or the past seven years Joe Astacio has taken care of his wife, Irma. Joe averages three to five hours of sleep per night, in segments of only two hours or less at any one time. During the past seven years he has slept on the floor beside her bed, with his head only about three feet from her head. For the last five years he has taken care of her around the clock, with no outside help. It's a miracle that his health has not broken under the strain, which he handles with ease, cheerfulness, and never a complaint.

Irma was diagnosed in November 2002 with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Years ago Irma's condition was misdiagnosed as multiple sclerosis, but CADASIL affects all of the body's systems, not just the nervous system.

Irma is now comatose and requires complete bed care. Her food and medicine are given through a feeding tube. She has a tracheotomy tube that must often be suctioned. Joe bathes her, shampoos her hair, and cares for her personal hygiene. She always smells sweet, and her complexion would be the envy of any woman.

Joe says he took his marriage vows--"for better or worse, to love and cherish, as long as life shall last"--very seriously. Every morning he prays for patience, wisdom, kindness, skill, endurance, resources, and life (his sequence) to care for Irma. Since he has been taking care of her she has not had one bedsore, even though she has lost all muscle tone. She has not had to go to the hospital or contracted pneumonia, which she had often under the care of others.

A Challenging Life
Joe was born in Puerto Rico, a sick child. The doctors gave him up to die. The priest even pronounced last rites for him at 3 months of age. He survived because of the kindness of a woman who worked for his family. Progress was very slow, and he did not attend school until the age of 8. He used to stop and rest four times on the one-mile walk to school. He was weak and sickly through high school.

One evening on his way to a dance, Joe stopped at an evangelistic meeting being held in an Adventist church. He joined the church during the last year of high school because of the influence of friends and schoolmates. His father, a devout Catholic, was very unhappy with his son's decision. He called the pastor who visited Joe, "the beggar." But later the same pastor baptized Joe's mother, his three sisters, one brother, and finally, his father.

Because of the conflict with his father, Joe joined the U.S. Army. He spent 13 months on the front lines in Korea as a medic.

After his discharge Joe decided to attend Atlantic Union College. There he met Irma, and after a two-year courtship, they were married.

Joe and Irma had been married only two months when she required surgery on her reproductive system. The doctors told them that if they wanted to have a family, they should start soon. Their first daughter, Jeannette, was born during their last year of college. Joe graduated in 1959 with a B.A. in business administration. Their second daughter, Lisa, was born 13 months later. Becky, their third daughter, arrived nine years later, after Irma had survived four surgeries. Becky was born prematurely at 7 months, and weighed only three pounds.

From that point on Irma's health steadily declined. Joe lost his job soon after Becky was born, and while in Florida looking for a job, Irma became ill. The same Jewish doctor who delivered Becky took Irma, the new baby, and the older girls to his own home and cared for them until Joe was able to return.

Joe says, "God has always been with us in many tangible ways."

In 1971 Joe and Irma moved to Orlando, Florida. He worked for General Elevator and then for Westinghouse Corporation. He had the South American Division accounts to care for, and was often gone for days and weeks at a time. With Irma's health in decline, he resigned to take a local accounting job at one third the salary he had been earning in order to care for her. With the mounting cost of Irma's care, he soon used up their savings.

On January 1, 2000, Joe retired so that he could care for Irma seven days a week, 24 hours a day. Hospice nurses call once a week.

Joe says that it has been a privilege to care for Irma. "I thank God for His promise: He will never leave me nor forsake me; He will be with me in the hard times as well as in the good times." He believes God spared and prepared him for this purpose.

Irma has experienced God's love through the hands of her husband, and knows that she is loved deeply by both her husband and by God. She was once asked by a friend, when her health was declining, what would happen to her. She replied with pride and confidence, "Joe will take care of me." Her confidence has been amply rewarded.

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Dick Shepard is the directory of Religious Liberty and Retired Workers Programs for the Florida Conference.