Looking after our elders has always been part of our circle of life.

Parents care for their children when they are young and vulnerable. Children return the duty when their aging parents become frail.

But several factors make the caregiving role more complicated than it's ever been. Our circle of life has become bloated by busyness, stretched by geography and warped with age.

Carolyn Rosenthal, a professor of gerontology and sociology at McMaster University, says no matter what your age, you're bound to experience "multigenerational pulls."

But caring for an elderly parent while holding down a job is partic-ularly stressful because of the conflicting demands on your time.

"It's not an easy job. The choreo-graphy of care is complicated," she said. "But it's part of being a family."

About 1.7 million middle-aged Canadians (ages 45 to 64) provide some type of informal care to about 2.3 million seniors, according to a 2004 Statistics Canada social trends report. The Sandwich Generation -- that middle-aged group with at least one child at home -- accounts for less than one-half of those caregivers.

The majority of today's caregivers are married women aged 45 to 64 working at a paid job. They are most likely to get help from another woman -- a sister.

Bloated by busyness: One crucial difference separates past and present caregiving: the majority of working-age women are no longer full-time homemakers. They are in the paid labour force.

Janet Dentinger, of Dundas, takes time off work for most of her mom's doctors appointments.

"It's stressful because it's all on my shoulders, making sure she has the right care."

Her mom, Erma Little, wants to be independent but needs her daughter's help communicating with her doctor.

Dentinger books off two- or three-hour blocks using lieu time or vacation days for those appointments.

In March, she took an unpaid day to take her mom to the emergency ward after worrisome fainting spells. The work was still waiting for her when she returned to the office the next day.

"No one at work has given me a hard time about it, but my company is like any other company, they're here to make money," she said.

Where to get help:

* Caregiver tax credit: Canada Revenue Agency allows Canadians to claim deductions and credits for individuals supporting people with disabilities. For example, care could have been provided to parents, parents-in-law and grandparents. The caregiver amount is a nonrefundable tax credit which reduces the amount of federal income tax paid. Visit: www.ccra-adrc.gc.ca
* Compassionate Care Benefits: Employment Insurance program covers a percentage of income for up to six weeks to an employee looking after a loved one at risk of dying within 26 weeks. Visit: sdc.gc.ca.

Stretched by geography: Today's Sandwich Generation is more likely to live in a different city than their parents, making decisions about caregiving more complex.

Wendy Brawn remembers driving from Hamilton to Collingwood after her dad suffered a stroke in 1990. She walked into the intensive-care unit and wanted to throw up.

"Where was my dad? The guy who travelled all over the world and was a social butterfly? There he was in a bed with diapers on, grunting at me."

She and her family travelled every weekend from the Hamilton area to Collingwood, until she could have him moved to a nursing facility closer to home. He died in July 2000.

Brawn now works for Catholic Family Services of Hamilton, which has created a new program to help caregivers. Seniors Select, a new privately paid, case-management service, identifies what supports a senior needs, develops a plan and arranges and monitors those services.

Where to get help:

* Seniors Select: 905-963-8988, cfshw.com The initial assessment costs $300 to $600, depending on case complexity.
* Ontario Community Support Association: www.ocsa.on.ca The association's website offers a "carefinder" guide to search for services in your community. If you only go to one website, this is the one.

Warped with age: People are living longer and the senior population is exploding. More middle-aged people have parents who are living into their 80s and 90s. Parents are having fewer children, which means fewer siblings to help shoulder caregiving responsibilities.

According to Statistics Canada, seniors are expected to outnumber children (those 15 and under) by around 2015 -- a phenomenon never before recorded. Adding to eldercare complications is that women are having children later in life, and it's not uncommon that support for those children --financial and otherwise -- continues into their children's mid-20s and beyond.

Where to get help:

* Shalom Village: 905-529-1613, shalomvillage.on.ca
Shalom Village is a pioneering nonprofit organization that provides services to older adults, including long-term care and assisted-living apartments.

* St. Joseph's Villa: 905-627-3541, www.sjv.on.ca
The villa offers a popular seniors' day program and respite care which allows care-giving family members a break.

It's not all about burdens and sacrifices. Kevin Brazil, director of St. Joseph's Health System Research Network, says caregiving creates psychological, financial and physical stresses, but provides deep satisfaction too. Many caregivers feel empowered and discover skill sets they didn't think they had. It can also renew and deepen relationships, and create new levels of intimacy.

Brawn says the memories of her dad she treasures the most are those she shared with him after his stroke.

"Caregiving truly changes you. You learn a lot about yourself. You learn about patience. It really goes to show how far love can take you."

cprete@thespec.com

905-526-2487

Advice for the Sandwich Generation

* Plan now for the end of your life. Decide what care you want and how to make that happen. Don't leave the responsib-ility with your children.
* Take time out for yourself and don't feel guilty about it. You can't be a good caregiver if you're not healthy.
* Have a family plan. If you are considering having a parent move in, consult your siblings and relatives and find ways to share responsibility. Remember that your parent can and probably wants to have responsibilities in your household. Let them be involved, productive members of the family.
* Make a list of what you need help with and when you need it. Decide what family members can do and what outside services need to be brought in.
* Ask questions. If your mom or dad is moving into a nursing home, write down everything you want to know so you don't forget when you get there.
* Become familiar with community resources and organizations that offer caregiver support.
* Have at least one person you can confide in, who can give you support, and to whom you can provide support through a mutual relationship.
* Get organized. Complete a planning checklist that includes such things as your loved one's health insurance information, doctor, dentist, current medications, legal and financial information, bank accounts, burial-funeral information, etc.
* Talk to your elder loved one's health- care provider. He or she may be able to help you understand what may be needed in the future.
* Pay for a couple of hours worth of consultation with a geriatric-care professional. He or she will be able to assess an individual's situation and provide a plan that includes information and referral to appropriate resources.

-- from caregiving professionals, caregivers, marriage.about.com, Canadian Health Network