Scott Janssen’s heart was racing. He took shallow breaths. He couldn’t believe what he was seeing, but he tried to hide his shock.

It was a crisp autumn day, and Janssen was visiting Buddy, an elderly client, at his small brick home on a dead-end street in Durham, North Carolina.

Buddy had just lost May, his wife of 40 years. She was bed-ridden and had suffered from Alzheimer’s disease. Janssen, a hospice social worker, had been visiting the couple for nine months. During that time he had never heard May utter a sound and only saw her open her eyes once.

He also was worried about Buddy. The man was his wife’s sole caregiver; the couple never had children. He had spoon-fed, bathed and dressed May for years, with no help. At times, he’d open their bedroom window so his wife could smell the flowers in the garden he planted outside for her. He often talked to her while he worked in the garden, recounting stories of their life together.

As Janssen sat down, he noticed that Buddy’s depression had lifted. Janssen wondered why and probed for an answer.

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