September 29, 2023
September 29, 2023

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Stuck in the Middle: The Sandwich Generation

It was Sukkot a couple of years ago and my father was in the hospital in Cleveland. He was diagnosed with cancer. I wanted to go and see him, but which one of my families was more important to me? Am I the daughter or the mother? I was having an existential identity crisis. I went to Cleveland, and what was scheduled for a Shabbot visit turned into an eight-day trip. I stayed with my father in his hospital room (they had a cot for family members) the whole time. At 3 a.m. he’d say to me, “You up?” and I would say, “Yep.” Those were memorable, deep and lasting conversations.

My kids wondered what was going on. I really didn’t want to share just yet the extent of his illness. My kids had Sukkot, albeit without me and although they were fine, I wasn’t. In hindsight, it was the right move, but going through it was a decision-tree analysis every day.

Does this sound familiar? You’re choosing between your parents and your kids. Your kids say, “It’s OK, go and see Zadi,” and your dad says, “You should be at home with your kids.” However reassuring both parties tried to be, it didn’t negate the fact that I was choosing—my kids or my father.

There is a solution out there you may not be aware of. The industry has a name. It’s called Aging Life Care Association ( A life care manager acts as your surrogate brother or sister to manage a loved one (like your parents) when you can’t be there. They can organize and attend doctor appointments and report back to you. They can coordinate any home care needs your parents may need, especially when you are not living in the same city.

As the president of the Florida Private Care Association, we represent nurse registries who refer caregivers ( I have seen the value of an aging care manager. I started out as one 25 years ago, before there was an industry. I am also the CEO of a home care company in south Florida: Palm Beach, Broward and Dade Counties (

Many children, upon a visit to their parents (say in south Florida), open the fridge and see its bare, notice mom is repeating herself, has missed doctor appointments and denies a fall. You happen to notice this because there’s a bruise on her leg. You are in town, like I was, for a Shabbat and you must get back to your work, your children, your life. Besides an aging care manager, a home health aide can assist in your parent’s home, based on their best schedule, typically four hours a day. There are also ways to pay for this that many do not know about: long-term care insurance, Claims Conference-Holocaust reparations (, the VA, and Medicaid waivers.

Having a home health aide/caregiver in the home is not an all-or-nothing proposition. Care can start with minimal hours per week. Schedule flexibility is entirely at the patient’s request. A typical minimal schedule is four hours a day, three days a week. However, if a patient is getting discharged from a hospital or rehab center, care can be 12 hours a day or two 12-hour shifts a day. These schedules are also fluid. They are not set in stone, and when a patient needs to scale up or down in hours, this is entirely up to you and your family. Health needs change: Hours can reflect those needs.

Although referring a home health aide has a lot to do with your parent’s abilities, or lack thereof, and assisting with the activities of daily living (ADLs), transferring, toileting, eating, dressing or cognitive decline, one of the most important characteristics is the shidduch (the personality match) between the aide and the patient. Mom and/or dad need to get along with the aide, as does the aide with your parents. Patients may want someone who is quiet, young and caring. Some prefer a stronger personality (to nudge your parents to take a walk), more mature, and with experience with Alzheimer’s, as an example.

Another obstacle many children face is their parents’ resistance to change. Justifiably, your parents will want to hold on to their independence for as long as possible. However, this is a fallacy, a faulty premise. Why? Because having help in the home will maintain their independence in their own home environment. Having someone in the home helps minimizes the risk of a fall, encourages activities and prevents social isolation.

Short-term planning will lead to long-term solutions. No matter where you are with your parents and their aging process, help is out there. A good start is with your parent’s physician, friends who have gone through the same thing, and of course, search online for home health aides, caregivers, location of where they live and general aging terms.

Aging in the “golden years” may not be completely shiny, but the options are out there and there’s not a better time to start planning than today.

Lisa Kaufman, MBA, is the owner and founder of Boca Home Care, Boca Home Care Services, and Miami Home Care Services. She is the president of the FL Private Care Association, the senior services liaison for Jewish Family Services of South Palm Beach, is on the Katz Yeshiva High School board, and is the chair of AIPAC’s County of Palm Beach. Lisa can be reached at [email protected]

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