Who will care for our parents when work keeps us away?

Your mother is ready to leave the hospital, but she cannot yet manage on her own. She needs help getting around, preparing meals and attending follow-up appointments.

You have a job in Nairobi. Your brother lives abroad. The relative nearest to her can check in, but cannot stay all day.

The family can contribute money. Finding someone who can be there every morning is another matter.

This is the question we need to bring into Kenya’s conversation about healthcare: who provides care at home when relatives also need to earn a living?

We readily discuss hospital bills and medical cover. We need to give the time, work and cost of care after treatment the same attention.

The country’s changing population makes this worth addressing now. A national care-assessment brief involving KNBS and UN Women projects that Kenya’s population aged 65 and above will triple by 2045. Many older people will remain independent, but we should prepare for more households needing some form of support.

That preparation cannot rest entirely on the expectation that an adult child, spouse or other relative will be available.

A daughter may want to care for her father but be unable to take several weeks away from work. A husband may be willing to assist his wife but lack the strength to help her move safely. A sibling overseas can pay for services without being present to coordinate them.

These are practical limits, not a measure of how much someone loves their family.

The work also tends to fall unevenly. Kenya’s 2021 Time Use Survey found that employed women spent 4.2 hours a day on unpaid domestic and care work, compared with 48 minutes for employed men. Those figures include housework and childcare, rather than only care for sick relatives. They show how much responsibility may already sit with the person a family expects to take on another duty.

When someone says, “My sister will manage,” we should ask whether anyone has discussed the arrangement with her.

Can she manage alongside her job? For how long? Who will relieve her? Does she understand the assistance required, and is she comfortable providing it?

A family needs clear commitments. One relative might cover appointments and transport. Another might organise meals. Others could contribute towards appropriate professional support. The person providing most of the daily assistance needs an agreed break and someone who will actually turn up.

“Let me know if you need anything” leaves the organising to someone who already has plenty to do.

Employers belong in this conversation too. An employee may return to work after a parent’s hospital admission while still coordinating care, receiving calls and worrying about what is happening at home.

Workplaces cannot resolve every family need. They can make it easier for staff to explain a temporary caring responsibility and discuss workable arrangements. Depending on the job, that could mean adjusted hours, a short period of flexibility or an agreed way to attend essential appointments.

The point is to make an arrangement that both sides understand, rather than leaving an employee to negotiate each absence in a crisis.

Hospitals have an equally important role. A discharge discussion should establish what support the patient will need and whether it is available at home.

Who will assist them? Has that person been included in the conversation? Is equipment required? Are follow-up arrangements clear? Whom should the family contact if they are unsure about something?

These questions matter because care needs vary. A person may need assistance with daily activities, clinical nursing, rehabilitation or a combination of services. WHO Kenya’s 2025 Annual Report, published in 2026, states that non-communicable diseases account for 50 per cent of hospital admissions nationally. That figure does not measure demand for home care, but it reinforces the need to consider what support may be necessary beyond a hospital stay.

Families should leave hospital understanding the needs they must plan for. They should not have to work out the difference between a caregiver, a nurse and a physiotherapist while trying to arrange someone for the following morning.

Home-care providers must make those distinctions clear. They should explain who will attend, their qualifications, the agreed duties, supervision and replacement arrangements. Families need to know whom to call with a concern.

They also need costs they can understand. A daily rate means little without knowing whether it includes overnight support, nursing visits, transport or consumables. An itemised estimate allows relatives to make a realistic budget. The arrangement should be reviewed as the person’s needs change.

Professional support should not mean relatives withdraw. A nurse or caregiver may provide agreed services, while the family remains involved in appointments, decisions and companionship. The person receiving care should have a say in these arrangements wherever possible.

For some households, scheduled visits alongside family assistance will be sufficient. Others may need more sustained support. We should avoid presenting full-time paid care as the answer for everyone, particularly where affordability is already a concern.

Counties and hospitals could help by making local referral information accessible. Families need to know which nursing, rehabilitation, equipment and community services exist, how to access them and how to verify providers.

We also need better evidence about what happens at home: which needs go unmet, what households can afford and how caring responsibilities affect work. Population projections tell us to prepare. Listening to families will help establish what that preparation should involve.

For households, the first step is a conversation while there is still time to have it calmly. Where would a parent prefer to receive care? Who could help? What resources are available? Where would the family seek professional advice?

Our parents may never need prolonged assistance. If they do, their care should not depend on one relative quietly putting the rest of their life on hold.

We need arrangements that allow people to care for those they love—and keep earning the income their families depend on.

Jackline Malika is the founder and managing director of Oracle Homecare.