Sandwiched Couples: The dual burden of caring for parents and children

Work-family conflict is not a new concept. Many couples both have to work to make ends meet and balancing careers with families can be a challenge.

Today, the ageing populations of many countries raises a new problem — the need to care for elderly parents, on top of caring for one’s young children. This dual burden of care, alongside duties at work, can cause physical and mental strain, affecting an individual's well-being. Dr Tan Poh Lin, an Assistant Professor at the Lee Kuan Yew School of Public Policy, conducted a study on these “sandwiched couples” in the East Asian societies of China, Japan, Korea and Taiwan.

Putting the squeeze on families

Longer life expectancies mean that the number of persons aged 60 and above is set to increase drastically over the next few decades, from 962 million in 2017, to a projected 2.1 billion in 2050. Coupled with increasing costs of healthcare, ensuring financial stability for old age is becoming more of a challenge.

At the same time, family sizes are decreasing due to lower birth rates, increased labour participation amongst women and changes in value systems amongst the younger generations. There are fewer children (and resources) to ensure elderly parents’ well-being in their later years.

Adult children are less able to offer financial and physical assistance to their parents because they are already devoting their time and resources to caring for the next generation. Activities like washing, cleaning, feeding and supervising are time and energy intensive. Having to physically care for both children and parents can be extremely draining for sandwiched couples.

It has been traditional in East Asian countries for adult children to depend on their parents for income and housing. So caring for parents could have been motivated by economic need. Now, supporting one’s parents has become more of an act of conscience.

But many Asian households still emphasise filial piety (respect for one's parents and elders) and providing physical and financial help to one's parents is usually expected. In some societies, there is even a significant social stigma against not providing for one’s parents. In Singapore, even though filial piety has huge cultural significance, its practice is actually influenced by perceived social stigma and prevalence amongst peers. In other words, co-residence occurs to avoid being judged for not supporting one’s parents.

Levels of economic development within a country can also influence whether families co-reside or not. In rural China, declining fertility and increased migration from the countryside to big cities has led to a decrease in inter-generational co-residence rates. However, in urbanised areas, housing shortages and a lack of childcare options has led to more households with multiple generations.

Women and men

In all the countries studied, both men and women reported higher marriage satisfaction than life satisfaction, most likely due to the comfortable and intimate nature of marriage, compared to the complex relationships outside of the home. A common trend was that married women reported higher life satisfaction than men, due to closer associations between marital and life satisfaction, especially amongst non-working women.

The study also found that living with children reduced men’s life satisfaction and women’s marital satisfaction. Moreover, being sandwiched - living with both elderly parents and children -  had a negative impact on only women’s marital satisfaction. This points to the effects of gender inequality in Asia — where women are expected to perform the caregiver role. Although women’s participation in the labour force has increased, over the past few decades, working women are still expected to shoulder the burden of caring for the household.

This makes motherhood and taking care of elderly parents that much more demanding.



Couples under stress

Dr Tan points to a US study that suggests the stress and cognitive demands on sandwiched caregivers result in increased careless behaviours that can affect their health. These include failing to wear seatbelts, exercise regularly, or eat healthily.

In Hong Kong, sandwiched couples who can't manage to share duties between themselves often resort to engaging a domestic helper. This is also prevalent in Singapore, where monthly domestic helper levies total as much as USD 220 dollars a month in addition to the helper’s basic salary. While this may seem low by some countries' standards, it can present a heavy financial burden to Singaporean couples.

The age of the couple also affects how well they can care for their parents. For example, couples in their 30s are more likely to have healthy parents who are still active in the labour force. But their own children are likely to be young and require a lot of care. Couples in this age group are less likely to give financial and physical assistance to their parents, compared to other age groups. Some of these couples may even still be receiving support from their parents.
But couples in their late 40s — except those who had children later in life — can better focus on caring for their elderly parents. Their own children are no longer as young and as much of a physical and financial burden. This age group also tends to give more help than they receive, although this gap narrows for those in their 50s.

Co-Residing: Killing two birds with one stone

Dr Tan believes that co-residing can actually be a good thing. She tells Global-is-Asian that evidence suggests grandparents can be a wonderful source of childcare, instead of a burden. This is especially so if the couples and parents are still relatively young, as the latter may not need as much physical or financial help. Increasing affluence also means a better standard of life and better medical care. It is not uncommon to see senior citizens keeping healthy and fit well into their 60s and 70s.

In Japan, studies have shown that couples who live with or near their parents usually have higher intentions of having children and higher rates of female labour participation. Co-residence can also provide psychological benefits, as parents can be a source of emotional support to their children, especially those struggling to maintain a work-life balance.

Although Dr Tan’s study focuses on East Asian countries, the idea of co-residence can be applied to other cities in Asia as well, especially developed ones.

In Singapore, hiring a domestic helper or putting one’s children in childcare can be costly or unreliable. Living with parents who can help with childcare can result in significant social savings.

On how the study's findings could impact policymaking in Singapore, Dr Tan says the government could kill two birds with one stone by enhancing incentives for couples to co-reside or live near to their elderly parents. Not only does it address some of the issues surrounding an ageing population — like loneliness — but it could also boost current birth rates if childcare is less of a burden on younger Singaporeans.

In the case of Singapore, “all we have is urban high-rise housing,” says Dr Tan. There are already proximity housing grants for couples who wish to live closer to their parents, but there is little else to encourage grandparents to play the role of caregivers.

What can be done to bridge the gap? Current grandparent caregiving tax reliefs do not provide a large enough difference to act as an incentive. Childcare costs and domestic helper levies can be a huge burden on families struggling to take care of their children whilst working at the same time. As Dr Tan says, a more flexible version of current child care subsidies to allow for home-based care could be a possible partial solution.

An ageing population and declining fertility rate are often viewed as two separate policy problems, but as Dr Tan points out, it makes sense to deal with them together. According to Dr Tan’s study, a significant proportion of the elderly still prefer family members as their primary pillar of support. By encouraging co-residing and family-based care, governments could help to ensure that their older citizens are better supported, and perhaps that children are better cared for, while hopefully easing the pressure on the sandwiched generation.

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