A Place for Mom

How a Gap in Health Impacts Relationships

Kimberley Fowler
By Kimberley FowlerFebruary 14, 2018
How a Gap in Health Impacts Relationships

“I love you, I love you, I love you,” Claire kept repeating the words to her husband Frank because she knew one day she wouldn’t be able to say it any longer. “She wanted to say it for the times when she couldn’t,” Frank told Erika Gennari, Director of Marketing and Communications at Commonwealth Senior Living.

Claire, who has dementia, is a memory care resident at Commonwealth’s Sweet Memories and she’s now lost most of her verbal ability. Frank, who cared for her at home for several years has a suite just down the hall — Commonwealth is one of the senior living communities in Charlottesville that offers assisted living, independent living and memory care all in one place.

Communities like Commonwealth are ideal for couples with age splits or who are aging at different rates. In Frank and Claire’s case, the move allowed Frank to continue to care for Claire with the support of a health care team who can provide her with the around-the-clock care she needs.

Having a Gap in Health in Senior Living

The senior living industry hasn’t coined a term for communities that are equipped to help couples navigate a gap in health, activity level or care needs, and as Gennari explains, this is because there’s no one-size fits all approach to helping couples through this phase of aging.

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“Each couple has different needs,” Gennari says. “We’re focused on providing person-centered care and to do that we need to learn their life-story.”

According to Dr. Melissa Henston, a Geriatric Psychologist and professor at the University of Denver, age splits and aging at different rates poses several challenges for couples. “I see many couples who did well in other stages of life — raising their children, working, entering early retirement, but who really struggle with aging and long-term care needs,” she says.

A gap in cognition due to Alzheimer’s disease or dementia is a severe challenge that couples face, but there are others, Dr. Henston says. She has couples where one partner is vital, physically active and wants to bike, kayak or travel while the other is unable to keep up physically; is homebound or in a long-term care community. This gap can cause feelings of guilt, frustration, loneliness and a sense of lost independence for both partners.

“There’s often a sense of grief and loss of their marriage as it was,” Dr. Henston explains. In situations where one partner is a full-time caregiver they need to negotiate what works for them and give themselves permission to live their life, she advises. This may mean negotiating family opinions and expectations, but it’s an important step.

“Marriage is a constant contract negotiation,” Dr. Henston says. “As couples go through each phase of life they need to re-examine their marriage expectations and re-negotiate the dynamic of their relationship.”

This means having a conversation with your partner while you’re still healthy to discuss how you’ll manage to change health needs and expectations within your marriage. “It’s a wonderful conversation to have when you’re younger and capable,” Dr. Henston advises. “People don’t like to talk about age planning, but you need to plan for this and think about what it will look like.”

Having this conversation and giving your partner “permission” to make difficult choices in your best interest and theirs — like choosing a long-term care community when it’s no longer safe to remain at home, or deciding to date again when one partner has dementia and no longer remembers the other — can relieve feelings of guilt that hold some seniors back from living a happy life.

According to Dr. Henston, one of the biggest emotional challenges aging couples face is feeling bound to a promise they made to their partner that they’d never put them in a long-term care community.

“I wish people wouldn’t make that promise,” she says, pointing out that long-term care communities offer safety and security for both spouses. “There’s so much guilt around these promises, and the truth is, sometimes promises need to be renegotiated.”

Frank, who has been married to Claire for 63 years, has navigated several role changes — being a husband, a caregiver and now with the help of Commonwealth’s staff, a spouse once again.

“When he was taking care of everything by himself he was barely getting by,” Gennari says. “It was difficult for him to do anything for himself and it created such a strain. Now, they’re in an ideal situation because he can go back to his room and rest and take a break so he has the positive energy that she needs him to have.”

Frank and Claire’s relationship may look different than it used to, but their love for each other hasn’t diminished. “You save up the wonderful memories and they keep you going,” Frank told Gennari, explaining that their love feels more like a long-distance romance. They’re still in love, he says, but it’s love from afar.

Do you have any suggestions for couples with a gap in health or those struggling with decisions around caregiving and long-term care? We’d like to hear your stories and tips in the comments below.

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Kimberley Fowler
Kimberley Fowler

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