86-year-old Marion Taylor organized puzzle pieces into colorful plastic dishes, also shaped as puzzle pieces. “This is my first thousand-piece puzzle,” he exclaimed. “It will probably be my last.”

The room filled with laughter, but Gail Taylor, Marion’s wife, stood quietly by the sofa. “No, it’s not,” she said.

“It isn’t?” Marion asked. “Well, it feels like it is.”

While seemingly minuscule, these moments were increasingly common reminders to Gail that while her husband was the same man she had fallen in love with over 60 years ago, he was not the same. “He was so funny before,” she said. “He was always in the middle of everything.”

Before his dementia diagnosis in 2021, Marion was regularly described as the life of the party. Now, he sits on the periphery, even in groups, including family. “It’s like he’s melting away,” their daughter Tammy Crews said.

What started with forgetting people’s names has slowly progressed into the inability to recall life’s biggest milestones: retirement, having children and grandchildren, getting married and even meeting Gail.

On a hot summer day in 1964, a young Gail Lay unpacked her things into a humble rental house in Charlestown, Indiana. Struggling with her familial life, she decided to spend the summer living with her older sister, Emma Leona Woodcock and her brother-in-law, Reathel Woodcock. The house had a large field, but neighboring houses were visible in the distance.

A gentle breeze eased the heat as Reathel began working on his car. Gail and Emma were close, their personalities opposite but complementary. Where Gail was reserved, Emma could never meet a stranger. When Reathel needed a tool to fix his car, Emma grabbed Gail, and together they skipped to the neighbor’s house to fetch it.

When they arrived, two men greeted the sisters, Marion and his brother Charlie Taylor. For Marion, it was love at first sight. For Gail, not so much. He was older, and she was still attending high school.

Over the next few months, Marion and his brother would make their way across the field. Charlie to play cards with the sisters, and Marion to become closer to Gail. In time, Marion and Gail went for a ride in his jeep through the knobs, or Indiana hills. On top of the knobs, the view expands over ten miles. Marion showed Gail the old power plant that rests seven miles away. Smoke billowed as they sat in the breeze, taking in the view. Next thing they knew, they had fallen in love.

Marion, a bricklayer and construction manager, was the helper type–buying Gail’s school books and clothes as acts of love. The warm feeling of safety enveloped Gail every time she was around him. He was her protector, and soon, they were married.

These days, Gail has taken on the role of caregiver. “Marion was always in charge, and now I feel like I’m in charge,” she said. While she happily accepts her new role as caregiver, Gail misses the independent, confident Marion she used to know.

In the past couple of years, Gail has become Marion’s lifeline. When Crews took her dad to an appointment because Gail, in her 70s herself, had a doctor’s appointment of her own, Marion became anxious. “He was uncooperative,” she said. This was unlike her sweet Marion. “That's when I realized he's completely dependent on me.”

Moments like these were small reminders that Marion’s dementia was advancing. What seemed manageable soon became turbulent on an October evening in 2024.

When the Taylors moved to Bowling Green, their granddaughter Cora decided to live with them while she attended college. This plan excited Gail and Marion, who pride themselves on their tight familial bond. With family portraits carefully hung in decorative frames on each wall, the Taylor house reflected nothing less than love and connection.

Marion had a special bond with each of his grandkids, and Cora was no different. “She and Marion were always so close, and they did everything together,” Gail said.

Marion was never one to sweat the little things, making living with a college student easygoing. When Cora would cook her rice on too high a heat and leave a layer at the bottom of the pot, he’d clean the pot and shrug it off.

Then, there was a moment that stopped the Taylor family in their tracks. Confusing another dish for rice, Marion saw the burner on high, and his temper bubbled over. He yelled at Cora, leaving her in tears and begging her dad to pick her up. This moment would stick with Gail as the rude awakening. Marion, her caring, patient husband of 61 years, was losing himself. And therefore, so was she. “It was just so out of character for him,” Gail said. “And, when that happened, that's when it really sank in to me. It's really real.”

For Marion himself, the change is scary, too. “I'm just praying as I lose my memory and stuff that I don't turn angry or something,” he said. “...get mean to her or something, because it seems like little things just set me off anymore.”

