Sensing the Squeeze of Sandwich Generation Women in Jakarta, Indonesia

Sensing the Squeeze of Sandwich Generation Women in Jakarta, Indonesia

  • Dian Kristiani Irawaty 1Directorate for Policy Integration of Population Control, National Population and Family Planning Board, Jakarta, Indonesia
  • Maria Gayatri 2Directorate for Development of Service Quality of Family Planning, National Population and Family Planning Board, Jakarta, Indonesia
Keywords: elderly, Indonesia, sandwich generation, women

Abstract

The majority of Indonesian women, known as "sandwich generations," have taken care of their young children and aging parents. Individual role-balancing challenges among these "sandwich" women have not yet, been fully investigated. This study aims to highlight Indonesian women's obstacles for being a sandwich generation. A qualitative descriptive case study through semi-structured interviews was carried out. A purposive sampling by key informants was conducted in June 2022 until saturation of the information was reached. This study involved six informants who live in Jakarta. Qualitative content analysis was carried out to generate codes and assign categories. From female respondent perspectives, males frequently provide financial support, whereas women are more likely to do so emotionally and assist with daily tasks like housework, grocery shopping, and personal cleanliness. Because of this, there was a significant conclusion that most sandwich-generation women received limited help during children and elderly care, evidencing the existence of other external factors favorable to physical, emotional, and mental stress and financial challenges.

Downloads

Download data is not yet available.

References

Aazami, S., Shamsuddin, K., & Akmal, S. (2017). Assessment of work–family conflict among women of the sandwich generation. Journal of Adult Development. https://doi.org/10.1007/s10804-017-9276-7

Adioetomo, S. M., & Mujahid, G. (2014). UNFPA Indonesia Monograph Series No 1: Indonesia on the threshold of population ageing. In United Nations Population Fund (UNFPA) (Vol. 01). https://doi.org/10.1299/kikaic.65.1319

American Diabetes Association. (2018). Economic costs of diabetes in the U.S. in 2017. Diabetes Care, 41(5), 917–928. https://doi.org/10.2337/dci18-0007.

Andrade, C., & Neves, P. C. (2022). Emotional exhaustion in female health support workers in elderly care facilities. Women’s Studies International Forum, 93.

Anindya, K., Ng, N., Atun, R., Marthias, T., Zhao, Y., McPake, B., … Lee, J. T. (2021). Effect of multimorbidity on utilisation and out-of-pocket expenditure in Indonesia: quantile regression analysis. BMC Health Serv Res, 21(1). https://doi.org/10.1186/s12913-021-06446-9.

Aziz, D. S. N., & Krisnatuti, D. (2017). Cognitive function, social interaction, and self concept of elderly widows and widowers. Journal of Family Sciences, 2(2), 1. https://doi.org/10.29244/jfs.2.2.1-10

Badan kependudukan dan Keluarga Berencana Nasional, Badan Pusat Statistik, Kementerian Kesehatan, & ICF. (2018). Indonesia Demographic and Health Survey 2017. Retrieved from https://dhsprogram.com/pubs/pdf/FR342/FR342.pdf

Badan Pusat Statistik. (2021). Hasil Sensus Penduduk 2020. Jakarta: Badan Pusat Statistik (BPS). Retrieved from https://jakarta.bps.go.id/backend/materi_ind/materiBrsInd-20210122142034.pdf

Betancourt, S. M. (2019). How Latino Women of the sandwich generation cope with everyday stress (Capella University). Capella University. Retrieved from https://www.proquest.com/openview/550350250ae9ed8581409a04f39dd382/1?pq-origsite=gscholar&cbl=18750&diss=y

Cameron, L., Suarez, D. C., & Rowell, W. (2020). Female labour force participation in Indonesia: Why has it stalled? In Achieving Inclusive Growth in the Asia Pacific.

