One Day at a Time: A Caregiver's Journey Through Alzheimer's

Cathy Friedman wakes before dawn most mornings. At 75, she has developed a rhythm that begins before her husband Joel opens his eyes—medications laid out, blood pressure checked, a fresh bagel waiting from the deli down the street. She keeps her doorbell camera notifications active. Joel, 78, has Alzheimer's disease. He was diagnosed in January 2020, six years into what should have been their retirement together in the Kensington neighborhood of Brooklyn, where they've lived for three decades.

They met on Wall Street 57 years ago and married within a year. When people ask Cathy why she stays, she answers simply: "Because it's for better or for worse." But the disease has made that vow harder to keep with each passing day.

Joel's diagnosis came as a shock, though the disease ran through his family—his grandmother, mother, and sister all had it. Cathy hadn't considered him at risk. The first sign was ordinary and devastating: he sat at the table unable to focus on the newspaper he'd once read cover to cover every morning. Within weeks of the diagnosis, Cathy found herself lost. She had seen Alzheimer's in the nursing home where she works, but seeing it in her husband was different. She called the Alzheimer's Association's 24-hour hotline repeatedly those first months, learning how to respond when Joel became agitated—leave the room for 15 minutes, they told her. Dr. Zaldy Tan, director of the memory and healthy aging program at Cedars-Sinai Medical Center, notes that no one is truly prepared for this. More than 7 million Americans live with Alzheimer's disease, and at least 11 million serve as unpaid caregivers for loved ones with dementia. The numbers offer no comfort to those living inside them.

A few years into the disease, Cathy and Joel had settled into a rhythm, but Alzheimer's kept breaking it. Joel no longer recognizes their home half the time. The house where they built their life together has become a source of confusion and stress for him. Cathy describes the progression as relentless: "Every day is a little worse, and every day is different." Sometimes he rolls over in bed and asks who she is, or tells her to get out. The loss that cuts deepest is his reading. He developed cataracts and can no longer see the words. For years, he would sit for hours in the backyard with a book. Now they watch the news every night, and he usually doesn't understand what he's seeing.

The disease has narrowed their world. Cathy cannot leave Joel alone, so when she needs to run errands or get her nails done, a family member must stay with him. They can no longer walk through Prospect Park, which they did every day. She cannot ask him spontaneously if he wants to do something—breaks in routine agitate him. These restrictions have changed the texture of their marriage. Dr. Tan emphasizes that changes in relationship dynamics are among the hardest aspects of the disease, which is why early diagnosis matters: it allows couples to talk while the person with Alzheimer's can still communicate their preferences and wishes.

Cathy has learned that structure is survival. She fills pill boxes once a week, keeps a card documenting every medication and its timing. She has a morning regimen and a nighttime procedure that gets them both to bed by 9 p.m. "Staying in my routine gives me my comfort zone and helps him not get aggravated," she says. Research confirms what she has discovered through experience: predictable schedules help people with Alzheimer's stay oriented to the day-night cycle and can reduce the sleep disturbances that exhaust both patient and caregiver. Without routine, Joel might wake at 3 a.m. thinking it's time to go to work.

The toll on caregivers is measurable and severe. Studies show that caregivers of people with Alzheimer's have higher rates of depression, isolation, divorce, medical problems, and even premature death from stress. A 2025 study found that spousal caregivers developed two new health conditions within two years. Cathy manages by building a network: a health aide while she works, her adult children and grandchildren who provide breaks so she can attend to herself. Dr. Tan stresses that this network is critical—adult children, neighbors, church communities, medical professionals, social workers. "You need a lineup of people who can provide respite," he says.

Yet joy persists in small moments. Joel still makes Cathy laugh. He sleeps more now, but his sense of humor remains. He tells her constantly how much he loves her, even when he doesn't recognize her. Her grandchildren bring her comfort. Recently, she and her grandson saw Les Misérables together. Every year, Cathy attends an Alzheimer's march with other patients and caregivers, and that collective witness helps her continue. "I hope they find a cure for this," she says. "I worry for my kids and their kids. Until then, I take it one day at a time."