These differences he is noticing feel beyond his ability to prevent, much of the time. “When you lose your memory, you don't really know where your control button is,” he explained. “That's what hurts me the most, is that I don't know if I'm doing the right thing or the wrong thing; But I always try to do what I think is right.”

Even in the hardships and confusion, Marion knows where his heart lies. “We just love to work together,” he said. “And she goes way beyond because I don't even think to do some of the things I needed to do to take care of myself.”

While Marion feels insecure about his condition, Gail reminds him that there is nowhere she would rather be. “I tell him, ‘Honey, I don't love you. I'm in love with you. I'm still in love with you,” Gail said.

The closeness between Marion and Gail extends into their relationships with their children and grandchildren. With two children and four grandchildren, the Taylors have built a familial bond focused on love, support, and honesty. After Marion’s outburst to Cora, a family meeting was called. These meetings happen after any event in the family. When they lost a grandchild, a family meeting was called for grieving. When Marion was diagnosed with prostate cancer in 2014, a local doctor advised that he refuse treatment and ride out the rest of his life. “He said, at your age and your life expectancy, you'll probably die before you die of prostate cancer,” Gail recalled. “So we said, ‘Family meeting.”

After finding a new doctor in Nashville, Marion began a year and a half of radiation treatment. As of 2026, he has been in remission for over five years. “Marion would have died,” she said.

In this case, the Taylors needed to put their heads together to figure out how best to help Marion with his challenges due to dementia. “We didn't know at that moment if [an angry outburst] was something that was going to happen continuously,” Gail said.

As the meeting adjourned and family members began speaking amongst themselves, Gail and Marion’s son, Kevin, pulled his mother aside. “He said, ‘Mom, we want to know if anything happens or that you're not safe. You have to be safe, too,” Gail recalled.

Within all of the unknown, Gail knew she needed someone to talk to. As a member of the United Methodist Church, she was introduced to a support group held for family members of those struggling with dementia. Walking into her very first meeting, Gail met a woman presenting to the group named Jenny Jacobs, the founder of Defying Dementia.

In May of 2005, cherry blossoms were blooming on Western Kentucky University’s campus as the senior class prepared for graduation. Amongst them was Jacobs, a speech pathology major. In her profession, there are two main client groups: children and the elderly. Jacobs knew that she did not want to work in a nursing home— they were ‘gross.’ So when she received a job offer for a speech therapist position in an Owensboro, Kentucky, nursing home, she was reluctant to accept. That was, until she took a closer look at the salary. As a fresh college graduate, Jacobs was just looking to pay the bills. So she packed up her things from Bowling Green and made her way to her new home.

This was the beginning of finding her passion: helping patients struggling with cognitive decline, and preventing that decline in the first place. Her career shifted toward management roles, overseeing multiple nursing homes and assisted living facilities. While her job was to maximize profit, her goal always remained to provide the best care possible to the residents of the facilities. When COVID-19 struck, the standard of care in nursing homes nationwide dropped. According to Health Affairs, one in five homes reported severe staffing shortages throughout the pandemic. “I don't think our industry has recovered, honestly,” she said.

Jacobs couldn’t shake the feeling that she could do more for the residents, particularly surrounding memory and cognitive care. The opportunity presented itself in 2023 when she was asked to oversee activities at a larger facility in Louisville, Kentucky. There were three units: two memory units and a men’s behavioral unit. The facility had an Immediate Jeopardy tag (IJ), which is defined by the Association of Health Care Journalists (AHCJ) as “a situation where a hospital, nursing home, or other medical entity violates regulations in a way that causes or creates a likelihood for serious harm to patients or residents.”

Jacobs witnessed the issues at the facilities: Resident-to-resident altercations once, sometimes twice a day, and a general lack of anything to do. Not only were activities limited, but they were also not tailored to fit residents’ needs. “They were trying to play bingo with people who have never played bingo before, or don't have the actual ability to play bingo independently,” Jacobs said.

IJ tags require action within 23 days, so Jacobs knew she was working on a clock. The entire facility was at risk of shutting down, and it was her job to prevent it. She used her knowledge from her education in speech pathology to aid her research into dementia and cognitive decline. “A lot of people don't realize that cognition is within a speech therapist's scope of practice,” she explained. “Before you can actually tell someone a story, you have to, in your mind, be able to sequence the steps and relay different things.”

