At UC San Francisco, caregiving isn't just something we do for patients — it’s a shared reality for many staff, faculty, and learners. Now, it’s finally becoming part of the public conversation.
As more employees find themselves in the “sandwich generation,” which refers to adults caring for both children and aging parents, the need for elder care support has never been more urgent. Leaders and caregivers from across the university are sharing powerful personal stories and calling for greater awareness and systemic support.
“This is very similar to the advocacy we saw around childbearing and parental leave,” said Nathalie Larsen, director of UCSF Family Services. “It took time for those needs to be acknowledged, and elder care is not there just yet.”
Many UCSF employees spoke openly about the emotional and logistical toll of caregiving, especially for aging parents with serious illnesses. From juggling surgeries with emergency phone calls from confused parents, to quietly navigating grief while leading teams, their stories reflect a shared truth: elder care doesn’t stop when you walk through UCSF’s doors.
"While caring for an aging loved one can be a rewarding experience, it often is accompanied by stress and limited resources to support the caregiver,” Larsen explained.
The Invisible Labor of Caregiving
Despite UCSF’s reputation as a leader in geriatric care, with one of the largest geriatrics programs in the country, access remains limited. The waitlist for the UCSF Care at Home program (formerly House Calls), which provides medical services to homebound patients, has decreased to 28 days, down from more than 400 days in 2023. However, this is just one piece of the puzzle.
Caregivers emphasized that navigating elder care, especially within the U.S. healthcare system, is daunting — even for those in the medical field.
“With all my healthcare knowledge, even I couldn’t figure out how to get my parents the care they needed. Imagine what it’s like for someone without that knowledge,” said Julie Ann Sosa, MD, MA, chair of UCSF Department of Surgery.
A National Spotlight
UCSF’s leadership in this area recently caught national attention. The university was featured in a PBS documentary, “Aging in America: Survive or Thrive,” honoring the legacy of Robert Butler, MD, the founding director of the National Institute on Aging and the physician who coined the term ageism. When PBS asked which institutions were truly moving the needle on elder care, the answer was clear: “Go to UCSF.”
“The producers told us UCSF was doing the kind of elder care Dr. Butler would be proud of,” recalled Louise Walter, MD, chief of UCSF Division of Geriatrics. “Still, we have a long way to go.”
Building a Culture of Support
UCSF is beginning to respond to these needs in tangible ways. This year, Family Services piloted support groups for caregivers through a UCSF wellness grant. Additionally, existing backup elder care services are being promoted. These programs are designed to offer both practical support and emotional validation.
“We had one employee use our backup care services four times in a single month this year,” said Larsen. “It shows the real need for these resources, and why we need to make them more visible.”
Beyond services, employees said what’s truly needed is a culture shift — one that normalizes elder care responsibilities and removes the stigma that admitting them is a sign of weakness or professional liability.
“When I started my leadership role, I didn't know if I should tell my boss I was caring for my father with Alzheimer’s. Although some people told me not to say anything, I chose to be open because this is my real life,” shared Christina Mangurian, MD, MAS, vice dean for Faculty and Academic Affairs at UCSF School of Medicine. “If we don’t normalize these conversations, we’ll lose talent.”
Equity, Retention, and the Road Ahead
The issue also has equity implications. Staff and trainees, especially those from underrepresented or economically disadvantaged backgrounds, often carry the heaviest caregiving loads with the fewest resources.
“If we don’t protect our people now, we risk losing them — especially those who are already vulnerable,” Sosa said. “Caregiving impacts our entire workforce, from faculty to frontline staff.”
As UCSF continues to lead nationally in elder care research and services, there’s growing recognition that supporting caregivers is not just compassionate — it’s strategic.
From publishing in national journals to speaking at the National Academies, UCSF leaders are using their voices and their own stories to push for systemic change.
“It’s time we stop seeing aging as a crisis,” said Walter. “People are living longer. Let’s build the systems that help them and their caregivers thrive.”
For those navigating elder care responsibilities, UCSF Family Services offers resources, webinars, and community support.
Learn more on the Adult and Elder Care page
