Caring for The Greatest, Muhammad Ali

The champ at home

A surge in spring pollen has renewed Ali's allergies. Fortunately, they are not so bad that he needs his breathing machine. He remains in the house watching the old Western TV series Bat Masterson as Lonnie, 57, casual in a peach-colored blouse, blue slacks and white athletic shoes, offers insight into the round-the-clock life of caregivers.

In her case, that includes her sister Marilyn, 51. The family also employs a housekeeper, gardener and other help.

With degrees from Vanderbilt University (psychology) and UCLA (Master of Business Administration), Lonnie is every bit the inspiration her spouse is. She is a committed wife and mother and a tireless advocate for Parkinson's research. AARP honored her with an Inspire Award in 2010.

A pragmatic businesswoman who built a postcareer branding strategy she has called "Corporate Ali," she is the person most responsible for building upon, preserving and safeguarding the Ali legacy. She organized his once-precarious finances while giving him the best life possible during a slow progression of the debilitating disease.

"I am so fortunate," she says. "I have a husband who doesn't complain about anything. He is not a moaner, a whiner or a poor-me kind of person. Muhammad has learned how to not sweat the small stuff. He is amazing that way."

Advice for caregivers

Lonnie Ali uses several coping mechanisms in her role as caregiver.

One piece of advice she offers others filling that role: Learn to care for the caregiver — yourself.

Three times a week, Lonnie attends Pilates classes. She makes it a point never to miss her doctor's appointments because "I know if something happens to me, it is going to be bad for him."

She also recommends knowing when to ask for help. As her husband's illness intensified, Lonnie realized she needed more aid.

"As long as Muhammad was fairly independent, it wasn't a big deal," she says. "But when he required more attention, I would be stupid not to think I didn't need some assistance. Frankly, I could not do this if my sister did not live with us."

Research and education are paramount, as is being well-organized.

"When you get up, you have to start planning their day," she says. "What am I going to make for breakfast? What is he going to wear? What doctor appointments does he have? What are we going to do today?" To keep track of her husband's cocktail of medications, Lonnie keeps an app on her smartphone and regularly monitors his activities, appointments and any physical changes. "We have a daily sheet, because you forget things," she says. "What time did he get up? How did he sleep? When did he last go to the bathroom?" Keeping up-to-date on medical needs is critical, too.

After Lonnie gave a speech on Parkinson's disease, a health care worker told her they had lost a patient to a melanoma lesion that had formed on the sole of his foot.

"Turns out Parkinson's patients are very susceptible to skin cancer," she says. "Now we haul Muhammad in every year for a strip-down checkup."

Lonnie and Ali have known each other for more than 50 years.

Steve Schapiro/Corbis

A love story begins

Lonnie understands her husband better than anyone. No wonder: They have known each other for more than 50 years.

Their families lived across the street in Louisville, Ky., when Yolanda Williams, an exceedingly shy 6-year-old Catholic schoolgirl, met the brash 21-year-old young boxer then named Cassius Clay.

When he would return home to visit, the children in the neighborhood were mesmerized. "Whatever you were doing, you dropped it — he was the entertainment," Marilyn says. "It wasn't like, 'Oh, hi, guys.' He took time with us."

Lonnie recalls: "Here was this big, beautiful specimen of a human being — I mean, gorgeous. He had everything — everything.'' At 17, she says, she knew she would spend the rest of her life with him.

Their relationship began more as big brother-little sister. It deepened after Ali's third divorce, during a period when his symptoms of slurred speech and unsteady gait became obvious.

Ali was diagnosed with Parkinson's syndrome in 1984, after he displayed symptoms of the illness. By the time they wed in 1986, five years after his last fight, Lonnie was 29 and Ali 44. (The couple adopted a son, Asaad, now 23. Ali has eight other children.)

The diagnosis of Parkinson's syndrome "didn't really disturb me because I grew up with a father who had polio," Lonnie says. Parkinson's is often associated with head trauma. It remains unknown whether boxing caused, or contributed to, Ali's affliction. "It started in Muhammad's thumb," Lonnie recalls. "That is where I saw the first tremor when he prayed."

Initially, Lonnie focused on making sure her husband ate nutritiously and took his medication. That was a big challenge, because "I never knew Muhammad to even ask for an aspirin or have a headache," she says. Ali put the pills in saucers or potted plants — everywhere but in his mouth.

Dealing with Parkinson's

Over the years, the symptoms worsened, including an often-blank expression caused by rigid facial muscles, a shuffling gait or "freezing" in place, and a hushed voice. Parkinson's-related issues of constipation and sleep disturbances also complicated his condition.

Several years ago, when Ali began having difficulty writing and noticed tingling in his toes, doctors diagnosed spinal stenosis, a narrowing of the spinal canal. He underwent surgery in 2005.

While potential falls by her husband remain a fear, Lonnie says that managing the illness with pharmaceutical therapies worries her more. "Over time, [patients] develop side effects, and I wish that didn't happen," she says. "It can really alter a person's personality and perspective." Flexibility is essential in friends and caregivers. And expectations can go unfulfilled.

In April, Ali was scheduled to appear for the 18th consecutive year at a gala in Phoenix to support Parkinson's research. He made it to the resort, but not out of the green room, because he wasn't feeling well. Not even the sight and sound of good friend and comedian Billy Crystal could change the outcome.

"Everything now is about protecting him and making sure he is healthy," says Marilyn.

That means carefully monitoring something as innocuous as the sniffles. Abraham Lieberman, medical director of the Movement Disorders Program and the Muhammad Ali Parkinson Center in Phoenix, visits Ali every other Sunday.

"When there is influenza, we don't go to the movies," Lonnie says. "We don't want him exposed."

The Alis' home is filled with candor, and with optimism. "Everyone in this house is at his beck and call," Lonnie says, smiling. "Anything he wants, he knows we will do it for him. In a way, that's not good. I think that's why his voice is not as strong as it could be. We can read him — he doesn't have to talk."

In 2013, doctors performed surgery in Boston on Ali's vocal cords, which had become thin and brittle. Ali never has been a big fan of voice and speech therapy, so the surgery had limited benefits. His speech remains restricted.

Yet, rarely does a whisper of complaint come from the man known as "The Greatest."

"This is the beauty of Muhammad. He has made this illness, as horrible as it is, as much as it has taken away from him, serve him in some way," Lonnie says. "If there was ever anyone who always lands on his feet, and comes out smelling like a rose, it is Muhammad. It is his remarkable attitude toward life. He never has let anything stand in his way."

Jon Saraceno, who first met Ali covering boxing for USA Today, is freelance journalist covering sports and pop culture.