A generation is raising children and losing parents at the same time. The system assumes we can absorb it. My mother had early-onset dementia diagnosed in 2019 when she was 70. We did what you are supposed to do. Power-of-attorney documents were drawn up on the advice of the mood and memory clinic at the hospital, along with the warning that no one can say how fast or slow the progression will be. We kept the quarterly medical appointments already in place for her diabetes. And we were advised to monitor changes in her behaviour and eating habits, and to record significant incidents of cognitive decline.

Read that last part again, because it speaks to the heart of this piece. A clinic asked a family — untrained, unpaid, working long shifts — to keep a medical record. No one ever asked to see it.

In January 2022, my mother fell in her bedroom, on the tiled floor, at home. We suspect that is what happened, because she could not tell us. None of us knew about it until my sister noticed bruising on her face and arm. When we asked, she said she did not think she had had a fall. That is when she realised she could not remember, and understandably, she was frightened. We took her to the doctor. There were no signs of concussion. There was a black eye on my mother’s face and no formal record anywhere that it had happened.

The more frightening manifestation came later. My mother went missing. Early afternoon we made frantic calls to family, friends and the police. A small search party was being assembled when a longstanding family friend spotted her in St George's. They could tell that something was wrong and brought her home.

We were lucky, grateful and relieved. But it was not an agency or a system or a process that found my mother. It was a woman who had known her for decades and knew something was wrong.

My mother passed away in January of last year at the age of 76. My oldest sister called me just before midnight Bermuda time to tell me.

At the time of the fall, nearly three years had passed since her diagnosis. It was on file. It was known, named and recognised by the health system, and in those three years there was no proactive monitoring except ours. My father’s own dementia diagnosis came not far behind my mother’s, so there were two of them, living alone together, both declining day by day. My son arrived at the end of 2019, and we all know what happened in the early months of 2020.

My siblings and I checked in when we could, between work shifts and on days off. My oldest sister carried the daily weight of it. She lived closest and worked in a nursing home five minutes away — which tells you something about how little professional proximity is worth when no single organisation has custody of the case. My sister was the one who noticed the bruising on my mother's face and body, and a dozen other things that never reached the rest of us. I handled much of the logistics and the appointments. All of us were drowning in our own ways, and none of us said so. None of us felt we could.

If the 2019 diagnosis made the sandwich, the pandemic pressed down on it. There was no getting away from it. We were the care plan.

I don't believe this is a phenomenon unique to my family.

It has recently been reported that 40 patients a day, on average, are medically fit to leave King Edward VII Memorial Hospital and cannot, because there is nowhere for them to go. They occupy roughly 46 per cent of the acute care beds. In June, 41 such patients had been awaiting discharge a median of 73 days, with an average of 111. Their median age was 74. The island has around 367 licensed long-term care beds in the community, with a further 160 people needing that level of care sitting inside the hospital system instead. Seniors are projected to make up about a quarter of the population this year. The last full census was taken in 2016.

Read those numbers again and notice what is missing from them. Behind each of those beds is a family doing what mine did: making the calls, chasing the placements, keeping the record without anyone to give it to. The healthcare system counts the bed days. Nobody counts us.

The health minister, Kim Wilson, has told families they must step forward to care for relatives once they are medically fit for discharge, so that those beds remain available for those who truly need them. She is right, and I do not think she says it lightly. There is nowhere else for those people to go. A family that can take these patients home, should.

But “step forward” is a phrase that costs the person saying it nothing and costs the person doing it a great deal: the missed hours at work, the promotion not chased, the emergency savings spent, on an island where two incomes are increasingly required to keep a household. And the cost that can't be counted in dollars: the time not spent with your own children.

My generation has been stepping forward for years, without anyone on the outside noticing. It is what is expected, and it is often our default setting. But it is a plan built on the assumption that we always will — or can.

I should be honest about where I am writing this from. I left Bermuda in 2024. Prior to this I was on the island, going to appointments in person and taking notes like my sanity depended on it. But for the final months and years I handled some of the co-ordination from four thousand miles away, five hours out of step.

That is not a confession. It is the reality for a growing number of Bermudian families, not only those with adult children overseas. The assumption is not just that an adult child is willing and able. It is that they are near by. For more and more of us that is not the case, for reasons this island understands perfectly well.

Our healthcare system's plan for this, insofar as they have a plan for our ageing population, uses data from a census taken in 2016.

To be clear, I have no policy proposal to offer, but two things would have changed my family's experience over the last five years, and neither involves a new building, a new system or a new line of government expenditure.

The first is a clear and fulsome record that follows the person. My mother's fall existed nowhere but in my sister's memory and, for a week, on her face. A diagnosis should open a file that every professional after it can see and add to.

The second is that someone owns the case — not a department, but a named person a family can call, who knows who they are. We worked with departments, agencies and some brilliant social workers. We never had one number to ring.

The last time I saw my mother, she did not know who I was. We sat together anyway. I talked, and though once or twice she spoke to me directly, for the most part she was somewhere else. I made my peace with that over the course of the afternoon. When it was time to go, I took her hand and said: “I love you, Mum.”

She squeezed my hand back and said: “I love you too, son.”

Relief and grief are painful pills to swallow together. But I had that moment, and I will always have it. The afternoon she went missing, it was a family friend with good instincts who found her.

That was luck. We should be careful about building a system that depends on it.

• Paolo Odoli is a former aide-de-camp to two Bermuda governors of Bermuda and a former government communications officer. He is living in Italy with his wife and two children