Taking care of aging parents is becoming more and more common these days. One expert says caregiving today is comparable to running a small medical unit in the home.
Courtesy photo
By Sunita Sohrabji
Contributing Writer
SAN FRANCISCO — When Dan Salinger thinks about when his caregiving journey began, he realizes it didn’t start with a single dramatic event. Instead, it happened slowly, and so gradually that he didn’t even realize the role he had stepped into.
“I was a caregiver long before I knew I was a caregiver,” Salinger told reporters last month during an American Community Media news briefing. “I had my dad with me for about five years, but the caregiving journey really started 10 or more years ago.”
Salinger’s 93-year-old father had been living independently before small but significant changes began to worry the family.
“One day he walked into the room he had napped in a thousand times and said, ‘Oh, you put in a new room,’” Salinger recounted. “That was the first severe symptom. It opened our eyes. This was not normal aging.”
Then came the misplaced cashier’s check, the unexplained bruises, the driving mishaps.
“That was the day my dad moved into my brother’s house,” he said. “Within a week, we realized it was too hard for any one person to do alone.”
His father eventually moved in with him full time. Last year, a fall resulting in a broken hip changed everything.
“Since then, every single need he has, someone has to be there,” Salinger said. “Assisting with the bathroom, showers, eating — everything.”
Salinger, a former attorney, had already stepped back from full-time practice after a heart attack in 2019. Caregiving has been financially destabilizing, he said, though his father’s unexpected popularity on social media helped bridge a small portion of the gap.
“But that’s like hitting the lottery,” he said. “It’s not something you can rely on.”
What has sustained him, he said, is his wife.
“I couldn’t do this without her,” Salinger said. “Anytime you bring someone into your home, it disrupts both lives. Watching her change my dad at three in the morning — she’s become this amazing mother-like caregiver.”
The experience, he said, has reshaped him. “It’s the most difficult thing I’ve undertaken, but also the most rewarding. I’m a better person, more empathetic. I like myself today more than I did when I was working and playing full time.”
There are more than 7 million family caregivers in California, noted Susan DeMarois, director of the California Department on Aging.
“These are your neighbors, your coworkers, your relatives,” she added. “People quietly stepping in to help loved ones with everyday tasks.”
But the biggest barrier to supporting them is that many don’t recognize themselves as caregivers, she said.
“If you ask someone directly, ‘Are you a caregiver?’ they will probably say no,” DeMarois said. “But if you ask, ‘Do you drive your mom to appointments? Do you pick up your husband’s medications? Do you help your neighbor with meals?’ — that’s caregiving.”
California’s 33 Area Agencies on Aging (AAAs) and 11 caregiver resource centers (CRCs) are designed to support families statewide. Still, people often don’t know where to start.
“These systems have decades of experience — 50 years of AAAs and 40 years of CRCs,” DeMarois said. “But the first step is recognition. People need to know they’re not alone.”
Her own caregiving experience shapes her work.
“I cared for both my parents,” DeMarois said. “My father with heart disease, my mother with dementia. I know what exhaustion feels like. I know the emotional weight. None of this is theoretical to me.”
“Our resources can help alleviate part of the strain: emotional, financial, or physical,” said DeMarois.
Alma Valencia’s caregiving journey began even earlier than she realized — but unlike Salinger, her mother was just in her late 50s when symptoms appeared.
“My mom, Arminda, wasn’t herself,” Valencia said. “Bills were piling up. People we didn’t know — and didn’t trust — were showing up at her house. She was forgetting basic things. But we thought it was menopause, or stress, or depression. Dementia wasn’t even on our radar.”
Her mother stopped paying her mortgage. She misplaced important documents. Her personality seemed to shift.
“We were trying to solve a mystery while raising our kids,” Valencia said. “I was in the fashion industry, working full time. I was juggling my career, parenting, and this growing worry about my mom.”
Valencia became her mother’s power of attorney to avert financial disaster — but the medical answers didn’t come quickly.
“We had misdiagnoses for years,” she said. “It took a long time to finally hear the words ‘frontotemporal dementia.’”
Her mother moved in with her family in 2019, just before the pandemic. Through Medi-Cal, she qualified for In-Home Supportive Services, allowing Valencia to be compensated for part of her caregiving work. She went from earning $90,000 a year in the fashion industry to just $17.50 per hour for caring for her mother.
The caregiving experience reshaped her family life.
“I’m part of the sandwich generation,” she said. “My husband has been my rock. Spouses are unseen heroes. And my kids had to learn why their grandmother was changing. They would ask, ‘Why is Nana angry?’ or ‘Why does she forget me?’ I had to teach them compassion for something even adults struggle to understand.”
Valencia said she still learns something new every day.
“Caregiving forces you to grow,” she said. “It pushes you into roles you never imagined — advocate, medical coordinator, financial manager, peacemaker, educator.”
Her message to other caregivers: “You’re not failing. You’re adapting. And that’s the bravest thing you can do.”
Dr. Donna Benton, director of the USC Family Caregiver Support Center, placed the issue of caregiving in a broader historical context.
“For most of American history, families cared for one another at home,” Benton said. “But people didn’t routinely live into their late 80s or 90s. Care wasn’t something that lasted a decade.”
Today’s caregiving, she said, is more comparable to running a small medical unit in the home.
“You’re dealing with medication schedules, mobility issues, behavioral symptoms of dementia, hospital-level care tasks,” Benton added. “It’s almost like you need a health care degree just to keep up.”
But what hasn’t changed, she said, is the emotional core of caregiving.
“We do this because we want dignity and respect for the people we love.”
The state’s 11 caregiver resource centers offer coaching, counseling, support groups, and training — all available regardless of income or immigration status, Benton said.
“Caregivers are invisible because they don’t see themselves as caregivers,” she added. “But they need wraparound supports. That’s how families survive and how communities stay whole.”
“Caregiving is deeply personal, but it’s also universal,” said Paul Dunaway, director of Sonoma County’s Adult and Aging Division and a board member of the California Association of Area Agencies on Aging. “Every family’s story is unique, but the themes — burnout, confusion, isolation — repeat across the state.”
Area agencies on aging serve as the connective tissue for families seeking support.
“Caregivers need more than services,” Dunaway said. “They need validation. They need someone to tell them, ‘You’re doing everything you can, and you don’t have to do the rest alone.’”
The agencies are the quiet workhorses of California’s aging network, running hundreds of programs from dementia trainings and in-home respite to caregiver counseling, fall-prevention classes, and transportation assistance.
Too often, families contact their AAA only when they’ve reached a crisis.
“Caregivers call when they’re overwhelmed,” Dunaway added. “They say, ‘I can’t do this anymore.’ Our job is to help stabilize things and show them a path forward.”
He encouraged early engagement.
“If people reach out sooner, we can help sooner,” he said. “We can help them build a community they didn’t know they had.”
Sunita Sohrabji is a reporter for American Community Media.
