Ten years ago, when Geeta K Vemuganti, 45, began working at her present job as an ocular pathologist at L V Prasad Eye Institute in Hyderabad, her biggest worry was how her six-year-old daughter would manage to braid her hair in the mornings. "I had to be at work by 7 am most days, and so some of these things had to take care of themselves!" she recalls.
Today, her daughter is in college and quite independent, but reaching office by seven is still a struggle for Vemuganti. "Now, it's my father-in-law who needs me in the mornings - his blood pressure needs checking, or his pulse rate has to be monitored, or he just wants to talk to me about how he feels," she says.
Many women in their 40s and early 50s may identify with this situation. The diaper-changing years are long past; children do not need to be accompanied everywhere and no homework needs to be supervised. But other demands kick in to fill the space left by intensive mothering.
Vanitha Ganesh, 42, an administrator in a private hospital in Hyderabad, had to take more than two months of leave, much of it unpaid, in order to care for her ailing mother-in-law. Her two daughters are beyond needing constant attention; one is working and the other is in the final year of college, and she was just about at that stage in her career where a bit of focus would have gone a long way. Ganesh and her husband could not afford to get paid help round-the-clock, so one of them - more often Ganesh - had to stay home to provide the full-time care required.
In the past year, Rama Bharadwajan, 50, has exhausted practically all the leave due to her from her bank job. "It's the most time I have taken off since my children were born," she says. Her children are now grown, but her father-in-law, who recently suffered a stroke, needs more care than can be provided by his own wife, whose arthritis is beginning to severely affect her mobility. Bharadwajan's husband's job requires a lot of travel, so the primary caregiving and supervision of daily care is her responsibility.
As Vemuganti notes, this kind of care-giving has always been a natural part of the family cycle. Parents take care of their children, and the children then take care of their parents, in a sequential cycle. But shifting demographics have altered the curve of this cycle somewhat. Two or three decades ago, there was a good 10 to 15 year gap between raising one's children and caring for one's parents. This time allowed the generation 'in between' to generate their own resources for retirement, catch up on professional growth, and perhaps (in cultures like India) fulfil other social obligations, such as the marriage of their children.
Today, however, marriage happens later in life, and the first cycle of care-giving - raising children - is very quickly followed by the second. "Personnel policies do not formally recognize this cycle," says Vemuganti. "Maternity leave is the only concession they make to family responsibilities." She feels that organizations could adopt a more 'benevolent' approach that would allow caregivers to fulfill their familial obligations without compromising on their careers.
Shifting demographics is leading to yet another trend that affects the care-giving responsibilities of the generation in between - sometimes referred to as the 'sandwich generation', a term coined by sociologist Dorothy Miller in 1981.
Because an increasing number of educated urban men and women marry relatively late in life, their dual responsibilities - caring for young children and ageing parents - often occur simultaneously. Researchers studying western cultures in transition have commented on the particular stresses faced by women who perform multigenerational care-giving roles. These 'women in the middle' play multiple complex roles - mother, daughter, daughter-in-law, wife, employee and caregiver - that must all be managed simultaneously.
After 14 years in the US, Suchitra Reddy, 42, recently moved back to Hyderabad on the death of her mother, so as to care for her ageing father and mentally-disabled sister. Her own children, at three and eight, are still very demanding. "I'm constantly pulled in different directions because of all their competing demands," says Reddy.
The problem appears to be compounded by a variety of accompanying social changes - the break up of extended family networks, higher costs of living and, for the middle class, lifestyles that demand higher and higher incomes. Elders often have to move out of familiar contexts and give up networks built over time so that they can be taken care of by their children, whose professions take them far from home.
"Of course there's another side to this - these elders often do this to be caregivers to their grandchildren - but that seems to be a more commonly accepted and more clearly defined role," says Vimal Balasubramanian, 60, a Hyderabad-based writer and former journalist. "There are a lot of issues surrounding care-giving, particularly the gender dimension, that need to be explored."
"The question is: Is there a trend here that we as a society need to pay attention to?" she asks. Balasubramanian feels that the stress involved in care-giving needs to be explored further, as it probably varies across communities and socio-economic groups. As we move to a society in which the elderly form an increasing proportion of the whole, where care-giving roles cannot be shared among several siblings (as families get smaller), and where the income-generating demands on families increase, we need to think about how and where support can be provided.
For Reddy, it's a very long day. Though she is a stay-at-home mother and caregiver, the multiplicity of caring demands take their toll. One moment, she worries about getting the children to the bus stop on time; the next, she ferries her mentally-challenged sister to her special school. And the next, she makes sure that her father, who has early dementia, remembers to take his medicine. "I'm already making plans for my old age," she says, mentioning the possibility of assisted care in a retirement community. "I don't want my children to have to go through this!"