Alzheimer’s disease is one of the most enigmatic brain afflictions and among the greatest health care challenges facing the nation. It affects more than 7 million Americans — a number projected to double by 2060. This article, which first appeared in Trojan Family Magazine on May 26, 2026, is the fourth in the series “USC United Against Alzheimer’s: Collaborating in Research and Care,” which illustrates how USC researchers and clinicians are making groundbreaking strides in the treatment, prevention and care of Alzheimer’s. Read the first article, second article, and third article.

Fifteen years ago, Cindy and Dudley Goss noticed something was off. Dudley had started missing small deadlines and details at work — unusual for the wealth advisor known for his financial expertise.

Dudley Goss, now 77, a certified financial planner in Trabuco Canyon, Calif., who had served in the U.S. Navy, had begun having difficulty remembering and completing the tasks required for his high-level leadership position.

“Dudley was always a high-functioning and an extremely talented and quick-witted individual,” Cindy Goss says.

After the couple consulted with a local hospital, a battery of tests revealed minor deficits in Dudley Goss’ cognitive functioning consistent with early-onset dementia. The couple believes his participation in a three-year clinical trial at the hospital stalled the progression of his memory loss, but at the end of the trial the treatment failed to receive approval from the Food and Drug Administration. As they looked ahead, they wanted more options — and more support. With no new drugs on the market at that time, Cindy Goss reached out to the Keck School of Medicine of USC.

“I knew that USC has one of the best [neurology] programs in the country,” she says. “And as a teaching hospital, [it] has access to first-time trials.” After much research, Cindy Goss reached out to Professor of Neurology and Raymond and Betty McCarron Chair in Neurology Helena Chui.

Chui helped Dudley Goss enroll in a USC program involving Leqembi, a medication that received FDA approval in 2023 as the first drug to slow progression of Alzheimer’s disease. Dudley received semimonthly infusions for the first year and half of the program and is now on a maintenance dose once a month.

“It was a match made in heaven because Dr. Chui and Dudley have developed a very special relationship,” Cindy Goss says. “Their relationship is highly personal, mutually respectful, and Dr. Chui has shown great compassion and support in so many ways.”

This type of compassionate care is emblematic of USC’s approach to the physician-patient relationship. USC practitioners are nationwide leaders in providing empathetic care to individuals with Alzheimer’s disease, as well as to the caregivers who join their loved ones on this unpredictable journey.

Impactful donations drive research

Keck School of Medicine has one of the largest neuroscience programs focused on Alzheimer’s disease, with centers across the university dedicated to accelerating research and discovery.

Impactful gifts make this research possible: Most recently, the USC Epstein Family Alzheimer’s Therapeutic Research Institute at Keck School of Medicine was renamed in honor of a transformative gift from longtime USC supporter Daniel J. Epstein ’62; his wife, Phyllis; and their family.

In 2022, the family provided support for the founding of the Epstein Family Alzheimer’s Research Collaboration between USC and the University of California, San Diego, to more quickly advance research focused on discovering effective treatments.

Because this complex and progressive disease affects millions, Keck School of Medicine Dean Carolyn Meltzer says it attracts many researchers and practitioners to USC to meet the challenge.

Chui, the director of the Alzheimer’s Disease Research Center (ADRC) at USC, is one of those researchers. The center studies genetic risk factors, including apolipoprotein E4 (APOE4), and how to intervene and prevent the disease from worsening before symptoms appear.

Her colleague Paul Aisen, professor of neurology and director of the USC Epstein Family Alzheimer’s Therapeutic Research Institute (ATRI), leads clinical trials targeting individuals with early biological signs of the disease.

“If we can treat in that window, we may delay or prevent Alzheimer’s,” Chui says.

Focus on drug discovery

Donanemab is another treatment drug that the FDA approved in 2024. Like Leqembi, it aims to slow the progression of Alzheimer’s disease. Although neither drug can reverse memory loss, both represent a shift in Alzheimer’s treatment from merely managing symptoms to attempting to slow the disease itself.

Chui believes the most effective treatment for Alzheimer’s patients would be a cocktail tailored to the individual, depending on what stage of the disease they have.

