Written by Holly Hazelton

Holly Hazelton is a people-focused content and communications leader with more than 10 years of experience supporting HR, benefits, coaching, and people analytics audiences. She has shaped employee experience narratives and content strategies for Workhuman, Crunchr, and AceUp, helping leaders create workplaces where people feel seen, supported, and connected. She also founded a global ERG for working parents, reflecting her belief that human-centered storytelling drives stronger performance and belonging.

Connect with Holly on LinkedIn.

This past August, my world was shattered when I got a call that my mom had fallen in the middle of the night. I immediately drove into Boston — half asleep and half in shock — and when I arrived, she was going into emergency brain surgery. My mom was having a hemorrhagic stroke. 

I didn’t realize it then, but this wouldn’t be her last hospital stay.

That was the day I unexpectedly joined the sandwich generation. It’s a somewhat endearing term for those of us who are simultaneously raising children while caring for our aging parents. 

There aren’t as many of us in this club as there are people who enjoy eating sandwiches, but still, we make up nearly 25% of U.S. adults. Plus, 71% of employees today have some form of caregiving responsibility. That includes childcare, elder care, medical coordination, household management, and unpaid labor.

Luckily for me, I was working part-time during the early days of my mom’s stroke and had the flexibility to support my family fully. Had I been working full-time, I would have quickly exhausted paid family leave and PTO while coordinating her care — all while juggling school schedules and the everyday logistics of parenting young children. Even so, there were some days I didn’t make it home in time to get them off the bus. 

I was stretched thin. 

When caregiving becomes a workplace issue

My experience isn’t an isolated one, and it reflects a reality many employers are already navigating. When caregiving responsibilities collide with full-time work, the effects extend beyond the individual employee and into day-to-day business operations.

Caregiving can cost employers $6,410 per employee per year in productivity loss, and employees who are caregivers miss an average of 3.2 workdays per month.

For HR leaders, this raises a pressing question: how can employers support the sandwich generation in a way that meaningfully reduces strain, without adding administrative burden or unpredictable costs?

One of the most practical options is caregiving stipends. These are a type of family stipend that employers can offer employees to support family members. Other types of family stipends typically include elder care stipends, fertility support, and childcare benefits.

Read ‘’Stipends for Caregiving Employees: Everything You Need to Know’’ to learn more about how to offer caregiver stipends in practice. 

What is an elder care stipend, and how does it work?

An elder care stipend typically rolls into a family stipend. It is a predetermined amount of money an employer provides to employees on a recurring basis to cover approved elder care expenses. 

Caregiving or elder care stipends can be granted monthly, quarterly, or annually, depending on your approach to benefits. You can also vary the categories of approved expenses based on your policy. Caregiving stipends can provide a financial safety net for:  

• Medical expenses
• Adult day care
• Children’s day care or babysitting services
• Personal care attendants 
• Transportation costs
• Home modifications or renovations
• Everyday personal needs 
• Household expenses 

The hidden costs of dual caregiving for employees and employers

Caring for even one other person is demanding. When employees are responsible for both children and aging parents, those demands compound quickly and create ripple effects that show up emotionally and operationally.

Sandwich generation employees perform complex, demanding work outside their regular hours, with little support. So it’s no surprise that caregivers are 48% more likely to have experienced increased anxiety and depression over the past year.

Carrying the mental load

Dual caregivers often feel constant worry and anxiety. We make medical decisions with limited context or preparation while assisting with homework or addressing behavior issues in our children. This unavoidable mental load often shows up as burnout, disengagement, or reduced capacity at work.

Financial strain 

Costs for childcare, elder care, transportation, meal support, and medical devices add up fast. Many caregivers pay thousands out of pocket each year, even when insurance or Medicaid covers some costs. Over time, that financial pressure limits employees’ ability to stay fully engaged at work or plan for long-term career growth.

Organizational impact: absenteeism, presenteeism, stalled careers

Many employees, myself included, try to keep caregiving struggles quiet at work, but the impact is felt nonetheless. If your sandwich generation employees feel overworked and underpaid before they even log on, it’s only a matter of time before the business experiences related pressure.

For organizations, the strain of caregiving shows up in measurable ways:

• Higher absenteeism: Working caregivers are twice as likely to take disability-related leaves of absence, and one-third of caregivers who take leave to care for family end up taking another leave for themselves.
• Missed promotions: One in five take demotions or leaves of absence to manage their intense responsibilities.
• Part-time transitions: 29% of caregivers are reducing their work hours.

Despite the growing need to support caregivers, Compt’s Midyear Benchmark Report found that fewer than 4% of companies offer caregiving stipends. This is a significant and surprising gap between employee reality and employer action, considering the number of family caregivers has increased by 45% over the past decade. 

For HR teams, this disconnect should be a wake-up call. Without intentional support, caregiving challenges translate into higher turnover, increased absenteeism, and lower performance and productivity — often long before they show up in engagement surveys or exit interviews.

Why flexible, multiuse stipends solve modern caregiving challenges

Addressing caregiving challenges doesn’t require adding more rigid benefits. Rather, it requires designing support that reflects how caregiving actually works. 

Caregiving needs rarely fit into neat categories. Employees may be supporting aging parents one month, coordinating childcare the next, or managing both at the same time. That variability makes rigid, single-purpose benefits ineffective and difficult to manage. This is where targeted family care stipends — or better yet, a flexible, single Lifestyle Spending Account (LSA) — come in. 

Unlike point solutions, with an LSA, employees can move between caregiving needs as their situations change:

• Childcare
• Elder care
• Transportation
• Groceries
• Visiting Nurse assistance
• Tutoring
• Wellness support

Other caregiving-related categories may apply here, depending on your team’s unique needs and how you structure your program. 

