Mental Health, Caregiver Stress, and Anticipatory Grief in the Sandwich Generation

There is a moment in adulthood that few people feel prepared for.

It is not graduating from college.

It is not getting married.

It is not becoming a parent.

Instead, it is the moment you realize your parents may not always be able to care for themselves in the way they once did.

For example, you may help your dad access a patient portal because he cannot remember his password.

Perhaps you notice your mom repeating the same story several times during dinner.

You may also find yourself picking up medication for your child and your aging parent on the same afternoon.

Or, you may receive the phone call you have quietly feared for years.

For many older Millennials and Gen X adults, this stage of life arrives while they are already managing many responsibilities.

They may be:

• Raising children
• Building careers
• Maintaining relationships
• Managing finances
• Caring for their homes
• Supporting friendships
• Scheduling appointments
• Keeping up with school events

Meanwhile, their parents begin needing more help.

As a result, these adults often find themselves caught between two generations that both need their care.

Researchers commonly refer to this group as the sandwich generation.

And, understandably, this season can feel overwhelming.

What Is the Sandwich Generation?

The sandwich generation includes adults who care for aging parents while also supporting children, managing careers, maintaining relationships, and handling daily responsibilities.¹

Often, these adults are members of Generation X or older Millennials.

Families throughout Southeast Michigan and across the state experience this challenge every day.

For instance, you may be coordinating care for aging parents in Grand Blanc. At the same time, you may be driving between medical appointments in Birmingham. Meanwhile, you may also be raising children and managing a household in Oxford.

Because of these overlapping responsibilities, the emotional and physical effects can be significant.

Even so, many people feel that they should simply handle everything on their own.

However, caregiver stress and anticipatory grief are both common. More importantly, both deserve attention and support.

Anticipatory Grief: Grieving Before the Goodbye

One of the most difficult parts of caring for an aging parent is realizing that grief may begin before death.²

You may grieve:

• The parent who once had all the answers
• The loss of family traditions
• Their declining independence
• Changes in their memory or personality
• The gradual reversal of family roles
• A future that may no longer be possible

This experience is known as anticipatory grief. In other words, it is the grief that occurs before an expected loss.³

Anticipatory grief may bring sadness, anger, guilt, fear, exhaustion, and even relief.

Although these emotions can feel confusing, they are common responses to a painful and uncertain situation.

For example, you can miss someone who is still sitting across the table from you.

Likewise, you can love your parent deeply while also feeling frustrated by the demands of caregiving.

At the same time, you can feel grateful and overwhelmed.

Both feelings can be true.

The Hidden Mental Load of Caregiving

Caregiving is not only physical.

It is also emotional, logistical, and often invisible.

For example, caregiving may involve:

• Knowing which specialist to contact
• Tracking medications
• Researching assisted living options
• Coordinating care with siblings
• Completing insurance paperwork
• Checking in on your children
• Responding to work emails
• Remembering birthdays and appointments
• Supporting your partner after a difficult day

Individually, these tasks may seem manageable.

However, together, they can quickly become exhausting.

Research shows that family caregivers often experience more stress, anxiety, sleep problems, and symptoms of depression than people who are not caregivers.⁴

Even so, many caregivers continue telling themselves:

“Other people have it harder.”

“I should be able to handle this.”

“I do not have time to fall apart.”

However, admitting that caregiving is difficult does not mean you are ungrateful.

Instead, it means you are being honest about what this role requires.

Why Caregiver Guilt Is So Common

Guilt often becomes part of the caregiving experience.

For example, you may feel guilty because:

• You do not call often enough
• You become frustrated
• You live far away
• You want a break
• You disagree with your siblings
• You need to set boundaries
• You wonder whether you did enough

The truth is that no one handles caregiving perfectly.

There is no perfect script for helping a parent move into assisted living.

Likewise, there is no reward for saying every right thing during hospice care.

There is also no simple handbook for explaining dementia to your children while trying to understand it yourself.