Along with this, Jacobs explains the correlation between hearing loss and cognitive decline. “I can't tell you how many times I've had people come and sit in my office whose children are like, I just know they have dementia. Or they think, I just know I've got it. I just know this is happening to me,” Jacobs said. “Sometimes it’s as simple as, ‘When's the last time you had your hearing checked?”

Jacobs’s assertion rings true on a national scale. According to a study by PubMed Central, those of senior age with hearing loss are 30-40% more likely to experience cognitive decline. The worse the hearing loss, the worse the decline. Marion wears a cochlear implant himself.

Jacobs created a system of assigning stages of cognitive decline to residents and matching them to activities based on those results. Much of her education came from her schooling at WKU, and she has dedicated much of her time to independent research as well. “[I] just really try to educate myself,” she said.

If one resident struggled heavily with reading comprehension, physical or audio activities would complement books and word-related games like bingo and crossword puzzles. While she wanted to exercise the parts of patients’ brains that aren’t working, she also aimed to preserve the highest-functioning part of their brains. Immediately, the facility noticed a difference. “When we implemented our program in this nursing facility, we eliminated resident-to-resident altercations within 30 days,” Jacobs said. Falls in the facility also halved. The facility was no longer in jeopardy, and Jacobs knew she had created something special.

Ever since she was young, Jacob’s father had Parkinson’s Disease. “My dad was diagnosed with Parkinson's when he was 38 years old,” she explained.

Jacobs’ father received a series of brain surgeries in 2015 called Deep Brain Stimulation (DBS), which aims to reduce involuntary movements by sending electrical pulses to the part of the brain that controls movement. “He went from taking 30 pills a day to taking four after the deep-brain stimulator,” Jacobs said. “Though that's when I noticed more of the cognitive issues start. His dementia started showing itself.”

Tasks that seemed trivial became difficult for her father. “He needed my help paying his bills,” Jacobs said. “It was a big deal when he finally came to me and said, ‘I can't do this anymore.”

As her father’s sole caretaker, Jacobs became a pro navigator of the American healthcare system. While she managed to find resources, she felt there were holes in both care and information given to her family on the realities of living with someone in cognitive decline. “I just remember thinking, I wish there was somebody I could talk to, and there wasn't anyone,” she said. “I wanted to figure out how to be a support for other people so that nobody had to go through a similar situation.”

Jacobs’s father passed away in 2024. “His name was Irvin Abney. He was a federal probation officer,” she explained. “The last four years of my dad's life were brutal. I was the one that was responsible for making every decision and coordinating moves and coordinating all the things.” With her passion already in cognitive care, this firsthand experience lit a fire within Jacobs. She wanted to find a way to fill in the missing pieces that exist in prolonged cognitive care. It was then that she started Defying Dementia.

The practice is best described as a dementia care and prevention program that specializes in empowering and informing family members, as well as regular interaction and personalized care plans called Mindful Aging. It has a wide set of participants, from elders struggling with dementia to those in their early 40s aiming to prevent it. “There's a ton of research that's come out…in the last two to three years, in particular [of] things that we can do to prevent dementia and decline,” she explained. “Decline and dementia actually start in our midlife.”

At age 44, Jacobs is already adding lifestyle changes to preserve her brain health as she grows older. Preventing Cognitive Decline and Dementia: A Way Forward by the National Academies of Sciences, Engineering, and Medicine details studies in the last decade related to prevention. According to the U.S. Department of Health and Human Services’ alzheimers.gov, “The review found ‘encouraging but inconclusive' evidence for three types of behavioral changes (called interventions): physical activity, blood pressure control, and cognitive training. The findings mean that interventions in these areas are promising enough that researchers should keep studying them to learn more.”

Jacobs took this information and began her own independent research. With two of her own children enrolled in Montessori school, she knew she wanted to incorporate Montessori principles into her own program.

Doctor Maria Montessori developed ten principles for educating children after years of observation and experimentation. According to the official Montessori Academy, the principles “are based on respect for children’s learning process.”

PubMed Central compiled evidence from 24 independent studies comparing Montessori and traditional school students, and found that “positive standardized mean differences favor Montessori education over traditional education.” The practice is over a century old and is practiced to varying degrees in over 20,000 schools worldwide. Jacobs herself dreams of opening her own Montessori school one day. “I've attended workshops and trainings, particularly utilizing Montessori principles for dementia care.”

