Though men have become more involved and taken on more responsibilities at home, “it hasn’t been a significant contribution and certainly hasn’t kept pace with women’s increased participation in the work force,” said Dr. Clifford C. Sheckter, a fellow at Stanford University’s Clinical Excellence Research Center, surgery resident and a co-author of the essay.

When it comes to caring for people with dementia, “the numbers are skewed strongly toward women, and it’s hard to imagine that by 2030 the numbers will even out to 50-50,” said Nicholas Bott, a neuropsychologist and another co-author who is also a fellow at the Clinical Excellence Research Center. “It shouldn’t be an unspoken rule that this falls on certain members of the family, but as of now, it still is falling primarily on the daughters and female spouses more than on men.”

Dr. Sheckter recalled how this played out in his own family. When his grandmother started losing her cognitive function and diabetes complications left her blind, Dr. Sheckter’s mother, a nurse, started using her lunch breaks at the hospital to run home and check on her.

One day she found her mother backed up in a corner of a room, disoriented and agitated; another time she was trapped in a closet. When the grandmother became incontinent, Dr. Sheckter’s mother had to clean up the mess and bathe her.

“The hospital wasn’t happy about her absences,” Dr. Sheckter said, but the family lived in a remote rural area in the Sierra Valley of California, and it was hard to find help.

Eventually the situation was untenable, and the family placed Mrs. Sheckter’s mother in a nursing home. “This was my mom’s mom, so my dad didn’t really pitch in,” Dr. Sheckter said. “I don’t blame him for that — but it really did fall on my mom. She was a saint.”

According to a report from the Alzheimer’s Association, employed women who are caregivers are seven times more likely than men to cut down from full-time to part-time employment because of caregiving duties. They are more likely than men to take a leave of absence from work, to lose employment benefits because they cut back their hours or to be forced to quit working altogether. A significant percentage say they were penalized at work because of their caregiving responsibilities.