The story below is from our July/August 2025 issue. For more stories like it, Subscribe Today. Thank you!
Roanoke’s sandwich generation finds support.
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As people are living longer and many young adults are struggling to gain financial independence, about a quarter of U.S. adults (23%) are now part of the so-called “sandwich generation,” according to a Pew Research Center survey conducted in October 2021. These are adults who have a parent age 65 or older and are either raising at least one child younger than 18 or providing financial support to an adult child.
In the Roanoke Valley, this demographic faces unique challenges while juggling responsibilities to both older and younger generations. Local organizations are stepping in to provide crucial support.
Caught in the Middle
Courtesy of Ian Reynolds
Dr. Ian Reynolds, medical director at the Carilion Center for Healthy Aging, sees firsthand how this demographic struggles.
“It often gets overlooked, especially for people who fall into that sandwich generation,” Reynolds says.
Reynolds explains that this issue has become more prevalent in recent years, partly because people are living longer and millennials are having children later in life.
Two major challenges stand out to Reynolds: time constraints and financial strain.
“These caregivers are putting their own concerns, whether it be their own health concerns, their own emotional needs, kind of get pushed to the back burner,” Reynolds says.
The financial aspect can be equally daunting. Reynolds notes that caregivers often become the primary breadwinner for multiple generations, creating financial burdens that catch many by surprise.
Jamie Starkey, chief program officer of Family Service of Roanoke Valley, echoes these observations.
“One of the most significant struggles we observe is the conflict between competing priorities, particularly around time,” Starkey says. “Individuals caring for multiple generations often find themselves so focused on meeting the needs of others, including their employers, that they tend to neglect their own well-being.”
Health Consequences
This neglect can lead to serious consequences. Mike Grepiotis, executive director of the Adult Care Center of Roanoke Valley in Salem, warns about caregiver burnout.
“When elderly individuals take on the role of full-time caregiver for a spouse, the physical, emotional and mental demands can be overwhelming,” Grepiotis says.
This is especially true when caring for those with chronic illness or cognitive impairments like dementia. The result can be physical decline from neglected health needs and emotional strain from isolation.
Courtesy of Courtney Smith
Grepiotis cited research showing that spouse caregivers reporting strain had mortality rates 63% higher than non-caregiving spouses.
Ron Boyd, president and CEO of the Local Office on Aging, Inc. in Roanoke, sees similar patterns.
“Health and medical appointments are placed on hold which can lead to further health complications,” Boyd says.
Financial Pressures
Courtney Smith, a social worker at Westside Elementary School in Roanoke City Public Schools, observes these financial struggles daily.
“Everything is so high,” Smith says. “You get your paycheck, you are trying to stretch it every which way you can.”
Smith notes that housing costs are particularly challenging in the Roanoke area. Without housing assistance or support, families struggle to juggle the cost of caring for parents, childcare expenses and high rent.
Boyd adds that financial concerns are particularly acute for those caring for older adults “that fall through the cracks because they make too much money to qualify for Medicaid, but not enough to pay privately for assistance.”
Support Networks
Courtney Smith, a social worker at Westside Elementary School in Roanoke City Public Schools, observes these financial struggles daily.
“Everything is so high,” Smith says. “You get your paycheck, you are trying to stretch it every which way you can.”
Smith notes that housing costs are particularly challenging in the Roanoke area. Without housing assistance or support, families struggle to juggle the cost of caring for parents, childcare expenses and high rent.
Boyd adds that financial concerns are particularly acute for those caring for older adults “that fall through the cracks because they make too much money to qualify for Medicaid, but not enough to pay privately for assistance.”
Support Networks
Courtesy of Roanoke City Public Schools
The new Community Empowerment & Education Center
Despite these challenges, local organizations offer various resources to help the sandwich generation.
“That can be trying to identify when is the right time to try to bring in help into the home and what might that look like, what services could be offered,” Reynolds added.
The Center for Healthy Aging offers a variety of services. Reynolds says, “We work with a robust team of case managers, social workers, nurses and a team of providers who really try to work as part of the care network with the person’s primary care provider to kind of navigate through some of those difficult conversations through those difficult scenarios.”
The Adult Care Center of Roanoke Valley offers a weekday medical day program for elderly and impaired persons unable to remain safely at home unsupervised.
“We provide a safe, enjoyable weekday medical day program for elderly and impaired persons who are unable to remain safely at home unsupervised,” Grepiotis says. “We offer structured daily activities, socialization, health management and medication management supervised by a Registered Nurse. In many cases, we are the support network that allows families to stay together.”
Family Service of Roanoke Valley provides counseling services for individuals of all ages, accepting most insurance plans but committed to serving clients regardless of their insurance status.
“Our counseling services support ‘sandwiched’ caregivers, older parents who may be grappling with feelings of loss, depression or guilt, and younger family members who may be facing their own challenges,” Starkey says.
They also offer public and private guardianship services when an individual is deemed incapacitated by a circuit court judge.
The Local Office on Aging can provide meals on wheels to overburdened caregivers regardless of age if they are helping a senior who qualifies for the program.
“That can alleviate one task that the caregiver does not have to worry about — the noontime meal,” Boyd says.
LOA also operates an emergency food pantry, provides care coordination and options counseling and offers telephonic insurance counseling for Medicare, long-term care, Social Security and fraud assistance.
Roanoke City Public Schools is launching a Community Empowerment Center in July at the former Lucy Addison High School.
“It will be a one-stop shop for families, for all generations of families,” says a spokesperson for the school system. “One of the top suggestions we heard was actually kind of parenting as grandparents or classes specifically for those multi-generational families.”
Finding Balance
Despite the challenges, there can be positive aspects to multi-generational living.
“It can be really rewarding to have everybody in the same household. That’s time together. That’s time sitting down with meals,” Reynolds says. “People who are in this kind of sandwich generational living situation will rate their family life higher than individuals who aren’t in similar situations.”
For those feeling overwhelmed, Smith offers this advice: “The most important thing to remember when you’re dealing with a lot on your plate is that you can’t pour from an empty cup. You have to take care of yourself.”
Reynolds recommends several resources for those newly in this situation: the Caregiver Action Network, the local office on aging, the National Council on Aging and AARP.
“There’s a lot at our fingertips that people can utilize to help ease the transition and eliminate a lot of surprises down the road,” Reynolds says.
Smith also emphasizes the importance of civic engagement.
“I think it’s important for every generation that’s able to vote to understand just how our participation in our local, our state and our national politics can impact us,” Smith says. “When funding changes, that can impact our services that older adults get. It can impact the services that children get. So just understanding how your participation can impact your personal life and knowing when you can advocate for programs to aid you.”
As the sandwich generation continues to grow, these local resources provide crucial support, but the need for awareness remains high.
“Much of the public is not fully aware of the healthcare options available,” Grepiotis says. “Do not be afraid to ask questions. It is important to be informed when it comes to your loved one and their level of care requirements.”
The story above is from our July/August 2025 issue. For more stories like it, Subscribe Today. Thank you!