I’m part of the triple-decker sandwich generation. You probably are as well
You’ve heard of caregivers in the sandwich generation. In this anti-compassion Trump 2.0 era, it’s more like a triple-decker sandwich. Alissa Quart has experienced this first-hand
It was a crisp autumn day, but I had been trapped inside for hours, breathing the cold air of one of Memorial Sloan Kettering’s cancer centers with my mom. We were waiting for her latest infusion to finish dripping.
Time in hospitals moves differently – minutes stretch and lose their meaning. Meanwhile, my daughter kept calling. Would I be able to go to her school volleyball game? After a few calls, I had to break it to her: the answer was no.
A few minutes later, I checked my phone in search of a distraction. That’s when I saw the news: the national guard had landed in another city. It was the latest in a string of grim headlines, including sweeping federal plans to gut Medicaid and even Medicare, the latter of which my mother relied on. The so-called One Big Beautiful Bill Act aimed to strip $1tn from healthcare over the coming decade.
I sighed and resigned myself to only worry about what I could control for the next few hours, which might be the fifth-floor machine where I pressed buttons and made milky coffees for my mom, or staring again out the window at an antiseptic midtown Manhattan view.
You have probably heard the phrase “sandwich generation” – a term coined in the 1980s to describe people in their 40s to 60s caring for ageing parents while raising children. A growing number of gen-Xers and millennials are now joining in – but in the Donald Trump 2.0 era, it feels more like a triple-decker sandwich generation. Childcare, eldercare and a new layer of bread are baked out of our current economic and political crises.
Each slice adds pressure, and there are more of us than ever feeling it. The number of family caregivers has jumped to 63 million Americans – a 45% increase, or nearly 20 million more caregivers – in the past decade. Meanwhile, among caregivers under 50, 47% are caring for both a parent and a child.
I have been living my own triple-decker year. My mom’s cancer treatments tend to go on for five to six hours, with lengthy waits between blood draws, infusions and doctor visits. Each appointment carried its own prophecy about her future, sketching the outline of her dark diagnosis. Her results, and her mood, were always a sharp question mark.
“No one teaches us how to live or how to die,” my mother said that day in the waiting room, quoting a version of an epigraph of the late author Lore Segal: “Nobody knows how to live; nobody knows how to die. But we all figure it out, don’t we?” I took these words to heart: I did not fully know how to be a daughter and a mother at that moment. As an only child (thanks, 1970s!), this was part of my lot. I also did not know how to respond to the political events unfolding outside the hospital walls.
After a full day at the clinic, I rushed home to my daughter to make her a supposedly healthy dinner, one that she would actually eat, usually involving broccoli. I was caught in an intergenerational squeeze, but I also experienced it as a kind of time-space continuum – as if I had entered a zone where the most crucial stages of life occurred simultaneously.
Over the seven months since my mother’s diagnosis, I began to see the same strain on others. I could always figure out who they were, in every room. Friends, acquaintances, strangers – they shared a look: frayed, furrowed, moving from one appointment to the next, on the run, speaking quickly, And, surprise (not): we were mostly women.
I know dozens of us, but we are millions.
In 2025, a new layer of wariness settled in. Given the anti-care ethos of our political culture, with compassion looked down upon by the most powerful, caring for others can make a person feel like a patsy.
Julie Gayer Kris is one of the new sandwich generationites. A social worker who specializes in elders and their caregivers, she is caught between her mom who is 81 and just broke her ankle, her stepfather with Alzheimer’s, and her 14-year-old son. She now leads therapy groups for family carers.
The added pressure of Trump 2.0, says Kris, “creates another layer of hopelessness and stress. For my kid, I think, ‘It’s going to be a sucky world.’”
In the two groups for carers she leads, Kris hears constant frustrations: “The systems are terrible. It’s so hard to get the right care – and to get approved for it.” She does not sugarcoat it. “It’s a multi-layered sandwich of shit,” she says. “And in my private practice, I see more anxiety, too, even from people with means. All the therapists could tell you that.”
