John McCasland (right) of Goodlettsville, Tenn., hired a private caregiver to help with his wife, Jean (left), who suffered from dementia for eight years. Even when hospice took over, he still found he needed the extra help from Karrie Velez (center). Jean died in October after 13 months on home hospice.

John McCasland (right) of Goodlettsville, Tenn., hired a private caregiver to help with his wife, Jean (left), who suffered from dementia for eight years. Even when hospice took over, he still found he needed the extra help from Karrie Velez (center). Jean died in October after 13 months on home hospice.