My maternal grandfather was Thomas W. Durnin, an attorney with a distinguished practice and a successful local political career in Carbon County, Pennsylvania. I loved him dearly — he was a smart, sensitive and warm fellow with great insight and great wit. One day, when I was a teenager, I noticed during one of his regular visits that those qualities didn’t seem to shine in him as brightly as they once did. Then he became unexpectedly irritable at times, and nobody could understand why.

Years before, his wife Marie, my grandmother, was hit with a massive stroke that left her in a semi-vegetative state. She spent the last seven years of her life in a nursing home in Weatherly, Pa. As far as I can remember, she stayed in a good facility with kind and professional staff who took good care of her. Her condition never improved, and my grandfather visited her every single day. He would talk to her, hoping that somewhere inside her body, his wife was listening to him, knowing that he had not forgotten her, nor would he ever.

Until the day that he did.

A few years after my grandmother died, my grandfather had joined my family on a Christmas cruise, and during dinner one night, he became markedly disoriented and agitated. As my mom tried to figure out what was wrong, he asked my mother, “Where’s Marie?” There was a moment of stunned silence at the table before my mother had to inform her own father that her mother, and his wife was, in fact, gone. The news hit my grandfather like it was the first time. At that point, he was wheeled to the infirmary where he swiftly regained his composure, quietly humiliated that he had had a medical situation in front of so many strangers.

Later, he was diagnosed with Alzheimer’s disease, and in the years that followed, we watched him quietly lose grip of his mental faculties. And for a time, he was more angry than not, bitter in a way I had never before seen, because he was, through no fault of his actions or will, failing to live up to his promise. He was forgetting everything that mattered to him.

In his last years, my grandfather was himself a nursing home resident, where he could get the care he needed. I would visit him after school and take him out for ice cream, and he was really happy. He didn’t know who I was, but he sure was happy. He was flirting with one particular resident his age, and the two were adorable, acting like 11-year-olds in the throes of puppy love. That’s the thing with Alzheimer’s. By the time it hits you so hard that you need full-time care, you are so stress-free that you tend to live longer. And as hard as that was on the rest of the family, at least it wasn’t hard on him.

Here’s the thing, though. I don’t ever recall my grandparents having long-term care insurance. If they had, I am certain I would have heard about it, especially during my grandfather’s care. My mother had been given control of his finances, and I watched as she had to sell her family’s home in order to pay for my grandfather’s care. That was hard, seeing that old, historic house leave the family’s hands. I had secretly nurtured a desire to live there one day. As it was, my grandparents had enough resources to afford (barely) their nursing home stays. They were Depression-era people who worked and saved hard so they could give something to their children and their grandchildren. In the end, what they gave us most was the understanding that long-term illness is real, and you must prepare for it, or else those long, final years might be the worst ones of your life, even if you can’t remember the reasons why.