When she has an out-of-town business meeting, her 85-year-old mother-in-law comes to stay. Every few weekends, her daughter makes the three-hour drive from Washington, DC, to help out.
And Mrs. Melnick races home from work at 5:15. If she's late, she'll find her husband pacing, wondering where she was. It's a hint of Alzheimer's classic "sundowning," where agitation increases with dusk.
Some states are trying new ways to increase Alzheimer's services. In Colorado, for example, officials experimented with giving US$1,000 stipends to help families hire monitoring for their loved ones so they could attend a six-session training program called the Savvy Caregiver.
That doesn't buy much respite, but it's a good investment, says Cheryl Dunaway of the Colorado Alzheimer's Association.
"The caregiver is the one who sets the stage for whether it's a good day or bad day, calm day or chaotic day, in how they respond to the way the person with dementia is behaving," she explains.
In Congress, Senator Barbara Mikulski, is pushing legislation that would provide a US$3,000 federal income tax credit to offset some of the expenses and lost income incurred by caregivers of patients with Alzheimer's and other diseases.
NIH's Suzman says those costs increase as dementia worsens, from about US$7,400 a year for moderate dementia to US$17,700 for severe dementia
Back in New Jersey, Mrs. Melnick is anxiously hoping that tax credit will help. Within the year, she expects to have to hire someone to watch her husband all day while she works.
Trying to plan beyond that brings only fear.
"Do I have to think about a nursing home in a year, two years? ... It's not like cancer, where they say you have six months to live. They really can't say that with Alzheimer's."
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