Chui hopes such a drug could be developed within the next five years, but the reluctance of patients to join clinical trials is one of the biggest challenges to developing new drugs. Likewise, once drugs are developed, the United States’ fragmented health insurance landscape is no match for their cost, with Medicare as the only insurance that will pay for most treatments.

As loved ones join patients on this journey, Chui says they need education on how to think about what the basic, most important things are to quality of life.

“In caregiving, for each stage, it’s a little different,” she says. “You have to think about what a person can do to enjoy the present moment.”

Planning for the road ahead

Keck Medicine of USC licensed clinical social workers help doctors like Chui guide patients through the complex care landscape. Social worker John Danner suggests resources and develops systems that support individuals with dementia from the early stages, when they can still participate in their own care and express their wishes, through later stages, when the disease limits their ability to manage daily life independently.

What sets Keck Medicine apart, Danner says, is that practitioners are dedicated to joining patients and their caregivers on their journey with the disease from diagnosis to the care marathon, through death and bereavement.

“Most hospitals have a discharge planner, one discussion, a list and a goodbye,” Danner says. “USC provides a future care planner.”

This means deeper consultations that aim to better understand patient and caregiver areas of need, followed by an evolving care plan that adds levels of support and encouragement as the disease progresses.

“I work primarily with caregivers to set up systems that will continue to function all the way to the end and keep adding as we go,” says Danner, who has worked with Los Angeles County and USC since 1972. “It really becomes quite a task to get the right setups going before they’re needed.”

Part of that planning may involve Danner helping eligible patients enroll in Medi-Cal, where community-based adult services such as in-home care, protective supervision and out-of-the-home adult day health care may be covered by insurance. Many of these services reflect a common goal that Danner shares with most of his patients: keeping a person at home with their regular routines for as long as possible.

The unseen costs of dementia

Part of that future planning must take into consideration the financial impact of living with and caring for someone with Alzheimer’s disease.

A person with Medicare coverage but no supplemental health insurance can expect to pay about 20% of costs out of pocket for expenses related to diagnosing and treating Alzheimer’s, such as imaging tests, intravenous infusion medications and follow-up monitoring and treatments, says Professor Julie Zissimopoulos of the USC Price School of Public Policy.

The economic toll often goes beyond medications and therapies.

“Most of the burden lands on families through quality-of-life loss, through the hours of care that family members provide, and through the forgone earnings of care partners,” Zissimopoulos explains.

Zissimopoulos, chair of the department of health policy and management at USC Price and co-director of the Aging and Cognition Program at the USC Schaeffer Center for Health Policy & Economics, is a principal investigator for the United States Cost of Dementia Project.

The research team — who produces the annual estimate of the cost of dementia in the United States — estimated a national cost of $781 billion in 2025, which includes informal care, quality of life lost, medical and long-term care, and forgone earnings both of care partners and patients.

“The costs that go unmeasured are among the most devastating: how dementia erodes a family’s earnings, upends retirement plans and sets off a chain of financial consequences that are challenging, but important, to quantify,” Zissimopoulos says.

Without a more affordable long-term care system or treatment to prevent the disease or slow its progression, Zissimopoulos says the economic impact will only continue to increase as the U.S. population ages.

The Cost of Dementia Project aims to give the government, clinicians, people living with the disease and their care partners the information they need for care and financial planning and to better target scarce resources. “The goal is to ease the enormous burden dementia places on families and society, and better information is how we get there,” Zissimopoulos adds.

Caring for the caregiver

That burden often involves a financial, mental and physical strain on unpaid and unsupported caregivers.

“People who care for someone with dementia have the highest rates of financial strain, stress, depression and other negative health consequences compared to all other types of caregivers,” says Donna Benton, associate research professor at the USC Leonard Davis School of Gerontology.

Benton, also director of the USC Family Caregiver Support Center, is a longtime advocate for family caregivers. Her center serves multiple organizations by finding innovative ways to provide support for unpaid family caregivers and the individuals they care for.

In L.A. County, Benton and her colleagues test programs to address caregiver needs in areas such as financial strain, access to resources, elder abuse, cultural differences and psychological stress.

“We don’t have a lot of safety-net programs designed to help very low-income people or middle-income people,” Benton says. “We’re finding that caregivers are taking on more responsibility for the full care of their relative — and they’re less likely to ask for help.”

