The term "sandwich generation" has been around for a few decades, but the issue of caring for geriatric parents is gaining urgency as our population steadily ages.
Increasingly, baby boomers and Gen-Xers find themselves caught between their responsibilities to their children and the needs of their elderly parents, all while hurtling toward their own impending dotage.
It's an uncomfortable position, fraught with heartbreaking uncertainty and excruciating decisions complicated by the emotional baggage of family history.
Everywhere I go these days, I hear friends and acquaintances discussing the state of their parents' physical and mental health. They agonize over questions involving safety versus independence, finances and how to ensure an appropriate level of care and oversight.
An increasing number of Americans find themselves caught betwixt and between. According to a study released by the Pew Research Center earlier this year, nearly half of adults in their 40s and 50s have a parent age 65 or older and are either raising a young child or financially supporting a grown offspring.
About one in seven middle-aged adults provides financial support to both an aging parent and a child, the study found, and nearly one-third reported that their elderly parents needed help handling their affairs.
In addition to the personal burden, the needs of the elderly carry huge societal costs, from medical care to lost work productivity as grown children are forced to deal with their parents' health and daily living issues.
Those costs are bound to rise. The U.S. Census Bureau projects that the number of Americans ages 65 and older will more than double to 72 million from the year 2000 to 2030, compared with a 33% increase in the population overall.
But no study or data point can capture the heartache that many of us suffer when it comes to deciding what to do about Mom and Dad.
I've already been there. My dear mother passed away when I was still a young adult; afterward, my father went into a long and agonizing physical and mental decline.
Before that, Dad had been a proud, stoic, self-sufficient man. But his multiple health issues began to rob him of his memory, functional ability and reasoning capacity. His younger self would have been horrified at his loss of dignity.
It took some skillful bargaining before my three older siblings and I could convince Dad that he could no longer safely drive, and that he would have to move from our childhood home to a lower-maintenance condo. He rebelled against his caregivers and nearly fell prey to a con artist who tried to make off with the savings Dad had so carefully nurtured over the years.
As Dad's condition deteriorated, he went through a series of living situations with increasing levels of care. We had to remove him from one high-end assisted living facility when he kept breaking out and was found wandering the streets or in local bars. The latter could have sent him into a diabetic coma.
His final stop was a board-and-care facility where he received round-the-clock care and regular visits by various specialists, including a geriatric psychiatrist. By then, Dad was in the throes of full-blown dementia.
Some days I would just sit with him and hold his hand. Toward the end, I couldn't bring my sons — who were very young at the time — in case he launched into one of his violent spells when he would try to kick and bite his nurses.
At one point my siblings and I consulted an attorney — my brother's old college buddy — for advice on managing Dad's affairs. After reviewing all the paperwork, he sat us down and told us that back when Dad was still himself, he had done an excellent job of planning ahead.
"Your dad did you a big favor," he told us. "I can tell from this how much he loved you."
Blame it on the hormones — I was heavily pregnant at the time — but I balled like a baby. Plenty more tears and tough decisions followed over the next few years.
When I was the only one in my family who balked at a risky surgery, my siblings gently asked me, "What would Dad have wanted?" I knew they were right, but the choice to go ahead still haunts me since he only survived the operation by a few weeks.
Now my wonderful parents-in-law, who I love as my own, are experiencing some health problems. My husband and his sisters have leaped into action and done an admirable job caring for and supporting their parents through surgeries and hospital stays.
Chances are quite good that both my in-laws will be around for some time to come. Even so, the worry and stress are taking a toll on my husband.
But that's how it is, and will continue to be, for those in the middle of the sandwich.
Throughout our lives, our parents have been a constant and unquestioned presence. Now we face a new, role-changing reality in which grown-up children must take charge of the people who raised them.
There's no easy way around it, and all we can do is do our best. And when the time comes, I hope my children will also have cause to remember how much I loved them.
PATRICE APODACA is a former Newport-Mesa public school parent and former Los Angeles Times staff writer. She lives in Newport Beach.