Much of the Montessori practice involves meeting learners where they are. “Everybody's path looks different, right?” she explained.

Jacobs’ passion for both cognitive care and Montessori branched off into a separate but connected program, the pen pal program. Through Bowling Green Montessori School and the Bungalows, an assisted living facility in Bowling Green, Jacobs created a bridge that benefits those trying to grow their brains and those aiming to preserve theirs.

At the Bungalows, many of the residents do not have dementia in particular, but are still at the age of experiencing various levels of cognitive decline. For those who are experiencing decline, reading and writing offer a stimulating experience that preserves brain health. For residents without decline, the program acts as an intergenerational connection and a prevention of decline. “It makes their day to get the letters,” Bungalows Activity Coordinator Autumn Shadowen said.

At the end of the program, which spans over a few weeks, the students will go to the Bungalows to meet their pen pal. “They love getting to talk with them, getting to share their stories,” Shadowen said. “They love talking about the times whenever they were younger, and educating.”

While the students do their best to articulate their favorite colors, ask questions, and draw pictures, the five and six-year-olds are definitely still learning. “Now, I’m not sure what this word says,” Bungalows resident Brother Bob said with a chuckle. “I’m going to need the teacher’s translation.”

After finishing up physical therapy, Brother Bob enjoyed reading his new letter from his pen pal. Once he writes back, answering his pal’s question: What’s your favorite T.V. show? [spelling corrected for legibility], he will send it off.

This social engagement, while seemingly just generating a chuckle, will aid Brother Bob in preserving his cognition in the long run. According to a study conducted by the American College of Physicians, “Recent research suggests that older people who are more socially engaged tend to have a higher level of cognitive function.”

New research from institutions such as New York University predicts that cases of dementia in the U.S. will double by the year 2060. The National Institute of Health (NIH) released evidence in February of 2025 that showed that “researchers estimated that 42% of Americans over age 55 will eventually develop dementia.” In light of this, the NIH has reported competitive research proposals surrounding Alzheimer’s and dementia in recent years.

The NIH Categorical Spending data show that federal investment in Alzheimer’s disease research increased substantially from the early 2010s through the 2020s, rising from under $1 billion annually to nearly $4 billion in the past few years. However, increased total funding does not necessarily translate into broader access to research support.

At the National Institute on Aging (NIA), Alzheimer’s-related grants are awarded through a highly competitive process, in which most of the funded applications fall within the top 10–16% of peer-reviewed scores. Across the NIH overall, success rates for research project grants average around 20%, meaning only about one in five proposals receive funding.

News reports, such as from Scientific American, have described instances in which federal funding for Alzheimer’s research was delayed, frozen or revoked within the Trump administration, raising concerns about disruptions to ongoing research projects.

In recent years, NIH funding policy changes and budgetary pressures were widely reported to have contributed to awarded grants being decreased and disruptions in funding, including shifts in how grants were allocated. Some analyses of recent NIH funding policy changes and administrative disruptions have noted impacts on the number of grants awarded in certain research areas, though overall NIH funding levels have continued to rise. This highlights a gap between overall budget growth and researchers’ actual access to funding

While Bowling Green, Kentucky, may be known as a smaller town, research and innovation are currently in a boom within Warren County. In September of 2025, OgMentum ARK Research Company moved into Bowling Green, greatly increasing research initiatives on WKU’s campus.

Graduates like Jacobs are no different, with a program unlike most others in the nation. “I’m hoping I’m going to be the first one and change the world,” Jacobs said.

Nationally, there are resources to help those navigating through loved ones with dementia and Alzheimer’s, but few, if any, match the personalization and care that Defying Dementia offers. The Alzheimer’s Association provides consultations, a 24/7 helpline, education, and navigation of services— but weekly house visits and invaluable personal connections are not listed under services.

Programs such as the Benjamin Rose Institute on Aging offer telehealth and email consulting and advising, but do not offer cognitive assessment or house visits. Many dementia services exist, but the personalization of Defying Dementia is one of a kind.

Many insurance plans cover the program, extending care to families with financial constraints. However, Defying Dementia has hit a common roadblock for those in the medical field in America: the giants.

