When we heard the news of the deaths of Gene Hackman and his wife, Betsy Arakawa, we initially worried that it was a murder-suicide. Perhaps he, like Robin Williams, had decided that he was not suited for a prolonged decline, from dementia in his case, and his wife made the ultimate sacrifice to support his decision.

As the facts have come out, however, the reality of their situation is bleaker than we imagined.Hackman had Alzheimer’s disease, and Arakawa was his caregiver, looking after his daily needs and protecting his social image. When Arakawa became ill, she likely cared for Hackman to the end of her life, and then he endured another week alone in his home.

This bond is a reality for the millions of caregivers who care for the 6.9 million Americans age 65 and older with Alzheimer’s disease. Their numbers are projected to double to 13.8 million by 2060.

Why do caregivers sometimes trade their own well-being for that of the person with dementia? In a key way, the American health system encourages it. Each person has private relationships with their medical providers because the U.S.........

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