Gap Year Productivity Questions

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Get the MCAT out of the way and then take a full-time job. You will certainly be able to take a job after you submit your application and that will be something to talk about in interviews and/or provide as an update to your application if you aren't hired until after you submit. Ideally, you have that full-time job after the MCAT and before the application goes in.
 
I think you're spreading yourself too thin. Something I see people do a lot is decide "I'm going to go to medical school" and then imagine themselves applying the following year. It doesn't work that way, and in medicine, your chances are inversely proportional to the number of times you apply and take the MCAT.

Slow down, take a deep breath, and manage your workload appropriately. I can understand you don't want to oversell your caretaking role, but if it's as bad as you say it is, I think that responsibility is not compatible with what you're trying to do professionally. That doesn't mean you should toss your grandfather to the wolves, but you should probably make your own mental accommodations that, hey, you know, it's just going to take you longer to get to the point of applying than you probably would have liked.