Capeletto, C. da S. G., Santana, R. F., Souza, L. M. da S., Cassiano, K. M., Carvalho, A. C. S. de, & Barros, P. de F. A. (2021). Physical restraint in elderly in home care: A cross-sectional study. Rev. Gaúcha Enferm., 42. https://doi.org/10.1590/1983-1447.2021.20190410

Carmona-Torres, J. M., Rodríguez-Borrego, M. A., Laredo-Aguilera, J. A., López-Soto, P. J., Santacruz-Salas, E., & Cobo-Cuenca, A. I. (2019). Disability for basic and instrumental activities of daily living in older individuals. PLoS One, 14(7). https://doi.org/10.1371/journal.pone.0220157.

Castleberry, A., & Nolen, A. (2018). Thematic analysis of qualitative research data: Is it as easy as it sounds? Curr Pharm Teach Learn., 10(6), 807–815.

Chen, J., & Zhou, X. (2022). Sandwich generation in China: Exchange pattern with older parents and educational expenditure on young children. Asian Journal of Social Science, 50(2), 122–129.

Clark, K. C., Kelley, S. J., Clark, P. C., & Lane, K. (2022). Needs of grandparents raising grandchildren: A qualitative study. J Sch Nurs. https://doi.org/10.1177/10598405221115700.

Decimo, F. (2019). The transnational making of population: Migration, marriage and fertility between Morocco and Italy. Journal of International Migration and Integration, 289–310. https://doi.org/10.1007/s12134-019-00736-2

Dhakal, K. (2022). NVivo. J Med Libr Assoc, 110(2), 270–272. https://doi.org/10.5195/jmla.2022.1271.

Domond, P., Orri, M., Algan, Y., Findlay, L., Kohen, D., Vitaro, F., … Côté, S. M. (2020). Child care attendance and educational and economic outcomes in adulthood. Pediatrics, 146(1). https://doi.org/10.1542/peds.2019-3880.

Ejem, D. B., Drentea, P., & Clay, O. J. (2015). The effects of caregiver emotional stress on the depressive symptomatology of the care recipient. Aging & Mental Health, 19(1), 55–62.

Elmhirst, R. (2012). Gender in upland Indonesia. In Gender and Natural Resource Management: Livelihoods, Mobility and Interventions (p. 67). New York: Taylor & Francis.

Eltaybani, S., Abdelwareth, M., Abou-Zeid, N. A., & Ahmed, N. (2020). Recommendations to prevent nursing errors: Content analysis of semi-structured interviews with intensive care unit nurses in a developing country. J Nurs Manag, 28(3), 690–698. https://doi.org/10.1111/jonm.12985.

Estioko, D. A. C., Haveria, M. M. A., Veloso, E. B. R., & Teng-Calleja, M. (2022). Experiences of intergenerational caregiving among women belonging to the sandwich generation: An example from the Philippines. Journal of Intergenerational Relationships. https://doi.org/10.1080/15350770.2022.2053771

Evans, K. L., Millsteed, J., Richmond, J. E., Falkmer, M., Falkmer, T., & Girdler, S. J. (2016). Working sandwich generation women utilize strategies within and between roles to achieve role balance. PLoS One, 11(6). https://doi.org/10.1371/journal.pone.0157469

Fong, J. H. (2019). Disability incidence and functional decline among older adults with major chronic diseases. BMC Geriatr, 19(1). https://doi.org/10.1186/s12877-019-1348-z.

Fu, W., Zhao, W., & Deng, F. (2023). Intergenerational support and second-child fertility intention in the Chinese sandwich generation: The parallel mediation model of double burnout. Behav Sci (Basel), 13(3). https://doi.org/10.3390/bs13030256.

Garcia, O. F., Fuentes, M. C., Gracia, E., Serra, E., & Fernando Garcia. (2020). Parenting warmth and strictness across three generations: Parenting styles and psychosocial adjustment. International Journal of Environmental Research and Public Health, 17(20). https://doi.org/10.3390/ijerph17207487

Gehrman, P., Gooneratne, N. S., Brewster, G. S., Richards, K. C., & Karlawish, J. (2018). Impact of alzheimer disease patients’ sleep disturbances on their caregivers. Geriatric Nursing, 39(1), 60–65.

Gillett, J. E., & Crisp, D. A. (2017). Examining coping style and the relationship between stress and subjective well-being in Australia’s ‘sandwich generation.’ Australasian Journal on Ageing, 36(3).