In 2022, the USC Family Caregiver Support Center collaborated with other California support agencies and family caregivers to create the California Coalition on Family Caregiving. The coalition — which consists of both social service agencies and family caregivers — advocates for statewide policies and services that support unpaid caregivers and the people they care for. Some of the first issues the coalition tackled were better paid family leave for working caregivers and a change to the limited definition at the federal level of who qualifies as a caregiver.

USC’s Center for Advancing Caregiver Financial and Workplace Security — where Benton also serves as a principal investigator — recently launched a new podcast series, The Care Economy, that, according to its website, explores “today’s most pressing and often overlooked economic issues: unpaid family caregiving.”

Benton says USC has been a nationwide leader in caregiver support and research, including training physicians and other medical professionals to be aware of caregiver issues in its programs.

“A lot of the research on the emotional tolls of caregiving were done in collaboration with professors in the USC School of Gerontology,” she says. She adds that USC programs, such as the Los Angeles Caregiver Resource Center, are now models for the services provided nationwide. “USC has been part of that mix the whole time.”

Taking it day by day

In the decade since Dudley Goss was first diagnosed with Alzheimer’s, Cindy says he has participated in at least three Alzheimer’s-related studies at USC that have nothing to do with direct benefit to his health, in service of science.

“I felt that even though my condition was progressing, I really wanted to help other people who struggle with this disease to find other treatments or ideally a cure,” Dudley Goss says.

Since his initial diagnosis, Dudley Goss now deals with aphasia, a condition that makes it hard for him to recall words, in addition to trouble remembering names, dates and important milestones. Cindy Goss now handles the pair’s financial decisions, doctor appointments and social calendar. For Dudley Goss, giving up driving was the biggest adjustment. “It’s the lack of independence,” he says, “and not being able to help share the load that bothers me the most.”

For Cindy Goss, the challenge of managing an active business and the demands of daily living is also profound. After 34 years of marriage, the couple attributes their ongoing ability to travel extensively and volunteer in their community and church to their Christian faith and the relationships they have cultivated.

Throughout this journey, the Gosses say they are grateful to have USC as a partner. “We want to highlight the great care that Dudley has received at USC, and to educate others that need support for this complex and disruptive medical condition,” Cindy Goss says.

A web tool designed to spark reminiscence could help people with dementia and their caregivers feel more connected to each other and less impacted by feelings of pre-death grief, according to a clinical trial co-led by USC and Weill Cornell Medicine that was published in JAMA Network Open.

With features such as photo albums, autobiographical questions, and journaling prompts, the Living Memory Home for Dementia Care Pairs (LMH-4-DCP) website is a customizable virtual space that facilitates collaborative and interactive reminiscence therapy for both dementia patients and caregivers, said lead author Francesca Falzarano, assistant professor at the USC Leonard Davis School of Gerontology.

Reminiscence therapy for dementia includes guided conversations about past experiences and can involve music, art, familiar objects, or other sensory items. The goal is to lessen anxiety and promote well-being and connection, Falzarano explained.

“The idea is that getting them talking about those memories will promote the relationship between the person with dementia and the caregiver, which can improve numerous outcomes. If the caregiver has a better relationship with the person with dementia, they are more likely to keep them at home, and they’re less likely to transition into long-term care,” she said. “We also want to nurture the personhood and dignity of the person with dementia, document their memories while we still can, and alleviate pre-death grief.”

Pre-death grief, which includes both current and anticipated losses prior to a loved one’s death, is a common phenomenon for patients and families affected by dementia, Falzarano said.

“Even while the person with dementia is still alive, that relationship that once existed – whether it was a husband and wife, or mother and daughter – it can be transformed overnight,” she said. “For caregivers, everything that you knew about the person could be gone; you lose that existing relationship and support. Patients who are aware of their diagnosis can be grieving the loss of independence, skills, and memories. You lose a future you might have planned, and then you also are anticipating all of the losses that are going to unfold because of the disease.”

