If the first thing that pops in your mind is “turkey” or “tuna melt” when you hear “sandwich,” you must be hungry. Grab one and keep reading in recognition of National Family Caregivers Month.

While we label generations with the end of the alphabet, a lot of us have to pass through a phase known as the sandwich generation. This is approximately when we hit our mid-30s to our early 50s. The age range of a sandwich generation depends on the country they’re in because a lot rides on culture, society, and finance. During these decades, most Muslim Americans will raise children or at least get the last of the birds out of their curated, comfortable nests. More power to those starting their parenting journeys in their 50s; but as for me, I will weep tears of blood if I have to do that.

In addition to rearing those kids, we are starting to take care of our own parents in these two decades of our lives. It looks like picking up halal groceries for at-risk parents during the pandemic, to cleaning out the kids’ closets for the seventh time this year to figure out what size underwear they need now, from chauffeuring for both the kids’ playdates and a senior ladies’ halaqa your mom attends on Sundays, to organizing parents’ meds in weekly pill containers.

It may mean accompanying a widowed dad to his doctor appointments because he will always say “nothing” when you ask what the doctor said, but also keeping the kids’ vaccinations up to date. It sounds like waking up in the middle of the night to a teenage SOS call or an emergency room clerk notifying you that your mom is a patient there tonight after a fall.

It can even mean all three generations living together under one roof and the loss of personal space that comes with it. It’s a flashback to those early days of motherhood when you couldn’t catch a break or a breath. Only now as sandwich genners, our parents’ health, safety and lives may depend on us as much as our kids’ do.

It’s no wonder that like early motherhood, a lot of the burden of caregiving as a sandwich genner falls on women and moms. We’re just so darned good and “natural” at keeping our kids alive that we’re also often the safety nets of the parentals. The irony of it all is that if we’re married, caring for the in-laws also falls to us, not because our husbands drop it in our laps (at least some of the time) but because sons don’t ask doctors the questions that need to be asked in the majority of cases.

Or they may not take the time to just sit and chat with their parents. They also don’t know what kind of pads their elderly mom is requesting when she says “I need pads.” Ask them what dad’s medication is for and find a deer in headlights.

This phenomenon exists across all religions and cultures, South Asians, so don’t side shake those heads yes like you’re the only ones who know ALL about it. I consider myself a mom boy and I love my sons, but I say this based on experience. I’ve only seen at most five sons take great care of their elderly parents in the decade I’ve been treating geriatric patients. It’s one of the reasons why I made sure to have a girl. Everyone needs at least one. Or a really close niece.

1. Modeling – What a great way to teach our kids how to respect parents! Do you see us rolling our eyes at our moms? Oh, you did? Well that was like once, as compared to your constant state, son.

2. Social skills – Research has shown that the Eden model of geriatrics keeps seniors independent with better quality of life and longevity. In this model, senior independence is a big focus, and having them close by and engaging regularly with children is both routine and therapy. It also shows distinct advantages for children; when raised in and around grandparents, they exhibit earlier literacy and language acquisition (think foreign languages!!!), numeracy and emotional intelligence.

3. Childcare – More of us rely on our parents or in-laws to help us out on occasion as caregivers for our children. Some of them are primary child caregivers. There’s peace of mind in being sandwiched between these two generations while we go out to bring home the halal bacon. There are headaches, too, like grandma giving a breastfed baby formula because “he was too hungry and your milk is not enough.” But we’re focusing on the pluses here.

4. Barakah – Insha’Allah the good deeds we earn serving two or more generations will serve us in this life and in the Hereafter. As long as we can do it without losing our cool more than twice a day,

For sandwich generation caregivers, life is a myriad of schedules, appointments and color-coded strategy until one person can’t make it to help or someone else vomits. Or falls.

1. Pray – This is an article in a Muslim blog written by a Muslim. What’d you think step one was going to be?!?!? Pray for guidance, patience, resilience, good health and the preservation of relationships. Most of all, pray for your children and parents.

2. Tame the guilt – Accept the impossibility of being everything to everyone, because that’s Allah’s (S) job. Do what we can humanly do, and leave the rest to Him. If we’re lucky (or unlucky in some cases ;)) to have siblings, these are discussions to have as a group and figure out what the future may look like as a team of caregivers, and how physical and financial responsibilities will be shared. Chances are one adult child is the primary sandwich genner caregiver. But the other siblings should help and be the primary at times as well (see “respite” below).

