The Overlooked Burden Of The Sandwich Generation: Behavioural Science Can Help
The ‘’sandwich generation’’ takes on a big responsibility of care for their aging parents and their own children, but there might be a way to help manage it all better.
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By Joel Lao, Medical Affairs Director, APAC, Abbott
Amid busy careers and lives to navigate, there is an entire generation that finds itself caring both for elderly parents and their own children. Often in their mid-30s to 50s, they are the ‘sandwich generation’.
In Asia, a strong heritage of family centricity and respect for older family members, as well as traditions of multiple generations often living in close proximity, means that the sandwich generation takes on a big responsibility of care. While the multigenerational household is traditional, the sandwich generation remains prevalent in modern Malaysia as the population ages and life expectancy rises. 70% of elderly Malaysians live with their children or extended family members.
Across Asia, older generations are increasingly finding their health deteriorating in their early 60s with much of their older years experienced in poorer health. Changing demographics across the region mean that in the future, the burden of care for those in the sandwich generation might often be shouldered by fewer siblings.
The rise of non-communicable diseases (NCDs) – such as cancer, heart disease, chronic respiratory diseases, and diabetes – is also having an impact on the daily burden of the sandwich generation, especially in emerging countries. For example, in Malaysia, NCDs remain the most significant contributor to premature mortality among adults under 70 years, causing 72% of all premature deaths. The responsibility of being a carer can be all the more challenging when it comes to NCDs, as patients often require long-term care.
Helping family members get and stay healthy
One of the main challenges in caring for parents is ensuring they stay get and stay healthy, in part by taking their treatments as prescribed. On average, around one in two people do not adhere to medical prescriptions. Malaysian adults average around 50% when it comes to following the doctor’s instructions when taking medications for NCDs. This is not only a significant public health challenge, but also puts a considerable strain on carers and healthcare systems.
Taking medications as prescribed can have a major impact on the healthcare system: a recent study conducted by Abbott in Thailand, China, and Mexico demonstrated that improving medication adherence in patients with heart-related health issues can result in significant cost savings for public health. Optimal medication adherence could prevent up to 63 cardiovascular events per 1,000 patients over a lifetime, depending on the country.
The reasons why so many people don’t stick to their treatments are as complex as each individual. Some may believe they don’t need the medicine in the first place. For others, potential side effects may be a concern. Some may find it difficult to ask for help. Over 700 factors have been found to influence adherence, involving social, cultural and economic factors at play.
This is where behavioural science can make a lasting impact on health.
Benefits of behavioural science and digital tools
Behavioural science uses insights from psychology and neurosciences to understand
people’s motivations, beliefs, capabilities and behaviours. These insights can be used to find ways to empower people to foster healthier habits and follow their doctor’s advice.
New support tools are doing exactly that, combining learnings from behavioural science with digital. For doctors, these science-based tools help them better understand their patients and get insights into their behaviour so that, together with their patients, they can find the best path forward for their treatments.
For patients, these digital health tools act like a personal coach, helping them build healthy habits by tracking progress. Some use gamification and virtual rewards to keep people motivated. In the MY A:CARE app, for example, people get tailored nudges through behavioural science and can visualise whether they stick to their healthy habits, including taking their medicines, through a coloured cube. A green cube means you are on track on your journey to better health. The app provides plenty of tips and advice to keep the cube green.
Commenting on his experience, caregiver Syafiq Azlan remarked, “Keeping track of multiple medications, appointments and dietary needs is overwhelming. I constantly worry about my parents missing a dose or having a health setback due to non adherence. Having tools that can help simplify this process, and give them a sense of control, would make a world of difference, not just for them, but for me as well.”
New digital health tools as solutions can be very beneficial. 72% of Malaysians are already finding information from health apps useful in managing their health, Currently, widely used apps like the MY A:CARE app have seen success in helping Malaysians manage their healthcare requirements in a more convenient way. The MY A:CARE app currently supports over 750,000 patients globally. The growth in digital tool usage is providing additional solutions that put the potential of better health in more people’s hands.
The combination of behavioural science and digital health technology could be instrumental in empowering people to manage their health in a more personalised and effective way. In doing so, it may help relieve some of the burden of care from the sandwich generation – and help their families live longer, healthier lives.
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