When my mom first went into the hospital in Boston, my expenses were primarily travel costs, lunches for myself and my father, and after-school care for when I couldn’t be there for my children. Upon returning home, we needed help purchasing sheets, blankets, and accessibility upgrades.

This is why flexible LSAs are so effective: they provide employees with direct support where it’s needed most, month by month, without forcing them into predefined categories that fail to reflect real life.

For HR, flexibility matters, too. LSAs reduce the need to juggle multiple point solutions or define numerous family scenarios. This makes it easier to offer solid benefits without adding operational complexity, and it trickles down to employees like me.

There’s also a generational aspect to all of this. Mercer uncovered that Gen Z and millennials want digital-first tools, personalized options, and flexible benefits, and when the benefits don’t address real needs, it can erode trust. Flexible stipends help close the trust gap by giving employees more choice rather than limited options.

The business case for supporting the sandwich generation

Supporting employees who are caregivers is a human decision — but it’s also a strategic one. When caregivers receive even modest levels of support, research shows the benefits extend beyond employee well-being to workforce stability, cost control, and better long-term performance.

Mercer’s CFO survey highlights why caregiving support aligns directly with finance leaders’ top concerns:

• 67% of CFOs view healthcare costs as a major concern.
• High-cost claimants are the #1 driver of increasing cost volatility.
• 72% say healthcare is less predictable than other expenses.

Caregiving support plays an important role here because it helps reduce disruptions that drive cost volatility, such as sudden leaves, burnout-related exits, and delayed care, which can lead to higher-cost health claims in the future.

As the workforce ages and healthcare costs continue to rise, the risk of inaction becomes harder to ignore. The sandwich generation is growing, and fewer families have access to affordable private care. This increases the likelihood that caregiving responsibilities will fall directly on your employees. 

Employers that fail to adapt risk compounding these pressures over time, particularly among experienced, mid-career employees who are hardest to replace.

In contrast, organizations that invest in flexible, modern caregiving support are better positioned to retain critical talent, plan benefits spending with greater confidence, and continue to innovate. For many organizations, especially midmarket companies, this shift isn’t theoretical. It’s here, and it’s already shaping how benefits strategies are evolving.

How midmarket companies are integrating family care reimbursements into broader benefits strategies

Among midmarket employers, caregiving support is increasingly being addressed through broader, more flexible benefits strategies rather than standalone solutions. Instead of adding more vendors, these organizations are using flexible stipends to consolidate support across caregiving, wellness, and everyday needs and drive a more holistic and manageable benefits strategy. 

Simply put, caregiver support isn’t just for large companies. 

Compt’s Annual Benchmark Report highlights how this approach is taking shape in the midmarket:

• 64% of employers offer all-inclusive LSAs (not just siloed categories), reflecting how midmarket organizations are consolidating support into broader, more flexible programs rather than adding new vendors.
• Average stipend funding reached $850 per employee in 2025, while midmarket employers averaged $1,055 per employee, demonstrating how midsize organizations are refining existing stipends to support multiple use cases and deliver holistic support in a predictable, manageable way.

Why leaders at midsize companies choose LSAs

LSAs have become a central organizing layer for modern benefits programs at many midsize organizations. Instead of adding new benefits each year, companies can use LSAs as a central hub for all types of benefits. This approach helps HR:

• Consolidate vendors. One platform can replace several separate solutions.
• Lower administrative workload. HR teams often lack time for manual reviews or managing specialized programs.
• Forecast budget needs for Finance. LSAs avoid unpredictable claims, unlike expanding medical or EAP programs.

Plus, this flexible, trust-based strategy grows with employee needs, which is especially important for those in the sandwich generation.

The takeaway for HR and Finance teams? Flexibility doesn’t have to mean complexity. For midmarket employers, it often has the opposite effect.

How to design a caregiving or elder care stipend that cuts down admin work

Once an organization decides to support caregivers more intentionally, the next question is how to do so without adding administrative burden. Benefits programs don’t fail because of poor design; it’s because too many rely on manual workflows, fragile spreadsheets, disconnected systems, and tools that weren’t built to handle stipends at scale. 

Simply put, even the best-laid benefits plans can go awry without the right system in place.

Luckily, whether you’re looking to offer a single caregiving stipend or a holistic Lifestyle Spending Account (LSA), Compt can help transform your benefits while cutting down on admin work. Compt’s flexible employee stipends help you:

• Design a customized, easy-to-modify plan including spending categories, amounts, and timeframes.
• Automate accurate payments with built-in tax compliance and payroll integrations. 
• Simplify reimbursements by allowing employees to snap a photo of their receipt, upload it to the platform, and submit. 

For an example of how this works in practice, read “How to Set Up an Employee Stipend in Just One Hour.”

Simplify caregiving and family support with Compt

Supporting caregivers should feel authentic, not forced. Have you ever had an experience like mine, where a friend offered to help, but gave strict limitations on what they were willing to do to support you? Of course not, and it should be the same for caregiving stipends. These benefits are meant to help, not hinder, people from accessing the resources they need.  

Compt is designed to help support employees and their families, including employees in the sandwich generation. It offers the flexibility employees demand and the compliance employers expect.

Compt’s LSAs were designed for employers seeking to support families and caregivers without additional administrative work. With flexible categories, employees gain access to benefits for a wide range of needs, ensuring families at every stage can find support that fits their real lives. Plus, Compt’s tax-compliant reimbursement system makes it easy for teams everywhere to access benefits without extra paperwork.

Support your sandwich generation employees with flexible, reimbursement-based LSAs built for real caregiving needs. Schedule a demo with Compt today.

FAQs: Supporting the sandwich generation