“We've got Med Center, we've got Greenview, and then we have Graves Gilbert, and they're the giants,” Jacobs explained. “They also tend to typically refer back to themselves, so Med Center may realize that I'm here and that I exist, but they're still just going to refer to their outpatient therapy.”

This problem is not unique to Bowling Green. The National Library of Medicine released a study titled “When Getting Bigger is too Big—Challenges of Growing Healthcare Systems” in 2025. This study detailed how, in America, “Nearly two hospital mergers occur per week and the majority of hospitals are now part of a larger health system.”

Additionally, “64% of acute care hospitals are now part of a multi-hospital health system comprising 84% of acute care hospital beds.” In turn, smaller programs like Jacobs’ are buried. The authors of the study, Nader N. Massarweh and Andrew M. Ibrahim, urge state agencies to support local initiatives in ways such as “implementing policies that limit insurers’ ability to create narrow networks or that incentivize regional collaboration between health systems.”

Lack of knowledge about programs like Jacobs’s not only affects those who offer them, but also those who could benefit from them if they were aware. “People don't know that resources actually exist because nobody's telling them about it,” Jacobs said.

With this, some providers misunderstand dementia as hopeless rather than simply more difficult. “I can't tell you how many times I've listened to therapists say, well, they've got dementia. What do you want me to do with them?” Jacobs said. “When I hear that, what I hear is that there is a healthcare provider that's been educated, that's been working for a while in our industry, that is just immediately taking off the table their ability to help about 50 million people.”

She emphasizes that there is nuance to cognitive decline. “People that have dementia, even in the later stages, can still learn new things, just have to learn them differently,” she said.

In her consultations, clients sit down with Jacobs to gather information about their own or their loved one’s cognitive decline. While the main goal is to educate, supporting and empowering caregivers is also a primary goal. “If you can explain why something is happening, it alleviates frustration,” Jacobs explained.

Throughout their entire lives, the Taylors strived to stay active. Working outside and regular exercise have allowed them to remain independent into their senior years. “I'm trying to walk 2000 steps or better a day just to keep my strength up and stuff,” Marion explained. Through his cancer and his dementia, Marion and Gail both strive to be the healthiest versions of themselves they can be. “I talked to my doctor…I said my biggest fear is if something happens to me,” Gail said. “If I have a stroke, or even if I just fell and broke my leg or something…I feel like he's so dependent on me.” In their current chapter of life, the Taylors’ health journey is solely about preservation.

Gail, Marion and their grandson Noah take a seat at Marion’s Neurology appointment. The memory care unit is buried within the building—up an elevator, through multiple hallways, and winding signs finally lead you to neurology. A route Marion could never navigate on his own.
“So, there are a lot of things out there,” the neurologist said. “Some of them I know about, some of them I don’t.” The doctor was answering Gail’s question about Creatine, a supplement known for muscle growth and retention. Jenny had told them about multiple studies showing promise in cognitive preservation. “Do you have any more questions?”

In the span of seven minutes, the appointment was complete. The National Library of Medicine published a study in 2025 detailing the positive cognitive effects of using creatine. “Creatine monohydrate was associated with improvements in cognition. The efficacy of creatine monohydrate in Alzheimer's disease should be studied further.”

Defying Dementia gives the Taylors another avenue of personalized treatment, otherwise not recognized in traditional medicine. “I have someone to turn to, that is a resource to help, that I don't feel like I'm out on an island by myself,” Gail explained.

The Taylors appreciate the program’s focus on prevention. “That's part of our health care crisis right now, is nobody talks about prevention or forming good habits,” Jacobs explained. “They just talk about how to treat and manage symptoms with medication.”

The most important part of the program to the Taylors is the personalization and regular access to hands-on support. “She just brings joy to my heart when I see her,” Marion said. “When she comes, I just light up like, you know?”

“She interacts with Marion, and so I feel like she knows him. She knows about him, but she also knows him,” Gail said. “And I think that makes a difference to it. She's evaluated him and interacted with him until she understands who he is and what his needs are.”

