Self-care for the Sandwich Generation

Self-care for the Sandwich Generation

The financial challenges of those in the current “sandwich generation” (generally those in the GenX generation), can derail retirement plans and the emotional fallout of being stretched so thin also takes a toll. When you’re in the middle, self-care can help you manage all the demands.

Journalist Carol Abaya, who has studied aging and care giving, even went a step beyond the term sandwich generation. With a nod to the complex and complicated situations in so many families, she coined some new phrases for this kind of caregiving.

  • Traditional: those sandwiched between aging parents who need care and/or help and their own children.
  • Club Sandwich: those in their 50s or 60s, sandwiched between aging parents, adult children and grandchildren. OR those in their 30s and 40s, with young children, aging parents and grandparents.
  • Open Faced: anyone else involved in elder care.

No matter where you fit, you are going to feel some additional stress in trying to take care of the needs of so many people. Here are some tips to help.

Talk to Others

You aren’t the only person going through what you are going through. Other people who are also juggling so many things will have some tips that will help you navigate these sometimes confusing paths. Whether it is a friend, a coworker, a faith leader, or a professional, talking with others and sharing experiences helps.

Get Help

Getting help doesn’t always mean paying for help. Look for assistance by asking what’s possible. If they are old enough, get your kids to help with tidying up your parents’ home. Enlist coordinators to help set up driving help—those can come from senior centers, volunteer organizations, or even the medical community. If you can afford help, paying for someone to do yard work or clean the house can be a huge time saver, as can grocery delivery services.

Try to Care for Yourself

In the middle of so much caregiving, any time for you seems impossible. And sometimes, it will be impossible to take care of your own needs when so many others are depending on you. But if your tank runs dry, there’s nothing left for the people you need to help or for the career you love or for the relationships you want to nurture. Because burnout is damaging and pervasive, it’s important to recognize when you need a break and what that means for you. A break can encompass a whole range of experiences—figure out what will bring you relief. Even the smallest break can offer huge benefits in recharging your outlook,

The Usual Suspects

It is repeated so often because it’s important. The trifecta of nutrition, sleep, and exercise keeps you on an even keel. Look at your pillars on a weekly basis so you don’t feel like each day has to be perfect. Overall, try to fit in some more movement, more sleep, and nutritious food that gives you energy. Being aware is half the battle and the small efforts add up.

Being in the sandwich generation means you are taking care of the needs of many people all while trying to juggle your own family and work life. It’s not easy, but taking care of yourself is an essential part of managing this time successfully.

Challenges of the New Sandwich Generation

Challenges of the New Sandwich Generation

Are you part of today’s “sandwich generation?” If you are in Generation X (born between 1965 and 1979) you very likely are. And if you are, a recent study notes that you might want to pay extra attention to your retirement planning.

A recent study by the Employee Benefit Research Institute, found that Generation X-headed families are more behind on their retirement than previous generations were at the same life juncture.

Each generation goes through the time in their lives when they are likely caring for parents while also caring for children at home, often paying for college expenses, and working at the same time. All of this happens right when retirement planning becomes more urgent. The squeeze from all sides, hence the “sandwich” name, creates all kinds of pressure and stress.

And while many in the sandwich generation don’t bemoan caring for those they love, the emotional, physical, and financial struggles that come with it are very real. Some families have three generations (or more) under one roof and others are trying to balance parents who live nearby with kids at home. Either way, there is a lot of running around and reshuffling priorities depending on health, living situations, and financial needs.

Some of the biggest findings showed that the best off GenX families showed remarkably little discrepancy with prior generations. But those who were at the biggest financial disadvantage had such a drastic reduction that it influenced the study results overall.

These are findings that are worth noting for many in GenX. Although GenX sandwich generation families might have some retirement accounts in place, there are other important factors that are missing. For instance, the study found, “Generation X families in 2016 were more likely to have an individual account (IA) retirement plan than families of Millennial and Baby Boomer generations, but they were less likely than the Baby Boomer families to own a home or have any type of retirement plan.”