Hämäläinen, H., & Tanskanen, A. O. (2021). ‘Sandwich generation’: generational transfers towards adult children and elderly parents. Journal of Family Studies, 27(3), 336–355. https://doi.org/10.1080/13229400.2019.1586562

Hannes, Z., Rudolph, C. W., & Reinicke, C. (2017). Caregiving and organizational support. In The Sandwich Generation (pp. 129–151). Edward Elgar Publishing.

Harrad, R., & Sulla, F. (2018). Factors associated with and impact of burnout in nursing and residential home care workers for the elderly. Acta Biomed, 89(7). https://doi.org/10.23750/abm.v89i7-S.7830.

Hayslip, B., Fruhauf, C. A., & Dolbin-MacNab, M. L. (2019). Grandparents raising grandchildren: What have we learned over the past decade? Gerontologist, 59(3), e152-e163. https://doi.org/10.1093/geront/gnx106.

Hernandez, J. F. (2019). The sandwich generation caregiver: Hope for the future. J Clin Nur and Prac, 1(1).

Huyett, P., Siegel, N., & Bhattacharyya, N. (2021). Prevalence of sleep disorders and association with mortality: Results from the NHANES 2009-2010. Laryngoscope, 131(1), 686–689. https://doi.org/10.1002/lary.28900.

Indonesia Subnational Collaborators. (2022). The state of health in Indonesia’s provinces, 1990-2019: A systematic analysis for the global burden of disease study 2019. Lancet Glob Health. https://doi.org/10.1016/S2214-109X(22)00371-0.

Iragorri, N., Oliveira, C. de, Fitzgerald, N., & Essue, B. (2021). The out-of-pocket cost burden of cancer care—A systematic literature review. Current Oncology, 28(2), 1216–1248. https://doi.org/10.3390/curroncol28020117

Irawaty, D. K., & Gayatri, M. (2021). Challenges of male contraceptive uptake in Indonesia: Opinion of married couples. Global Journal of Health Science, 13(3).

Jang, S. J., Song, D., Baek, K., & Zippay, A. (2021). Double child and elder care responsibilities and emotional exhaustion of an older sandwiched generation: The mediating effect of self-care. International Social Work, 64(4), 611–624.

Joshi, D. S., & Lebrun-Harris, L. A. (2022). Child health status and health care use in grandparent- versus parent-led households. Pediatrics, 150(3). https://doi.org/10.1542/peds.2021-055291.

Kennedy-Shaffer, L., Qiu, X., & Hanage, W. P. (2021). Snowball sampling study design for serosurveys early in disease outbreaks. Am J Epidemiol, 90(9), 1918–1927. https://doi.org/10.1093/aje/kwab098.

Kent, E. E., Ornstein, K. A., & Dionne-Odom, J. N. (2020). The family caregiving crisis meets an actual pandemic. Journal of Pain and Symptom Management, 60(1), e66–e69. https://doi.org/10.1016/j.jpainsymman.2020.04.006

Khairunnisa, I., & Hartini, N. (2022). Hubungan antara caregiver burden dengan subjective well-being pada ibu generasi sandwich. Jurnal Ilmu Psikologi Dan Kesehatan, 1(2). https://doi.org/10.47353/sikontan.v1i2.383

Khalil, R. A., & Santoso, M. B. (2022). Generasi sandwich: Konflik peran dalam mencapai keberfungsian sosial. SHARE Social Work Journal, 12(1).

Koetsenruijter, K. W. J., Veldhuijzen, W., Lepeleire, J. De, Leeuwen, Y. van, Muris, J. W. M., & Teunissen, P. W. (2022). Learning from complex elderly care: A qualitative study on motivating residents in family medicine. BMC Prim Care, 23(1). https://doi.org/10.1186/s12875-022-01908-3.

Komonpaisarn, T., & Loichinger, E. (2019). Providing regular care for grandchildren in Thailand: An analysis of the impact on grandparents’ health. Social Science & Medicine, 229, 117–125.

Lau, J. D., Au, L. Y., Chao, E., Elbaar, L., & Tse, R. (2019). The association of grandparent care with childhood overweight and obesity in Chinese American families. Child Obes, 15(1), 14–20. https://doi.org/10.1089/chi.2018.0113.