Ultimately, there is simply love doing its best under difficult circumstances.

Parenting Children While Caring for Aging Parents

Many Gen X and Millennial adults are parenting children while also supporting aging parents.⁵

For example, one generation may need a ride to soccer practice.

Meanwhile, the other may need transportation to a medical appointment.

One child may need help with algebra.

At the same time, a parent may need help accessing an online bank account.

Both generations need support.

As a result, it can become easy to disappear from your own life.

Millions of Americans provide unpaid care to aging family members while also balancing work and family responsibilities.

Therefore, feeling stretched thin does not mean you are failing.

Instead, it may simply mean that you are carrying too much.

Signs of Caregiver Stress and Burnout

The emotional demands of caregiving can affect your mental health.

For instance, caregivers may experience:

• Anxiety
• Depression
• Chronic stress
• Sleep disruption
• Irritability
• Emotional exhaustion
• Social withdrawal
• Loss of interest in enjoyable activities

Over time, the effort required to support aging parents while maintaining a career, relationships, and parenting responsibilities may lead to caregiver burnout.

You may need additional support if you feel:

• Constantly exhausted
• Overwhelmed by daily responsibilities
• More emotionally reactive
• Disconnected from other people
• Unable to enjoy activities
• Unable to rest without feeling guilty

Unfortunately, there is no way to remove all the pain that can come with watching someone you love age.

However, there are ways to carry that pain more gently.

Let Other People Help

First, allow others to support you.

Accept the meal.

Say yes when someone offers to sit with your parent.

Ask a sibling to make a phone call.

Delegate tasks whenever possible.

Although asking for help may feel uncomfortable, you do not have to manage every responsibility alone.

Name What You Are Feeling

Next, try to identify your emotions.

You may feel:

• Grief
• Fear
• Anger
• Sadness
• Relief
• Love

Naming your emotions can make them feel less overwhelming.

In addition, it may reduce the shame that often surrounds difficult feelings.

Protect Your Own Health

Caregivers often place their own health at the bottom of the list.

However, your well-being matters too.

Therefore, try to:

• Attend your medical appointments
• Move your body regularly
• Sleep when possible
• Eat complete meals
• Take short breaks
• Make time for quiet

These actions may seem small.

Even so, they can help protect your physical and emotional health.

Stay Connected to Other People

Isolation can make caregiver stress feel worse.

For that reason, stay connected whenever possible.

You may benefit from:

• Calling a trusted friend
• Joining a caregiver support group
• Talking with a therapist
• Asking relatives for practical help
• Spending time with people who understand

Connection may not change the situation.

However, it can make the situation feel less lonely.

Let Go of Perfection

You will forget things.

You may lose patience.

You will probably second-guess some decisions.

Even so, you can only make choices based on the information you have at the time.

Therefore, you do not have to perform caregiving perfectly.

Sometimes, doing your best is enough.

River’s Bend Resources That May Help

You may also find these River’s Bend resources helpful:

• Mid-Year Mental Health Check: Signs It Is Time to Recenter
• Mid-Year Mental Wellness Reset Workbook
• Emotional Fatigue vs. Burnout: When Summer Stress Signals a Need for Support

After all, caregiving does not happen in isolation.

Your mental health matters too.

Grief After the Loss of a Parent

When a parent dies, grief may feel immediate and overwhelming.

However, it may also feel quiet or delayed.

In some cases, a caregiver may first feel relief after years of stress.

Then, guilt may follow that relief.

There is no single correct way to grieve.⁶

Grief does not move through a neat series of stages.

Instead, it may return unexpectedly.

At times, it may soften.

At other times, it may become sharp again.

For example, you may still reach for the phone.

You may still hear your parent’s voice in your mind.

You may still want to tell them something funny.

These moments are also expressions of love.

Mental Health Support for Caregivers in Michigan

If you are dealing with caregiver stress, anticipatory grief, anxiety, depression, or a major life transition, support is available.

River’s Bend provides compassionate, evidence-based behavioral healthcare for individuals and families throughout Southeast Michigan.

