An NASW report shows that "sandwich generation" women are ill-prepared for the challenges of providing care to aging relatives and find it hard to ask for help.

The report, "Not Ready for Prime Time: The Needs of Sandwich Generation Women, A National Survey of Social Workers," explores the challenges faced by some 42 million American women sandwiched between the needs of their own children and their aging relatives through information provided by their social workers. The report was commissioned by NASW and the New York Academy of Medicine.

In 2006, NASW released data from a survey of these women that highlighted some of the strains they experience in caring for their children and aging parents. The new data come from a survey conducted with social workers and geriatric care managers, as well as a journaling project with sandwich generation women.

"What this research reveals is that many of the things social workers can help with — managing and relieving day-to-day stress and helping to navigate the maze of health and social services that their older relatives need — are precisely the things that women say would most relieve their anxiety and unhappiness," said NASW Executive Director Elizabeth J. Clark.

Key findings from the survey and the journaling project include:

• Sandwich generation women are overwhelmed, and that is taking a toll. Among social worker respondents, 47 percent believe that the lack of happiness among sandwich generation women reported in last year's survey can be attributed to these women being overwhelmed with too many responsibilities. The women responding to the online journal questions also supported this sentiment. They reported that they could use the most help with housework and fundamental parenting responsibilities.
• Social workers provide services that can help sandwich generation women care for their aging parents. Nearly half of social workers surveyed said they ease caregivers' burdens by providing care management or care coordination for aging relatives. Thirty-two percent make referrals to health and social service providers, 31 percent arrange transportation and food delivery, 21 percent advise on financial management and benefits, and 18 percent act as a liaison for long-distance care.
• Social workers most often help sandwich generation women by providing counseling, therapy or mental health services. Of the primary or initial reasons social workers hear most frequently from sandwich generation women for assistance, 37 percent provide counseling. They most frequently help them "manage the stress of daily life" (58 percent) or "manage feelings of depression/anxiety" (56 percent).
• Social workers say that sandwich generation women are "not at all prepared" for shouldering the cost of an aging parent's care. The new survey among social workers showed that 74 percent of them believe sandwich generation women are not prepared for the cost of paying for care for an aging relative, 63 percent believe these women are not prepared for care planning, and 53 percent believe they are not prepared for end-of-life planning.
• Sandwich generation women underestimate the toll of providing care to aging loved ones, including the toll on their own health and the emotional toll. Of social work respondents, 91 percent report that sandwich generation women underestimate the toll caring for an aging relative will take on their own health, 86 percent believe these women also underestimate the emotional toll of providing care, and 80 percent believe they underestimate the stress providing care will put on their marriage or partnership.

The survey was completed between Nov. 19, 2007, and Dec. 17, 2007, by 1,489 respondents who were randomly selected members of NASW and the National Association of Professional Geriatric Care Managers who work with sandwich generation women.

The qualitative journaling project included responses from 41 sandwich generation women recruited from the metropolitan areas of Westchester, N.Y., Chicago, and Irvine, Calif. The respondents were between ages 35 and 64 and were in some capacity taking care of their children and elderly parents. Each respondent answered questions online for a two-week period in November 2007.