That means they are losing money to rent instead of investing in a home that would give them equity and hopefully additional funds upon selling the home. But the market crash of 2008 threw many in GenX into a financial turmoil, giving them less job stability and income. Without either of those, a down payment and loan approval for a home were out of reach.

And while many in the new sandwich generation in GenX are on track for retirement, the unexpected financial challenges of caring for parents and kids can take a big chunk out of retirement savings. Parents may require extra funds for health challenges, home repairs, and living expenses, particularly if they did not have enough put aside. And as children go to college, tuition expenses can be more than what was planned for.

What can families do? Even in an emergency, it’s important to remember that retirement can’t be put off. You will reach retirement age no matter what and being financially prepared is a gift to you and to your children who will not have to support you. Your savings make take a hit or drop off as you help your loved ones financially, but keeping your eye on the goal of growing your retirement will help.

The Role of Cultural Sensitivity in Building Patient Relationships

The Role of Cultural Sensitivity in Building Patient Relationships

Culture is everywhere—and it defines almost every aspect of our lives in one way or another. That can be true across a variety of dynamics, including how someone functions within a family, relates to others, or responds to stress. Nurses encounter patients and families with myriad cultural influences every day. That’s why understanding and practicing cultural sensitivity is so important for building relationships and providing excellence in patient care.

The Importance of Building Relationships

In any setting, trusting relationships are important. However, some patients may hesitate to trust health care providers because of several factors—such as a history of discrimination, disparity in representations of diverse people as care providers, and lack of recognition of the particular challenges that some patients face.

According to a report from the American Psychological Association (APA), individuals with low incomes or those from racial or ethnic minority groups are more likely to experience severe stress than others, a dynamic that can lead to poorer mental and physical health outcomes. Unfortunately, such individuals may be less likely to pursue medical care because of financial concerns or fear of discrimination from a provider. However, if clinicians learn to build trusting relationships, then those who need care may feel more comfortable in accessing it.

The Role of Cultural Sensitivity

Previously referred to as “cultural competency,” cultural sensitivity requires that nurses possess the needed skills to affirm diversity and embrace the values of people from different social or cultural backgrounds. Practicing cultural sensitivity is essential to building relationships, since it helps nurses step outside of their own perspectives to better understand the unique needs of the patients and families for whom they provide care.

The shift in language from “competency” to “sensitivity” underscores the role of culture across an individual’s life and care continuum, and the need for clinicians to recognize the importance of this dynamic. Thus, when nurses become educated about different cultures, they are better equipped for building relationships with patients and families, which can help to improve outcomes of care.

Strategies for Building Trust

In addition to learning about different cultures, nurses can make use of empowering strategies to help patients and families feel understood and accepted; such strategies are included in The National Education Association’s Diversity Toolkit:

  • Use inclusive language in written and verbal discussions.
  • Ask each client for their preferred pronouns, even when you feel sure of their gender.
  • Take time to learn proper pronunciation of each person’s name.
  • Ask for permission before touching or hugging each person.
  • Learn cultural customs for any community or group with whom you are working closely.
  • Encourage patients to have a family member accompany them if privacy is needed.
  • Offer to translate information or rewrite it in more understandable terms if someone is having difficulty reading or understanding complex medical information.
  • Know the cultural or diversity-related resources in your community.

To learn more about the role of cultural sensitivity in building relationships, see “How To Be Culturally Sensitive Working with Clients with a Range of Identities.”

The Indian Nurses Association of Illinois: Taking Matters to Heart

The Indian Nurses Association of Illinois: Taking Matters to Heart

Quite often a nurse will ask me how to become engaged in the health policy arena. I frequently advise nurses to get involved with their professional organizations as a start. Many nursing organizations have an advocacy and legislative agenda and are oftentimes engaged in advocating on behalf of patients and the profession. Here, we share a conversation with Aney Abraham, DNP, RN, NE-BC, who is a founding member and current president of the Indian Nurses Association of Illinois (INAI). Abraham discusses the origins of her organization and current issues they are addressing.

