Caring for kids and parents at the same time: how do I cope?

If you are looking after your children and your ageing parents at the same time and feel worn out in body and mind, you are not alone, and it is a heavy load. Many Thai families live across generations: in a 2018 national survey of 2,048 Thais aged 60 and over, 55.9% lived with at least one of their children, and a study using Thailand's 2021 national survey of older persons found that family caregivers who had left work tended to feel a heavier burden. Things you can do include sharing jobs out clearly across the family, protecting your own sleep, keeping a little time each week that is just yours, asking about community care for your parent, and seeing a doctor if tiredness or low mood goes on for weeks.

This article is about carrying both roles at once. For carers whose main problem is broken nights, see Caring for a parent and not sleeping: what can I do?, and for tiredness from raising young children, see Worn out from parenting and it keeps piling up. What helps?

How many Thai families care for children and parents at the same time?

Several generations under one roof

Thai families often live across generations. Phulkerd and colleagues at Mahidol University's Institute for Population and Social Research analysed a nationally representative household survey carried out from June to December 2018, covering 2,048 people aged 60 and over:

In homes like these, the middle generation may be looking after both their parents and their own children.

Care goes both ways

Help does not only flow down to grandparents. Knodel and Pothisiri, comparing national surveys of older people in Thailand and Myanmar, found that Thai older people were considerably more likely to look after grandchildren whose parents were away.

More households need a carer

Phetsitong and colleagues, using the National Statistical Office's surveys of older persons, found that the share of Thai households with an older person who needs help with daily activities rose from 5.0% in 2007 to 6.6% in 2014, and was higher in urban areas and Bangkok.

Who ends up doing the caring, and why does it feel so heavy?

Who the carers are

Aung and colleagues studied 867 older adults and their main family caregivers in Chiang Mai. Their full report shows how many carers were also holding down jobs and household finances.

The caregivers' average age was 55. The study was in one province, so the numbers may be different elsewhere.

What goes with a heavier burden

Juntasopeepun and colleagues analysed 3,192 older adults and their main family caregivers from Thailand's 7th national survey of older persons in 2021. On average, carers felt a mild burden, but a heavier burden went with:

• having left the workforce
• living in an extended family
• the older person being in poorer health or needing more help with daily activities
• the older person having poor hearing
• not getting visits from community health workers

These are associations from one survey, not proof that one thing causes another.

What studies abroad have seen

In the UK, Xue and colleagues followed parents living with children under 16 across 10 waves of a national household study (2009 to 2020). Those who took on unpaid care of an older relative tended to see their mental health worsen, especially if they cared for more than 20 hours a week, and the change lasted several years. Those who cared intensively also tended to see their physical health decline. These are UK figures, and they show which things went together rather than proving cause.

The US National Institute on Aging (NIA) puts it simply: family caregivers often have to juggle work and family life, and the ongoing demands of caring for someone can strain even the most resilient person.

How can I share the load with my family?

Make the jobs visible

Write down everything that has to happen in a week for both the children and your parent, then share it out. The NIA suggests:

When older children help

Teenagers can often help a grandparent, but caring should not push out school and friends. The NHS page for young carers advises young people who help look after someone at home to let at least one teacher they trust know, so the school understands if homework is late, and to put aside some time each day for something they enjoy.

Living under one roof

If your parent is moving in with you, the NHS advice on sharing your home suggests thinking about:

• your relationship with your parent; tensions from the past can become harder in a shared home
• how day-to-day living will work, and how other people in the house, including your children, will be affected
• privacy for everyone, and some ground rules agreed before the move
• whether your parent is likely to need more care later, and whether that will be practical at home

How can I look after my own sleep and energy?

Sleep

The NIA advises caregivers to aim for 7 to 9 hours of sleep a night, to develop a relaxing bedtime routine, and to go to sleep and get up at the same time each day. The NHS page on tiredness and fatigue adds: relax for a couple of hours before bed, keep the sleeping area not too bright, noisy or warm, and avoid screens in the hour before sleep. If nights with your parent are broken, taking turns with another adult, even one or two nights a week, gives you some full nights of sleep.

Time that is just yours

The NIA's suggestions for overwhelmed caregivers include:

• Be active: find something you enjoy, such as walking or dancing; even short periods count.
• Eat well: a balanced diet with a variety of healthy foods, and plenty of water.
• Make time to relax: each week, do something that has nothing to do with caring, even a favourite TV show or a hobby.
• Be kind to yourself: you don't have to look cheerful all the time; sadness, frustration and guilt are normal and understandable.

Your own health

Carers often put their own appointments off. The NIA suggests making the doctor's appointment you have been delaying and telling your doctor that you are a caregiver.

Where can I get help in Thailand?

Community long-term care

Thailand runs community-based long-term care under the Universal Coverage Scheme to support family caregiving for older people who depend on others. It is organised at subdistrict level and involves volunteer caregivers. Ask your local hospital or subdistrict health centre whether your parent can be assessed.

Someone to talk to

In Thailand, the 1323 mental health hotline is free to call, 24 hours a day. The NIA also suggests talking to a trusted family member or friend, and joining a support group for caregivers, online or in person.

When should I see a doctor about being this tired?

Book an appointment

The NHS advises seeing a doctor if:

• you have felt tired for a few weeks and are not sure why
• your tiredness affects your daily life
• you feel tired and have other symptoms, such as weight loss or mood changes

The NIA advises not waiting until you are completely overwhelmed. Tell your doctor that you are a caregiver, and if you feel anxious, frustrated or down, ask about a counsellor. If you use any medicines or supplements, tell your doctor or pharmacist.

Get help straight away

If you have thoughts of harming yourself, or the person you care for, get help now: call 1323 or go to the nearest hospital emergency department.