I would describe my family as typically atypical. My wife and I have a pair of twin babies, and I have a sibling with an intellectual disability. He lives with my parents, but there’s a good chance my wife and I will someday be his primary caregivers, quite possibly while our children are still school-age. It’s provoked a lot of late-night conversations: will we both work, or will one of us stay at home? How will we navigate schedules and public assistance systems? What will our housing need to look like? What caregiver benefits, if any, would we be able to use? And, above all, how can we harmonize our commitments to care with our own futures, needs, and aspirations?

Amid a rapidly aging society and rising child and health care costs, more people are finding themselves part of a “sandwich generation.”

A growing number of Americans are asking themselves the same questions. Amid a rapidly aging society and rising child and health care costs, more people are finding themselves part of a “sandwich generation,” the cohort of working-age adults serving as caretakers for children and an older family member, or a family member with a disability, at the same time. 

This group is already large. There are currently 16 million Americans caring for a child and adult at the same time—that’s 29 percent of family caregivers—and more than one in five Americans who provide elder care have children under 18. Those numbers are likely to keep growing as American society ages. The Baby Boom generation is starting to need elder care, and is likely to live longer than previous generations. Meanwhile, rising costs of health and child care increase pressure on working-age family members to take on care work themselves.

Parents in all kinds of families—not just sandwich caretakers—are facing financial and mental pressures. In its Quarterly Insights from America’s Families survey, Capita has found that roughly three in ten families (29%) with a child under 18 had to borrow money or take on debt to cover basic needs in the prior 12 months. Half of parents reported feeling down, depressed, or hopeless at least once in the prior two weeks. Employment offered its own sources of stress; many parents reported having difficulty finding full-time work, experiencing unpredictable hours that disrupted their child care plans and routines, or having to drop out of the workforce altogether to provide care.

More care commitments might mean extending time away from the workforce—a child might be graduating and moving out right as a grandparent’s health begins to decline.

In the case of sandwich caretakers, these pressures compound. An unpredictable work schedule is all the more difficult when you have to schedule a babysitter and accompany a disabled loved one to a doctor’s appointment. More care commitments might mean extending time away from the workforce—a child might be graduating and moving out right as a grandparent’s health begins to decline. And all the while, you have to spend countless hours navigating entirely separate support systems—schools and Social Security; CHIP and Medicare—to ensure your loved ones of all ages are getting what they need. These burdens fall hardest on many who can already least afford it. The sandwich generation is disproportionately Black and Hispanic; 36 percent of Black family caregivers and 43 percent of Hispanic family caregivers take care of both a child and an adult at the same time, both higher rates than the overall population.

I can’t speak for the 16 million Americans who are already sandwich caretakers, but my wife and I know we wouldn’t have it any other way. For all the challenges, our care work confronts us every day with the simple truth that we need each other. Whether old or young, able-bodied or disabled, we are part of a single fabric.

Public policy ought to view caretaking the same way.

The key to helping the sandwich generation is to make family policy more holistic, in recognition that helping one family member helps the whole family, and vice versa.

As Capita’s Elliot Haspel, Joe Waters, and Caroline Cassidy point out, America doesn’t so much have a family policy as it has an array of “disconnected and disjoined” family policies, which “prioritize funding streams, programmatic interventions, and age bands over a holistic view of family life and the broader systems and conditions that mold it.” The key to helping the sandwich generation is to make family policy more holistic, in recognition that helping one family member helps the whole family, and vice versa. Accessible, affordable child care options, for example, help parents—as well as other family members they might be caring for. Almost 60 percent of stay-at-home parents reported needing child care at least a few times per month. Their reasons vary, but for many, external child care allows them to devote time and attention to caring for an elderly relative. Similarly, policies that make working hours more predictable—such as fair workweek laws—aren’t just a benefit for working parents; they’re also a benefit for the children, elderly, or disabled family members they care for, allowing caregivers to plan child care, schedule appointments, and keep a handle on the family finances.

There are, of course, specific policies that offer more targeted help for sandwich caregivers. As is, Social Security penalizes leaving the workforce, even temporarily, to care for a relative. The amount you get in retirement depends on the years you spent in the workforce, so spending a few years at home to raise a child, care for an elder, or both translates to reduced retirement benefits down the line. Instituting caregiver credits to stand in for forgone wages during years spent doing full-time care work when calculating Social Security benefits would prevent sandwich caretakers from jeopardizing their own retirement savings when weighing whether to step away from the workforce. Measures like Social Security caregiver credits would codify the principle that care work is work, that caretakers are no less part of our society, and that their work is no less valuable to our common social fabric than work done for an external employer.

The sandwich generation is here to stay. Its members do socially necessary work, making countless sacrifices every day to ensure that their loved ones have what they need in every stage of life. The question is whether policymakers will recognize it—and whether any help is coming. 

Philip Jeffery is a writer and editor, and former deputy opinion editor at Newsweek.