Lei, L., Leggett, A. N., & Maust, D. T. (2022). A national profile of sandwich generation caregivers providing care to both older adults and children. J Am Geriatr Soc. https://doi.org/10.1111/jgs.18138.

Lendon, J. P. (2017). A decade of love and hate: Trajectories of intergenerational ambivalence experienced by two cohorts of older parents and adult children. Journal of Family, 38(3), 336–357.

Li, W., Wang, G., Yu, Z., Ip, P., Leng, Y., Zhang, Y., … Jiang, F. (2021). Grandparental care and sleep disturbances in preschool children: A population-based prospective cohort study. Sleep Med, 82, 165–171. https://doi.org/10.1016/j.sleep.2021.03.033.

Lim, J. (2021). Characteristics of elderly care work that influence care workers’ turnover intentions. Healthcare (Basel), 9(3). https://doi.org/10.3390/healthcare9030259.

Luna, S., Rivera, F., & Ramos, P. (2021). Dual caregiving by grandmothers with older relatives: Personal factors influencing health and stress. J Health Psychol, 26(11). https://doi.org/10.1177/1359105319893112.

Madyaningrum, E., Chuang, Y.-C., & Chuang, K.-Y. (2018). Factors associated with the use of outpatient services among the elderly in Indonesia. BMC Health Services Research, 707. https://doi.org/10.1186/s12913-018-3512-0

Mandell, N., & Kim, A. H. (2017). Intergenerational relations in later life families. In The Sandwich Generation (pp. 62–78). Edward Elgar Publishing.

Marum, R. J. van. (2020). Underrepresentation of the elderly in clinical trials, time for action. Br J Clin Pharmacol, 86(10), 2014–2016. https://doi.org/10.1111/bcp.14539.

McDermott, M., Brown, D. L., & Chervin, R. D. (2018). Sleep disorders and the risk of stroke. Expert Rev Neurother, 18(7), 523–531. https://doi.org/10.1080/14737175.2018.1489239.

Mehri, N., Messkoub, M., & Kunkel, S. (2020). Trends, determinants and the implications of population aging in Iran. Ageing International, 327–343. https://doi.org/10.1007/s12126-020-09364-z

Molina, Y., Henderson, V., Ornelas, I. J., Scheel, J. R., Bishop, S., Doty, S. L., … Coronado, G. D. (2019). Understanding complex roles of family for latina health: Evaluating family obligation stress. Fam Community Health, 42(2), 254–260. https://doi.org/10.1097/FCH.0000000000000232.

Mondal, N. A. (2021). Quality of life among elderly in developing countries: Issues and challenges. China Population and Development Studies, 5, 363–377. https://doi.org/10.1007/s42379-021-00099-1

Mutchler, J. E., & Roldán, N. V. (2022). Economic resources shaping grandparent responsibility within three‑generation households. Journal of Family and Economic Issues. https://doi.org/10.1007/s10834-022-09842-3

Nair, S., Sawant, N., Thippeswamy, H., & Desai, G. (2021). Gender issues in the care of elderly: A narrative review. Indian J Psychol Med. https://doi.org/10.1177/02537176211021530.

Noda, S., Hernandez, P. M. R., Sudo, K., Takahashi, K., Woo, N. E., Chen, H., … Kobayashi, J. (2021). Service delivery reforms for Asian ageing societies: A cross-country study between Japan, South Korea, China, Thailand, Indonesia, and the Philippines. Int J Integr Care., 21(2). https://doi.org/10.5334/ijic.4739

Noor, S., & Isa, F. M. (2020). Malaysian sandwich generation issues and challenges in elderly parents care. International and Multidisciplinary Journal of Social Sciences, 9(3), 289–312. https://doi.org/10.17583/rimcis.2020.5277

Noviani, A. (2021). Who have a higher risk of falling into catastrophic health expenditures? Jurnal Ilmu Kesehatan Masyarakat (JIKM), 12(3). https://doi.org/10.26553/jikm.2021.12.3.217-228

Nursolehah, E., & Krisnatuti, D. (2017). Communication elderly-children and elderly-children in law, social support and successful aging in elderly men and women. Journal of Family Sciences, 2(2), 11. https://doi.org/10.29244/jfs.2.2.11-22

O’Young, B., Gosney, J., & Ahn, C. (2019). The concept and epidemiology of disability. Phys Med Rehabil Clin N Am, 30(4), 697–707. https://doi.org/10.1016/j.pmr.2019.07.012.

