Feeling the Sandwich Generation Squeeze?

How integrated care models like PACE help Bay Area families reduce stress and support aging parents

Dale Corpus

1/11/20263 min read

Feeling the Sandwich Generation Squeeze? How Integrated Care Can Help Bay Area Families Breathe Easier

Imagine this: your mom is struggling to manage her medications, your dad can no longer drive safely, and you are stuck in the middle—juggling a full-time job, your own children, and endless doctor appointments for your parents.

If every week feels like a crisis and the healthcare system feels impossible to navigate, you are not alone.

As a senior transition specialist and real estate expert here in the San Francisco Bay Area, I work daily with families in Contra Costa, Alameda, Santa Clara, San Mateo, San Francisco, Solano, and Napa counties who are facing these exact challenges.

Whether it’s the emotional stress of choosing care options, the logistical nightmare of downsizing a home filled with decades of memories, or the complexity of selling a senior’s property to fund their care, the overwhelm is real.

But what if there was a single program that coordinated everything—medical care, transportation, home support, and social activities—under one roof?

What You’ll Learn in This Episode

  • What PACE actually is: A breakdown of the Program of All-Inclusive Care for the Elderly and how it differs from traditional healthcare

  • The “One-Roof” Solution: How On Lok coordinates doctors, transportation, and home care so you don’t have to

  • Eligibility & Cost: Who qualifies and how the program is funded through Medicare and Medi-Cal

  • Real-Life Relief: How this model supports the sandwich generation and helps seniors age in place with dignity

Meet the Expert: Nicole Torres of On Lok

In this episode, I’m joined by Nicole Torres, Chief Operating Officer of On Lok.

With nearly 24 years at the organization, Nicole’s journey began personally when she sought care for her own grandmother, or “Lola,” who was battling cancer.

Her insight matters deeply to families because On Lok isn’t just another service provider—they are the pioneers who created the PACE model right here in San Francisco 55 years ago.

Nicole understands that caring for a human requires understanding their medical, social, and functional needs holistically.

The Challenge: Siloed Care vs. Integrated Care

Most families are used to siloed healthcare.

Your parent has a doctor in one building, a pharmacy in another, and maybe a physical therapist somewhere else—and none of them talk to each other. It falls on you, the overwhelmed adult child, to coordinate it all.

Nicole explains that PACE is the opposite.

PACE functions as both a health plan and a care provider. An interdisciplinary team of 11 disciplines—including doctors, nurses, social workers, and drivers—meets regularly to coordinate care for each participant.

This integration is the “secret sauce” that prevents premature nursing home placement and reduces hospitalizations.

Practical Help for Daily Living

For families trying to decide whether parents can remain at home or if the house needs to be sold, PACE offers a compelling third option: aging in place with robust support.

A typical day might include:

  • A home caregiver arriving in the morning to help with dressing and breakfast

  • A driver picking the senior up—going inside the home and assisting with stairs if needed

  • Time at the PACE center for medical visits, meals, and social engagement

  • A safe ride home with a prepared meal for dinner

For sandwich-generation families, this support provides immense relief.

Nicole shared a powerful example of a Fremont couple caring for both sets of parents while raising three children and working full-time. PACE allowed them to protect their careers and marriage while knowing their parents were safe.

Navigating the Transition

While On Lok manages the care, many families still face difficult questions about the home itself.

Is it safe?
Does it need to be sold to fund care?
What are the emotional and financial tradeoffs?

On Lok PACE currently serves San Francisco, Santa Clara, and parts of Alameda County—including Fremont, Newark, and Union City—with new centers opening soon in South San Jose and Union City.

If you’re outside those areas—or your parents’ needs require a different setting—you still have options. The key is knowing you don’t have to do everything alone.

As Nicole wisely shared, aging can be hard—but it shouldn’t be lonely.

Ready to Reduce the Stress?

If you’re drowning in decisions about downsizing, selling a parent’s home, or simply figuring out where to start with senior care, let’s talk.

Schedule a FREE consultation at:
www.simplifyseniortransitions.com

I also encourage you to listen to the full episode to hear Nicole’s deeper explanation of eligibility and how PACE compares to other programs like CBAS.

If you have a quick question, you can reach me on Instagram @soldbydale.

P.S. Got news or an amazing story to share? Email us at dale.corpus@exprealty.com and you might be featured in an upcoming episode. Remember to check out the transcript for detailed insights. Happy listening!

Watch The Podcast Here