HUBEI, Central China — Smiling cheerfully at the camera, 76-year-old Cao Xuemei greets the over 20,000 subscribers on her livestreaming channel, “Happy Grandma”: “Thank you, darlings. Silly Grandpa is happy. His memory is improving.” Next to her stands her 80-year-old husband, Cui Xingli, wearing sunglasses and a floral shirt that matches his wife’s. He repeats her words, and netizens’ comments start popping up on the screen: “Hello, Grandma and Grandpa!” “Bravo!”

For more than a year, Cao has been livestreaming with her husband, who has Alzheimer’s disease. The pair have become a refreshing addition to the livestreaming platform Inke, largely dominated by young people.

At first, they just broadcast in the evening. Now, the elderly couple livestreams three times a day, sometimes for up to eight or nine hours, from their home in Wuhan. Before each session, Cao picks a special outfit for her husband — some days, he dresses up as a character from a traditional Chinese play, while other times, he wears a pirate’s hat.

The couple’s granddaughter initially suggested that Cao try livestreaming because she had always wanted to be on TV. Since she started, the channel has not only risen in popularity; Cao says she has also noticed gradual improvement in her husband’s condition.

Cui was diagnosed with Alzheimer’s disease five years ago after beginning to show signs of memory loss. One day, he refused to open the door for his daughter. Peering through the narrow gap of the door secured by a chain, he asked, “Who are you?” Doctors told the couple that Alzheimer’s was an incurable disease that could only be treated to delay the onset of further symptoms. Cui’s condition, they said, would inexorably deteriorate to the point where he could no longer remember anything or live independently.

More than 8 million people in China have Alzheimer’s disease, and taking care of them is a difficult and time-consuming task. After his diagnosis, Cui would often wake up in the middle of the night, get lost on his way to the toilet, open the front door, and defecate outside the family’s apartment. Cao found her husband’s feces everywhere: in the doorway, the corridor, and even the stairwell. Whenever she put an adult diaper on him, he’d tear it off.

One early afternoon in the fall of 2015, Cao discovered the front door wide open and that Cui, who had been watching TV a few moments earlier, was nowhere to be found. Their daughter called the police and went off to look for Cui with her husband. Cao didn’t dare stray too far from home. She waited at the nearest intersection and every time someone walked past, she asked them, through tears, if they had seen her husband. Eight hours later, her son-in-law spotted Cui standing by the side of a road. When they were reunited, Cao threw her arms around her husband and asked, “Where did you run off to?” He replied, “I went looking for you.”

Ultimately, Cao began handcuffing her husband’s hands together to stop him from tearing off his adult diaper and running away in the middle of the night.

Worried that Cao wouldn’t be able to shoulder the burden of caring for her husband, the couple’s children suggested putting their father in a nursing home. But Cao declined. “I couldn't bear to send him to a nursing home. I don’t trust the nurses to take care of him,” she said. For most of their 54-year marriage, Cao struggled to take care of the family while her husband worked on construction sites across the country. After Cui had a stroke 20 years ago, Cao faithfully stayed by her husband’s side, helping him eat and take his medication.

When Cao started livestreaming, she had difficulty using the app on her phone. If anything went wrong while broadcasting, she would take a video and send it via messaging app WeChat to her granddaughter, who would instruct her on how to operate the phone.

“Back then, everyone was sending her ‘gifts,’ but she didn’t know what they were,” her granddaughter recalled, referring to the virtual cash sent by fans. However, as Cao became more adept at using the platform, “Happy Grandma” garnered a loyal following.

Cao and her husband now spend every day in front of the camera, singing and dancing. To enhance Cui’s memory, judgment, and communication skills, Cao asks him questions on camera. She encourages him by applauding if he remembers his age or giving him a kiss if he finds his way to the bathroom. Sometimes, she will deliberately make a mistake and let him correct her.

“Happy Grandma” often ranks on Inke’s list of channels with the most viewers in the province. The majority of the couple’s fans are young people who affectionately call Cao “Grandma.” She enjoys spreading cheer among viewers, sometimes singing a little ditty she made up: “Boys and girls are all the same; anyone can be a good example.” Some fans have even asked her for romantic advice.

Thanks to livestreaming, said Cao, Cui’s condition appears to be improving. In the past, he hardly spoke a word all day, and anything he did say was unintelligible. Now, not only is he more coherent — he also sings along to whatever songs Cao puts on. More importantly, he remembers his family again.

A lack of human connection can often worsen a patient’s condition, Li Xia, a psychiatrist from Shanghai Mental Health Center, told Sixth Tone. “If he likes livestreaming and it increases his social interactions, then it can be helpful in improving his health,” Li said.

During the couple’s first six months on air, their relatives anxiously watched each episode, fearing that online trolls would send them cruel comments. Some people did leave negative messages, but while Cao was initially disheartened, she eventually grew used to it and even began sending critics heartfelt replies.

Cao is certain that her husband “will be even more clearheaded” in the future. Though she knows that his disease cannot be cured, Cao has witnessed such dramatic changes in her husband since they began livestreaming that she can’t help but hope for a miracle.

Their daughter, however, is not so optimistic. Last year, during the National Day holiday in October, she took her parents on a trip to the Yangtze River. Using a cane, her father was able to walk for 10 minutes. During their vacation this year, however, he remained in his wheelchair the whole time. This was perhaps the final trip she’ll ever take with her father, she said, no matter how many hours he spends livestreaming.

A Chinese version of this article first appeared in Sixth Tone’s sister publication, The Paper.

Translator: Lewis Wright; additional reporting: Cai Yiwen; editors: Denise Hruby and Cai Yiwen.

(Header image: Cao Xuemei takes her husband, Cui Xingli, out for a walk in Wuhan, Hubei province, Sept. 26, 2017. Zhang Xiaolian for Sixth Tone)