Naval architect Jayanta Roy, 44, lives with his family in their Kolkata home. There's wife Rupa, 39, son Deepro, 10, and parents, Kalyan Kumar, 65, and Kana, 65. In October 2007, Kalyan had to be hospitalised with respiratory trouble. Since he has no medical insurance, Jayanta had to pay the Rs 20,000 for his treatment. But the Rs 1,000 or so worth of medicines Kalyan and his wife need each month is paid for from his pension of Rs 8,500. 

While Jayanta is financially vulnerable to his parents' medical emergencies, at an emotional level he and his parents are glad that he can help during their moments of need. But life is never that simple. Jayanta's own financial needs are swelling. He has to pay home loan EMIs of Rs 17,000 for 14 more years, and Deepro's education costs are looming. He doubts that he is prepared to be, 25 years later, where his father is today. 

	Medical Cushion OptionsStandard and special health insurance policies and their premiums available for senior citizens Cheapest regular health covers Sun insured (Rs lakh) Age 0.50 1.00 2.00 3.00 4.00 5.00 7.50 10.00 60 1,799 Oriental Insurance 2,255 Cholama- ndalam 4,002 Cholama- ndalam 5,935 Cholama- ndalam 7,695 Cholama- ndalam 9,140 Cholama- ndalam 14,669 Cholama- ndalam 16,647 Cholama- ndalam 65 1,799 Oriental Insurance 2,255 Cholama- ndalam 4,002 Cholama- ndalam 5,935 Cholama- ndalam 7,695 Cholama- ndalam 9,140 Cholama- ndalam 14,669 Cholama- ndalam 16,647 Cholama- ndalam 70 2,369 Oriental Insurance 5,196 Cholama- ndalam 10,018 Cholama- ndalam 14,428 Cholama- ndalam 18,562 Cholama- ndalam 22,696 Cholama- ndalam 14,669 Cholama- ndalam 16,647 Cholama- ndalam
	How to read this table. If a 60-year-old wants a Rs 100,000 cover, the lowest premium on offer is Rs 2,255 by Cholamandalam. These are only base premiums; actual premium depends on health profile. Taxes extra. For Cholamandalam, premiums for ages 60-70 are only for renewals and dependent parents.
	Special health covers for senior citizens Insurer Bajaj Allianz General National Insurance Star Health Insurance United India Insurance Policy Silver Health Varistha Mediclaim Senior Citizens Red Carpet Senior Citizens Entry age (yrs) 46-70 60-80 60-69 61-80 Renewals up to (yrs) 75 90 Not specified* 80 Max cover (Rs lakh) 3 1** 2 3 Premiums: 61-65yrs 66-70 yrs 71-75 yrs 76-80 yrs 7,170 10,755 13,444 NA 4,180 5,196 5,568 6,890 5,000 5,000 5,000 5,000 3,715 4,417 4,872 6,013 Cover for pre- existing disease From second year From the policy inception From the policy inception After 3 claim- free periods Pre-insurance medical tests Required*** Required**** Not Required Required
	Oriental Insurance and New India Assurance have general mediclaim policy which is extended up to the age of 80. Pre-existingdiseases are covered in some cases but the premium load will be decided by the insurance company *Star Health says guaranteed renewals beyond 69 years but does not specify the age limit for Rs 200,000 available for additional premium **Anual premium for sum insured of Rs 100,000, excluding taxes ***Reimbursed if proposal accepted ****No medical check up required if holding health plan for preceeding three years

India's emerging 'Sandwich Generation'. Jayanta is part of India's emerging 'sandwich generation'. It comprises, says the Merriam-Webster Dictionary, people caring for their ageing parents and supporting their own children. The term is a US coinage of the Seventies that gained enough currency to be included in the dictionary. People have dealt with being sandwiched for generations, but with the social structure changing this set is facing new challenges and must prepare for it differently. 

What's Creating the Sandwich Generation? 

Rise of nuclear families. Based on Census of India data, Bert N. Adams and Jan Trost, in Handbook of World Families, say the percentage of Indian households that are joint families has declined from 20 per cent in 1981 to about 18.50 per cent in 2001. Simultaneously, the percentage of nuclear families has risen from 68.10 per cent to 70.40 per cent. In other words, more and more Indian adults are staying away from their parents. In many cases, that's limiting their concern to those that they live with. 

