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As they say, it takes a village! We rely on both. I have bulbar-onset ALS, and my needs are primarily food-related and communication. However, my husband has moderate dementia plus cardiac problems, so caregiving for the two of us can be quite a challenge. It’s a blessing to have both daughters nearby, but they have their own families and can’t do it all. We rely on paid caregivers four hours a day to manage my husband’s needs and to give me time for self-care. As my disease progresses, we anticipate additional paid hours.