Of course, caregiving has never been easy. But we are now facing cascading crises, many of them directly threatening older people or those who soon will be. The stock market may crash, AI is coming for our jobs and our retirements could be going up in smoke. The recent defunding of medical research just cannot be good for a physically vulnerable population, either.
My colleague and friend Celina Su, a political science professor at Brooklyn College, spent much of 2025 caring for her dying father and six-year-old daughter while weathering Trump-era cuts to academic funding. When her father fell gravely ill with a rare neurological disease, she struggled to secure adequate care, going so far as to create a QR-coded medical history to force doctors to pay attention.
One morning, without childcare, she brought her daughter to the hospital in Queens, only to find children barred from entry. On her father’s final day, Su got special permission for them to see each other and pressed their hands – small and large – into clay as a keepsake.
As her father slipped away, Su faced another blow: two research grants had been revoked under the new federal crackdown on academic studies that are diversity-based and even equality-based.
This is what the squeeze looks like. Caregivers themselves do not have the time or means, especially if they are paying for childcare and are still scrambling to work overtime to pay off medical and outstanding student loans, or simply their rent or mortgages. We are being pressed from all sides – elaborate paninis of obligation and guilt. If it were a game, it would be a dark one, maybe called: which family member will I disappoint today?
I am my mother’s main caregiver for assessing her medical care and her appointments. Still, I am also one of the lucky ones.
I co-created a labor-conscious non-profit that has allowed me to take as much paid family leave as I could, in New York state, where such leave is provided. This is not true for those in other states or for jobs within the gig work economy: access to paid leave benefits is far more common for salaried workers than for hourly-wage workers. I also have a spouse, who could look after my daughter when I was with my mother, which makes things considerably easier.
As for my mom, she was also relatively lucky, as she had procured long-term care insurance in the 1980s, a benefit akin to a dodo bird. She’s only sometimes hired nurse’s aides for her treatment visits, but she can do that, of course, because she can afford to: a lifetime of savings and a solid pension pay for the extra help. (Being gen X, most of us tend to shrug and say “whatever” in the face of the comparatively meager social support we have to look forward to.)
Demographic and economic shifts go part of the way to explaining the sizeable number of sandwich generationers today. The elderly parents live longer and have more complicated health issues (my mother, for instance, is 90). More of us have children later (I was 38 when I had my daughter). Eldercare is eye-wateringly expensive, and childcare costs in New York City went up 79% between 2019 and 2024.
The supply of caregivers has also winnowed. Many caregivers are immigrants with precarious legal status – and with Immigration and Customs Enforcement (ICE) agents showing up at preschools and daycares, it’s hard not to imagine nursing homes next.
Dessy Acevedo, 55, a former court clerk and preschool teacher from Middletown, New York, became a full-time caregiver when both her parents developed Alzheimer’s and dementia. While her children are young adults, they are very much in her life as well. “It’s so difficult, doing it on my own,” she says. “The medical system doesn’t care. The doctors say: ‘See you in six months’ and have no investment.”
She worries about what is next, especially since her father is on Medicaid. “With so much uncertainty in the political climate, I worry about whether my father will be able to maintain the Medicaid support he is rightfully eligible for moving forward.” Acevedo is one of many facing economic instability tied to the ongoing dismantling of a program that millions of low-income, working-class, and even middle-class elders depend on. Constant shifts in requirements, deadlines and paperwork only deepen the uncertainty.
One way to understand this particular medical insecurity is through the late sociologist Ulrich Beck’s theory of individualization of risk. Health risks, under this very American framework, are cast as every single person’s responsibility, as opposed to an understanding of health- and eldercare as at least partly a public good.
In the US in particular, each of us create our own mini “care economy” against the backdrop of an anti-compassion presidency – one that promotes a so-called pronatalist agenda while cutting access to food and vaccines for families.