3. Hire help – Ask parents what kind of activities in their household can be hired out– for example, housekeeping or landscaping – so that they can conserve their energy for ibadah (worship) and their grandkids. Or gossiping at the masjid after ‘Isha, a favorite pastime of all generations. This step will look different for every family because much of it is based on finance and how stubborn your parent is about letting a stranger in the house. If you have siblings, this is hopefully something that can be cost shared.

4. Plan – We do, not just du’a. So what are we planning?

Finances – It’s not “whatever Allah wills,” because His instruction is for us to write one. A will, that is. In speaking to the co-founder of Islamic Social Services Association Sr. Aneesah Nadir on multiple occasions, the overwhelming majority of Muslims families she’s encountered reportedly have not prepared their estates in any manner, Islamic or otherwise.

More importantly, how are our aging parents getting by financially? It’s really important to ask these questions without inciting defensiveness on either side. Especially within immigrant communities, it’s not uncommon for many of us in the sandwich generation to be raised with the understanding that we are the retirement plan our parents invested in, and we need to align resources to meet these cultural expectations as best we can.

Health issues – Medicine is advanced enough to keep people living longer, but it’s also managed to keep people living longer. For the first time in American history, we have more seniors than children in this country. Figuring out how to get them all the best care and live their best lives without going bankrupt in the American healthcare system is no small task.

Our parents will undoubtedly have at least one chronic medical condition. Get to know what their conditions are and how they're following up because one day soon, a doctor might ask us questions about it. May we all have years of good health to age in place and remain strong in both our faith and bodies. Ameen.

Advance care planning – We recorded Advanced Care Planning last year on Mommying While Muslim with a Muslim social worker and a lawyer. It’s a good conversation to have with friends who share the sandwich generation experience with you.

Death – That leads us right into planning for the inevitable end of this temporary life. Allah (S) promises us a return to Him, but more and more Muslims appear fearful of facing the questions of death and dying or suffer health illiteracy about end of life care. They don’t want to talk about death because then it’ll happen.

Well, if that were true, can we start talking about me losing 10 pounds a year? Or not having any more babies because now I have two sets of parents to take care of?

Where do you want to be buried, how does ghusl (the ritual Islamic cleaning of the body after death) happen, do you have any debts to resolve, do we have a funeral fund somewhere and what’s the size of a death shroud? Difficult conversations exist, but as Muslims, talking about death and preparing for it should not be one of those.

If you’re not a caregiver of a multigenerational household, you may be someday. We’ve discussed it on Mommying While Muslim before on our past episode Intergenerational Family, so listen for the special circumstances that are bound to come up for you or some of your friends.

1. Meal train – Especially if one or another generation is sick, sandwich generation mom-sisters may not have time to get together a decent meal, or maybe she just doesn’t want to. Help her out by sending something portionable and freezable. Send containers without any expectation of getting them back.

2. Respite – Caregiver burnout is real. Pick up her kids from school so she can take her mom to the doctor. Take her on a spa day while the kids are at another friend’s for a playdate. Offer to do her laundry (you can set boundaries and say “no underwear, girl.”) Mom-sisters won’t mind if just their towels and sheets are washed, folded, and put away. Chip in with a mom crew so a housekeeper can go over and do her pre-Eid cleaning she probably won’t get around to doing in time.

If you're a sibling to a primary caregiver, make sure you’re thinking about that caregiver and asking what family holidays they might want to take with a spouse or their children. Be there to pick up caregiving duties in their absence. If nothing else, drop off a cup of coffee on her door the way you know she takes it. Lastly, don’t forget to call her, even if she never returns the phone call. Leave a message to let her know you see her invisible work when no one else does.

3. Support – Get to know resources like The Family Youth Institute, whose Elder Care Toolkit is one of many resources they have at the ready for the Muslim American community. Your mom-sister who's caregiving may not have time to read through it, but you can give her the Cliffs notes.

Not just because it’s National Family Caregiving month, but because the work a sandwich generation does is so tough and important to a sustainable and functional society, we send our salam and respect. And hopefully, our support. Remember, we don’t just du’a, we do.

Dr. Uzma Jafri is originally from Texas, mom to four self-directed learners, a volunteer in multiple organizations from dawah resources to refugee social support services, and runs her own private practice. She is an aspiring writer and co host of Mommying While Muslim podcast, tipping the scales towards that ever elusive balance as the podcast tackles issues second generation Americans have the voice and stomach to tackle.