Jennifer Cortes, 39, walks across the hall to her father's bedroom each morning to get him ready for the day. His bedroom walls are painted blue, with street signs from the "Cars" movie franchise – the remains of Cortes' son's middle school obsession.

Her son only enjoyed the signs for a little while before his grandfather moved in in 2017.

Cortes' dad, 82-year-old Julio Rivera, has COPD, diabetes and late-stage vascular dementia. He has a home health aide who helps him bathe and eat, providing assistance for two hours three days per week, but otherwise his care falls to Cortes and her husband, Ismael Cortes Sr. Their two adult sons help out sometimes, too.

But even when the paid caregiver is there, Cortes can't fully relax. The home health aide doesn't speak Spanish, despite Cortes asking for a Spanish-speaking caregiver, and Rivera doesn't speak much English. Cortes translates for her father while the aide is around, instead of taking a break.

"We’re supposed to be able to step away," Cortes said, noting that the paid caregiver is trying to learn words in Spanish but still needs significant help. "She does her best."