Three years ago, my sister Carla became an official member of the sandwich generation. The sandwich generation refers to people who care for their aging parents while supporting their own children at the same time.

It was around then that Carla and I and our other sister, Paula, had a discussion with my parents about moving closer to one of us.

My dad’s medical condition had become quite challenging, and we three girls felt being hours away did not give my mom the support she needed in caring for my dad.

So my parents moved back to New Hampshire, into a place only minutes away from Carla.

I want to point out two things. I am forever grateful that my parents use logic, rather than emotions, to deal with a situation like this. Moving, we all agreed, was the right thing to do. And second, my sister Carla found the perfect home for my parents just five minutes away from her own. It was love at first sight for my parents.

Before the move, I did my best to share with my sister what she might be getting into as she took on the responsibility of being there for our parents as they aged. I later realized that words could never anticipate the situations that arose.

Carla works part time assembling parts for a U.S. military supplier. Her husband has a job working for a defense contractor. They are hardworking, caring folks.

Carla’s kids, my niece and nephew, are great human beings.

Her daughter is a recent college grad who has found it difficult to find meaningful full-time employment in her field of study, so she cobbles together part-time jobs. My nephew is a budding entrepreneur in community college and works part time for his dad’s employer.

Both kids live at home.

Carla has her hands full with just her immediate family. Keeping a household and caring for her husband and kids while working is a job in itself.

That’s one side of the sandwich.

When it comes to our parents, my sister is a natural caregiver. She supports them at just the level they need. She never inserts herself where she is not wanted or needed, but is available for whatever task they allow her to help with.

Carla was there when our mom went to the ER with vertigo. She is there to help bathe our dad because it is too big a job for our mom alone.

She is there to drive them when their car is in the shop. She picks up groceries for them when she is at the store, and she is there during snowstorms and power outages.

That’s the other side of the sandwich.

All too often these days, the sandwich generation is becoming overstuffed or overburdened.

Take Carla, for example.

For the last week Carla has been in the hospital, diagnosed with a particularly nasty intestinal bacterial infection. All her caregiving duties are on hold. Our parents are on their own, as is my sister’s family. As a matter of fact, they are all now rallying to take care of Carla.

According to the Pew Research Center, more than 1 out of every 8 Americans age 40 to 60 are both raising a child and caring for a parent, in addition to between 7 million and 10 million adults caring for their aging parents from a long distance. It’s a place most boomers have never been before.

Women in the sandwich generation often take the lead, and if they become incapacitated, life gets increasingly difficult for everyone.

Caregiving is a job. When you have more than one generation to care for, it’s an even bigger job.

The worry of your parents’ health and your children’s well-being, as well as the financial concern of putting kids through college and saving for your own retirement, is a lot to handle.

How a sandwich generation mother manages the caregiving experience is often a model for the rest of the family.

If you are a member of the sandwich generation, begin by putting yourself first. Setting boundaries is an important first step.

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