Gail Schwartz, 78, helped her husband David, 85, out of his wheelchair at their home in Chevy Chase, Md., where she thinks he does better than he would at a nursing home. Credit Drew Angerer for The New York Times

“Gail Schwartz wants to keep her 85-year-old husband out of a nursing home as long as she can, but it isn’t easy.

“Because David Schwartz, a retired lawyer, has vascular dementia and can no longer stay alone in their home in Chevy Chase, Md., she tends to his needs from 1 p.m. to 11 p.m. every Monday through Saturday and all of Sunday.

“When she dashes out for errands, exercise and volunteer work in the morning, she checks in by phone with the aides she has hired. ‘I’m always on alert,’ she said. ‘At the grocery store, I’m thinking, Is David O.K.?’”

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