JOAN’S BLOG – MONDAY, OCTOBER 6, 2008 – CAN CAREGIVING FOR AN AD SPOUSE ACTUALLY REDUCE STRESS?

This blog was prompted by a reader’s reaction to the “Stress Gets a Bad Rap” section in our October 1st guest blog by Dr. Teena Cahill. Dr. Cahill’s assertion that “In fact there is a study that shows with women, care-giving can actually be a stress reducer, if the woman can set some boundaries and take care of her.” prompted this response from our reader – “And saying that “care-giving can actually be a stress reducer, if….”  I don’t care how big the “IF” is, care-giving is not a stress reducer.  And yes, it helps if you can set some boundaries and take care of yourself, but that’s not always possible.  Dementia has a way of creeping past any boundaries that you try to set, and taking over the best laid plans of caregivers.”

In discussing this issue, I need to keep the focus narrow. I am talking only about caring for a SPOUSE, and I am talking only about caring for a spouse with DEMENTIA. The question is – Can caring for a SPOUSE WITH DEMENTIA be a stress reducer in any way, shape, or form, IF you are able to “set boundaries” and take care of yourself? In thinking about this idea (and you may well be reading this and saying – What’s to think about? Caring for a spouse with dementia is nothing but STRESS, STRESS, AND MORE STRESS.), I thought first about the emotional stress, because that is what I have been dealing with for 4 years. To those of you with spouses who are in more advanced stages than mine, the physical stress is added to the emotional.

What specifically is causing all of this stress? Emotionally, when dementia is involved, it is the loss of the personality and essence of our partner, lover, and friend. The loss of meaningful conversation, closeness, sharing of decision making, mutual activities, the loss of the ability to reason, discuss, and solve problems with our life-long soul mate. That is a cause of massive stress. It is all consuming, unrelenting, and never ending. As I discussed in a recent blog, only with acceptance and learning that you cannot relate to your “old” partner; that you must relate to the “disease”, does the stress lessen. But the sadness remains.

Physically, the demands are obvious. Caring for a grown adult whose needs are the same as a toddler, is overwhelming. There was the time my 3-year old decided it would be funny to run out of the house, and down the street, while Mommy gave chase. I was 28 years old, in good shape, and I barely caught him. At this stage of our lives, most of us are not in good enough physical condition to scour the neighborhood for our spouses if they wander away and get lost. Struggling to bathe and dress a defiant two-year old can be challenging. Struggling to bathe and dress a defiant, frightened, full grown adult is exhausting and stress laden. Add that to cleaning, cooking, serving, doing laundry, grocery shopping, errands, chauffeuring to doctor appointments, and isolation, and you have STRESS.

Then there are the finances. To those who are lucky enough to not have to worry about that, it is liberating. But waking up every morning with the first thought in your head – how am I going to pay the bills, keep my house, and take care of my spouse, is the stress that can destroy you.

So, back to the original question – Can caring for a spouse with dementia be a stress reducer if you are able to set boundaries, get the help you need to take care of yourself, and do not have to worry about  FINANCES? Financial difficulty is a deal breaker in all cases. I do not think it is possible to set boundaries and take care of yourself if you have no resources.

My initial gut reaction answer was NO WAY. In thinking more about it, I did come up with two instances. First, there are people who thrive on caring for others. They are never truly fulfilled or happy with any aspects of their lives unless they are administering to the needs of others.  Maybe for them, care giving reduces, rather than increases, their stress. I do not know.

The next instance I thought of was regarding MEN, not women caregivers, as Dr. Cahill referenced. There are some men who had traditional marriages, in which their wives stayed home to care for the family, while they pursued fascinating, intellectually stimulating, personally satisfying, financially rewarding careers. They accomplished their life goals, and are now content to be caregiver to the woman who supported them emotionally, and took care of the home and family. They wish to make her life as pleasant as possible, given the state of her illness. Does doing something as positive as care giving for her, reduce their stress? I do not know.

On the female side of this, there are the wives whose husband's high powered, successful careers allowed them to focus on their homes and children without having to work. They may now derive great satisfaction from taking care of the man who took care of them most of their lives. Does doing something as positive as care giving for him, reduce their stress? I do not know.

The “Stress Gets a Bad Rap” was only one section of the article. Dr. Cahill’s main message in her articles, speeches, and book, is that caregivers, especially spousal caregivers, need to access all the help they can get, stop trying to be perfect, cannot change their situation, only their reaction to it, and can enhance their lives as caregivers by supporting and educating others – something we do here every day. Reaching out to help others does reduce stress – I can attest to that.

I’m always open to a good, respectful debate on issues that involve caring for spouses with Alzheimer’s Disease. Please read Dr. Cahill’s October 1st article below, and then post your opinion on the Message Board Topic: Can Caring for an AD spouse REDUCE stress?

©Copyright 2008 Joan Gershman

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