In addition, virtual appointments are available across the state of Michigan.

You may be looking for support while caring for an aging parent.

You may be grieving the loss of someone you love.

Or, you may be trying to balance the many demands of this stage of life.

Whatever you are facing, you do not have to face it alone.

Healing does not require having every answer.

Sometimes, it begins with having support when you need it most.

For Anyone Walking This Road Right Now

Several members of the River’s Bend team have recently lost parents.

Others are caring for aging loved ones while also raising children and managing careers.

Therefore, we understand that this season can feel especially heavy.

Please remember:

You are not alone.

There is no perfect way to love someone through aging and loss.

Sometimes, love looks like:

• Making the phone call
• Asking the difficult question
• Sitting beside the hospital bed
• Listening to the same story again
• Holding a hand
• Remembering a recipe
• Packing a dorm room
• Attending the meeting
• Trying again tomorrow

Ultimately, love is often found in the ordinary and extraordinary moments that make up a life.

If caregiver stress, grief, anxiety, or life changes have become difficult to carry, support is available.

Our therapists understand that mental health is not separate from the realities of life.

Instead, it is woven into them.

Sometimes, strength does not mean carrying everything alone.

Rather, strength may mean allowing someone else to help carry it with you.

Because even the people everyone depends on deserve support.

Resources

1. Lei, L., Leggett, A. N., & Maust, D. T. (2022). A national profile of sandwich generation caregivers providing care to both older adults and children. Journal of the American Geriatrics Society, 71(3), 799–809. https://doi.org/10.1111/jgs.18138  ↩︎
2. Vandersman, P., Chakraborty, A., Rowley, G., & Tieman, J. (2025). “I thought he had longer than that”: family caregivers’ experiences of grief, loss, and bereavement in residential aged care. BMC Palliative Care, 24(1), 296. https://doi.org/10.1186/s12904-025-01929-6  ↩︎
3. Rogalla, K. B. (2018). Anticipatory grief, proactive coping, social support, and growth: exploring positive experiences of preparing for loss. OMEGA – Journal of Death and Dying, 81(1), 107–129. https://doi.org/10.1177/0030222818761461  ↩︎
4. Schulz, R., & Sherwood, P. R. (2008). Physical and mental health effects of family caregiving. AJN American Journal of Nursing, 108(9), 23–27. https://doi.org/10.1097/01.naj.0000336406.45248.4c  ↩︎
5. atterson, S. E. (2022). Feeling the squeeze. Contexts, 21(4), 20–23. https://doi.org/10.1177/15365042221131075  ↩︎
6. Corr, C. A. (2024). Is it True That “There are no Right or Wrong Ways to Grieve”? OMEGA – Journal of Death and Dying, 302228241266643. https://doi.org/10.1177/00302228241266643  ↩︎

The post The In-Between Generation: Caring for Aging Parents While Raising Children and Living Your Own Life appeared first on River's Bend, P.C..

Spring is a season of milestones. Caps and gowns, college acceptance letters, first jobs, and big decisions, it’s a time filled with pride, anticipation, and, for many families, an undercurrent of stress.

At River’s Bend, we see this moment for what it truly is: not a single outcome to measure, but a transition worth honoring in all its forms.

Whether a young person is heading to college, entering the workforce, pursuing a trade, or taking time to discover their path, each step forward represents growth, resilience, and courage.

The Hidden Pressure Behind “What’s Next?”

“For adolescents, graduation often comes with an unspoken weight. Where are you going? What’s your plan? Did you get in?,” said Amy Fresch, River’s Bend Clinical Director at our Troy location. 

“These questions, while often well-intentioned, can amplify anxiety, especially in a culture where college admissions have become intertwined with identity and social status,” said Fresch.

When teens compare themselves to peers or feel they’ve fallen short of expectations, it can lead to:

• Increased anxiety and self-doubt
• Feelings of inadequacy or shame
• Depression during what should be a celebratory time

Parents, too, feel this pressure. The desire to see their child succeed can sometimes translate into heightened expectations, expectations that adolescents are already placing heavily on themselves.

