Husbands and wives constitute a large proportion of carers of those older people suffering dementia. Many older people with dementia have had a long history of personal relationships, often having lived with the same partner for most of their lives. Following the life course approach, this study explores the ways in which a couple's marital experiences impinge upon the challenges faced when a spouse develops dementia in late life and is cared for by his or her partner. I start by surveying the relevant literature. The second section outlines a study of nine couples and includes brief case vignettes. In the third section I seek to test out hypotheses extrapolated from the material, with the theme of how perceptions of the caring situation are related to perceptions of the pre-morbid marital relationship, drawing heavily upon the case material. No single discussion is exhaustive, as any of these hypotheses are worthy of intensive study in their own right. I conclude with a summary of the findings and a reflection on how professionals might put these findings into practice.