It often starts off easy. For me it did. An elderly friend needed some help with food shopping and dealing with the cable company. He has no family to speak of, and his close friends have died. Pushing 90, his thinking had obviously slowed, but he could still shave, bathe and dress.

So I volunteered to run some errands. No big deal. I’d drive him to doctors’ appointments and pick up drugs. When he was diagnosed with multiple myeloma, I started taking him to the cancer center for infusions.

But as his three prescriptions swelled to seven prescriptions (he also has heart issues), he needed someone to manage the medications. That became me. I was soon tracking them, ordering refills and filling the pill organizer. My friend now swallows 77 pills a week, on top of the cancer infusions.

As time has moved on, the demands have grown. My friend currently suffers periodic bouts of confusion, diarrhea, serious pain and fatigue. Is it the cancer? Is it the meds? Age? Something else? No one seems to know. Several of the medications list the same side effects. Same goes for the conditions themselves. On low-energy weeks, I find myself also doing his laundry and cleaning the house.

I have no legal obligation to do this. I took on providing this elder care because my friend is a great old guy. But also — to be very honest — because I had no idea what I was getting into.

Millions of Americans are taking care of their beloved elders, many stuck in situations far more agonizing than mine. Some are dealing with dementia, whereby the afflicted can’t do anything for themselves.

Caregivers are known to suffer depression, insomnia, anxiety and loneliness. Any time away requires exhaustive planning. (Try to find someone willing to take over changing an adult’s diapers for a weekend.) And as people will keep telling you, it will only get harder.

Also, it could go on for 10 years. New treatments for incurable conditions can greatly extend lives while burdening patients, especially the older ones, with debilitating side effects.

Money helps, of course, but for extended elder care, that money has to come by the tanker load. Medicare covers only a few specialized nursing services.

The disappearing corporate pension, unexpected crises (floods, fire, sick family members) and poor financial planning have left many elderly broke at retirement’s door — except for Social Security. Meanwhile, grown children often give up paying work to care for their parents.

The median cost for a private room in a nursing home hovers around $100,000 a year, according to Genworth Financial. The lucky ones can sell their house and use the proceeds to go into independent or assisted living communities. For those who stay put, hiring 24/7 home health care aides easily costs $80,000 a year. How many American families have budgeted a half-million dollars for years of elder care?

An illuminating piece in Barron’s described how these demands can shock even experts on the subject. One was AARP’s Amy Goyer. Her parents were relatively well-prepared. They had pensions and long-term care insurance. But when Goyer’s mother suffered a stroke and her father was diagnosed with Alzheimer’s, their continuing-care retirement center would no longer keep them.

Goyer moved to Phoenix to tend to her parents at their home. Her mother died, but she was still taking care of her father 12 years later.

As my friend needs more and more help, I’m hoping he will sell his house and move into an assisted living arrangement. The equity would pay for a few years there. And after that? I don’t even want to think about it.

Froma Harrop is a syndicated columnist. Follow her on Twitter @FromaHarrop. She can be reached by email at: fharrop@gmail.com.

Froma Harrop