Promising early results

Trial participants included 34 pairs consisting of people with mild to moderate dementia and their caregivers, or caregiving dyads. Dyads were randomly assigned to either the full LMH-4-DCP app, complete with reminiscence therapy activities, or to a limited version of the app without access to reminiscence features. Each dyad used their assigned version of the app at least two times per week for two weeks and completed baseline and post-intervention surveys regarding usability of the app as well as on feelings of grief and relationship quality.

Study results not only indicated that the LMH-4-DCP app was feasible and acceptable for caregiving dyads to use; it also showed that using the full version of the app was associated with significant reductions in feelings of pre-death grief. In addition, there were minor increases in relationship quality after the two-week period for the users with access to reminiscence features versus those without access. While not quite reaching statistical significance in this small trial, the trend toward significance may indicate that a larger study sample or a longer period of usage may provide more improvement and shows the need for further study, Falzarano said.

“I feel like we got a lot closer”

Beyond the encouraging survey scores, caregivers shared their positive experiences with LMH-4-DCP in feedback to investigators. An open-ended question asked respondents about what they noticed regarding memory recall, interpersonal engagement, and relational closeness while using the app with their loved one.

• “It was an awakening of the memories my mom had never spoken about before, and I enjoyed learning about her.”
• “Surprised how much [care recipient] engaged with LMH-4-DCP. It brought a light to him seeing photos of himself on the application and being able to retell stories of his past.”
• “It was very nice hearing my mom talk about things she has never told me, I feel like we got a lot closer. … I also was able to find resources and outlets to help her so I was not feeling all of the stress of not doing enough! I enjoyed all of the resources and being able to talk on a deeper level with my mom!”
• “I appreciated the prompts for engaging my dad in conversation and learned things I had not known before.”

When participants were asked whether they would continue to use the app after the study:

• “Yes, I would because my mom does not interact a ton with me, but this was the first time she really showed a lot of emotions!”
• “Yes – it opened a different memory building connection and bonded us closer.”
• “Yes, I would like to; it will be nice to have these memories when [care recipient’s] condition becomes worse so we can reminisce.”

The power of sharing memories

LMH-4-DCP is modeled after the original Living Memory Home (LMH) web app, a digital bereavement platform for individuals grieving the death of a loved one developed by collaborators at Weill Cornell, including Holly Prigerson, co-director of the Center for Research on End-of-Life Care and senior author of the current study. Previously, LMH showed that its reflective journaling prompts and other bereavement activities reduced prolonged feelings of grief.

“People may not be aware of how severely distressing and disabling grief is,” Prigerson said. Pre-death grief is remarkably similar to post-death grief, which has been more extensively studied for its role in Prolonged Grief Disorder. Unlike natural grief that diminishes over time, Prolonged Grief Disorder involves pervasive and profound distress, hopelessness and impaired daily functioning, she explained.

“We have found grief to be the strongest predictor of suicidal thoughts and behaviors; it is also linked to serious medical outcomes such as heart attacks and cancer,” Prigerson added. “Detecting and addressing grief will help reduce these related risks.”

The similarities between bereavement and reminiscence therapy activities inspired the researchers to adapt the web tool for use with caregiver dyads, Falzarano explained.

“In the original Living Memory Home website, recently bereaved individuals would journal and do different activities to honor, reflect and reminisce on the deceased. This had really positive effects on bereavement adjustment; the severity of their post-death grief was significantly reduced,” Falzarano said. “A lot of the terms they were using were very bereavement-focused, but the concepts were exactly the same as in reminiscence therapy. Reminiscence therapy is widely used for people with dementia in general and can trigger memory recall, but there hasn’t been a ton of rigorous research into the effectiveness of it.”

Looking to the future, Falzarano aims to take advantage of the LMH-4-DCP’s scalability and conduct larger and more in-depth clinical trials. She also wants to develop new tools that can provide a more comprehensive and inclusive picture of how the app can help everyone involved.

“The next step is not only testing the efficacy of this reminiscence therapy tool with a very large, nationally representative sample, but also the inclusion of the person with dementia. I hope this establishes a line of research that we should be targeting both the caregiver and the care recipient, and that includes measurement,” she said. “We can’t just give the same questionnaire that we give to a caregiver to a person with dementia. What are the best ways to develop effective measures for people with dementia so we can know whether this is something that can help alleviate some of the stress or grief that they’re experiencing? To have a tool to assess that – and then an intervention to address that – could be really powerful.”

