Living with Dementia Brings Challenges - Quality Care Allows Better Quality of Life

You can spend a lifetime building something meaningful — a career, a community, a sense of purpose — and still find yourself blindsided by a word you've never heard before. Most of us assume we'll see the hard moments coming. We plan for retirement, for slowing down, for the natural rhythm of getting older. What we don't plan for is sitting across from a physician and hearing a diagnosis that reframes everything — not just your future, but the present moment you're living in right now.

Arthur English was 80 years old, sharp-minded enough to guide tourists along the Hudson River and still drawing on decades of creative work as a film and commercial producer. He was, by any measure, a man still fully engaged with life. Then his memory started slipping in ways he couldn't ignore. He brought it to his doctor. And he heard a word he had never once encountered in eight decades of living: dementia.

A Life Well Lived, Then an Unwelcome Diagnosis

Arthur celebrated his 80th birthday in May 2022. Throughout his career, he built a reputation as a noteworthy film and commercial producer, working on projects for major advertising agencies. Later, he found a second calling as a New York Waterways tour guide, bringing tourists along the Hudson River and meeting new people every day.

Despite that long and fulfilling career, Arthur began noticing something unsettling — his memory wasn't what it used to be. He finally brought his concern to his doctor. The diagnosis stopped him cold.

I don't know where I am. This is a very strange experience. Up to that moment, I never, ever, heard the word dementia." — Arthur English

What Is Dementia?

Dementia is a chronic brain disorder that affects memory, reasoning and personality. It interferes with daily functioning and is far more common than most people realize. The World Health Organization (WHO) reports that 57 million people had dementia worldwide as of 2021, with nearly 10 million new cases diagnosed every year.

Many families also face a loved one with MCI — mild cognitive impairment. MCI is characterized by subtle changes in memory and thinking that are noticeable but don't yet interfere with daily activities. According to the Alzheimer's Association, an estimated 10 to 15 percent of individuals living with MCI develop dementia each year. 

The impact extends well beyond the person diagnosed. Dementia reshapes family dynamics, strains finances and profoundly changes quality of life for everyone involved.

Many Types of Dementia Exist

Alzheimer's disease is the most common form of dementia. According to the Alzheimer's Association's 2026 Alzheimer's Disease Facts and Figures report, 1 in 3 older Americans dies with Alzheimer's or another dementia, and the disease kills more than breast cancer and prostate cancer combined. Alzheimer's Association

Alzheimer's disease was officially listed as the fifth-leading cause of death among people age 65 and older in 2024, and deaths from Alzheimer's have more than doubled between 2000 and 2024 — even as deaths from heart disease have declined. 

Many families are caught off guard by how quickly a loved one's health can change. When a crisis arrives, the pressure falls on everyone — emotionally, physically and financially.

Family Caregivers Are Overwhelmed

Nearly 13 million Americans provide unpaid care for people with Alzheimer's or other dementias. Most are untrained for this demanding role and struggle to balance caregiving responsibilities with careers, family obligations and their own wellbeing. These 13 million part of of the 63 million unpaid caregivers taking care of loved ones in the United States often due to a lack of planning, and no Long-Term Care Insurance to help.

For Arthur, dementia didn't silence him — it changed how he communicated.

Having dementia is about learning how to compile your thinking; that's the beginning." — Arthur English

As dementia progresses, individuals typically require supervision and help with activities of daily living that most people take for granted. For many, a long-term care facility with specialized dementia experience becomes the best option.

Finding the Right Care Environment

For Arthur English, the recommended facility was The Riverside in Manhattan's Upper West Side. He had initial episodes of withdrawal and reluctance to socialize, but his outlook shifted as he settled into his new environment.

Cathy Diamond, Director of Recreation Therapy at The Riverside, encouraged Arthur to paint, exercise and explore his creativity. That encouragement opened a door he hadn't expected.

This place in particular, and her regimentation of how to deal with people — you learn that maybe I can paint. Maybe I can study music." — Arthur English

Quality Care Means a Better Quality of Life

With the right care environment and support, people living with dementia can still experience meaning, connection and joy. Arthur went on to serve as Resident Council President at The Riverside — a role that speaks to how much his engagement and sense of purpose returned.

