Growing up, Ray Payton, like many people, was especially fond of her grandparents.
As a young child, when visiting their Arlington, Va., home, she would hide under the dining room table, one of her favorite spots. Admittedly a tomboy, Payton would play with toy trucks given to her by her grandfather, Dowell Tillman.
Payton's mother died when Payton was in her 20s, and so her grandparents were more like parents to the only daughter of their only daughter.
But as Payton grew, even by the age of 12, she knew the day would come when she would be called upon to take care of them. That day is now here.
"I reflect on how my grandparents brought me up, what they sacrificed for me," Payton said. "They gave up things for me when I was a baby, and they gave things when I was going to school, and now it's my time to show them that they taught me well."
According to USA Today, Payton, who is 38-years-old, is one of the millions of Americans caring for elderly family members, working through the financial burden and emotional hardship that such a task requires.
Dowell Tillman, who turns 94 next month, is now blind from glaucoma. Payton's grandmother, Vidalia Tillman, is 90 years old and suffers from dementia. The couple has been married for 70 years.
Despite their deteriorating conditions, Payton made the difficult decision to maintain their care in the same Virginia home where the couple lived for 54 years. Keeping them there, she said, is the only option.
"[I] think if I lost the house, it would kill them. They built this house. I don't want to give it up because this is my family home," she explained. "They came up with two trunks and a little girl -- my mom. They built this house, they saved, they worked. My grandfather and my grandmother pretty much had two or three jobs all the time."
Payton's father also died when she was in her 20s. As the conditions of her grandparents and their home began to worsen, and as she began to shoulder more and more of their care, she briefly considered moving them into an assisted living community.
"When they had mold in the house, I had to move them out, move all their furniture out, renovate the house. I looked into nursing homes in the area," she said. "I called some of the most popular nursing homes that you see all over the place and because of the types of diseases that they have and the number of medications that they have, they quoted me a price of $12,000 a month."
But it wasn't only the steep cost that dissuaded Payton from moving her grandparents. She also said many of the homes she consulted would have separated her grandparents due to the disparity of their ailments.
"After being together for 70 years, I couldn't imagine having to separate them," she said. "They would be in the same facility, but they wouldn't be able to even be in the same room or in the same area because their diseases are so different. It would kill them."
But around-the-clock care is now required, and Payton said despite her desire to do it, she just doesn't have the skills. "My grandmother is always stiff in the morning. I don't know how to lift her. I don't know how to rotate her so that I'm not going to break a bone. I don't know how to clean her to get her ready.
"They need somebody with them 24 hours a day," she continued. "A doctor has written prescriptions for them. They need 24- hour care. And that's what we're giving them."