One of the trickiest things I had to learn was how to ask for and accept help. I had prided myself on my independence, but now I was swimming in much deeper waters. It was hard to let go of a self-image based on the "rugged individualist" mentality, but in reality, I had no choice.

It started the first time Alan woke up in the middle of the night hearing robbers on the porch. Suddenly, I was faced with major life-changing decisions, and I had to craft a future for us that was entirely new. Money issues, health issues, and my new, more dominant role in our relationship all seemed to be intertwined. I was now "the decider.' I was already familiar with being the project manager for my own life. I planned my trips and athletic events and managed my own businesses. In those areas, everything I needed to do I could either figure out on my own or look up

With Alan's new changes, it was different. I was no longer in the land of looking up the prices of a plane ticket or booking a hotel. As I got more honest with myself and others, I realized I was being asked to plan for the next ten to twenty years without really knowing what was coming down the pike.

Even with my hope of Alan remaining stable, I started waking up to the doublethink that happens with early-onset Alzheimer's disease. I needed to plan for the worst-case scenario while keeping our spirits up and our lives on track.

I started to realize that I needed major advice and lots of information in an area in which I had very little experience. It seemed strange at such an early age to visit a land reserved for our later years. I was only forty-eight years old when all this began, and Alan was only sixty-one. We were both athletic, full of life, and not expecting a health issue of this magnitude to show up on our doorstep.

All these years later, I realize that major life-changing events can happen at any time, and our reaction was quite common. The disbelief and confusion is typical of the early stages of any major life-altering change. I've certainly developed incredible compassion for the stories I often hear about catastrophic changes and loss in other couples' lives. Sharing our story will, hopefully, give others a glimpse into a world of love, intimacy, and caring that often comes with catastrophe. We are a wonderful, resilient species.

It slowly dawned on me that caring for Alan was a journey I wouldn't be taking alone. Asking for help started with the medical team. There were oncologists, nurse oncologists, chemo lab techs, neurologists, and evaluators.

Coming from the world of alternative medicine, I felt like I was in a foreign country. I had been trained in the language and concepts of Western medicine but never expected to have to dive so deeply into it. There were tests to see if the breast cancer had spread and tests to find out what could've caused his dementia, all during the same six-month period.

Even though I was asking for information and advice, I was still adding my knowledge of alternative medicine and how it could apply. There were many theories about how to prevent dementia but few good modalities to treat it once it occurred. To be able to slow it down was all I hoped for. Happily, Alan did stay stable for many months and years.

Outside of the medical community, I held off asking for help during many of the early years. It started out as a challenge for me to deal with my caregiving duties. I felt like I'd lose the title of "Best Caregiver Ever' if I asked for help, sort of the way athletes are disqualified if they take water from a friend or coach during a race.

What I didn't realize consciously at first is that I was actually asking for and receiving help the entire time. Alan's friend Dick is a lawyer, and he gave me lots of advice when I decided to buy a house. He really shaped how I should think about all of the overlapping concerns so I could make good decisions. My neighbors in the city always asked about how we were doing, and I felt like I was becoming a part of a community of care. The security guards at the apartment building knew Alan and told me when they thought it was time for more supervision.

For the first few years after he started showing signs of dementia, Alan was still able to jog all over town and go to the gym on his own. But once he started getting lost, we adapted our schedules so we could do many of the same things together.

One piece of the journey I'm grateful for is that as Alan changed and needed more help, there was very little self-awareness on his part of what was going on. He took everything in stride and let pieces of his old life go without much fuss. I, on the other hand, struggled to adapt to the changes, and sometimes I wasn't ready for the new challenges. But having him feeling cheery and "in the moment' helped me adjust more quickly.

My friends were great in a really hands-on way. Libbie and Sheila were in weekly contact and relieved me whenever they could. They watched the gradual progression and were quick to jump in when something new was needed. During the middle years, when I was taking Alan to the office, it was great to know that Sheila would be there when the unexpected happened. My clients were also wonderful and understanding. It was tricky to find the right moment to tell them about our situation and, more importantly, to let them know that I'd continue to be able to care for them as well as handle my responsibilities for Alan. I was walking a very thin line.

Libbie came up to the house and cooked hundreds of meals and went for bike rides, swims, and hikes with us. Alan started calling everyone he liked "Libbie,' even me. I considered it an honor and a tribute to her.

While I was competing in athletic events, I had hired a personal trainer to work with me. Alan needed to come with me to the gym. He did his workout while I worked with Kevin. Eventually, when Kevin started his own gym, Alan came with me and followed us around. Once I started doing acupuncture at the gym, Alan waited for me in the lounge area.

Every plan we came up with worked for many months-and sometimes years-but then a change would come. The only problem I had was in trying to find solutions quickly and mentally adjusting. I still have trouble with this.

Once I bought the house and had a car, I was able to finally realize my dream of playing the upright bass. Alan's friend Lyn lived in Yonkers, and I started taking lessons from him. I went there once a week, and for several years, I could leave Alan at home alone to garden or to watch TV or DVDs.

One day, when I came home from my music lesson, all of our neighbors were at our house. Alan was claiming that I was trying to freeze him to death, we'd had a big fight, and I had left him. None of this was true, I might add. From that point on, I took him to my lessons with Lyn. I appreciate the flexibility and patience Lyn showed toward Alan.

Social events were easy at first; Alan just got quieter. When he did join a conversation, there was a set group of topics he talked about. Later in the course of the illness, he got more anxious and required more attention. I got really good at dealing with him and keeping the conversation going-multitasking galore! The feedback I got from my friends was often about the degree of patience they saw as they watched me quickly simplify and explain things to Alan.

From my point of view, that was what I could do to show him respect and keep his dignity intact. I was never interested in using my superior abilities as a tool for power over him, except when I got angry or frustrated. Even though Alan has been in a nursing home for close to a year, I still regard us as equals. If skill levels make the man, then what are we-a bunch of behaviors? I choose to think of our connections and spirit as being always present, despite superficial appearances. This has been a real test for my beliefs, that's for sure. So far, they've stood me in good stead. I have yet to go through the later stages of the dying process with Alan, but I'm confident I'll find spiritual comfort to guide me.

Once I could no longer bring Alan with me to my office, I started looking for alternatives. At this point, my "in-laws,' Lloyd and Susan, stepped in. They kept Alan on the afternoons I worked and I picked him up afterward, or they dropped him off at my office. I've often thought about how hard it must be for a big brother to watch his little brother suffer with Alzheimer's. In a way, it was easier for me because I saw Alan every day and had lots of warning when certain changes occurred. Lloyd often had to adjust to several changes at once. He is the only other person who has continued to see Alan on a somewhat regular basis in these last years at the nursing home. Susan gave me a book called Empty Room when her sister died. It was about how devastating the loss of a sibling can be. I know that somewhere in there Alan appreciates all that Lloyd has been for him.

As Alan got more anxious, I needed to find a place where people were skilled at dealing with people who are in the early to middle stages of dementia. I found a daycare center near my office and was able to have him go there for a half-day twice a week. The first day gave me the only hours I had to myself all week, and the second day allowed me to work in my office and trust that he was being cared for. The only hitch was his anxiety about being transported in the van. They did the best they could, but it was always an issue.

Once I started getting him plugged in to more state programs, I found a daycare center he could go to seven days a week. I was starting to get my life back, and he enjoyed being with the staff and the residents in the program. They had an ideal setup with activities, room to move around, and lots of love for their charges. The fact that he couldn't relax in the van meant two hours of driving each day for me, but it was worth it.