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Dear Editor
Today, with the increase in the elderly population and life expectancy, the need to use care services for this significant part of the population is increasing [1]. Beliefs, cultures, and social norms among different ethnicities and races are vital in the extent and nature of care. Two types of care exist, informal and formal. According to statistics by the Secretariat of the National Council on Aging, almost 0.2% of the elderly receive formal care. Therefore, a significant percentage of the elderly live with their families [2]. 
The cultural background of the Iranian society in respecting the elderly, high costs of care centers, fear of being judged by others, religious factors, such as disinheritance, and Islam’s emphasis on benevolence to parents are among the factors affecting the preferences of the elderly who live with them [3].
According to the latest statistics released by Iran’s Statistical Center, 42.3% of the country’s households consist of four or more people and more than 20 million of the population are children and adolescents younger than 18 years of age, which make up more than 25% of Iran’s population. In addition to caring for elderly parents, family caregivers also care for and support children. Children (such as the elderly) need physical care, financial and emotional support, independence, and education, etc. [2].
A group of family caregivers who care for both generations of the elderly and children is called the sandwich generation. The care provided by this group of family caregivers is complex and multidimensional. The sandwich generation may experience challenges in the field of emotion, relationship change, physical issues, environmental challenges, time constraints and care demands, work balance, childcare, parenting, marital relationships, and other life demands [4, 5].
 The number of sandwich generation in the world and Iran is increasing. Currently, 9% to 15% of the world’s population belongs to the sandwich generation [6]. No exact statistics are estimated for this group in Iran but based on the statistics of home-dwelling elderly people, children younger than 18 years, and households of four or more people, it can be predicted that the population of the sandwich generation in Iran is increasing. Therefore, this group of caregivers should be considered. 
Policy-making and planning for this group are significant necessities in paying attention to the elderly and their families. Further, researchers have neglected the sandwich generation in the field of family, the elderly, and children. However, not focusing on this generation affects the other two generations (elderly and children). Involving the sandwich generation in programs, actions, and interventions can increase the quality of life of families, reduce government costs for care, and increase the presence of the elderly in society and intergenerational interactions.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the University of the University of Social Welfare and Rehabilitation Sciences (Code: IR.USWR.REC.1400.236).

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors.

Authors' contributions
All authors equally contributed to preparing this article.

Conflict of interest
The authors declared no conflict of interest.


References

1. Salmannezhad M, Momtaz YA, Sahhaf R, Rassafiani M, Foladi SH. The effect of "elder care by elderly people program" on life satisfaction and quality of life among institutionalized senior citizens. Journal of Education and Health Promotion. 2022; 11:1. [DOI:10.4103/jehp.jehp_487_20] [PMID] [PMCID]
2. Statistical Center of Iran. [Population and housing censuses 2016 (Persian)] [Internet]. 2023 [Updated 2023 September 25]. Available from: [Link]
3. Aghajani A, Nazari AM, Zahrakar K. [Study of psychological distresses in married children caring for their aging parents: A qualitative study (Persian)]. Salmand. 2018; 13(3):346-61. [DOI:10.32598/sija.13.3.346]
4. Noor S, Isa FM. Malaysian sandwich generation issues and challenges in elderly parents care. International and Multidisciplinary Journal in Social Sciences. 2020; 9(3):289-312. [DOI:10.17583/rimcis.2020.5277]
5. Riley LD, Bowen CP. The sandwich generation: Challenges and coping strategies of multigenerational families. The Family Journal. 2005; 13(1):52-8. [DOI:10.1177/1066480704270099]
6. Timmers M. Workshop’family supportive supervisor behavior for the sandwich generation’. Paper presented at: ESF Time4Help partner meeting. 28 January 2020; Brussels, Belgium. [Link]