This as-told-to essay is based on a conversation with Carla Romagnano, who is in her 60s and lives in Idaho with her 84-year-old mom. The following has been edited for length and clarity.

In 2022 my mom suffered a serious fall after already receiving a dementia diagnosis. She fractured her femur and required round-the-clock support. I realized my dad could not manage that level of care alone, so we brought in an in-home aide for roughly a year.

My dad proposed relocating closer to me to reduce costs and stay near medical facilities. We agreed we could share the responsibilities between us.

My dad died unexpectedly

We listed their house for sale, expecting a quick transaction. Then my dad passed away from sepsis, which came as a complete shock given his good health. I somehow packed up the entire home, rising at 7 a.m. and working until midnight with limited assistance. We donated or sold what we could and transported the rest to my place, where I had already settled a few years earlier. The added belongings created even more clutter.

The situation felt overwhelming, yet I had promised my dad I would avoid placing her in a facility unless it became essential, and that point has not arrived. Suddenly everything rested on my shoulders alone. I miss my dad deeply; we had planned to handle this as partners.

After work I often sit in the driveway to gather myself before entering the house, where my second shift begins. I attend to my mom's needs, care for my two border collies, and plan the evening. It amounts to two full-time roles, and I would not wish this experience on anyone. Caregiving ranks as the most demanding work I have ever done.

My mom moved in with me in October 2023

I arranged home care for my mom because she faces a high risk of falls and relies on a walker. She lacks the strength to walk independently. She prefers routine, so if a regular aide cannot come we skip the visit rather than introduce someone new and cause added stress.

I sleep on a couch

I rest on the couch outside her room so I can reach her quickly if needed. With dementia she sometimes acts on impulse, and I wanted to prevent her from leaving the bedroom without help. A commode stays in her room for nighttime use, and she can call me if assistance is required. For nearly three years I have chosen the couch to keep her safe, unwilling to risk any delay by sleeping farther away.

I love my job and have no plans to retire

I have worked for the same grocery company for 45 years and transferred when I moved. I serve as a bookkeeper and assist with hiring. While I am at work a caregiver looks after my mom. Our schedules stay packed with personal tasks and medical appointments. Last year alone I drove 800 miles for visits and prescriptions; the prior year it was 600. My position provides my sole income, and I hope to continue if her condition changes. Retiring now is not possible. I have always aimed to reach 50 years with the company, and that goal still feels achievable. The benefits are solid, and union membership has supported my career throughout.

After 50 years the decision will depend on her health and our circumstances. With her illness, each day brings uncertainty, and time passes quickly.

I go to a caregiving group twice a month

The meetings offer a chance to discuss changes in our loved ones, share coping strategies, vent frustrations, and focus on self-care. Taking care of ourselves is essential if we are to support others.

My mom and I spend time with family and friends. She enjoys leaving the house and had lost significant weight before arriving, so few of her clothes fit. She likes visiting thrift shops. I create reasons to get her out, whether for groceries or other errands, because she wants to stay active and around people.

She loves Chinese food, so we dine weekly at a favorite restaurant and follow it with ice cream. Relatives or friends sometimes join us. For holidays we assemble baskets for children or wrap gifts together so she feels involved. She can no longer cook safely or handle laundry, yet she still contributes where possible and feels badly about the limitations.