Helping the Sandwich Generation balance health care needs for their global family

Health care

As the next generation of wealth holders grapples with an increasingly global world, how can families be more prepared for health care needs?


The COVID-19 pandemic has highlighted the need for families to plan ahead for a health crisis, in particular, providing improved care for older generations most at risk.

In many families, the responsibility of ensuring older people receive proper medical care lies with adult children and includes finding the best medical professionals and facilities. It’s a challenge for many in the so-called “Sandwich Generation” — the commonly used term for adults responsible for bringing up their own children and caring for aging parents.

“Since the insurgence of COVID-19, I am much more conscious of my health, my children’s health and my parents’ health… How do we keep my parents, who are nearing their 80s, out of harm’s way as their health is at greatest risk?” a mother in the United Kingdom said in a recent report by RBC, in partnership with Campden Wealth.

Health and wealth: It’s more than just financial

The Shaping tomorrow, today report shows just one-in-five of these next-generation wealth holders feels very prepared to care for their aging parents, while a stark 80 percent are concerned about the care their parents will receive.

“I’m very blessed that we have financial resources, but at the end of the day, it’s really about the people,” a 40-something women from the United States said in the report. “The money becomes irrelevant if you’re sick or alone or you make poor choices.”

For 39 percent of the report’s respondents, their biggest concern around caring for aging parents was time, followed by who in the family will take primary responsibility for them (17 percent).

A major challenge is geography, as more adult children move to different cities and countries — far from their parents — to pursue careers and raise their own families. The closing of borders and reluctance to travel during the COVID-19 pandemic has made that separation even more difficult for families.

The pandemic’s physical distancing measures have accelerated the demand, use and availability of virtual medical services over telephone, video and other online options, giving people virtual access to everything from checkups and prescription refills to at-home monitoring of medical symptoms such as high blood pressure.

It’s a rapidly changing system the Sandwich Generation is being forced to figure out to help their parents stay healthy from afar.

Health care for your personalized needs

Navigating the health-care system, either in-person or online, can be a challenge for many families.

“We have clients saying, ‘yes, you’re doing a great job for us financially, but we’d like you to help take care of us in a more substantive way, beyond wealth — which is health,’” says Vijay Parmar, president of RBC Phillips, Hager & North Investment Counsel Inc.

“After all, wealth isn’t just financial, it’s also about physical and mental health. People want to be healthy, not just wealthy. We try to create a very strong understanding of our clients beyond just the financial.”

For instance, Parmar says clients are increasingly asking for help finding health care providers to meet their specific medical needs. “There’s a niche of patients out there that want a differentiated level of health care and health-care planning at a more holistic level,” he says.

One situation involved a client whose child, living in another city, had a serious medical condition. Through vast professional networks, the investment counsellor was able to connect the client and his child to a private health provider, which scheduled the much-needed surgery within days.

“The connection added a tremendous amount of value far beyond what we can do for clients in a financial sense,” Parmar says. “This is a direct example of how having access to this kind of medical care can help deliver a solution sooner.”

“Health care is extremely personal,” adds Parmar. “Your client has to feel comfortable sharing their medical issues with you. It’s a very sensitive approach, based on trust that’s built up over time.”

How to find ‘real wealth’ from an advisor

Many clients are looking for advisors to provide them with “real wealth,” which considers the combination of time, health and wealth, says Kim Mason, executive vice-president and head of RBC Private Banking. Time is something few people, in particular the Sandwich Generation, have enough of today.

“Many already have wealth, but not necessarily the time nor health to enjoy it,” she says. “Our role and desire is to be seen as partners, providing advice to them for their household financial wellness, but also their physical and mental wellness, which also has implications on their success.”

Services like these are more in demand as health care continues to move into the virtual world. Mason says advisors can help guide families through the complexities — no matter where in the world they live.

She also urges families to proactively discuss health care matters, alongside wealth and estate planning, to ensure they’re ready for a potential medical event. Families should also bring advisors in on the conversation, to ensure the right plans are in place.

“By having these conversations earlier, advisors can also play a more important and deeper role in helping plan for how to manage it,” Mason says.

She says the discussions are part of a broader “real wealth” plan that will serve the family now and well into the future.

“It’s about understanding the depth of the relationships we have not just today, but for generations,” she says. “Our job will evolve to provide value — and health care is a natural input to wealth planning.”

Download the full report

Explore the motivations, insights and attitudes of those who have the power to shape the world around us.

RBC Wealth Management is a business names used by various affiliates of Royal Bank of Canada. Private Bankers are employees of Royal Bank of Canada and registered mutual fund dealing representatives of Royal Mutual Funds Inc. (RMFI). Financial planning services and investment advice offered through Private Bankers are provided by RMFI. RMFI, RBC Global Asset Management Inc., Royal Bank of Canada, Royal Trust Corporation of Canada and The Royal Trust Company are separate corporate entities which are affiliated. RMFI is licensed as a financial services firm in the province of Quebec.

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The information contained in this report has been compiled by Royal Bank of Canada and/or its affiliates from sources believed to be reliable, but no representation or warranty, express or implied is made to its accuracy, completeness or correctness. All opinions and estimates contained in this report are judgments as of the date of this report, are subject to change without notice and are provided in good faith but without legal responsibility. This report is not an offer to sell or a solicitation of an offer to buy any securities. Past performance is not a guide to future performance, future returns are not guaranteed, and a loss of original capital may occur. Every province in Canada, state in the U.S. and most countries throughout the world have their own laws regulating the types of securities and other investment products which may be offered to their residents, as well as the process for doing so. As a result, any securities discussed in this report may not be eligible for sale in some jurisdictions. This report is not, and under no circumstances should be construed as, a solicitation to act as a securities broker or dealer in any jurisdiction by any person or company that is not legally permitted to carry on the business of a securities broker or dealer in that jurisdiction. Nothing in this report constitutes legal, accounting or tax advice or individually tailored investment advice.

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