Vega's dedication to her bedridden, 98-year-old mother, Juana Martinez, has been going on, almost without respite, for the past decade. Cecilia, 57, is the youngest daughter in a traditional Salvadorian family.

As expected in her culture, she is the one designated to wash, feed, tend wounds and give constant care and comfort to her mother for as long as it takes.

Living on a tight budget in a modest Vacaville ranchette with her disabled husband, Raphael, Vega also tidies the house, cooks elaborate meals for her family and even milks the cow on a daily basis. It is clearly Juana's well-being that consumes her, resulting in stress, hardships and sacrifices that she admits have taken a toll on her.

"It's very typical in Latino families that either the youngest or oldest daughter is in charge of caring for their elderly parents," explains NorthBay Hospice & Bereavement volunteer coordinator Veronica Wertz, also of Latin descent. Wertz says that one of the most difficult challenges for women in Cecilia's position is to accept help with her mother's care.

"It takes a lot for someone who gives that much to let someone else take part," she says. "It's a kind of cultural leap to admit that you need assistance."

Cecilia's leap came when she accepted help from hospice physicians, nurses and volunteers.

She remembers feelings of depression and desperation until Dr. Kathryn Amacher, a private-practice physician specializing in geriatrics, began to talk with her about all that could be done to lift some of the heavy burden of full-time home care (including Cecilia's literal burden of lifting and carrying of her mother).

"Doctor Amacher really helped me to get over the bad experiences I had at a care home my mother was in for awhile," she says, recalling a brief time when she would return to the facility and find her mother bruised or unclean. "And then I saw how caring and kind the NorthBay Hospice nurses were, and it was great to know my mother was OK and I could relax a little and let them take over for awhile."

Amacher knew it was hard for Cecilia to relent and let someone else lend a hand.

"It's so easy for the caregiver to get burned out -- particularly someone as conscientious as Cecilia," says Amacher, who visits the Vega home when needed. "She's really an angel -- an amazing, giving daughter. But, if she doesn't get time to rest, take full care of her family and herself, she's not going to be able to sustain it. And, I'm sure her mother wouldn't want her to wear herself out and not have any joy in living her own life."

For now, Juana spends most of her time sleeping in a clean and quiet room that smells of fresh powder and the sweet-smelling lotions that her daughter uses to keep her mother's hands and limbs supple and moist. A well-worn crucifix hangs above the bed and colorful panels divide the space where, scant inches away, her daughter and son-in-law sleep so they can hear her in the night. In Juana's small-partitioned room, ointments, diapers, medications, soaps and extra blankets are organized like a highly appointed, fully staffed hospital room.

Gently stroking her mother's cropped hair, Cecilia tells stories about Juana's life as a loving mother and gourmet cook in El Salvador. She remembers that the meals created and skillfully served were so wonderful that Juana worked for a wealthy family as their personal chef for a number of years. A photo taken of her mother more than 70 years ago shows an exotic beauty, with high cheekbones, slightly almond-shaped eyes and a shiny cascade of caramel-colored hair. The daughter says that Juana was healthy and energetic well into her older years, always ready to cook her famous chili rellenos and gather the family together. Those days are, sadly, gone.

NorthBay Hospice & Bereavement officials say that those who care for their loved ones, need to discuss and face the inevitability of death.

"Families really need to talk to their doctors -- or call hospice directly," says Amacher. "Who wants to talk about death or dying? But it is a reality, and it should start with an honest discussion about when hospice care is needed."

Wertz hopes women in Cecilia's position will accept much-needed help, care that can arrive two to three times a week (as in Cecilia's case).

"Most of the Latina women I talk with say they are not raising their daughters to give up everything just to care for them at the end. They want them to have a freer life. We gently encourage them to think of themselves to be just as important to the family as their children are -- and to seek help from hospice when they want help caring for their loved ones at home. Many of them are surprised to learn that they or their loved ones don't have to be a patient of NorthBay to receive our services -- and it's free."

NorthBay Hospice & Bereavement provides care to all in Solano County who need hospice services, regardless of their ability to pay. For more information call (707) 646-3575.