By Rachel Sokol

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For many women in their 40s and 50s, life can feel like a constant balancing act. Not only are we exhausted and dealing with hormonal changes via menopause, but we're raising children, managing careers, and increasingly caring for aging parents—all at the same time. 
   It’s a LOT–and that’s an understatement. They call us the “sandwich generation,” because we are quite literally squeezed between two generations (our kids, and our parents) that depend on us. 
  The pressure can be intense. On any given day, a woman in this phase of life might be coordinating their parent’s medical appointments, helping their kids with homework, answering work emails, and trying to maintain a relationship with their partner—all before bedtime. Of course, every family dynamic is different, but research consistently shows that daughters often take on the bulk of elder caregiving.
   For example, according to Northeastern Global News, eldest daughter syndrome is not a real diagnosable condition, cites Laurie Kramer, a professor of applied psychology at Northeastern University. Nor does one’s birth order and gender mean they will automatically have certain traits or roles within the family. 
   But Kramer, whose research focuses on sibling relationships, did say that many eldest daughters DO end up taking on duties without recognition due to societal norms.

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Women Caretakers
Marianne Schnall, founder of Feminist.com, agrees that longstanding cultural expectations still play a powerful role in family caretaking–even in 2026. 
   “While of course there are many exceptions, it is unfortunately true that this is often the case, largely because of outdated yet still deeply ingrained gender stereotypes and norms, that caregiving is somehow ‘women’s work’ or an ‘unmanly’ thing for men to do,” she explains.
   Those expectations persist even in modern households where both partners work full time. 
   “There’s also the default expectation that women should be able and willing to ‘balance it all,’” Schnall adds. “And of course in the U.S. we do not have systems or policies that adequately support working women, even though they are typically the ones who shoulder the unfair burdens and responsibilities of caregiving work.”

Older Daughter Dependence
For many families, the oldest daughter is the one parents instinctively rely on during times of need. 
   “The eldest daughter has always been the one who people have looked up to and who your parents have relied on, because you are the first and the only first,” explains NYC-based therapist Dr. Kathryn Smerling, LCSW, Ph.D. While Dr. Smerling emphasizes that many men are stepping into caregiving roles today; she acknowledges that historically, “generations have not raised men to be caretakers,” which can still shape family expectations.

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No Laughing Matter
The emotional toll of this juggling act is often underestimated. It’s a big deal.
  “The overwhelm isn’t just about the physical tasks,” says Allie Buttarazzi, MD, a double board-certified physician in lifestyle and internal medicine and founder of AllieMD Coaching. This is a topic she personally understands deeply as a caretaker daughter, a doctor, and a mother.
  “It’s the ‘mental load’—the constant worry and cognitive juggling that leads to burnout, poor sleep, and stress-eating.” 
  Many women in the sandwich generation are managing medical paperwork, school schedules, work deadlines, household logistics, and emotional needs simultaneously. We may aim to be “superwomen” but we aren’t. We’re human just trying to not break down.

   That constant mental checklist… “how can I do this all in just a few hours?”...can make it feel nearly impossible to find a moment for yourself.  I myself have felt immense guilt if I race into DSW for new shoes after visiting my parents, and before picking up everyone’s medicine at CVS. Not to mention my eldest daughter is a tween craving more time with me. I sometimes feel like it’s not enough, and I am not enough.

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Time is of the Essence
Yet, experts say even small breaks are essential. 
   “It feels counterintuitive to add one more thing to a packed calendar, but scheduling even 10 minutes for yourself is non-negotiable,” says Dr. Buttarazzi. “Whether it’s a morning meditation or a walk at lunch, these moments aren’t ‘extras’—they are how you recharge so you can show up for everyone else.”
   The current spotlight on the sandwich generation (there are even podcasts dedicated to this era of life)  isn’t surprising to experts. Demographics are shifting in a way that has created what Buttarazzi calls a “perfect storm.”
   “The Boomer generation is aging at the same time that many Gen X-ers and Millennials are raising young children, having started their families later in life,” she explains. “We are literally squeezed in the middle.”  (I myself had children in my late 30s, as did most of my friends, even well into their 40s.)

   At the same time, growing awareness around mental health has encouraged caregivers to speak more openly about the strain. “This is demanding, and we need to talk about it.”

