Do you consider Pru to be Spence's primary caretaker? What do you feel helps Pru come to terms with her husband's decline? Do you think she gleans any insight about her husband or his early life as his decline accelerates?

Pru is Spence's caretaker for many years. Do you consider her Spence's primary caretaker, or do you think someone else fills this role? What do you feel helps Pru come to terms with her husband's decline? Do you think she gleans any insight about her husband or his early life as his decline accelerates?

Well it depends on how you define caretaker. As the decision maker responsible for Spence's care, then yes, she was primary. But Pru had a lot of help and despite challenging financial circumstances, she had much more help that the vast majority of people trying to care for a loved one in similar circumstances - a day nurse and a night nurse - and still we see how the wear and stress take their toll on Pru.

It's interesting that the apartment they bought, at Pru's urging, with Spence's book advance windfall from so many years earlier, helped to finance his care. Even more interesting was Arlo's action in this regard - don't want to be explicit for fear of spoiling.

Although she had a lot of physical help, she was his main mental and emotional support. After Spence developed Alzheimer’s he did reveal some things about his early life. He had not really talked about those things before.

I think Ginny was the physical caretaker but Pru was the emotional caretaker which is definitely the most difficult and draining role

Pru was the primary caretaker so far as emotional care and support goes, but Ginny, and Elaine at night, provided the physical care for Spence, which Pru couldn't do by herself. Ginny and Pru also became caretakers for one another in that they supported each other the way that families support each other emotionally. Each relied on the other in different ways. Regarding Pru's acceptance of Spence's decline, she frequently compared his current condition to how it had been some time before that, and knew that what was considered a bad day today would be a good day down the road. Sarah also kept trying to be realistic when talking to her mom about her Dad's condition.

Yes, I considered Pru the primary caretaker as she made all the decisions, hiring people, deciding their salaries, etc. Certainly Ginny did much of the physical care, but then so did Pru. I think Arlo could have been much more help, but wasn’t surprised when he wasn’t. Maybe Pru should have asked more of him? But many times people don’t want to ask.

Pru was primary as a decision maker, and at the beginning, until she realized that she couldn't do it all along. At that point, Ginny became primary from a physical care aspect and, for a period of time, perhaps even the emotional support aspect, both for Spence and Pru. Arlo later did what he only knew how to do.

Pru was the primary caretaker (emotional care and support) where Ginny and Elaine provided the physical care.

Pru was the primary caretaker. She was the one that had to deal with it all the time. Ginny and Elaine could go home to their own houses, but when Pru tried to separate herself a bit by sleeping in the guest room, Spence couldn't deal with it. He needed her.

I think the comment that Pru couldn’t separate herself from the caretaking/couldn’t go home at night like Ginny and Elaine is an insightful one. While Pru had an enormous support and help from Ginny, she was the one for whom the responsibility never ceased and who could not walk away, at least not without destroying who she was and what her marriage was in the process. I think it’s nearly impossible for a single person to be a caretaker for someone with Alzheimer’s, it’s just such a physically and emotionally demanding disease. I feel like so many people are in the position of trying to cobble together a network of cafe, especially when trying to keep a loved one at home. The administration of caregiving support seemed to become another part-time job, worrying about reliability of help - Will the person show up, will they stay long term, are they good with my loved one, am I following all the correct tax rules, etc. I think Mr Henkin capture ma these challenges very well, especially since Pru is coming from a place of relative privilege (especially in regards to reliable help) and still experiences these worries.

Pru was very lucky that she had help, most do not. I do not know if Pru was capable of giving Spence what he needed in that regard. She certainly the main caregiver in that she had to handle all the paperwork, bills, doctors, etc. She also lost the support of her husband. As someone who is in somewhat the same position, I know what stress she is under. Being a caregiver is hard. Although she had help. she lived in the home 24 hours a day. She was never away from it.

Of course Pru was the primary caretaker, though fortunately she had and accepted help from others.