Increased job mobility. Helping the creation of nuclear families is work-related mobility, which has increased over the same period and continues to do so. Experts say that people joining the workforce today will end their careers after having been in as many as 15 jobs, not all of them in one place. This, along with increasing urbanisation and industrialisation of India, traditionally a catalyst for growth of nuclear families, is breaking up the joint family system. 

Increasing longevity. Meanwhile, Indians are living longer than before. Today, an urban Indian can expect to live till the age of 80, perhaps more, longer than the 60-plus years that his father could, and will need a much bigger corpus to see him through retirement. Unlike many other countries, India doesn't have old-age doles that provide baseline retirement income and public healthcare systems that provide subsidised healthcare. Clearly, among the urban Indian middle class, the children will have to eventually take up the role of providing financial and other support, despite the changing family structures.

Different folks, different strokes. The impact on the members of the 'sandwich generation' manifests itself in different ways. Take the case of Delhi-based Saikat Roy Chowdhury, 37, a manager at a trade event firm. In his case, it is not money but caregiving that is the foremost issue, something that is exacerbated by the fact that he and his aged parents stay in different cities.

Saikat lives with his HR consultant wife, Shinjini, 36, and son, Soham, 6. This limits the extent to which he can take care of his parents Soumen, 73, and Shila, 62, who live in Kolkata. The fact that his father is strongly independent does not make the task any easier. 'We are fine; you need to look after yourself and your family' often ends any effective conversation even before it can start.

His parents' support system is in people of their age. Minor illnesses are often attributed to 'advancing years' and ignored. Saikat worries. It will be a good four hours before he can reach home if there's a contingency.

"Today, parents want to be independent; they do not want to live off their children's earnings," says Mumbai-based Gautam Nayak, partner at chartered accountancy firm Contractor, Nayak & Kishnadwala, who, among other things, handles legacy and money management matters for a number of elderly clients. He adds, however, that many of them do need people to do their running around for them.

Like Saikat and Jayanta, an overwhelmingly large number of the urban mass affluent Indians around 40 are at a stage where the responsibility of the parent is getting added to those of their children. The umbilical cord remains intact, even across geographical distances.

Apart from looking after her daughters, she has to meet half the expenses in her parents' household, where she now stays. Evidence of her vulnerability came in when her father, Dipankar, 71, had to undergo complex heart surgery in June 2006 at a private hospital. The total cost: Rs 600,000. Since he did not have medical insurance, after drawing out her father's available cash, Malini and her sister had to chip in with the rest, even borrowing to cover the last bit.

Fortunately, her employee health benefit covers her parents as well as her daughters. She could get most of the costs reimbursed.

Not everybody can. So, experts recommend adequate health covers for ageing parents. "It helps you manage the risk of unforeseen and substantial lump sum expenses without jeopardising the rest of your finances," says Swami Saran Sharma, a tax and risk management expert. It makes sense to buy health insurance for yourself too, he adds. 

You can also include your parents in your medical policy and avail a deduction of up to Rs 15,000 under Section 80D. If your parents are senior citizen taxpayers, you could gift them up to Rs 20,000 a year and they will get a tax break if they pay their health insurance premium. This cuts the household's tax outgo. Now, special health covers are available for the elderly along with the regular covers.

Create an effective support system. Parents might require funds to supplement their retirement funds or they may simply need logistical support to manage their finances, especially if they live in another city. Sometimes, relocation of either the parents or children is the best way out. 

Shubhomoy Ray, 37, lives in Delhi with his wife and 2-year-old son, and has another child on the way. About a year ago, he quit his job and started his own consultancy company with two partners. His brother Shantomoy, 34, who runs an advertising agency, too, lives in the same city with his wife and 3-year-old daughter. A few months ago, they shifted their parents from Kolkata to Delhi.

Their father, Debatosh, 66, was living in his house in Kolkata after retirement, but was spending a lot of time in Delhi. Besides the problem of looking after the house when they were away, there was the issue of having someone at hand in case of an emergency.

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