Navigating the caregiver’s strain: psychosocial well-being among sandwich generation caregivers in India


  • A. H. Sruthi Anil Kumar Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India



Caregiver burden, Caregiving, Intergenerational caregiving, Sandwich generation


Background: Sandwich generation caregivers, while providing simultaneous care to two generations, face unique challenges and responsibilities. This research tried to understand the intricate aspects of this caregiving paradigm, with an emphasis on the difficulties faced by the sandwich generation in India and its impact on their psychosocial well-being.

Methods: The study used the Montgomery Borgatta caregiver burden scale to measure the burden experienced by the caregivers. Furthermore, both bivariate and multivariate analyses were done to understand the effects of background factors on the burden experienced by the caregiver.

Results: The findings demonstrate significant associations with demographic characteristics such as age, caste, education, income, religion, and employment status, emphasizing the multidimensional nature of the burdens. Younger caregivers experienced greater objective and demand burdens, suggesting that the caregiving challenges intensify as caregivers age. Higher education and income were associated with increased subjective demand burden, possibly due to higher expectations and greater responsibilities.

Conclusions: The study results highlight the critical need for tailored support systems that identify and address the unique issues of sandwich generation caregiving. As population ageing continues to impact societies worldwide, understanding and addressing the concerns of sandwich generation caregivers is crucial for the well-being of individuals, families, and communities.


Miller DA. The ‘sandwich’ generation: adult children of the aging. Soc Work U S. 1981;26(5):419-23.

Chisholm JF. The sandwich generation. J Soc Distress Homeless. 1999;8(3):177-91.

Hammer LB, Neal MB. Working sandwiched-generation caregivers: Prevalence, characteristics, and outcomes. Psychol-Manag J. 2008:11(1):93-112.

Loomis LS, Booth A. Multigenerational caregiving and well-being: the myth of the beleaguered sandwich generation. J Fam Issues. 1995:16(2):131-48.

Dukhovnov D, Zagheni E. Who takes care of whom in the United States? Time transfers by age and sex. Popul Dev Rev. 2015;41(2):183-206.

DeRigne L, Ferrante S. The sandwich generation: a review of the literature. Fla Public Health Rev. 2012;9(1).

Burke RJ. The sandwich generation: individual, family, organizational and societal challenges and opportunities. In: The Sandwich Generation. Edward Elgar Publishing; 2017:3-39.

Solberg LM, Solberg LB, Peterson EN. Measuring impact of stress in sandwich generation caring for demented parents. GeroPsych J Gerontopsychol Geriatr Psychiatr. 2014:27(4):171-9.

Keene JR, Prokos AH. The sandwiched generation: Multiple caregiving responsibilities and the mismatch between actual and preferred work hours. Sociol Spectr. 2007:27(4):365-87.

Starrels ME, Ingersoll-Dayton B, Dowler DW, Neal MB. The stress of caring for a parent: effects of the elder’s impairment on an employed, adult child. J Marriage Fam. 1997:860-72.

Buffardi LC, Smith JL, O’Brien AS, Erdwins CJ. The impact of dependent-care responsibility and gender on work attitudes. J Occup Health Psychol. 1999:4(4):356-67.

Seaward MR. The sandwich generation copes with elder care. Benefits Q. 1999:15(2):41.

Litvin SJ, Brody EM, Hoffman C, Albert SM. Marital status, competing demands, and role priorities of parent-caring daughters. J Appl Gerontol. 1995:14(4):372-90.

Oh S, Yu M, Ryu YM, Kim H, Lee H. Changes in family dynamics in caregiving for people with dementia in South Korea: a qualitative meta-synthesis study. Qual Health Res. 2020:30(1):60-72.

Brenna E. Should I care for my mum or for my kid? Sandwich generation and depression burden in Italy. Health Polic. 2021;125(3):415-23.

Do EK, Cohen SA, Brown MJ. Socioeconomic and demographic factors modify the association between informal caregiving and health in the Sandwich Generation. BMC Public Health. 2014;14(1):362.

Gillett JE, Crisp DA. Examining coping style and the relationship between stress and subjective well-being in Australia’s ‘sandwich generation’. Australas J Ageing. 2017:36(3):222-7.

Montgomery RJ, Montgomery RJV. Using and interpreting the Montgomery Borgatta caregiving burden scale using and interpreting the Montgomery Borgatta caregiver burden scale. Available from: Accessed on 18 February 2021.

Garlo K, O’Leary JR, Van Ness PH, Fried TR. Burden in caregivers of older adults with advanced illness. J Am Geriatr Soc. 2010:58(12):2315-22.

Boyczuk AM, Fletcher PC. The Ebbs and Flows: stresses of sandwich generation caregivers. J Adult Dev. 2016;23(1):51-61.

Snyder W, Rene J. Caregiving and care receiving: an investigation of burdens and satisfactions. University of Illinois at Urbana-Champaign. 1993.

Steiner AM, Fletcher PC. Sandwich generation caregiving: a complex and dynamic role. J Adult Dev. 2017;24(2):133-43.

Noor S, Isa FM. Malaysian sandwich generation issues and challenges in elderly parents care. Int Multidiscipl J Soc Sci. 2020:9(3):289-312.

Schulz R, Sherwood PR. Physical and mental health effects of family caregiving. Am J Nurs. 2008:44(sup3):105-13.

Duxbury L, Higgins C, Smart R. Elder care and the impact of caregiver strain on the health of employed caregivers. Work. 2011:40(1):29-40.

Lei L, Leggett AN, Maust DT. A national profile of sandwich generation caregivers providing care to both older adults and children. J Am Geriatr Soc. 2023;71(3):799-809.




How to Cite

Anil Kumar, A. H. S. (2024). Navigating the caregiver’s strain: psychosocial well-being among sandwich generation caregivers in India. International Journal Of Community Medicine And Public Health, 11(2), 841–850.



Original Research Articles