“Caregiving is not just a task—it is sacred labor. It teaches patience. It
forces humility. It exposes fragility. And sometimes, it unlocks unexpected
spiritual growth.”
D.S. came to the US with his parents in the 1930s. He worked in men’s haberdashery, married for 50 years, and had 2 children, a physician and an attorney. After his wife died with Parkinson’s disease, he lived alone, attended daily religious services, but began to feel isolated and lonely.
It took a toll on his physical and mental health. Despite his children’s visits and hiring aide, his frailty led to hospitalization. After a family meeting to include his physician and social worker, he agreed to move out of his apartment to an assisted living facility. For the next few years, before his health worsened, he continued to live his life in a community with dignity. At each stage, his autonomy was respected, and his family felt that they chose the right path for the remaining years of his life.
Between his two children there were financial conflicts with caregiving, about paying for care, professional guidance, and health insurance benefits to include long term care insurance.
Life rarely unfolds as we plan. People retire expecting rest and freedom. Illness can arrive without warning, bringing physical decline, memory loss, personality change, and fear. Families are thrust into roles they never trained for.
America is aging rapidly. Medical uncertainty, skyrocketing costs, long-term care, and housing insecurity touch nearly every family. There are 59 million caregivers today, many underpaid, often overwhelmed, and most often women. Many caregivers suffer silently from exhaustion, depression, isolation, and burnout.
Caregivers grieve twice:
• First, for the person who is still alive but slowly changing.
• Second, for the life they themselves had imagined.
• There is loss of time. Loss of identity. Loss of future dreams.
• Guilt, sadness, numbness, confusion, these emotions often exist
behind brave faces. And yet, caregivers carry the emotional weight of
keeping families intact.
A caregiver provides hands-on physical, emotional, and spiritual support—out of love, empathy, and deep respect. A caregiver with a deep sense of empathy provides physical, emotional, and practical support to another based on genuineness, selflessness, and respect.
A caretaker manages logistics—property, finances, and legal responsibilities.
Both roles are heavy. Both demand strength. But caregiving asks for the deepest human currency: presence.
Maimonides says children must take care of their parents, but when the burden is too high, you should seek other resources. In the case described, when D.S. entered an assisted living home, it bestowed honor and respect in enhancing his quality of life.
We must accept the realities of the situation, although it may be painful reality. Say to yourself: “I did a mitzvah for what is best for the person. It is not selfish when I care for myself.” Situations may arise where the patient’s autonomy can override the clinicians’ recommendations. Informed consent mat be required at times.
Elder caregivers and fraud can cause painful issues, including financial, emotional, or material exploitation of older adults. This can include identity and account abuse, manipulation and grooming, and creating emotional leverage, positing themselves as indispensable. There are many ways to protect the elderly to include third party bookkeeping, digital security, among others.
Spirituality and caregiving are deeply connected. Spirituality supports caregivers by giving people meaning and purpose, it can be a source of strength, it provides compassion and empathy, it fosters resilience in hard moments. Caregivers witness life’s fragility, that relationships are sacred. Some people experience compassion fatigue, and others spiritual growth.
• Organize volunteer visits.
• Provide food delivery and rides.
• Create Bikur Cholim programs.
• Build intergenerational connection.
• Help seniors use technology for virtual community.
• Bring Jewish life into homes where mobility has faded.
Judaism teaches us: children must care for their parents—but not alone when the burden becomes crushing. As Maimonides teaches, seeking help when needed is not failure. It is wisdom. When D.S. entered assisted living, it restored dignity—not abandonment.
Caregiving is one of life’s hardest chapters—but it is also one of its holiest. It demands boundaries, support, legal guidance, rest, faith, and compassion. It asks us to honor our parents by honoring ourselves. It teaches us that love is not always heroic, it is often quiet, exhausting, and deeply sacred.
Caregiving is not only how we help someone live.
It is how we learn what it means to be human.
Written by
Steven Mandel, MD
Heidi Mandel PhD, DPM,LMSW
December 11, 2025
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