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Exclusive: Nearly 1 in 3 Caregivers of Adults Are in the Sandwich Generation

For millions of Americans, caring for family means being pulled in two directions — raising children while supporting an aging or disabled family member

Paul Wynn,

Published September 15, 2026

a person being sandwiched between different tasks

Lily Qian

Key takeaways

Sandwich generation caregivers are carrying a double load, balancing the everyday demands of raising children while providing care for adult family members.
While parenting children, many caregivers are also supporting older loved ones with complex medical tasks and other hands-on care like bathing, toileting and dressing.
Juggling careers and providing care for two generations can leave caregivers with little flexibility when a family crisis arises.

An estimated 17 million Americans – 29 percent of all caregivers of adults – are part of the sandwich generation, simultaneously caring for a child under 18 and an adult with a disability or complex medical condition, according to newly released research from AARP and the National Alliance for Caregiving. These caregivers are considerably younger than other family caregivers, with an average age of 42, compared with 55 among caregivers without children under 18. The first-time report on sandwich generation caregiving in the Caregiving in the US 2025 series shows that nearly half of these caregivers are ages 35 to 49, and nearly 70 percent are employed while providing care.

“What’s different about sandwich generation caregivers is that they’re juggling more hours and doing more complex care,” says Rita B. Choula, senior director of caregiving at the AARP Public Policy Institute. In addition to preparing meals, providing transportation and paying bills, they may be changing catheters, managing complicated medication regimens and providing other types of medical or nursing care, all while caring for their children. Although sandwich generation caregivers provide about 27 hours of care a week, similar to other family caregivers, they help with an average of 2.2 activities of daily living, such as bathing, dressing and feeding, compared with 1.7 activities among other caregivers.

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The pressure of caregiving can take a toll on their health. Twenty-two percent of sandwich generation caregivers report physical strain, compared with 17 percent of other caregivers, while almost 40 percent report high emotional stress. More than a quarter say caregiving makes it difficult to care for their own health.

Self-care, Choula says, is essential, but it doesn’t have to be elaborate or time-consuming. “Caring for themselves may mean finding a way to get more sleep, asking a neighbor to watch their child while running errands or simply sitting in the car for 10 minutes to breathe,” she says. “It’s about finding what care for yourself looks like and recognizing that it’s not a luxury, but necessary to keep going.”

Caregiving in the middle

In 2021, during the COVID-19 pandemic, Robyn Frank of Minneapolis was a 41-year-old mom to her 18-month-old son, pregnant with her second child, and running her cookie business. She was looking forward to having her parents, Dan and Barb, bond with the new baby. “I imagined my parents enjoying the grandchildren they’d always dreamed of having,” she says.

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Instead, Frank suddenly found herself caring for her parents. Her father had a stroke, leaving him hospitalized and then in rehabilitation. Her mother, who had already been showing signs of cognitive decline, was suddenly living alone. It quickly became clear she was struggling to manage on her own, without her husband’s help. Then, while driving to visit Dan in rehab, Barb was involved in a serious car accident.

Suddenly, Frank, now 46, was juggling a toddler, a pregnancy, a growing business and the escalating needs of two parents, while her husband, Ryan, 47, worked from home to help care for their young son.

Her parents had worked together for decades, essentially running their own sales business. After her father’s stroke, Frank and her sister also had to take over their parents’ finances and business affairs, sell their parents’ house and move them into long-term care.

Frank’s father, 78, has since regained his speech, but continues to have physical limitations. Her mother, 75, now diagnosed with Alzheimer’s disease, is in a memory care unit three floors away from her husband, who is in an assisted living unit.

When caregiving collides with work

For sandwich generation caregivers, the demands of caregiving disrupt careers, strain finances and leave little room for anything else. Nearly 7 in 10 employed sandwich generation caregivers report experiencing at least one work disruption because of caregiving.

Katie Kristofic was just 32 when she found herself caught in the middle. She was working full time and raising a 3-year-old daughter and newborn son when her mother, Vicki, began experiencing rapidly declining cognitive impairment. Kristofic’s parents lived in Pennsylvania, and her sister provided weekday support. Kristofic became the weekend caregiver, making the two-hour drive from her home in Delaware.

Her mother, who was eventually diagnosed with Alzheimer’s, remained at home with Kristofic’s father, Bill, who was Vicki’s primary caregiver. During her weekend trips, Kristofic stocked the freezer with meals and handled other tasks, including scheduling appointments and arranging lawn care, snow removal and other services.

Eventually, her mother lost the ability to walk and communicate and required extensive help with feeding and other daily activities. Finding qualified outside help proved difficult. The family tried home care agencies but found that some caregivers lacked the dementia-specific training they needed. Instead, family and friends became the respite network.

Kristofic brought her children along on many of her caregiving trips. “It was a boost for my dad,” she says. “But it was also because it was our reality.”

Rather than shielding her children from their grandmother’s condition, Kristofic and her husband talked openly with them in age-appropriate ways. Her daughter was in third grade and her son was in kindergarten when Vicky entered hospice, shortly before the COVID-19 lockdowns.

After her mother’s death, in 2023, Kristofic founded the Carefullist, an online resource, podcast and community for caregivers. She now shares lessons from her caregiving experience while supporting her 81-year-old father, who has cut back his driving. For Kristofic, caregiving didn’t end with her mother’s death; it simply entered a new chapter.

That may be one of the hardest parts of being sandwiched: Someone else always seems to need attention first. Frank, who cohosts The Sandwich Generation Pod, found support in her community. As she navigated her parents’ move to assisted living while preparing for the birth of her daughter, friends brought meals, provided transportation and stepped in with practical help. One friend even flew in from New York for 48 hours to help with groceries and transportation.

For Kristofic, family and friends filled the gaps when professional services could not meet her mother’s needs.

Struggling with financial strain

One in 5 sandwich generation caregivers experience significant financial strain due to caregiving, significantly more than all other caregivers. Further analysis shows that sandwich generation caregivers are at a 60 percent higher risk of high financial strain compared to other caregivers.

In addition to shouldering increasing out-of-pocket costs for childcare, sandwich generation caregivers often cover some costs for care recipients. Kristofic’s parents were, fortunately, in solid financial shape, but she would often purchase meals and new clothes for her mother without expecting reimbursement from her father.

To help sandwich generation caregivers and caregivers more broadly, AARP is pushing for a bipartisan proposal in Congress that could help ease the financial strain by allowing them to use tax-free flexible spending accounts (FSAs) and health savings accounts (HSAs) to pay for a parent’s or parent-in-law’s qualified medical expenses. Under current law, these accounts generally cover medical expenses for the account holder, spouse or dependents. The proposed measure,  the Lowering Costs for Caregivers Act, would expand eligibility to parents and parents-in-law, even if they aren’t claimed as dependents.

“This measure recognizes that family caregivers are often paying significant out-of-pocket costs for a parent or parent-in-law’s care,” says Choula. “Allowing them to use FSA and HSA funds for qualified medical expenses would give families another way to recoup some of those costs and ease the financial strain of caregiving.”

Paul Wynn, a veteran health care writer, has spent over a decade immersed in the caregiving community, both as a family caregiver and as a journalist covering caregiving issues for national publications.

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