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Andrew, 33, cares full-time for his grandmother Elo, who has vascular dementia and Alzheimer’s. Isadora Kosofsky spent four years documenting their relationship
On a Sunday afternoon in October, Andrew Rahal locked his grandmother Elo’s wheelchair in place – “click it or ticket”, he told her – before heating up a bowl of borscht from the Armenian grocery store near their home in Granada Hills, California. He then sat in front of her, patiently feeding her spoon after spoon.
Yeghsabeth “Elo” Voskian, 83, has vascular dementia and advanced Alzheimer’s disease. For nearly a decade, Andrew, 33, has been her full-time caregiver, assisting her from bed to wheelchair, showering her daily, managing her medications and helping her at meals. He is one of approximately 12 million millennials caring for a family member, a diverse cohort that already constitutes 23% of the caregiving population in the US, according to a 2020 AARP report. The number of millennial caregivers will almost certainly increase exponentially in coming years.
In 2015, Elo was driving down a freeway when she forgot how to get to her daughter’s house. This incident led to her diagnosis. One of Elo’s daughters looked after her initially, but found it too difficult to do so while also being responsible for her children and work.
Before his grandfather died, Andrew had made him a promise: he would take care of Elo no matter the obstacles. So, when his family asked, Andrew readily assumed his caregiver role. He signed up for a caregiving bootcamp at UCLA, learned the Montessori approach to dementia care and read every book about Alzheimer’s he could find.
Andrew does more than watch Elo at home and accompany her to hospital visits. He chauffeurs her to salon appointments, holding her hand as each of her fingernails is painted. He pushes her wheelchair around Santa Monica pier and Universal Studios, and to spas for lymphatic drainage massage.
“It changes the mood in some way,” Andrew said of their outings. “Just because they have Alzheimer’s and dementia, I think people forget they are sentient human beings. They still feel.” He wonders if the outings have increased her longevity. “Clinicians told me the more she sits on the chair, the more she will become the chair. I tried really hard to prevent that,” he said.
Elo, who is of Armenian descent, was born in Lebanon and raised her four daughters there during the country’s civil war. Sylvia, Andrew’s mother, said Elo would venture from their basement to the kitchen as bombs dropped to get her children a hot meal. “She was the backbone of the entire family,” said Sylvia, who runs a carwash business with Andrew’s father. Elo continued to be a symbol of strength for the family after they emigrated to the US in 1988. “She has the same strength to fight this sickness,” Sylvia said.
Millennial caregivers are on average 30 years old. Studies show that many feel rewarded by caregiving and have deepened ties with family members they care for, but they also find caregiving to be a highly stressful responsibility. They face challenges in school, secondary careers and personal relationships, and are more likely to feel economic pressure due to caregiving, which is often unpaid.
Andrew was a college student when he began caring for his grandmother. She was still mobile then, and he worried she would wander off. If she needed immediate care, he had to ask professors for permission to skip class; they were often surprised when he explained the reason. On one occasion, Andrew took Elo to class with him. “It is only in the last few years that universities have daycare for children, but they do not have daycare for the elderly,” he said. “If you’re a millennial caregiver, where am I supposed to put her?”
Elo now requires 24/7 assistance from Andrew. She is largely non-verbal and does not communicate pain, so he is her emotional interpreter, constantly looking for signs of discomfort and infection. “You have to advocate for her everywhere. Not just for her in the hospital, but in the family.”
Andrew receives compensation from the state of California for 283 hours of caregiving labor a month; most states do not have compensation programs for family caregivers. Should Elo require advanced care in a nursing home, Medicaid would cover the expense, but her family worries about the quality of care in these often understaffed centers. Top-of-the-line memory care centers in California can cost more than $6,000 a month out of pocket. (Trump has pledged additional support for family caregivers, claiming at a rally in October that he would back a proposed tax credit.)
To Andrew, caregiving isn’t just “glorified babysitting”. “It’s a job. And it’s a tough one,” he said. He posts to Instagram and chats online with caregivers around the country, making him one of a number of young caregivers who are attempting to demystify their jobs and push back against dementia-related stigma. One day, he hopes to go into public relations and dementia advocacy.
Still, he wonders if he meets all of his grandmother’s needs. “In an educated brain, I know I did everything” to care for Elo, he said. “In an emotional brain, it is not enough.”
When he wants a break from it all, he drives to the base of a mountain near his home and watches old episodes of Lucifer and Ugly Betty in his car, periodically checking in on his grandmother through a video monitor app as she sleeps, often restlessly. He feels moments of sadness, particularly as he watches her slip away from the grandmother he remembers.
But his sense of duty overrides it all. “I love being with her,” he said.
English (US) · 