With regard to legislative issues, Abraham highlights a piece of legislation that was introduced during the 115th Congressional Session. The proposed legislation “H.R. 3592 South Asian Heart Health Awareness and Research Act of 2017” aims to address the high rate of cardiovascular disease in the South Asian community. And while the proposed legislation did not gain much traction during the 115th Congressional Session, the INAI is hopeful that the original sponsors of the proposed legislation will reintroduce it and continue to seek funding to support research focused on finding solutions to the high rate of cardiovascular disease in this population. This targeted approach to improving the health and well-being of this population takes into consideration cultural factors that may influence health status and calls for early intervention and treatment through education and awareness.

As president of the Indian Nurses Association of Illinois (INAI), can you share with me a bit about the INAI, its origins, its mission, and membership?

Aney AbrahamThe Indian Nurses Association of Illinois was established in 2002. I was a nurse with about 18 years of experience at this time and among one of the few nurses that thought of this idea of forming a professional organization for nurses of Indian origin. There were many reasons for starting this organization. The first and foremost was that Indian nurses who immigrated to the U.S. faced many challenges as they transitioned in the United States.

At a Glance:
South Asians and Heart Disease

  • South Asians are one of the fastest growing ethnic groups in the United States.
  • Family origins mostly from: Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka.
  • High cardiovascular prevalence not readily known due to lack of data.
  • Research examining heart disease in Asians in general lacks subgroup analyses.
  • Possible contributing factors include early onset of diabetes, cholesterol abnormalities, westernized diets, and lifestyle.

Source: American Heart Association

For a more detailed discussion of heart disease in South Asian populations, please see the American Heart Association’s Scientific Statement.

Foreign nurses become minorities overnight having little or no orientation to the country or health care facility that they worked for. We realized that many nurses were eagerly anticipating the birth of this organization and thus successfully established the organization in 2002.

The mission of INAI is to identify and meet the professional, cultural, and social needs of nurses of Indian origin. In addition to our mission, our purpose is to ensure that we provide representation and interact with other professional organizations as well as promote cultural awareness by communicating the uniqueness and diversity of the Indian culture.

What do you believe are the top nursing issues impacting our profession today?

Job safety is important to all professions; nurses are not exempt from working in unsafe environments. One of the top nursing issues impacting our profession is workplace violence. Every day, our nurses are impacted by violence perpetrated by patients, their family members, and visitors. Incidents that may start small can spiral out of control within minutes. Even though nurses are very familiar with incidents of violence, research seems to suggest that workplace violence is increasing. We certainly hear about these incidents through TV, print media, and reports from nurses.

The second issue that is impacting our nurses is stress and burnout. Nurses are on the front lines providing direct nursing care, advocating for patients’ medical needs, comforting patients/families, and working with a multidisciplinary team to ensure that patients receive safe high-quality patient care. Stress and busyness can easily escalate with the demands that are placed on nurses daily.

As nurse leaders and professional organizations, we need to work on finding ways to address awareness and ways to mitigate these issues that are facing our profession.

What are some of the top policy or regulatory issues impacting the Indian nursing community?

One of the issues impacting nurses of Indian origin is abusive employment practices. To address this, in 2008 the ANA released the Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States. The code addresses minimum fair labor standards, civil rights, age discrimination, equal pay, and family/medical leave.

Another issue impacting Indian nurses (majority of which are of South Asian descent) is that they suffer from heart disease, high blood pressure, and diabetes too frequently and too early in life. Compared to other ethnic groups, South Asians are four times more likely to have heart disease, experience heart attacks 10 years earlier in average, and have a 50% higher mortality rate from heart disease. To address this, in 2017 Rep. Pramila Jayapal (D-WA-7) proposed H.R. 3592 “South Asian Heart Health Awareness and Research Act of 2017.” This is a very specific piece of legislation targeting Asian Americans.

What is the overall purpose of this legislation, and why is it important to you as a nursing organization and to the Asian community at large?

Representatives Pramila Jaypal and Joe Wilson co-sponsored this bill to raise awareness of the alarming rate at which the South Asian community is developing heart disease.

The overall purposes of this legislation are to:1) promote heart healthy eating among Asians; 2) conduct research to understand why South Asians are at an increased risk for developing heart disease and; 3) develop educational tools about heart disease for South Asians.

