Struggling to find balance

Hi, dad lives with me and has moderate stage Alzheimer's. Despite lots of other health concerns, his progression has been very slow- I've been giving him care (first IADLs like paying bills, now progressing to physical, Hands-On hygiene and such) for a little more than a decade.

In addition to this stressor, last summer I merged my family with my partner and 14-year-old stepkid, so all four of us are living together in the same small house.

I have to manage my own health concerns, including chronic pain, as well as be a supportive co-parent to the autistic teenager.

I do have someone coming to help twice a week and they mostly make sure he eats while I'm at work and do some lighthouse keeping. (temporarily increased to three times a week while I've been unable to physically provide the care while I've been in a pain flare).

I feel like I have no patience, am constantly irritable, + genuinely struggling. I am in therapy, couples counseling, and receiving mental health medication support. I've asked for an increase in frequency with my therapy and an additional visit for medication management.

I don't knowI don't know what question I have specifically, maybe looking for additional support, maybe looking for understanding, maybe looking for advice in avenues I haven't considered.

Summary -

Physically disabled caregiver struggling with overwhelm in a complex " Sandwich generation" situation.