Dr. Herbert Lerner kisses his wife, Dr. Ruth Lerner, in her bed at their son's Berwyn, Ill., home. She has vascular dementia, which deprives the brain of food and oxygen and has taken her ability to communicate or care for herself. "This is a person you love," he said. "You're not going to abandon somebody you love after 60 years."
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CHICAGO -- Doug Wyman got up early on Valentine's Day to make breakfast for his wife, Barbara: coffee, oatmeal, and fresh fruit. He drew a bath and helped her get dressed, then sat with her through her favorite morning TV shows.
Not because it was Valentine's Day. Because of love.
After 63 years of marriage, the couple developed their routine when Alzheimer's disease left Mrs. Wyman unable to do things herself. But it's a routine that Doug Wyman -- like a growing number of men who have assumed the role of caregiver in recent years -- embraces proudly.
"She took care of me for 60-something years," said Mr. Wyman, 84, of Oak Park, Ill. "It's absolutely a pleasure to serve her now."
In the last 15 years, the number of men caring for loved ones with Alzheimer's or dementia has more than doubled, from 19 to 40 percent, according to the Alzheimer's Association. The trend mirrors the higher number of women over the age of 65 in the United States with the disease -- 3.4 million compared to 1.8 million men. Those demographics have changed the tone of local support group meetings by adding a chorus of male perspectives. It has also prompted an outpouring of new books, organizations, and online resources for men learning how to be nurturers.
Experts attribute the increase in male caregivers to several societal changes, including evolving gender expectations as well as new life expectancy rates.
"Men say, 'This is hard. It's challenging, I didn't realize we would ever be at this point, but I'm not giving up,'" said Edrena Harrison, a social worker and specialist for the National Caregiving Center, part of the Family Caregiver Alliance in San Francisco.
The sentiment is shared by some husbands, who find themselves making spaghetti, separating laundry, and coordinating doctor's appointments for the first time as senior citizens. For these men, assuming their new role was never a question.
"Birds of a feather'
Bob and Pat Quas met on Rush Street in Chicago. He was sitting at a bar when Patti, a gorgeous blond out celebrating her girlfriend's birthday, walked over to order drinks. They struck up a conversation that continued on to an ice cream parlor, and then to the front seat of his 1965 Dodge Dart parked in a friend's driveway until dawn.
"We just gelled. We were birds of a feather -- we got along and hit it off well," recalled Mr. Quas, 62. "From that point on, we just built a relationship."
The couple married a year later in 1970, had two children, and built a career working side by side in his custom cabinetry business. She prepared delicious dinners, with her signature homemade baked goods for dessert.
Decades later, their son and daughter grown, the couple retired. Mrs. Quas began exhibiting strange behavior in their longtime Elmwood Park, Ill., home. Once, she served tacos with raw meat straight out of the package. Another time, she poured cake batter into a plastic container and placed it in the oven. Her husband smelled it burning and ran in to clean it up, he said.
In 2010, doctors diagnosed her with frontotemporal dementia. She is now unable to drive, perform simple household tasks, or follow and participate in conversations.
Since then, Mr. Quas has sharpened his cooking skills, learning to make pork chops, steam vegetables, and bake sweet potatoes. He took over the household duties and has grown used to guiding Mrs. Quas through conversations with friends and family. He also joined a support group for caregivers of those with dementia to learn how to cope with and handle the new lifestyle.
He fears the day when she needs more help than he can provide, and he will be forced to turn to Medicaid and other government assistance programs.
But for now, he said, he does what he can for his wife.
"It's a sense of duty," he said. "She has good days and she has bad days... I just look forward to the good days."
Men sometimes can be better positioned than women to serve as caregivers, said Julie Bach, an assistant professor of social work at Dominican University in River Forest, who runs a monthly support group for caregivers.
Women often attempt to tackle care-giving alone, feeling guilty about the burden they place on others. Men, however, are more inclined to seek out help in the difficult process, Ms. Bach said.
"It doesn't mean that men are not having emotional reactions, or they don't feel the loss," she said. "But their whole life is about moving forward and solving the problem. Women just want to vent, and guys just want to fix things."
Mr. Wyman was certainly in that category. He desperately wanted to step in and help, but he recognized how difficult it would be taking over his wife's duties after she was diagnosed with Alzheimer's in 2005.
While he worked, Mrs. Wyman raised their nine children in a home kept spotless and stocked with all the family's needs.
But when she began going to the grocery store and forgetting what she wanted to buy, or having trouble remembering the grandchildren's names, she knew it was time to begin training her husband.
"She worked me to death," Mr. Wyman recalled with a laugh. "She had me cleaning this and cleaning that. She saw dust that I couldn't see. And I had never, ever washed clothes."
Today, her Alzheimer's disease has progressed enough that the Wymans have hired extra help so Mr. Wyman can still work a few hours each day in sales and marketing. He purposely structures his time so that he can dress and feed his wife each morning.
At night, he prepares dinner and holds hands with her on the couch as they watch TV before he leads her to bed.
"When we got married, we said 'in sickness and in health,'" said Mr. Wyman. "Our generation meant that when we said it."
Certainly there were male caregivers in earlier generations, but the number documented today is probably higher for several reasons, said Ms. Harrison of the Family Caregiver Alliance.
The size of the average family has become smaller, so leaving the caregiving to women is not always an option. There is also a greater geographic divide among family members today, sometimes putting children in other states far from aging parents.
And perhaps most notably, men are no longer hesitant to be known as something other than the breadwinner, Ms. Harrison said.
"Historically, men have always tried to help ... sometimes we've called them Family Men, or The Good Son or The Loving Spouse," Ms. Harrison said. "I think we're just seeing more men being willing to self-identify as caregivers now."
Herbert Lerner was a caregiver by profession, long before his wife's illness.
For 44 years, Drs. Herbert and Ruth Lerner ran a successful pediatric practice in Chicago's Hyde Park.
The couple got married after meeting in medical school. They had three children.
In the mid 1990s, "Ruthie" retired when macular degeneration began to take her eyesight. Not long after, she began complaining or getting uncharacteristically angry about things.
Doctors diagnosed her with vascular dementia, in which the brain is deprived of food and oxygen.
As his wife began to lose the ability to communicate or care for herself, Herbert Lerner dutifully cooked and fed her. He dressed her for the day and took her to the bathroom.
All the while, he never stopped seeing her, he said, as the woman he fell in love with: a brilliant doctor, a tennis champion, a loving mother of their three children, a creative artist who filled their home with homemade chandeliers and other elaborate projects.
"This is a person you love," Dr. Lerner said. "You're not going to abandon somebody you love after 60 years."
The couple has moved in with their son and his wife in Berwyn, Ill. Ruthie, who is bedridden, fades in and out of consciousness. Hospice caregivers have taken over most of her needs after doctors told the family her days are numbered.
Herbert Lerner fills his time now by watching old Super 8 films of their family. Ruthie in her white bathing suit swimming with the children in Wisconsin. Ruthie walking through the beautiful gardens she used to keep. Ruthie playing guitar.
He doesn't take his eyes off the screen, even though he has seen the film countless times.
"I'm reliving all the wonderful experiences we had," he said. "It feels like it was just yesterday."
Then he walks over to his wife's bed and searches for her face, which is buried in a pillow.
"Ruthie, would you like a kiss?"
The hospice nurse helps him to lower the bed's side railing, so he can plant a peck squarely on her lips.
In a rare moment of lucidity, she responds to her husband.