Summary: Sandwich carers—people simultaneously caring for dependent children and older relatives—experience substantial declines in mental and physical health over time. A longitudinal study following carers for up to nine years found that especially intensive caregiving (more than 20 hours per week) is linked with persistent mental health deterioration and measurable physical health decline.
On average, sandwich carers in the study were in their late 30s, juggling childcare, care for ageing family members, work, and other responsibilities. Researchers recommend targeted support—such as respite services and workplace flexibility—to protect the health and resilience of this growing group.
Key Facts:
- Mental health impact: Becoming a sandwich carer is associated with lasting declines in mental health, most pronounced among those providing intensive care.
- Physical health decline: Providing more than 20 hours of care per week is linked to worsening physical health during the transition into sandwich caring.
- Support needed: Respite care, flexible work arrangements, and other targeted resources are important to support carers’ well-being.
Source: UCL
Overview
A new study by researchers at University College London (UCL) examines how entering the role of a sandwich carer affects mental and physical health over time. The analysis used data from the UK Household Longitudinal Study covering 2009–2020 and compared roughly 2,000 sandwich carers with a similar number of non-sandwich carers. The goal was to identify how health changed before, during and after the shift into combined childcare and eldercare responsibilities.
Sandwich carers are defined here as adults looking after dependent children (under 16) while also providing care for ageing parents or older relatives. The prevalence of this dual caregiving role is rising, driven by longer life expectancy and trends toward later parenthood. In the UK, it is estimated that about 1.3 million people are sandwich carers.
Researchers followed participants for up to nine years and collected repeated questionnaire responses to map health trajectories. Mental health was assessed using the General Health Questionnaire (GHQ), which captures symptoms such as difficulty concentrating, sleep problems, and feeling under strain. Physical health was summarized using a Physical Component Summary (PCS) that covers general health, mobility, pain, and limitations in daily activities caused by physical health issues.
The average age of sandwich carers in the sample was 36.8 years, reflecting the fact that adults aged 30–49 are most likely to occupy this role. The study modelled changes in GHQ and PCS scores around the point when participants became sandwich carers, comparing those trajectories with changes observed in non-sandwich carers. Researchers also examined whether caregiving intensity (hours per week) and gender influenced these changes.
Key findings show that parents who transition into sandwich caring experience a notable decline in mental health compared with peers who do not take on dual caregiving. This decline is most marked among those delivering more than 20 hours of care per week and remains for several years following the transition. For intensive caregivers—again defined as more than 20 hours weekly—the study also detected a deterioration in physical health during the same period.
Dr Baowen Xue (UCL Epidemiology & Health Care), the lead author, emphasizes the scale and persistence of these effects: “Our study highlights the significant mental and physical health challenges faced by sandwich carers. Those balancing the demands of dependent children and ageing relatives often experience sustained declines in wellbeing. Recognising and supporting their specific needs is crucial to maintain their health and resilience.”
On the basis of these results, the research team calls for improved policies and services to support sandwich carers. Suggested measures include greater access to respite care, workplace policies that allow flexibility in hours and location, and targeted programmes for those providing intensive care. These interventions could help reduce strain and mitigate both mental and physical health consequences for carers.
Funding: This work was supported by the UK Economic and Social Research Council.
About this mental health research news
Author: Poppy Tombs
Source: UCL
Contact: Poppy Tombs – UCL
Image: The image is credited to Neuroscience News
Original Research: The findings will appear in Lancet Public Health