As a physician, I’m accustomed to both giving care and maneuvering within a complicated healthcare system. Despite my background, I was not adequately prepared to assume care of my parents.

Healthcare is a topic currently at the forefront of the collective American conscience. It’s time to address how we care for our aging society. A recent New York Times article highlights an under-discussed but heavily relied upon source of care for aging citizens: their daughters. I am one of them. The article outlines the disparity in the number of women who step into caregiver roles as opposed to their male counterparts. In addition to economic sacrifices made to care for elderly parents, women in America who step into these roles also shoulder physical and mental burdens. Additional complications ensue when parents live a distance away from their grown children.

As an emergency physician, I’m blessed to have medical knowledge, years of experience with the healthcare system, a solid financial base, and the ability to manipulate when and where I work. If I feel frustration and self-reproach in caring for my parents and my children with these resources at my disposal, how do others in caregiving positions fare?

For caregivers and the people they care for, we must find a more sustainable way to attend to our aging population.

It is neither easy nor simple to watch a loved one nearing the end of their life. To be faced with parting with a person who has loved you since before you drew your first breath can be unfathomable. Of course, we step in to provide the care they showed us (or our spouses). Of course, we put our lives on hold as they once did for us (or should have). There is honor and grace in aging. There is honor and grace in holding the hands of those who are aging. But how do we integrate the notion that, of course we will assume care of our parents with idea that of course we will maintain a career, financial stability, our ability to rear children, some semblance of a personal life, and any of the multitude of other aspects of our lives that can fall by the wayside? As a society, we need to fortify our caregivers. We must recognize both their strength and their pain.

Caring for a loved one is important and meaningful work. We must find more solutions that allow us to both care for our parents and care for ourselves. We cannot continue to ignore the dearth of caregiver support and elder care programs. Left unsolved this situation will continue to grow ever more dire for aging patients and their loved ones.

The stressors placed upon daughters caring for aging parents with nothing but their own devices often results in a direct negative impact on family dynamics, arrested career development, and personal stress. These pale in comparison to the financial impact on caregivers. Millennials face a troubling situation. As a generation, they carry most the 1.2 trillion dollars in student debt owed in America, debts most of them will be paying off for decades. Coming of age in a sickly economic environment has also poised them to earn less than their parents. How will they support their parents, manage their own retirement plans, and not unduly burden their own children?

It is unconscionable as a society to acknowledge the situation we face and yet continue to decrease government funding that would offer much-needed support to sick and elderly citizens and their caregivers. We are being asked to take a hard look at what we value as a society and country.

How can we move forward?

I don’t have the answers. I can only echo the angst and cry for help. We must begin the difficult conversations. Why is this a responsibility that primarily falls to daughters? How do we reset societal expectations? How do we educate the next generation to see nurturing as a gender-neutral and honorable quality? Why do we shy away from the end-of-life care conversations? Why don’t we discuss what is ideal, what is achievable, and what is expected from caregivers? Why do we ignore the costs of care and the financial impact on the caregiver’s ability to work? Arresting or derailing the careers of the daughters of America has a resonating personal – and ultimately societal – impact.

As caregivers support those they love, how can we support their need to balance work, lives, and responsibilities?

Aging is natural, as it death. Caregiving at any stage of life is beautiful. But both aging and caregiving can be painful. Let us look deeply at what we can do to ease each other’s pain.