Do mental and physical health trajectories change around transitions into sandwich care? Results from the UK household longitudinal study

Objectives: Sandwich carers provide care to ageing parents or older relatives while simultaneously raising dependent children. There has been little focus on how mental and physical health trajectories change around becoming a sandwich carer - a gap this study aims to fill.

Study design: Prospective longitudinal study.

Methods: We used 10 waves of data from the UK Household Longitudinal Study (2009-2020) - a high-quality longitudinal data. Sandwich carers were parents who lived with children under age 16 and took up unpaid care of a family member in the older generation. Sandwich carers were matched with parents who did not take up any adult care (i.e., non-sandwiched parents) with similar characteristics. We then employed piecewise growth curve modelling to model the trajectories in mental and physical health before, during and after becoming a sandwich carer and comparing these with non-sandwiched parents.

Results: Among parents, the uptake of caring for a family member was associated with a deterioration in mental health, especially for those who spent more than 20 h per week caring for a family member. The deterioration persisted for several years. Those who cared intensively also experienced greater physical health declines during the transition. We did not see evidence of gender difference in the above associations.

Conclusions: It is essential for society to recognise the unique needs and challenges of sandwich carers and provide them with the necessary support systems, resources, and community networks to ensure their health is maintained. Targeted support is required for sandwich carers who care intensively.