The Taylors feel like Jacobs is more than a provider for them, but a friend deeply involved in Marion’s situation. “She continuously does research to understand dementia, and she's experienced it in her own life with her own family,” Gail said, referring to Jacobs’ father’s cognitive decline with Parkinson’s Disease. “That's part of why her heart is pulled towards it. She's a great inspiration to me.”

Unbeknownst to the Taylors, Jacobs feels the same way about working with families just like them. “My dad passed in May of 2024, so I took a little time to heal after that. But working with families like Gail and Marion…it’s helped me heal,” Jacobs’ voice broke. “That's been very helpful in my grieving process to be able to be with people like that.”

The clock ticked in the kitchen while Jacobs laid out colorful wood pieces as Marion patiently waited to begin his puzzle. This was a new puzzle, 3-D rather than flat puzzle pieces. The orders of the colors didn’t matter—the puzzle focused on matching the stained-glass-like pieces by shape.

Jacobs and Marion worked on the puzzle at their usual Wednesday morning meetings as the three caught up on what each had been up to the past week.

“What did you cook for Easter?” Jacobs asked Gail.

Gail turned to Marion. “Do you remember what we had to eat for Easter?”

“Uh, we had ham,” Marion recalled.

“Yeah,” Gail affirmed.

“Sweet potatoes-”

“No, we didn’t have sweet potatoes,” Gail said.

“Oh, we didn’t?” Marion replied. “Okay. Mashed potatoes and green beans…”

“Macaroni and cheese,” Gail added.

“What about deviled eggs?” Jacobs asked.

“We had deviled eggs,” Gail replied.

“Oh, did we?” Marion said. “Okay, I don’t remember.”

By the time the three made it through recalling their Easter Sundays, the puzzle was complete. “Whew, it’s hard work,” Jacobs said once Marion placed the last piece.

“You’ve done good!” Marion replied.

“You did it,” Jacobs said.

“...No, you helped me,” Marion responded.

“We figured it out together,” Jacobs conceded.

“We did it, we did it,” Gail said.

Jacobs put the puzzle under the table and let out a sigh. They were nearing the end of their weekly meeting. “So, can I give you some homework?” she asked.

“No,” Marion replied. “I’ll fail at it.”

“You can do this,” Jacobs reassured. She took out a pad of yellow paper and wrote out a three-word sentence.

The dog ran.

She turned the pad around on the table to face Marion and handed him a pencil. “Put these in alphabetical order,” Jacobs asked.

“I don't even know my alphabets anymore,” Marion said.

“Well, that’s what we’re going to work o-”

“A, B, C, D, E, F, G,” Marion exclaimed.

“Right!” Jacobs said. “Say A, B, C, D, E, F, G, and whenever you say the letter…that means it came first.”

“Do you want me to put an ‘A’ here or what?” Marion asked.

“We have a word that starts with a ‘T,’ a ‘D,’ and an ‘R,” Jacobs patiently explained. “So, in the alphabet, would the ‘T,’ the ‘D,’ or the ‘R’ come first?” Gail looked at Marion, a worrisome, but hopeful look in her eyes.

“D,” Marion said. Gail exhaled. “So, dog.”

With each word, with multiple practice sentences, Marion began to understand the instructions and complete each alphabetization. “Can I give you three of these to do every day until next week?” Jacobs asked.

“You’ll have to tell [Gail] because I already will forget,” Marion chuckled. “But she’s a good coach.”

“She is a good coach,” Jacobs reassured with a smile.

“She loves me even though I’m not all here,” Marion said.

“I know she does; we all love you,” Jacobs said. “And I’m not all here either, and I don’t have dementia. So we just got to love each other no matter what.”

“Unconditional love,” Gail added.

“That’s what it is,” Jacobs said.

“Unconditional love…” Marion trailed.

On her notepad, Jacobs gave Marion one more sentence to alphabetize before heading out for the day.

Marion loves Gail.

“Which word would go first in the dictionary?” Jacobs asked.

Marion ran through his alphabet. “Gail,” he said.

“Perfect!” Jacobs exclaimed. “Which one’s next?”

“Loves,” Marion said.

“Okay, and then the last,” Jenny said as she wrote Marion on the sheet of paper on the third line.

Gail loves Marion.

“And she does!” Jacobs exclaimed.

“Mm, Gail loves Marion, Marion loves Gail…” Marion said. “Hey, that makes a good deal.”