Men Are Stepping Up As Dementia Caregivers By Dr. Marc Rothman

By Marc Rothman, MD

A while back, I received a call from a college buddy, a successful family man who was running a small business but had no idea how to handle a parent with memory loss. His father had passed, and now his mother’s memory and behavior were changing. She was resisting efforts by him and his brother to help, and their concern overflowed for her health, wellness, and safety. They needed someone they could trust to guide them along this journey, about which they knew something, but were not experts by any stretch.

As a physician, a geriatrician, and now the CEO of a health care startup, I receive more and more of these calls every year. A husband, a son, or even a grandson who might have children of their own, but otherwise feels overwhelmed by the caregiver role, responsibilities, and intricacies, reaches out for help. Their ask is simple: “How do I help my loved one live their life to the fullest, remain independent at home, and avoid the perils and pitfalls of memory loss? How do I navigate the emotional, physical—and financial—minefield that lies ahead?”

The growth of the male carer population has been astonishing. Thirty years ago, men comprised around 11% of the caregiver workforce. Today, nearly 40% of all caregivers—not dementia specifically—in the United States are male. We’ve seen that on a smaller scale at our company, Lizzy Care, where the percentage of male caregivers rose from 22% to nearly 50% in under 4 years. 

To honor Men’s Health Month, in this column, I’ll explore the rise of male caregivers and the ways in which support systems for this group must evolve to meet their needs, help them avoid burnout, and thrive—so that their loved ones can thrive too. 

Experience born of necessity

Behavioral changes and self-neglect are the most common reasons that husbands and sons call me. For many, the memory loss has been tolerated, maybe even written off as normal aging, until now, when their loved one begins to lash out or refuse to bathe or groom for months and months, and now it’s time for a fresh set of eyes, possibly even an intervention. These families rarely have the support they need from primary care, which is not surprising since dementia is chronically underdiagnosed. According to a 2024 study, only 60% of those with mild or moderate dementia, and less than 10% with mild cognitive impairment, ever receive a formal diagnosis from a medical provider.

Only the best care 

In my experience, male care partners, especially sons, are most concerned about finding the best care for their loved one, even if that means outsourcing. They often recognize caregiving is not their area of expertise and want the best minds and the highest quality of services for their loved one. They also tend to embrace technological solutions as ways to expand their reach, bring in other members of the care team, and smooth the overwhelming burden of communication required of carers these days (texts, emails, reminders, scheduling, etc). 

Male caregivers also have a strong preference for providers who understand their family dynamics and can be sensitive to the changing roles as the disease progresses. One such caregiver working with Lizzy Care put it this way: “I think that the ability to identify the kind of support that my parents need and source companions to provide that support has been absolutely first rate. They are not people who would have, I think, been sourced for my parents by another organization.”

Working with family schedules and dynamics is key to building trust and a long-term relationship between providers and caregivers. And trust is the key, especially at Lizzy Care, as we look to the future to help caregivers anticipate and avoid the next crisis.

Combat loneliness, isolation, and boredom

To push back against the pervasive loneliness and isolation that people living with memory loss, dementia, and Alzheimer’s experience, they need socialization, engagement, and a sense of belonging to a community. And as their care partners begin to look a little different, the support services they need will have to evolve, too.

Socialization. Fulfilling the role of caregiver can lead to identity issues. I encourage caregivers to find hobbies and activities in which they find joy and continue to include time for those hobbies and activities within their day-to-day lives. Examples include going on hikes with a friend or the dog, participating in fantasy football, or playing an instrument in a band. Time away from caregiving should be fulfilling physically, mentally, and spiritually. 

Engagement. Caregiver burden has been shown to increase individual rates of stress, anxiety, and depression. Just as is done for loved ones living with cognitive impairment, caregivers must also identify support for themselves. For men specifically, physical fitness can help address these mental health concerns, including, for example, a group fitness class or a running club.

For example, photographer Juan Carlos Zaldivar, a caregiver for his mother, Nilda, for more than 8 years, attends an online meditation group every Tuesday. “Having a scheduled, recurring meeting option provides me with an outlet for unexpected emotions or challenging situations that come up, which I may not have been able to process entirely during a given week,” he says. 

Photographer Juan Carlos Zaldivar, a Dementia Spring fellow, and his mother, Nilda, who is living with dementia. Juan Carlos has been Nilda’s caregiver for more than 8 years and has learned a few things about taking care of himself along the way, including eating nutritious meals in small portions throughout the day to provide energy and scheduling alone time before and after Nilda’s day begins and ends, respectively.

Community. Male caregivers reported being reluctant to express their needs and to seek out external support for those needs; they sought relief from their burdens with family, friends, alone time, and, for some, male-only support groups. Clear communication and setting expectations with family members and friends, although challenging, will also help men to be able to find this space. One strategy, for example, is reaching out to another family member to set up a standing appointment of 2 hours weekly during which time caregivers may seek out a support group or suit up for the recreational softball league. 

Caregiver support

Different caregivers—men and women—need varying degrees of support and hands-on training to provide home care to their loved ones. At Lizzy Care, rather than bouncing from crisis to crisis, my memory care team and I focus on helping families understand that the journey is fairly predictable and that crises can be anticipated and prevented if we work together.  

We typically start with a comprehensive assessment that answers questions, such as: Where is the caregiver right now? In a crisis or not? Burning out or feeling empowered? Then, we line up support services tailored to the current situation: a caregiver coach, a companion for respite, a home health aide for personal care, physical therapists for mobility, dentists for malnutrition, and housekeeping for hoarding. We then coordinate everything with the primary care provider, if there is one.  

Early resistance to needing any dementia help; isolation and loneliness that settle over the home; frustration and behaviors that emerge throughout dementia care; need for physical help in home care; home safety and financial concerns as a result of memory care; questions about quality of life along the dementia journey; death and dying (which aren’t always discussed openly): These are the common threads that every family providing dementia care faces. But for physicians, like myself, and dementia-help organizations, like Lizzy Care, we have these discussions every day. 

Expanding, accessible community

Caregivers come in all shapes, sizes, and sexes. If you’re a man trying to think about caregiving for the first time, you’re in good company. The resources mentioned in this article, and more, are out there to help you through every step of this journey. 

Reach out, and take care. 

Dr. Marc Rothman has dedicated his professional career to helping older adults. As CEO of Lizzy Care, a full-service dementia care management company, Dr. Rothman draws from his years as a practicing physician and physician executive to design programs that deliver care more safely and effectively. Dr. Rothman is also the founder of Dementia Spring Foundation, a 501(c)(3) nonprofit that supports artists and innovators who are telling new stories of dementia, curating programs engaging those living with dementia, and harnessing creativity to foster community and hope.