The appearance of Alzheimer’s touches relatives or friends, close or distant, to change every aspect of their relationship with a loved one who has this disease. As Alzheimer’s advances, the only constant may be the love that you have between you, and that you can still maintain, if you don’t give up on the person prematurely.

For older couples, Alzheimer’s shatters the dream they may have of spending the golden years together on cruise ships and travel to places they always wanted to see. Some younger couples who face the disease early in a 50-60 year old spouse or an aging parent have an even harder time of it, trying to figure out how to pay the bills, raise teenagers, finance college, and take care of a husband, wife, or parent with Alzheimer’s. Those with the disease no longer can contribute to the family unit the old way and other family members take up the slack which redefines roles and identities.

In addition to their usual responsibilities, a wife may find herself as the new financial manager, suddenly in charge of writing checks, paying bills, and submitting medical claims, duties that her husband may have had. A husband may find himself having to learn how to prepare meals, do laundry, become a social secretary, or coordinate schedules. Economic pressures mount. Emotional strains take their toll. The additional obligations make people feel overburdened and resentful.

Children and friends watch the changeover with sadness and dread. They may find themselves facing the confusion of a reversal in the parent-child relationship or the friend-to friend tie, as loved ones can no longer be turned to for help or advice. Adult daughters, daughters-in-law and sons take on a dominant role as they struggle to balance the needs of their own families with the needs of their aging parent. Young children find themselves at a loss as they watch their parent or grandparent begin to fade away. If conflict operated within the family system prior to the beginning of the disease, Alzheimer’s complicates the situation to create even more dissension.

But wait. What about the love that drew you together in the first place, as a couple and as a family? Isn’t it worth preserving, whatever the circumstances? People with Alzheimer’s are still able to experience love. It’s just that your loved one may not be able to acknowledge it in the usual way.

Reach out and connect:

• Treat your loved one as a precious human being.
• Start a conversation with a smile.
• Ask your loved ones how they feel.
• Encourage them to express an opinion.
• Follow-up on the words they use and put them together to make sense.
• Ask if your deduction is correct.
• Try to be patient.

Create moments to share together. Go on walks, picnics, listen to music or look at family photographs.

Kindness and respect will not go unnoticed. They will know that you care. And they’ll respond whatever way they still can, with a smile, with words, a knowing look, a sparkle in the eye, a laugh, a touch. They’ll connect and communicate right back with you.

Roles change and expectations shift, but love and relationships remain: when you work at making them work. It’s well-worth the effort.

Judith L. London Ph.D. is the author of Connecting the Dots: Breakthroughs in Communication as Alzheimer's Advances .