibilities. In that situation, Auger said individuals need to be properly trained to care for someone, and learn how to lift a patient, for instance, so nobody gets injured.

For those working outside the home, carving out time off to tend to an elder relative may pose a challenge.

Compassionate care benefits are available for up to a maximum of six weeks if individuals are required to be absent from work to care for a gravely ill family member at risk of dying within 26 weeks. But for many families, elder care can be a responsibility extending over a far longer period of time.

Auger said there’s “definitely reluctance” on the part of caregivers to elderly parents to talk to employers about taking time off.

“If you had a sick child you wouldn’t have that reluctance, but somehow when it comes to aging parents it doesn’t seem to be as socially acceptable,” she said. “But a lot of corporations have taken a pretty proactive role to do lunch and learn sessions and start to recognize that if they can educate their employees on these realities and how they can start to reach out for help, it keeps them mentally and physically at work.”

Work and labour expert Anil Verma said other types of family care situations aren’t as well formalized and entrenched in the benefits system as maternity leave or parental care leave.

Creating a culture within companies where people wouldn’t feel fearful for asking for time off would also be of benefit, noted Verma, a professor of industrial relations and human resources at the University of Toronto’s Rotman School of Management.

“In those cases it can be very powerful because everyone’s need is different, and at the end of the day there’s organizational need,” he said. “Flexibly allocating staff could perhaps help to meet that need.”

“Of course, it cannot be done in every job, in every situation, and so there will be situations where the employers may … say: `You know we cannot accommodate this need.’ But the point is that if there is flexibility and understanding on both sides, then a lot can be accomplished.”