Their real life 'Notebook' romances: Aging couples stick together through hard times

Each day, Abe Hoffman sets aside one hour before dinner for a little time with his wife, Helen. They’ve been married 60 years, but they refer to it as their daily “date.”

And if Abe is lucky — and Helen is having a good day — she may even be able to remember her own name, her age or even the names of their two children.

“I never know what I’m going to find,” said Abe, whose wife suffers from Alzheimer’s disease. “Yesterday she was pretty good. The day before, I had a difficult time.”

The Hoffmans are residents of Cadbury Commons, an assisted-living facility in Cambridge. Abe lives in a one-bedroom apartment on the third floor, while Helen lives on the first floor in a secure wing reserved for residents with dementia and other cognitive impairments.

In recent years, assisted-living facilities have become increasingly popular among aging Americans who eschew dependence on children and prefer to avoid the rigid restrictions of nursing homes. In 2004, there were 37,000 such facilities in the U.S., housing more than 1 million seniors. In Massachusetts, the number of assisted-living apartment units increased by nearly 20 percent since 2000.

“You’re either going to have two people sick, or just one,” Abe said. “It would just ruin me to take care of her, and I would have to give up on life completely.”

By law, these facilities cannot provide medical care, but they do help older Americans manage what have become increasingly common dual roles: spouse and caregiver.

The Hoffmans traded their home in Bedford, where they had lived for more than 40 years, for Cadbury Commons because they wanted to be together in the same facility, but needed different levels of care. Helen’s worsening Alzheimer’s requires 24-hour supervision and a secure environment. But at 91, Abe leads an active, independent life — his time is filled with classes at Harvard’s Institute for Learning in Retirement, exercise and socializing with friends.

“Because we’re a relatively small operation here, it’s much easier for us to customize the situation to what [our residents] want,” said Susan Burgess, director of community programs at Cadbury Commons. “Assisted living isn’t that old a venture in this country, so we’re getting creative as we go along and [are] trying to find out what works best for what situations.”

Five years ago, John Pappenheimer, an emeritus professor of physiology at Harvard Medical School, and his wife, Hylie, were facing a dilemma similar to the Hoffmans’. In 1999, Hylie underwent surgery for a tumor, but when she woke up, she could no longer read, write, tell time or even dial a phone. She was suffering from dementia induced by the long anesthesia. 

At first, John tried to care for Hylie at home, but when he suffered his second heart attack, he worried that he could no longer be a reliable caregiver for his wife.

“It got beyond my capabilities,” he said. “It was necessary to be in a situation where she could be taken care of, in case I became incapacitated.”

So when an apartment in Cadbury Commons’ secure wing opened up for Hylie, the Pappenheimers seized the opportunity.

“We were lucky to have a place open at the time in this dementia section,” he said. “So she went in first, and then I followed as soon as I could.”

Neither John nor Abe had anticipated the assisted-living arrangements that have come to define home for them at Cadbury Commons.

“When you’re young, you think the world is this way forever,” Abe said. “I never imagined this, never planned for it. I just dealt with it when it arose.”

Similarly, John said he had been too busy with his professional life to think about retirement before Hylie became incapacitated. “It just happened,” he said.

But both men have embraced the norms of assisted living and have established comfortable routines that allow them to spend time with their wives.

Abe and Helen’s “dates” have become legendary at Cadbury Commons. “All the women [in the dementia wing] envy her because they don’t have that,” Abe said.

Meanwhile, John and Hylie have quietly established their own daily ritual. Just before 5 p.m. each day, John escorts Hylie from her apartment in Cadbury’s secure wing to his own apartment at the opposite end of the first floor. They have sherry and an aperitif, before going to dinner in Cadbury’s main dining room. After dinner, John reads to Hylie and then walks her home to her apartment.

“That’s one reason I’m in Cadbury Commons,” he says. “They allow this sort of thing.”

The Hoffmans’ and the Pappenheimers’ living arrangements may sound ideal, but Burgess warns that such relationships can be difficult to maintain.

“They want to keep the common thread of the relationship going,” she says. “The difficulty is that you’re keeping a relationship going with a person who is changing constantly and has good and bad times of the day.”

Still, Burgess is impressed with Abe’s and John’s efforts to make the best of their wives’ illnesses.

“These two gentlemen have accepted that the best of possible worlds would be that they could make sure that their wives received the kind of attention and care that they needed,” Burgess said. “It’s just wonderful to see people who love each other dearly be able to still be with each other — even when one of them needs far more care than the other can give them.”

Both Abe and John admit they miss sharing their own homes with their wives. But they are quick to point out that assisted living provides good care for their wives without hampering their independence. Under the circumstances, they said, it’s the best compromise they could find.

“This is a tremendous change in life,” John said. “You have to adjust. We’re very fortunate to be able to be this close. I go in and out all the time to see her.”

Abe is similarly pragmatic: “We had a nice home, nice neighbors — just a very lovely situation. And it would’ve gone on there,” he said. “Would I rather have it another way? Of course. But I’m dealing with what I’m dealing with, and that’s my job.”