Osorio, R. S., Martínez-García, M. Á., & Rapoport, D. M. (2021). Sleep apnoea in the elderly: A great challenge for the future. Eur Respir J, 59(4). https://doi.org/10.1183/13993003.01649-2021.

Otto, A.-K., Gutsch, C., Bischoff, L. L., & Wollesen, B. (2021). Interventions to promote physical and mental health of nurses in elderly care: A systematic review. Prev Med. https://doi.org/10.1016/j.ypmed.2021.106591.

Owen-Smith, A. A., Ahmedani, B. K., Peterson, E., Simon, G. E., Rossom, R. C., Lynch, F. L., … Braciszewski, J. M. (2019). The mediating effect of sleep disturbance on the relationship between nonmalignant chronic pain and suicide death. Pain Pract, 19(4), 382-389. https://doi.org/10.1111/papr.12750.

OʼSúilleabháin, P. S., Gallagher, S., & Steptoe, A. (2019). Loneliness, living alone, and all-cause mortality: The role of emotional and social loneliness in the elderly during 19 years of follow-up. Psychosom Med, 81(6), 521–526. https://doi.org/10.1097/PSY.0000000000000710.

Patterson, S. (2022). Feeling the squeeze. Contexts (Berkeley Calif)., 21(4), 20–23. https://doi.org/10.1177/15365042221131075.

Patterson, S. E., & Margolis, R. (2019). The demography of multigenerational caregiving: A critical aspect of the gendered life course. Socius: Sociological Research for a Dynamic World, 5, 1–19.

Rai, S. M., Brown, B. D., & Ruwanpura, K. N. (2018). SDG 8: Decent work and economic growth – A gendered analysis. World Development, 113, 368–380. https://doi.org/10.1016/j.worlddev.2018.09.006.

Rao, A., Stahlman, S., Hargreaves, J., Weir, S., Edwards, J., Rice, B., … Baral, S. (2017). Sampling key populations for HIV surveillance: Results from eight cross-sectional studies using respondent-driven sampling and venue-based snowball sampling. JMIR Public Health Surveill, 3(4). https://doi.org/10.2196/publichealth.8116.

Rechenberg, K., Cousin, L., & Redwine, L. (2020). Mindfulness, anxiety symptoms, and quality of life in heart failure. J Cardiovasc Nurs, 35(4), 358–363. https://doi.org/10.1097/JCN.0000000000000630.

Reynaud, D., & Bruneau, L. (2022). Feasibility and acceptance of self-hypnosis to reduce chronic stress levels on family in-home caregivers of elderly people: protocol for the POSSAID pilot, randomised, wait-list controlled trial. BMJ Open, 12(12). https://doi.org/10.1136/bmjopen-2022-066749.

Ribeiro, J. D., Huang, X., Fox, K. R., & Franklin, J. C. (2018). Depression and hopelessness as risk factors for suicide ideation, attempts and death: Meta-analysis of longitudinal studies. Br J Psychiatry, 212(5), 279–286. https://doi.org/10.1192/bjp.2018.27.

Rizzuto, D., Melis, R. J. F., Angleman, S., Qiu, C., & Marengoni, A. (2017). Effect of chronic diseases and multimorbidity on survival and functioning in elderly adults. Journal of the American Geriatrics Society, 65(5), 1056–1060.