“There’s a savagery to our society now,” says Danilyn Rutherford, an anthropologist in California who studies kinship, care and disability. She’s also the parent of a disabled young adult, the subject of her recent monograph Beautiful Mystery: Living in a Wordless World.
Rutherford already sees a future where there are restrictions on caregivers receiving overtime, referring to the administration’s proposed shift in labor rules that will remove overtime protections from homecare workers, where there’s a cap on the number of hours that some caregivers can be paid at all.
“It might seem like a technicality,” she said, “but if you get paid to take care of a disabled child who needs 24/7 coverage, say, or your mother plus some other clients in your community, this means our government will not be paying you at all for a lot of the time you spend doing this work.”
Rutherford’s child’s professional in-home caregiver, Julie Croghan, 49, is one of them. She lives in Santa Cruz, California, is a passionate Catholic, a mom to 12 children and the daughter of elderly parents. She describes herself as “not a Democrat”. Nevertheless, she’s “absolutely disgusted by the Republican party and the administration” for how they are “hurting disabled children”. including one of her own sons, who is severely disabled. “If you take $1tn out of Medicaid, it’s going to be really ugly,” says Croghan.
Meanwhile, her parents are getting older, and her mother is in need of help. Her mother “very much wanted me to become her caregiver”, Croghan says, but she felt the need to continue working to earn enough to send her kids to university and to help cover her family’s rent of $4,000 a month.
“What’s going to happen if I don’t? I don’t have retirement saved – I am working on that right now. I am pumping it so hard, with three kids in college right now and a disabled kid.”
Croghan also notes that the entire staff of the Office of Special Education and Rehabilitative Services was cut this month, except for a few top officials. The office has been crucial for children with disabilities and their families.
“I don’t even believe all of the programs I am signing my son up for will exist in three years,” says Croghan. “I may not have a job in three years.”
Brigid Schulte, the director of New America’s Better Life Lab, notes that care workers earn so little (“less than parking lot attendants”) that many qualify for public benefits. Without Snap and Medicaid, she says, “you’re seeing childcare workers leave and childcare centers close. I can only imagine what the loss of Medicaid will do to home care and home care workers.”
It’s been eight months since my mom’s diagnosis. Her health has stabilized, thanks to her doctors, her resilience and, yes, my care – but she is still living under a sword of Damocles.
As for me, I will not soon forget my intense caregiving days. They were sometimes surreal in their tragedy: there was that one day when a woman in a Wonder Woman costume with a giant unicorn stuffy attached to her told me and my mother about her cancer – it wasn’t clear if she was a performer, an ad hoc candy striper, an eccentric, or all three. There was the excitement nurses had when my mother’s paintings made her an unlikely minor celebrity or the doctor noticed my mom’s canary yellow scarf.
After the subway ride home to my daughter and husband, after dinner, reading school papers and bedtime, I would routinely go back to the news and the broader picture: the doubt about our political future, the AI slop that filled my feed and every Google search, the doltish bots.
I also returned to the sensation that in this anti-compassion time, caregiving itself feels like a losers’ game.
It is a dark irony that the pandemic often felt like a better era for giving care. That was when the federal government spent $5tn to help families survive and we often experienced financial wellbeing and a rare sense of security.
You might say there is an even longer history to this social cruelty, this anti-compassion. As Barbara Ehrenreich wrote in 2011, once “the word insecurity most commonly referred to a psychological condition”, but the Reagan and Clinton eras ushered in a “growing mean-spiritedness toward the unlucky, the underpaid and the unwanted”. America went from “intrepid to insecure”.
The non-wealthy elderly were and are, of course, targets of this mean-spiritedness. But now their middle-aged children are being demeaned as well.
What we need, of course, is paid sick leave and family leave laws. For our own sanity as well as for our futures, we have to remember all of these “sandwiches” are not experienced by us alone but collectively – and also, for each of us, with an eye to both our futures and our pasts. One day, it will be our turn to need such compassion.