This legislation is important to us as a nursing organization and to the Asian community at large. The members of the Indian Nurses Association spend a tremendous amount of time offering free community services in the Indian community. Our advanced practice nurses spend time on the weekends visiting the various churches conducting health fairs, offering lectures, and educating the community on the dangers of heart disease and diabetes. Legislation that supports research will enhance our ability to learn more about the root causes of the high risk for the Asian community and prepare us to share lifesaving information with the community at large.

Are there any updates on this given this did not pass out of committee?

We will continue to monitor where this is going as the original sponsors are committed to raising awareness and supporting research in this area.

What are some of the ways that your organization has engaged in community education regarding Asian American cardiovascular disease?

Every year we host a minimum of three community health fairs and lectures in the Indian community. Our members, many of which are advanced practice nurses, have the skills, expertise, and knowledge to effectively lead these health fairs. In addition to the health fairs, we offer free BLS and ACLS certification.

How does INAI prepare its members to be influential advocates in the policymaking arena?

INAI invites public officials and elected officials to speak at our meetings and conferences. For example, some of our guests in the past have included, at that time, Senator Barak Obama before he went on to become President of the United States and Dr. Ann Kalayil, Bureau Chief, Cook County Bureau of Asset Management. Dr. Kalyil was the former President of the South Asian American Policy and Research Institute.

Additionally, members stay informed through educational seminars and educational offerings posted on social media outlets such as Twitter and Facebook. We also stay abreast of issues by following the legislative agenda of the American Nurses Association.

Are there other policy issues that are a part of your health policy agenda?

Many of our members are advanced practice nurses. Thus, we support the policy agenda of the National Association of Clinical Nurse Specialists (NACNS). Their priorities—including nursing workforce issues, health care reform, and health information technology—resonate with our legislative priorities.

The Indian Nurses Association is an organization of about 200 members. We can be more impactful when we combine our voices with other nursing organizations to enhance our policy advocacy on behalf of patients and the profession.

If you had to offer advice on why nurses should be engaged in advocacy and policy advocacy on behalf of patients and the profession, what would you say?

Nurses instinctively advocate for their patients. Equally important is for nurses to engage in legislative and political advocacy. This is needed to advance the profession and patient care. It is important for the voice of the nurse to be heard when any new legislation or bill is being introduced. An example of a recent bill is SB2151, a bill sponsored by Senator Hastings. This bill is about the Nurse Practice Act language surrounding delegation. Specifically, nurse delegation in community-based settings is of concern. Nursing has to provide the definition of what nursing practice entails, how nursing interventions and tasks can be delegated, and in what care settings the delegation can occur.

Nurses can stay informed on legislation that impacts their practice and profession by following nursing forums like @ANAnurses [and] @RN Action.

To stay engaged or not engaged in policy advocacy is a decision each nursing professional has to make, and he or she must always err on the side of staying actively engaged on behalf of the patients and those they serve.

4 Top Minority Men’s Health Challenges

4 Top Minority Men’s Health Challenges

As Men’s Health Month closes out, it’s worth noting the disparities that exist among men of different racial and ethnic backgrounds. Although some health advice like eating well, getting enough sleep, maintaining a healthy weight, managing stress, and exercising are across-the-board good measures, men experience distinct health challenges they should be aware of. And among minority men, there are even more serious health challenges as well.

Here are four men’s health problems that minority men might want to pay extra attention to. Knowing what health issues they are more prone to, being aware of early detection, and having a plan to help mitigate these health threats can reap huge payoffs.

Heart Disease

Many factors influence heart disease, and racial and ethnic minority men tend to experience this condition at higher rates than whites, according to the American Heart Association. Trying to track and control blood pressure, cholesterol, and other lipid levels like triglycerides will help. It’s always a good idea to remind anyone, male or female, that high blood pressure and high cholesterol don’t always come with symptoms, but are especially problematic.

Prostate Cancer

Prostate cancer is one of the top men’s health issues. Black men receive a disproportionate number of new prostate cancer diagnoses. According to the Centers for Disease Control and Prevention, black men experience 160.5 new cases (per 100,000 men) of prostate cancer for every 91.9 new cases for white men. Hispanic men experience a slightly lower rate than both groups at 79.5, but the risk for all men increases with age. Regular checks can help with early detection.

