ROBERT SIEGEL, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel. Over the next few days, NPR is exploring long-term care giving. Fifteen million Americans care for a family member with dementia. That may conjure images of boomers caring for their elderly patients. But with early onset dementia, it's often a spouse who is the round-the-clock caregiver. Julia Mitric of Capital Public Radio reports on one couple living that reality.

JULIA MITRIC, BYLINE: When Rick Rayburn retired from the California State Park System, he had his heart set on balmy days of gardening, playing tennis and traveling to France with his wife, Marianne. But then she was diagnosed with dementia and it disrupted their lives top to bottom, right on the cusp of retirement. At 67, Rick's taking on a big, new role.

RICK RAYBURN: I'm 100 percent responsible for, you know, her well-being. I have to help her pick her clothes out - have to be there when she's getting dressed. I can't leave her alone too often. I mean, I can run out and empty the trash cans or do this or that. It's always a game you play. (Laughing) How long can I run out and brush my teeth and get shaved and stuff without something happening in the bathroom, in the morning, on her side, you know?

MITRIC: Rick rarely stops moving. By 6 a.m., he's up fixing breakfast for Marianne.

RAYBURN: Look what I got you, ma'am. Now what do you want on here? You want some berries - bananas?

MARIANNE RAYBURN: Bananas, please.

RAYBURN: Bananas, please - you sure about that?

RAYBURN: Yeah, I love bananas.

RAYBURN: How about a raspberry or two?

MITRIC: And he stays on duty until Marianne's bedtime, 10 p.m. No spare time to tend his vegetable garden - Rick's too busy making sure his wife keeps her weight up.

RAYBURN: Yeah, you've got to eat up your cereal, so we can get onto your hair, buster.

RAYBURN: We can get onto your hair. Are you in the hair-doing business these days?

RAYBURN: I am.

MITRIC: Rick's going to color his wife's hair right here, at his kitchen table.

RAYBURN: Honey, have you ever used the hair stuff?

RAYBURN: Me?

RAYBURN: Yeah.

RAYBURN: Yeah. I did your hair in the hospital.

MITRIC: The reality is Rick's played hairdresser many times. Marianne just doesn't remember. So he tries to ease her nerves by cracking jokes along the way.

RAYBURN: Where's the blue dye for the streak down the middle? I can't find it.

RAYBURN: The streak down the middle? There's not going to be a streak down the middle.

(LAUGHTER)

RAYBURN: Help.

MITRIC: Help is Rick's new middle name. He bathes his wife and sets out her clothes, styles her hair with a straightening iron. He cooks from scratch every day. Rick's goal is to keep Marianne at home for as long as possible. He's confident he can candle care giving's many physical demands. It's social isolation that's brutal for Rick. He says their social life as a couple evaporated when Marianne's dementia accelerated.

RAYBURN: It's hard as a caregiver to know how to relate to people in a way that just doesn't turn them off. You're a broken record, you know. And the disease part of life or the downside, you know, that's not all that interesting. And it's not relationship building, you know. It's more just kind of reporting the facts of a crummy situation.

CAROL KINSEL: Your world becomes very small. And as things get worse, the friends that were helping a little bit kind of drop off. And so you tend to be pretty isolated.

MITRIC: Carol Kinsel is a geriatric care manager. She hosts a caregiver support group for men. Rick goes there seeking coping strategies for the stress and loneliness of dementia care. Kinsel says it's common to find men in this role, grappling with the changing sense of identity, no matter what age group they fall into.

KINSEL: The older generation - it's really going to be a role reversal. I think the younger generation is more used to, maybe, participating. But it's still a big change, 'cause they have this wife that played a huge role in their marriage that's so-called fading or changing. And, you know, they're trying to pick up the pieces that she filled in the marriage.

MITRIC: Marianne no longer recognizes that she's married to Rick and has been for 42 years. Dementia transformed Marianne into someone who's dependent and vulnerable. And that's triggering changes within Rick, too. He sees himself gravitating toward traits Marianne was known for, like empathy.

RAYBURN: The importance of listening and caring for others - now I can see why that's so important and why, you know, you can go through life just giving and feeling totally satisfied. You know, that's a good thing.

MITRIC: Marianne may no longer be the woman Rick married. But he says she's still helping him become a better husband. For NPR News, I'm Julia Mitric in Sacramento.

SIEGEL: And that story came to us from the Capital Public Radio documentary series, "The View From Here."

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