But here’s an important truth worth remembering:

Once someone graduates, the question of “where did you go to school?” quickly fades. What endures is who they become, not where they started.

Redefining Success for Our Young People

Success is not a single path. It is not defined by a college name, a ranking, or comparison to others.

It is defined by:

• Emotional well-being
• Personal growth
• Purpose and direction
• The ability to adapt and thrive

As families, shifting the conversation from achievement to well-being can make all the difference. Supporting adolescents means celebrating effort, honoring individuality, and creating space for them to define their own futures.

The Role of Support Systems, At Home and Beyond

For many young people, especially those impacted by family substance use or mental health challenges, this transitional period can feel even more complex.

That’s why partnerships matter.

River’s Bend is proud to work alongside the National Association for Children of Addiction (NACoA), an organization dedicated to supporting the millions of children affected by family addiction.

Together, we are committed to ensuring that no young person navigates these challenges alone.

At the heart of NACoA’s mission is its CEO, Denise Bertin-Epp.

Denise’s vision is both urgent and compassionate. She recognizes that:

• One in four children grows up in a family impacted by addiction
• Substance use disorders have intensified in recent years
• The need for accessible, effective treatment and support has never been greater

Her leadership reflects a deep commitment to breaking cycles of silence and stigma, ensuring that children and families receive the care, understanding, and resources they deserve.

We value not only Denise’s expertise but the authenticity and heart she brings to this work. Our leadership team shares a close, collaborative relationship with her, rooted in mutual respect and a shared mission to protect and uplift young people.

Our working collaboration with NACoA is more than organizational—it’s mission-driven.

Together, we are:

• Advocating for early intervention and family-centered care
• Expanding access to adolescent outpatient treatment
• Raising awareness about the impact of addiction on children
• Celebrating resilience in young people during critical life transitions

In the video below, Denise shares why NACoA partners with River’s Bend and the importance of providing specialized outpatient care for adolescents during pivotal moments like graduation.

A Message to Parents This Season

As your child approaches graduation, consider what they need most from you right now. Rather than pressure, comparison, or perfection, they thrive on reassurance that their worth is not tied to a specific outcome. Give them space to explore their path without fear of judgment, and recognize that this moment is a massive achievement. Finally, make sure they have permission to ask for help so they don’t have to navigate difficult emotions alone.

This season can also be an important opportunity for both parents and young adults to seek support and guidance. Working with a therapist can help parents gain clarity on how to be a healthy, supportive caretaker during a major life transition while also managing their own fears, expectations, and emotions.

For teens and young adults, therapy can reinforce an important lesson early in life: struggling does not have to happen in isolation. Learning how to ask for help, process uncertainty, communicate openly, and build a support system are skills that can strengthen emotional resilience well beyond graduation.

Sometimes the healthiest thing a family can do is acknowledge that everyone is navigating change together and that support is a strength, not a weakness.

Your support, understanding, and perspective can be the difference between a stressful transition and an empowering one.

The Graduation Transition Toolkit: A Mental Health Guide for Teens and Families Facing Life’s Next Chapter

Created by Stephanie Howey, LMSW, this guide provides:

• Practical coping strategies
• Conversation starters
• Tools to navigate uncertainty with confidence

Download The Graduation Transition Toolkit For Free

Celebrating Every Path Forward

This spring, we celebrate all graduates. Some are heading off to college, while others are entering the workforce immediately. Many are still taking the time to figure it out.

Ultimately, every path forward is valid, and every single step represents meaningful growth.

At River’s Bend, alongside our partners at NACoA, we remain committed to supporting adolescents and families, not just through graduation, but through every stage of growth that follows.

Because success isn’t about where you go.

It’s about who you become, and knowing you’re supported along the way.

The post Supporting Adolescents and Families Through Graduation Season appeared first on River's Bend, P.C..