"It is our honor as health care professionals to provide the best support to our patients and residents, and to offer the finest amenities and programs," said Jake Hartstein, Administrator of The Riverside.

Arthur's own words capture what that care meant to him.

"When people say you have dementia, there's as many forms of dementia as our stars. For some people, it can be a space voyage. And I call it, in a very specific way, multi-'dementia'-nal. If it weren't for this facility, and for someone who motivated me like the sun by giving me light, I would not be here." — Arthur English

No matter where you or a loved one lives, there are quality long-term care services available. You can search for them by using the LTC News Caregiver Directory.

Planning Now Protects the People You Love

Arthur English's story is a reminder that dementia doesn't announce itself with certainty or give families time to prepare. The decisions made in the months after a diagnosis — about care settings, finances and who will take on caregiving responsibilities — can define quality of life for years.

Long-Term Care Insurance will help protect your family from the financial and emotional weight of a dementia diagnosis. Policies can cover professional in-home care, assisted living and skilled nursing facilities — including memory care units — so loved ones don't have to choose between quality care and financial stability. However, you don't start planning for long-term care and the costs and burdens of aging once you or a loved one requires help.

The ideal time to purchase Long-Term Care Insurance is before you retire, and most people do so in their 40s or 50s, although, depending on your health, you can find affordable options in your 60s and even into your 70s, althought the cost is higher and helath may limit your options if you wait too long.

👉 How to Apply for Long-Term Care Insurance

Use the LTC News Cost of Care Calculator to see what care costs look like in your area, and visit the LTC News Learning Center to learn how to start the planning conversation with your family.

Arthur English and his family were happy he is had the quality care he deserved. Be sure the same goes for you and your loved ones.

Frequently Asked Questions About Dementia, Caregiving and Long-Term Care Planning

What is dementia, and how is it different from normal aging?

Dementia is not a normal part of aging. It is a progressive condition that affects memory, thinking, reasoning and behavior. While occasional forgetfulness can occur with age, dementia interferes with daily life and often worsens over time.

What is mild cognitive impairment (MCI)?

Mild cognitive impairment (MCI) is a condition involving noticeable changes in memory or thinking that are greater than expected with normal aging but do not yet significantly disrupt daily activities. Some people with MCI remain stable, while others eventually develop dementia.

Is Alzheimer's disease the same as dementia?

No. Dementia is an umbrella term for a group of conditions that affect cognitive function. Alzheimer's disease is the most common type of dementia, but other forms include vascular dementia, Lewy body dementia and frontotemporal dementia.

What are the early warning signs of dementia?

Early symptoms often include:

• Frequent memory loss
• Difficulty finding words
• Repeating questions or stories
• Confusion with time or place
• Trouble managing finances or medications
• Changes in judgment or personality

If you notice these signs in yourself or a loved one, speak with a physician promptly.

How does a dementia diagnosis affect family members?

A dementia diagnosis impacts the entire family. Loved ones often take on caregiving responsibilities, coordinate medical care, manage finances and provide emotional support. As the condition progresses, caregiving demands typically increase.

Why do so many family caregivers feel overwhelmed?

Many family caregivers have little or no formal training. They often juggle caregiving with careers, raising children and other responsibilities. The emotional stress, time commitment and financial strain can lead to burnout if adequate support is not available.

When is professional memory care needed?

Professional memory care may become necessary when a person can no longer live safely at home due to wandering, medication issues, falls, behavioral changes or the need for around-the-clock supervision. Specialized memory care communities are designed to provide a safe environment and structured support.

Can someone with dementia still enjoy a meaningful life?

Yes. Arthur English's experience demonstrates that people living with dementia can continue to find purpose, creativity and social connection. The right care environment, meaningful activities and supportive relationships can greatly enhance quality of life.

What types of long-term care services help people with dementia?

Depending on the stage of the disease and individual needs, support may include:

• In-home care services
• Adult day care programs
• Assisted living communities
• Memory care communities
• Skilled nursing facilities

The appropriate setting depends on safety, health needs and the level of supervision required.