The sandwich generation of working carers in the UK face immense health pressure when juggling their home responsibilities with their professional lives.
The research, Do mental and physical health trajectories change around transitions into sandwich care? published by UCL in February 2025, analysed data from the UK Household Longitudinal Study by Understanding Society between 2009 and 2020, and found that sandwich carers suffer from deterioration in both their mental and physical health over time.
The UCL study found that sandwich carers, especially those who care for more than 20 hours a week, experienced a significant decline in mental health, such as issues concentrating or sleeping or had been feeling under strain, compared to non-sandwich carers. The decline continued for several years.
Office for National Statistics (ONS) research published in November 2024, meanwhile, found that 31% of sandwich carers, those that care for sick, disabled or ageing parents or older relatives while also raising dependent children, indicated some evidence of depression or anxiety, and a fifth (19%) reported being currently diagnosed with depression. The study showed that around three-quarters (76%) of sandwich carers are employed or self-employed. With such a large proportion of the UK workforce facing these issues, what initiatives can employers offer in the workplace to support the sandwich carers?
Pressure on working carers
Working carers who look after both younger and older relatives have to manage competing responsibilities and can be torn in many directions. As the research shows, their responsibilities can have hugely detrimental effects on health, causing emotional and physical stress, and exhaustion.
Katherine Wilson, head of employment and specialist delivery at Carers UK, says: “Carers just don’t have time for themselves. They are more likely to feel less satisfied with life, and it can also impact them financially. Perhaps they have additional costs of travelling at a distance to visit an elderly parent alongside childcare.”
Sandwich carers face the pressures of having to split their time three or more ways and ensure their financial situation can cover care costs, as well as the stress that comes with finding practical support. Stephanie Leung, co-founder and chief executive officer (CEO) of KareHero, says: “A lot of the root cause of mental burdens is financial, and carers are becoming increasingly difficult to attain from a cost perspective.
“The mental strain is more than just lack of sleep and time. It’s around ‘how do I make finances stretch; where do I put my parents? How much do they have in life savings?’ And then there is power of attorney. It’s extremely clerical and it’s a landmine.”
Affect on mental wellbeing
The pressure on working carers can present problems in their wellbeing in terms of lack of sleep and low energy levels, leading to more serious issues. Dr Heather Bolton, director of science at Unmind, says: “Caregivers often experience emotional depletion, guilt and isolation due to the difficulty of balancing family care with professional responsibilities. Chronic stress, caused by these pressures, can lead to physical symptoms such as sleep disturbances, fatigue, and weakened immune responses.”
Working carers are likely to put their own health and wellbeing needs behind those of others. “The impact of stress and anxiety can be compounded when [a person] has these additional responsibilities,” says Wilson.
For individuals with a limited, or no, additional support network around to help share the tasks of caring, the pressures of juggling childcare and eldercare can impact on their working life too. “If there isn’t a support structure, then it means [a person] is taking time off work, so absenteeism becomes a problem,” says Leung.
Employer support for carers
Employers can offer a range of schemes to ensure the sandwich generation of carers feel supported, can stay in work, and prioritise their own mental health. A key point to helping employees manage the burden of care, is practical help, says Leung: “Support that could be in place is practical companionship, hand holding people through what can be a nightmare. If employers want to keep their talent inhouse, it’s about understanding the practical needs they have.”
Building an open and supportive corporate culture will demonstrate to staff that they can discuss the responsibilities they have outside of work and find help to alleviate the mental burden. “Carers say that they just want a bit of understanding,” says Wilson. “It can be very hard to have a conversation at work with a line manager. If [a person] has childcare responsibilities, that can be hard enough but with additional care of an elderly relative, it can be a hard thing to talk about.”
Bolton agrees, explaining that employers could foster a supportive team environment where employees feel encouraged to share caregiving challenges and receive empathy and support from colleagues. “Educate managers on the challenges that caring responsibilities bring, how to lead with empathy, and when to direct employees to professional support,” she adds.
Offering flexibility can be a huge help to working carers and relieve a lot of the mental burden of trying to juggle work with different care needs. “Being able to adjust the start and finish time on an ad-hoc basis, or perhaps [offering] flexibility over the location of where [a person] works can really make a difference,” adds Wilson.
Schemes like employee assistance programmes (EAPs) and counselling can help working carers prioritise their own mental wellbeing. “Provide access to mental health resources, such as talking therapy or coaching, allowing space to discuss the complexities of caregiving and to process associated emotions,” says Bolton.
Help with the practical demands of caring, offering flexibility and providing mental health initiatives will, therefore, help support the physical and mental wellbeing of sandwich carers.