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It Takes a Village; and a Town
Isolation can also be a major challenge for women navigating this life stage. When caregiving responsibilities pile up, social connections and personal time are often the first things to disappear.
  “Isolation is the heaviest part of caregiving,” says Dr. Buttarazzi. “My best advice is to build your village intentionally. Reach out to a spouse, a therapist, or a support group of people who truly ‘get it.’ Validation is a powerful antidote to exhaustion.” 

    She emphasizes that self-care should not be seen as selfish. “You simply cannot show up for your family if you haven’t preserved your own energy first.”
 

Ask Siblings For Help
Family structure can also help ease the burden—particularly when siblings share caregiving responsibilities. But Dr. Smerling notes that this doesn’t always happen naturally.
  “When parents get sick, it’s the responsibility of all the children. So there should be a family meeting,” she says. Having open conversations early can help divide responsibilities more fairly. 
  Therapists and even caregiving calendar apps can help families organize schedules and avoid conflict. “Otherwise… you will probably be fighting over a dollar and a nickel–meaning, every little thing” she adds.

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Tell Work What’s Up
Workplaces and government policies could also play a significant role in reducing the pressure many women feel. Schnall points out that the United States still lags behind many other developed nations when it comes to caregiving support.
   “We are the only advanced-economy country in the world without national mandated family and medical paid leave programs,” she says. At the same time, childcare costs are rising rapidly, creating what she describes as “an economic crisis that requires businesses and the government to step up.”
   Schnall believes meaningful policy changes could make a transformative difference. “The government could implement policies like universal pre-school, paid leave, affordable health care, and aging and disability care,” she says. Flexible work schedules and employer-provided childcare could also help caregivers remain in the workforce without sacrificing their families’ needs.

The Emotions of Guilt
Beyond logistics, one of the biggest struggles for many women (myself included for sure) in the sandwich generation is guilt. Parents may worry they are not giving their children enough time while simultaneously feeling they should be doing more for aging relatives.
   Schnall urges women to release that pressure. “Please don’t waste any energy feeling guilty,” she says. “The realities you and so many other parents are juggling are not your fault—it is our inadequate systems that are failing in supporting you.”
  Instead, she encourages women to practice self-compassion and let go of perfection. “Life can be messy and it is impossible to do everything perfectly, so give yourself a break,” she says.
   Dr. Smerling agrees, noting that caring for aging parents can actually model compassion and responsibility for the next generation. “You’re setting a role model for your own children… saying, ‘I’m taking care of my parents.’ That’s how change is made.”
   Ultimately, experts say one message is especially important for women navigating the sandwich generation: you don’t have to do it all alone. Whether leaning on siblings, partners, therapists, or friends, building a support system can make this demanding stage of life more manageable—and remind you that your efforts, and emotions, truly matter.
 

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Kathryn Smerling, Ph.D. LCSW-A collaborative and dynamic psychotherapist, Dr. Kathryn Smerling specializes in creating healthy and meaningful relationships. Dr. Smerling provides individual adult therapy, as well as comprehensive couples and family therapy. She also specializes in family systems, with an approach that is both inclusive and supportive of children and their needs within the greater picture of the family. https://drksmerling.com/

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Marianne Schnall is a journalist, author, and interviewer. She is the founder of Feminist.com, 
an online community that fosters awareness, education, and activism for people all across the world. She is also the founder of What Will It Take, a media platform bringing together existing stakeholders and champions of women’s leadership across industries and issues on a single platform to foster collaboration and coordination. Marianne is the author of What Will It Take to Make a Woman President? Conversations About Women, Leadership & Power (recommended by Beyoncé), which features interviews with politicians, public officials, thought leaders, artists, and activists addressing the changing paradigms and issues around women, politics, 
and power. https://marianneschnall.com/

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Dr. Allison Buttarazzi is board certified in Internal Medicine and Lifestyle Medicine and is a certified Health and Wellbeing Coach. She grew up in Topsham, trained at Tufts University in Boston, and has dedicated her life to high quality primary care since 2016. 
https://www.mainestreetmedical.com/ 

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Laurie Kramer is Professor of Applied Psychology and Director of the University Honors Program at Northeastern University. She is also a Licensed Clinical Psychologist in the State of Illinois. Dr. Kramer was the founding Director of the Family Resiliency Center and The Pampered Chef Family Resiliency Program at the University of Illinois, initiatives which are aimed at enhancing the well-being of children, youth, and families through multidisciplinary research, education and outreach.
https://bouve.northeastern.edu/directory/laurie-kramer/