Many adults in Asia find themselves supporting ageing parents while raising children, managing careers, and saving for retirement. Yet support for this particular group of people, the sandwich generation, often remains fragmented, difficult to navigate, or poorly understood.
Grace Cheng, founder of Hong Kong-based social enterprise Agewhale, spends much of her time helping families navigate the realities of ageing and caregiving. Through workplace programs, caregiver consultations, and advocacy efforts, she has seen firsthand how caregiving can affect people’s finances, careers, health, and relationships.
Grace started Agewhale to help families like hers support elder relatives. When her grandmother began declining, her family confronted many questions they hadn’t anticipated, like how to make the apartment where her grandmother had lived for 50 years safe and comfortable for an older person. Nor did they know where to turn for help.
In this conversation, Grace discusses why many in the sandwich generation struggle in silence, the hidden costs of delaying action, and what employers, governments, and communities can do to better support a growing segment of the population.
Her comments suggest that many societies still view support as a matter of eldercare rather than recognising caregivers as a group with their own distinct needs.
Q: Are support services for caregivers becoming more available?
Grace Cheng: I think there are more services available, at least in Hong Kong. But when we talk about sandwich caregivers, I think it's a bit different. Much of the recent attention has been driven by concerns about very vulnerable caregivers, such as elderly spouses caring for each other or lower-income families.
For working caregivers who are juggling jobs, children, and ageing parents, there has been some improvement, but I wouldn't say support is very targeted yet. Caregiver-friendly employer initiatives have started to emerge. But we’re still very much at the awareness-raising stage rather than seeing significant policy changes or resources directed at this group.
Q: Where do sandwich caregivers typically turn for support?
Grace Cheng: In Hong Kong, we're privileged to have the option of hiring foreign domestic workers. That's a major source of support for families who can afford it and have space for them.
But for many others, they simply do it themselves because they have no idea what services are available through the government, NGOs, or the community. In a pilot we conducted with 20 companies, we asked employees whether they knew where to find caregiving support. More than 90% said they didn't.
It’s also something we see in our one-on-one social worker consultations. Most working caregivers have no idea what resources are available to them. Part of that is the system itself. It’s fragmented and hard to navigate for busy professionals. Or they assume they won’t qualify because they have a job. So, they end up carrying the burden themselves.
Q: What are the biggest pressures facing sandwich caregivers?
Grace Cheng: Time is probably the biggest one. They’re trying to split their time across work, children, parents and everything else, which often means they don't get enough rest.
The second major pressure is financial. Most people plan for childcare expenses. They budget for schools and other related costs. But many people don’t know much about their parents’ financial situation. They don’t know whether their parents have insurance, how much they’ve saved, or whether they can afford future care.
When a health crisis happens and parents can’t cover the costs, those expenses naturally fall on the children. That’s usually not something they have budgeted for.
Then there’s the emotional burden. We hear from caregivers who don’t feel like they’re being a good parent, a good son or daughter, or a good employee because they’re trying to do everything at once.
Q: Why do so many families wait until a crisis before seeking help?
Grace Cheng: Often, it’s because they don't see the need. A common attitude is: "My dad seems fine. He’s going to yum cha and playing mahjong." People have a hard time imagining that a stroke, cancer diagnosis, or fall could happen suddenly.
Even when services are available, older parents may resist them. They may refuse a helper coming into the home or reject the idea of attending a day-care centre. Adult children often find those conversations difficult to navigate. Even if they know help exists, they don’t have the skills or confidence to persuade their parents to accept it.
There’s also a structural issue. In Hong Kong’s public system, many subsidised long-term care services are only available after an assessment determines that someone’s impairment is already moderate or severe. The system is designed that way because resources are limited. But it means support often arrives quite late in the process of an ageing parent’s decline.
Q: What are the costs of waiting too long?
Grace Cheng: It can create a vicious cycle. Ideally, we want to prevent a fall, a hospitalisation or a serious decline in health. We want people exercising, maintaining their strength, and making simple modifications to their homes. But because prevention isn’t common practice, accidents become more likely. Once an accident happens, the recovery journey is much more complicated than taking preventive action earlier.
Q: How can we encourage caregivers to seek help earlier?
Grace Cheng: We need more conversations about what happens when families wait too long. People often only fully understand the risks after something happens to a friend, neighbour, or relative. That’s why storytelling is so important.
At Agewhale, we’ve recruited caregivers to become ambassadors to share with others what they learned through difficult experiences. They weren’t prepared for the role and didn’t know where to find help at first. By sharing those stories, hopefully others won’t have to learn the same lessons the hard way.
We also need to make support more accessible. Many services are provided through elderly centres where caregivers with jobs would be unlikely to encounter them. That’s one reason we’ve focused on bringing information and support into the workplace through our educational talks and onsite social worker consultations.
Q: What role can employers play?
Grace Cheng: Employers have a much bigger role to play than many realise, and it starts with understanding their own workforce. Most companies can't tell you how many caregivers they employ or how caregiving affects productivity, and people managers frequently lack confidence or the tools supporting staff who are caregiving. That's why we encourage employers to better understand their people's needs and equip managers with training.
When we run workplace talks, people suddenly discover that many of their colleagues are dealing with similar issues. That helps normalise the conversation and reduces the sense of isolation.
Employee resource groups and facilitated peer support can be especially effective because they create a safe environment for people to share their experiences and learn from each other.
Ultimately, this kind of support isn't just good for employees, it's good for business too. When people feel supported, they're less stressed, more present, and more likely to stay, which benefits both the employee and the employer.
Q: Do caregivers neglect their own needs?
Grace Cheng: Absolutely.
When everyone else needs attention, caregivers are usually the ones making sacrifices. They sacrifice sleep, wellbeing, and self-care.
Long-term career growth can suffer as well. We’ve heard from people who turned down promotions, reduced their working hours or even resigned because they simply couldn’t manage everything.
The impact on career development can be particularly significant for women who still take on a large share of caregiving responsibilities.
Q: What’s the biggest shift you’d like to see in how societies think about caregiving?
Grace Cheng: I’d like to see caregivers recognised as a group with needs of their own.
In many places, caregiver support is still bundled into eldercare services. Support is designed around older people, rather than around the people caring for them.
As populations age, I think governments, employers, and healthcare systems will need to recognise that caregivers are not just supporting older adults. They are a population with distinct financial, emotional, and practical needs that deserve attention in their own right.
