It doesn't look like the women's hearts are breaking.

They gather once a month at the Lutheran Family and Children's Services building in Cape Girardeau to talk about their common concern: All of them have a relative with Alzheimer's disease.

The number who come isn't always the same. Sometimes the table is full, sometimes it isn't -- it usually depends on how many sick relatives are in crisis. The participants share information about new discoveries. They laugh at quirky stories about their families.

But finally, if they talk long enough, somebody gets teary-eyed.

The Cape Girardeau Alzheimer's Support Group is an arm of the Alzheimer's Association in St. Louis. That organization dispenses information about the disease and services available to those affected. About 4 million Americans have the disease, and one in 10 American families is affected.

But the meetings on the third Tuesday of each month aren't just question-and-answer sessions. More than anything else, they give participants a chance to vent their frustrations.

Carol Dippold, a counselor and aging coordinator for Lutheran Family, is the moderator. In her time spent working with Alzheimer's patients and their families, Dippold has found many similarities. The disease begins ever so gradually, with little bits of memory loss. Families tend to dismiss the problem, attributing it to sickness or changes in medication.

Then comes a major event, when the patient wakes up completely disoriented or has an uncharacteristic outburst in a public place. When caregivers take their patients for medical help, doctors must diagnose Alzheimer's by eliminating all other reasons for the new behavior.

According to an Alzheimer's Association fact sheet, there is no clinical test to identify the disease. There is no known cause for it, although potential reasons range from genetic predisposition to environmental toxins.

And, most unfortunately, there is no cure.

Perhaps that is why those affected call it "the long goodbye." Friends and relatives start saying goodbye to the person they knew. Patients lose pieces of their personalities and memories until they are empty shells waiting to die.

Caregivers know what lies ahead, that things only get worse. That is why gathering for support is so important, Dippold said.

"They are physically drained from doing so much," she said. "They lack time to take care of themselves. They don't have time for good exercise programs, they aren't able to eat right. It is so important for them to be with other caregivers and not feel bad for being frustrated and angry."

Luvina Hennemann of Benton and her two daughters, Yvonne McVay and Geri Hennemann, know how frustrating Alzheimer's can be. Their husband and father, Ben Hennemann, started showing symptoms six years ago when he was 77.

After trying to take care of him themselves, they were forced to get help from the Lutheran Home.

"It's a catch 22," McVay said. "It really bothers Mom when she sees him in the home because she doesn't want him there. But if she doesn't go, she feels guilty."

The mother and daughters attend support group meetings together every time they can.

"It has helped me realize I am not the only person in the world dealing with this problem," McVay said. "You hear cases a lot worse than what you have, and that makes you dread what's coming down the road.

"But at least you know what's coming, and it helps to sit around and talk about it."