Diabetes

The American Diabetes Association states that while minorities deal with diabetes at higher rates, they also are more likely to suffer complications from the disease. Getting tested is essential to keep track of blood sugar numbers. If someone has diabetes, keeping on top of treatment is key to lessening the chances of complications. Like heart disease, diabetes can have life-altering and life-threatening complications if left untreated.

Mental Health

Cultural taboos around mental health issues can actually contribute to the problem. If men are uncomfortable or feel ashamed about their mental health struggles, they won’t seek treatment. A report by the American Psychological Association noted that of men reporting depression symptoms lasting longer than a year, black men are in a much higher bracket. In that category, 56 percent of black men vs. 38 percent of white men report those symptoms. The same report also states findings that show American Indian/Alaskan native men had the highest suicide rates of all ethnicities of men. This is a slow but steady struggle, but normalizing mental health to deal with it as the physical disease it is, and not a weakness, can help remoe the stigma. Many more minorities lack access to mental health care, so helping patients find care that is accessible might remove a barrier to getting help.

Minority men face specific men’s health struggles, and as a nurse just opening up the conversation around some of these topics can be a game changer.

What Are the Stressors in Your Patient Population?

What Are the Stressors in Your Patient Population?

A recently released survey by the Federal Reserve Board shows that many households reported similar or slightly more economic stability than in the previous year. But, the Report on the Economic Well-Being of U.S Households, doesn’t pretend everything is rosy.

Despite the overall positive results, which have continued to improve since the survey started in 2013, still shows some areas of concern. For instance, there are not widespread measures of improvement among all groups. The report found nearly 80 percent of white respondents reported that they were “doing OK financially,” but that only two-thirds of black and Hispanic respondents answered the same way.

It’s not a surprise that where people live also impacts their reported overall well being. Of the 11,000 respondents who answered the survey last October and November, only two-thirds of those living in low- and moderate-income neighborhoods were satisfied with where they live, compared with 8 in 10 in moderate- to upper-income neighborhoods. Those with at least a bachelor’s degree reported more stability than those with a high school diploma.

What does this mean for you as a nurse? It brings a different perspective into your practice depending on where you are located. As someone who works with the public every day, you know how the stressors of the environment can play out in the health of your patients. It’s worth digging a little deeper when you are able to find out the particular stressors of your area.

For instance, what are the pressures of a patient in a specific neighborhood? Some patients might report a lack of public or accessible transportation makes it difficult to get to appointments, buy groceries, or find a job. Other neighborhoods lack high-quality mental health care or they are in a food desert making it almost impossible to buy fresh groceries. Still other neighborhoods don’t feel safe for certain populations.

What can this Federal Reserve Report help you learn about your patient population? If you see many older patients, they may be struggling in retirement or they may feel forced to continue working to pay the bills. The report found that 25 percent of respondents who were not retired yet had nothing saved for retirement. Of those of retirement age 60+, 13 percent have nothing saved. Again, minorities reported being less prepared financially for retirement than white respondents.

The repercussions for the patients who are continuing to work to pay the bills can impact everything from their sleep schedules to what they can afford for food, medication, housing, and transportation. It can also have an impact socially and with their emotional health. If someone continues to work past retirement age because they have to, for instance, they may feel a resentment and exhaustion that is absent or not disruptive in someone who chooses to remain gainfully employed. On the other end of the generational spectrum is the younger population struggling to pay bills and launch an independent life because they are swamped with student debt. They may be raising a family and working more than one job to keep up.

All of the touch points in the report are good points for nurses to ponder. Knowing what your general population struggles with can help you ask the right questions to get to a deeper level of care. Some stressors aren’t as obvious (financial distress), aren’t acceptable to talk about in some cultures (gender identity), or may not be easy to bring up (domestic violence or mental health struggles).

As the top patient advocates, nurses can help bring issues to the forefront and can help patients get the kind of help they need to live the healthiest lives possible.

What are some of the top stressors your patient population faces?

You have Successfully Subscribed!