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About the study

The study, “Digital Reminiscence for Pre-Death Grief in Dementia Family Caregivers: A Pilot Randomized Trial,” appears April 22, 2026 in JAMA Network Open. Falzarano and Prigerson’s coauthors include Annabelle Greenfield of the USC Leonard Davis School; Sydney Saviano, Sindhu Kolla, Sosi Korian, Francesco Osso, Joseph Miller, and Paul Maciejewski of Weill Cornell Medicine; and Heather Whitson of Duke University.

This research is supported by National Institute on Aging (NIA) grants R21AG077144 (Falzarano/Prigerson), P30AG072958 (Whitson), and R00AG073509 (Falzarano); National Cancer Institute grant R35 CA197730 (Prigerson); and National Center for Advancing Translational Sciences award UL1TR002384 supporting the Weill Cornell Medicine Clinical and Translational Science Center.

The University of Southern California’s Center for Advancing Family Caregiver Financial and Workplace Security has launched a new podcast series, The Care Economy, which explores one of today’s most pressing and often overlooked economic issues: unpaid family caregiving.

“Caregiving financial strain can move a family from prosperity into poverty,” said Donna Benton, Associate Research Professor at the USC Leonard Davis School of Gerontology and the center’s principal investigator. “When we support the financial well-being of family caregivers, we are supporting younger generations’ health and welfare.”

More than one in five U.S. adults provides care for a family member, creating financial strain, workplace disruption, and long-term economic consequences for families and employers alike. Funded by an Administration for Community Living grant, the podcast features solutions-oriented conversations with leaders in policy, finance, workplace benefits, law, and aging services, examining how systems can better protect caregivers’ financial stability while strengthening workforce participation and community resilience.

Produced and hosted by Maureen Feldman — a former family caregiver and longtime leader in aging and social connection initiatives — the series bridges expert analysis with lived experience to deliver practical, actionable insights for family caregivers and the professionals who support them, including Area Agencies on Aging, healthcare providers, employers, and policymakers.

“When you listen to and engage with our podcast, we hope you will begin to look at how public and private support systems can be designed to build a secure financial foundation for family caregivers,” Benton said.

The Care Economy is available on major podcast platforms. To listen and learn more, visit gero.usc.edu/centers/cg-security/podcast.

A new USC-led report, “Achieving Abundance in Eldercare,” examines how California can advance policy solutions in response to the state’s growing population of older adults and the related growth in demand for care by tackling barriers creating scarcity in the state, strengthening public health and broader well-being.

The report, authored by Mireille Jacobson, professor of gerontology and public policy at the USC Leonard Davis School of Gerontology, was published as part of the UC Berkeley Possibility Lab’s Abundance Accelerator. This report is one of three released February 25, 2026 through a partnership between the Possibility Lab and CalMatters Knowledge Hub focusing on exploring innovative solutions to improve access to health care.

“I just think we need to make older age in California a thing that works for everybody and is something where we celebrate the progress we’ve made and make it an opportunity rather than this thing we avoid,” said Jacobson, who is also the co-director of the Aging and Cognition Program at the USC Schaeffer Center for Health Policy & Economics and a senior scholar at the USC Schaeffer Institute.  “It’s really about helping people live as older adults in the state of California and live well.”

California’s Potential Policy Responses to Growing Care Demand

Most older adults report that they hope to stay in their own homes as they age, but this is not a reality for many, as health needs and mobility options change. As California’s population ages, demand for eldercare is outpacing the system’s ability to respond, exposing deep structural weaknesses in the way society provides for the long-term services and supports that older adults rely upon, Jacobson said.

“One in four California residents is going to be 65 and over in 2040 and 1 in 13 will be 85 and over,” she said. “But we have this opportunity now, I think, to plan for that and make progress while we’re still a relatively young state.”

Highlighting the state’s leadership in this area through initiatives like the Master Plan for Aging and CalAIM, Jacobson and coauthor Jonathan Cloughesy, a USC doctoral student in health economics, described in the report how the state could further incentivize and invest in the supply of options for eldercare so that access keeps pace with the state’s growing need.