Rusdi, I. (2019). Health and Social Problems in Indonesian Elderly. How Can Health Care System To Overcome ? Caring:Indonesian Journal of Nursing Science, 1(2). https://doi.org/10.32734/ijns.v1i2.2860

Schulz, R., Beach, S. R., Czaja, S. J., Martire, L. M., & Monin, J. K. (2020). Family caregiving for older adults. Annu Rev Psychol., 71, 635–659. https://doi.org/10.1146/annurev-psych-010419-050754

Seltzer, J. A. (2019). Family change and changing family demography. Demography, 56(2), 405–426. https://doi.org/10.1007/s13524-019-00766-6

Shin, J. C., Kim, Y., Lim, H., Shim, B., & Choi, Y. (2015). The ‘sandwich generation’ in Korean academe: Between traditional academic authority and meritocratic culture. Studies in Higher Education, 40(8), 1406–1422. https://doi.org/10.1080/03075079.2015.1060710

Shrestha, S., Aro, A. R., Shrestha, B., & Thapa, S. (2021). Elderly care in Nepal: Are existing health and community support systems enough. SAGE Open Med. https://doi.org/10.1177/20503121211066381.

Sibilska, A., Góralczyk, A., Hermanowicz, K., & Malinowski, K. (2020). Spontaneous osteonecrosis of the knee: what do we know so far? A literature review. Int Orthop, 44(6), 1063–1069. https://doi.org/10.1007/s00264-020-04536-7.

Simeu, N. (2019). Disability and household economic well-being: Evidence from Indonesian longitudinal data. Oxford Development Studies, 47(3), 275–288. https://doi.org/10.1080/13600818.2019.1575348

Steiner, A. M., & Fletcher, P. C. (2017). Sandwich generation caregiving: A Complex and Dynamic Role. Journal of Adult Development Volume, 24, 133–143. https://doi.org/10.1007/s10804-016-9252-7

Sulityowati, A., & Krisnatuti, D. (2019). Family resources management and life satisfaction of elderly. Journal of Family Sciences, 3(1), 1. https://doi.org/10.29244/jfs.3.1.1-14.

Terkoǧlu, Ö. İ., & Memiş, E. (2022). Impact of elderly care on sandwiched-generation women in Turkey. New Perspectives on Turkey, 66, 88–121. https://doi.org/10.1017/npt.2022.12

Turana, Y., Tengkawan, J., Chia, Y. C., Shin, J., Chen, C.-H., Park, S., … Kario, K. (2021). Mental health problems and hypertension in the elderly: Review from the HOPE Asia Network. J Clin Hypertens (Greenwich), 23(3), 504-512. https://doi.org/10.1111/jch.14121.

Turgeman-Lupo, K., Toker, S., Ben-Avi, N., & Shenhar-Tsarfaty, S. (2020). The depressive price of being a sandwich-generation caregiver: can organizations and managers help? European Journal of Work and Organizational Psychology, 29(6).

Vermunt, N. P. C. A., Harmsen, M., Westert, G. P., Rikkert, M. G. M. O., & Faber, M. J. (2017). Collaborative goal setting with elderly patients with chronic disease or multimorbidity: a systematic review. BMC Geriatr, 17(1). https://doi.org/10.1186/s12877-017-0534-0.

Vlachantoni, A., Evandrou, M., Falkingham, J., & Gomez-Leon, M. (2020). Caught in the middle in mid-life: Provision of care across multiple generations. Ageing & Society, 40(7), 1490–1510. https://doi.org/10.1017/S0144686X19000047

Zakari, N. M. A., Hamadi, H. Y., Bailey, C. E., & Jibreel, E. A. M. (2022). Grandparents’ mental health and lived experiences while raising their grandchildren at the forefront of COVID-19 in Saudi Arabia. J Gerontol Soc Work, 65(5), 512–528. https://doi.org/10.1080/01634372.2021.1983684.

Zhao, Y., Atun, R., Anindya, K., McPake, B., Marthias, T., Pan, T., … Lee, J. (2021). Medical costs and out-of-pocket expenditures associated with multimorbidity in China: Quantile regression analysis. BMJ Glob Health, 6(2). https://doi.org/10.1136/bmjgh-2020-004042.

Published
2023-06-15
How to Cite
Dian Kristiani Irawaty, & Maria Gayatri. (2023). Sensing the Squeeze of Sandwich Generation Women in Jakarta, Indonesia: Sensing the Squeeze of Sandwich Generation Women in Jakarta, Indonesia. Journal of Family Sciences, 8(1), 52-69. https://doi.org/10.29244/jfs.v8i1.43942