Although there are many differences between raising children and caring for an elderly loved one, the presence of competent and loving caregivers is the most important factor in both endeavors. Many of the lessons that parents learn in caring for their children translate well to eldercare, especially those decision-making skills that protect the safety and comfort of loved ones. One member of the Sandwich generation told us that she employed similar strategies to find her mother an assisted living facility as she had employed several years earlier in selecting a day care program for her children. And she noted that the day she brought her mother to live at the assisted living facility brought back memories of leaving her children at day care for the first time.

It can be an emotionally taxing proposition to entrust the care of loved ones, be they children or adults, to other people. Just knowing that you will experience strong emotions when you must make a change in your elderly loved one's living and care situation helps to prepare you and your family for the transition, but finding ways to process and deal with those emotions is very important at this time. Talking, either with a friend who has been through this situation or at a support group is one way to work through these emotions. Another option is to speak with a counselor or a member of the clergy as part of the transition. Keeping a journal can also be a powerful way to sort out and internalize painful and conflicting emotions.

  1. Use your care team as a support and resource.

  2. Honor your loved one's choice as much as possible.Balancing your loved one's expectations with practical reality is a challenging proposition. Identifying your loved one's expectations is the first step in attempting to strike this important balance. Your elderly loved one may feel that his or her choices are being restricted as his or her needs for care increase, and this may be true to some extent. That said, it is important to honor your elderly loved one's prerogative and choice to every extent possible in deciding the most appropriate care and residential setting for him or her. The skills we in the Sandwich generation employ in developing decision-making abilities and independence in our children become important as we help our parents and grandparents strike the delicate balance between their wishes and practical reality. Sometimes we have to go against our children's expressed desires for their own good, and the same issues arises in eldercare decision making. Involving your elderly loved one to every extent possible in the decisions that affect him or her, consulting objective resources in making decisions, and communicating honestly and openly with your elderly loved one and all family members are the best ways of making sound decisions that reflect as much input from your elderly loved one as possible...

  3. Make the transition to assisted living or a skilled nursing facility as slowly as possible. Consider respite care programs that enable your loved one to stay at home as long as possible - chances are that is what he or she wants.

    But don't alternate between facility or home care for your loved one. This does not allow for structure or an opportunity for him or her to feel comfortable in one place. Your elderly loved one might find it confusing or disorienting to be frequently transported back and forth between part-time residences.

  4. Address your loved one's fear of isolation. Another concern that your loved one may have is fear of isolation from family and friends if he or she were to move to an assisted living or skilled nursing facility. The reality of moving your elderly loved one to facility is that he or she may become even more socially active than he or she would have been if continuing to live alone.

  5. Be aware of the health of your healthy parent if one parent is ill and the other is not. Make sure you provide respite for your healthy parent so the stress of caregiving does not burden him or her and affect his or her health negatively. When a parent's health declines it shakes the foundation of a family and may change the daily routines and way of live forever. The health parent will have to begin taking on more household responsibilities, and this may be emotionally draining as well as take a physical toll on the healthy parent. Both parents may start to feel powerless about the situation. This sense of vulnerability may lead to depression, feelings of anger, and moodiness in both the healthy and the sick parent.

  6. Stay in touch. One of the most important issues families face during these transitions is finding ways to stay in touch with the person who is moving to another location and level of care. If you cannot visit your elderly loved one as much as you would like to, providing him or her with a cellular phone and/or a landline in his or her new living quarters is a good way to keep in touch. There are many devices and accessories that can help elderly people make full use of the telephone to communicate with family and friends. These include enlarged keypads for both cellular and landline phones, some of which allow a picture of an individual to be placed under a particular key and will dial that person's number when pushed.

  7. Plan family and community events. Making arrangements to take him or her out to community or family events is beneficial for you and your loved one. You may find that you have more opportunities to spend quality time with your loved one once you transition him or her into the assisted living or skilled nursing facility because you are no longer singlehandedly overseeing his or her care on a daily basis...

  8. Involve family members and friends who live in another location or are unable to help in person on a regular basis. If a family member resides in another location and is unable to help in person or on a regular basis, he or she may be able to assist with online tasks such as bill payment, grocery shopping, and prescription refills. Encourage them to check in regularly with your loved one by calling him or her or sending a note or package.