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Caught in Between


(page 3 of 5)

Dexter Suzuki, along with wife Lena and sons Kahler (13) and Branson (8) remembers his mom Nancy, who passed away earlier this year.

Photo: Elyse Butler and Matt Mallams

A Balancing Act

Baby boomers tell stories about all sorts of physical challenges in caring for their relatives—whether changing an adult’s diaper, or lifting out of bed a person who weighs more than they do, or being spit, peed or puked on—but the responsibilities go far beyond those. Many adult children find themselves overseeing repairs to the homes their parents have lived in for decades, and most are consumed with paperwork and phone calls to sort out medical, financial and legal issues.

It’s not as if the extraordinary efforts of those in the Sandwich Generation are met with cooperation or appreciation by their loved ones. Attempts to take away the car keys or take over the finances are often met by resistance and resentment, as elders struggle to hang on to their independence. “It’s a fine line between when they can care for themselves and when you need to step in,” says Nancy Azeri, who tried to take over her mother’s finances when she found out that bills were being paid twice … or not at all.

Trying to persuade an elderly relative to accept help—whether it’s hiring a home-care aide or moving into assisted living—a family caregiver is likely to hear: “It’s too expensive,” “I can manage on my own,” “I don’t want a stranger in my house.”

This balancing act, between wanting to honor a parent’s wishes and wanting to do what is right for them, combined with juggling the expenses of more than one generation, can take a physical toll on the sons and daughters, who too often put themselves last on the list of priorities.

Health Effects

Due to high levels of stress, long-term-caregivers are at risk for sleep deprivation, immune-system deficiency, muscle and joint problems, depression, chronic anxiety, loss of concentration and premature death. Queen’s gerontologist Lam Nguyen, M.D., recognizes what a sad reward some receive for their devotion. He points to a recently published study linking caregiver stress to a 23-percent increased risk for stroke and warns, “We must not forget caring for the caregiver.”

In juggling the needs of four children ages 2 to 9 and a disabled father under one roof, Yos uses her nights for paperwork that she can’t get to during the day; she’s experienced vertigo from too little sleep. Preventative healthcare, like exercising, eating right and taking breaks, also seems to elude many who simply cannot leave their disabled parents.


Paying for long-term care can be a challenge, and there aren’t many resources out there, says Scott Makuakane, an estate-planning and trust attorney with Est8Planning Counsel in Honolulu.

There are three options: Self-pay, such as savings; third-party pay, like long-term care insurance; or government benefits, often Medicaid.

While Medicaid is a long-term solution—Medicare only covers up to 100 days of care—there are restrictions on income and assets. For example, the maximum amount of income for a qualifying individual is $50 a month; any excess must go to nursing-home care. They may have $2,000 in other assets and can own a residence as long as they maintain an “intent to return,” even if it is unlikely.

“The best option is private pay; you are going to have a lot more options available to you than if you do government benefits,” Makuakane says. “You can save over time, or you can get long-term care insurance policies.”

Family Dynamics

The resulting guilt, tension and exhaustion can trigger a combustible mix of family dynamics. Wes Lum, Ph.D., University of Hawaii School of Social Work, has observed that the caregiving burden often falls to a single person in the family, and not without resentment, as described in the book They’re Your Parents, Too! How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy.

Many families are turning to mediation for help in sorting out a family’s dysfunctional dynamics. “The best time to bring in the conflict is early on, before sides get too entrenched,” advises Tracey Wiltgren, executive director of the Mediation Center of the Pacific, which is seeing an uptick in elder-care mediations. Conflicts, left unaddressed, only grow; Wiltgren once mediated a case that had escalated to the point where each of six siblings brought attorneys into the mediation, as did their elderly dad.

Unforeseen Rewards

The work of caring for an elderly relative can be exhausting and frustrating, but it is not without its rewards.

Tam has no regrets about stepping away from a 30-year career, although he calls caring for his aging parents and in-laws “one of the toughest challenges I’ve ever had to face in my life.” One of the rewards for Tam is demonstrating to his college-age son and daughter “the kinds of sacrifices loved ones make for each other.”

“I think it’s good for kids to know their help is actually needed,” says Yos, whose four youngsters help out in lots of small ways: putting the walker in the right spot, helping to prepare food or keeping an eye on where Grandfather might wander.

Suzuki, too, has recognized the upside of involving his 8- and 13-year-old sons in the caregiving of his mother before she passed away this year. He cherishes a memory of his older son sweetly combing Grandma’s hair and putting cold cream on her face.

For Tam and Suzuki, the experience has also shaped their career decisions. Suzuki co-founded a company last year called EOM (Ease of Mind) Hawaii, which provides home monitoring and maintenance services to help elders stay safe in their own homes. Tam hopes to find a position that involves advocating for the elderly when he returns to the workforce. 

When It’s The Baby Boomers’ Turn

When the baby boomers are the ones in need of long-term care, Nadine Smith, COO of Ohana Pacific Management Co., predicts an increase in requests for private rooms with computer access and Wi-Fi in nursing and care homes, as well as more meal options. Baby boomers are also likely to differ in their attitudes toward hiring home health aides or drivers, since they are more accustomed than previous generations to paying for help, whether it’s for house cleaners or personal trainers.

They may know what they want, but that doesn’t mean they’ll be likely to afford it, especially if today’s caregivers have depleted their retirement cushions in caring for their parents. It may not be a flashy issue, but caregiving is the issue of our age, because, sooner or later, it will affect every person in Hawaii and every family in America.             

Jana Wolff is a published author and ghostwriter of five books and more than 100 feature articles.

Next Page, get some additional advice for the Sandwich Generation

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