One of the most pressing gaps is the persistence of a “missing middle” in eldercare provision, Jacobson said. Between limited home-based services and costly institutional nursing facilities, low- and middle-income older adults and their families often have few appropriate options. By expanding services and supports for this middle tier, California could better match services to need and increase capacity without leaving families with only the most expensive or restrictive options.

Jacobson also pointed out that workforce constraints can further limit access to care as people get older. She noted how restrictive scope-of-practice rules prevent trained home health aides from providing routine care (like administering eye drops and medication), thus reducing flexibility in options and increasing costs. In her view, streamlining licensure and expanding scopes of practice, paired with appropriate training and oversight, would enable more qualified providers to deliver care for older adults who have limited resources.

Jacobson also called for broader statewide reform, such as through Medi-Cal policies that align reimbursements with the true cost of care and reduce administrative fragmentation. In this way, eldercare reforms can address underinvestment and miscoordination in service delivery while better providing for the diverse needs of California’s aging population, she explained.  

Strengthening California’s Health Care System

“Access to quality, affordable healthcare, no matter what age or stage in one’s life, is critical to our wellbeing,” said Dr. Amy E. Lerman, executive director of the Possibility Lab and professor of political science and public policy at UC Berkeley. “The collective work of these researchers to explore the impacts on childcare, healthcare, and eldercare builds a foundation and intentional investment to expand healthcare policy for families and communities across the state.

In the summer of 2024, the Possibility Lab invited public policy researchers from across California to share their ideas addressing childcare, healthcare, and elder care. The reports are led by three policy experts: Anna Powell (childcare), Leif Haase (healthcare), and Jacobson (eldercare).

According to these researchers, California can achieve true abundance in health care, expanding supply and broadening access towards people-centered systems design.

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Release courtesy of UC Berkeley Possibility Lab

On November 8, 2025, family caregivers from across Southern California gathered for the 25th Annual C.A.L.M. (Caregivers Are Learning More) Caregiver Conference, an inspiring and free in-person event dedicated to empowering those who care for loved ones.

Hosted by the USC Family Caregiver Support Center and supported by SABRA Health Care REIT, Independence at Home, the California Department of Aging and the Los Angeles County Aging and Disabilities Department, caregivers spent the morning and early afternoon engaging in expert-led presentations, interactive wellness sessions, and a resource fair featuring support services ranging from elder law advice to dementia care resources.

The conference theme, “Empowered to Thrive,” was represented in sessions focused on brain health, resilience, and creative wellbeing. Participants connected, shared experiences, and left with tools to support both their caregiving journey and personal self-care. Midday breakout sessions offered everything from art therapy to digital literacy, celebrating the many ways caregivers can find strength and community.

A new highlight for 2025 was the Caregiver Film Festival, presented by the USC Leonard Davis School of Gerontology and sponsored by Front Porch, Sage Glendale Senior Living, and the USC Leonard Davis Arts and Healthy Aging Center. Held that evening at the school’s auditorium, the festival featured three powerful films exploring caregiving from multiple perspectives:

• Taking Care (2024)
  Taking Care is a 38-minute documentary following the journey of acclaimed filmmakers Seth Rogen and Lauren Miller Rogen as they navigate the complexities and heartbreak of Lauren’s mother’s advancing Alzheimer’s disease.
  Director: James Keach
  Producers: Seth Rogen and Lauren Miller Rogen

• Caregiving (2025)
  Caregiving is the story of paid and unpaid caregivers navigating the challenges and joys of this deeply meaningful work. Intertwining intimate personal stories with the untold history of caregiving, the documentary reveals the state and the stakes of care in America today.
  Director: Chris Durrance
  Executive Producer: Bradley Cooper

• Familiar Touch (2024)
  Familiar Touch is a sensitive coming-of-old-age film that follows an older woman’s transition into assisted living as she navigates her relationship with herself, her caregivers, and her family amidst her shifting memories and desires.
  Director: Sarah Friedland
  Producers: Sarah Friedland, Matthew Thurm, Alexandra Byer

Following each screening, audiences heard from filmmakers, caregivers, and experts. The festival concluded with a reception, giving attendees a chance to continue connecting and celebrating the caregiving community.