May 25, 2010

USA: Spouses face challenges in caring for themselves and their ailing partners

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WASHINGTON, DC / The Washington Post / Health / Seniors / May 25, 2010

AGING WELL
In sickness and in health: Elderly caregivers

By Paula Span, Kaiser Health News

They met on a blind date in 1949 and married two years later. They lived in the same Cape Cod-style house in Silver Spring for nearly 50 years. So when Leonard Crierie was diagnosed with Alzheimer's disease in 2005, there was no question that his wife, Betty, would take care of him at home for as long as she could.

Bob Treanor, an 88 year old suburban Maryland resident, became his wife's primary caregiver in 2004. After a recent fall, the responsibilities became too great and 90-year-old Ruth Treanor was moved to a nearby assisted living facility. See video

Betty led him into the shower, helped him dress each morning and took him everywhere with her because, once he started wandering, as some dementia patients do, she dared not leave him alone. She learned how to change the colostomy bag he wore since he'd survived rectal cancer years earlier. She slept, fitfully, with a monitor by her bed so that she could respond if he needed her at night.

"It was difficult, but I was able to take care of him," says Betty, now 80. "Because it happens slowly, you don't realize how bad it's getting."

She agreed to have Leonard attend an adult day program at nearby Holy Cross Hospital -- he enjoyed socializing there -- so that she could get a few hours' break several times a week; she found a Holy Cross caregivers support group very useful. But she refused the pleas from her three adult children to hire an aide to help at home. "I always felt like I had it under control," she explains, though her children thought the $18-an-hour cost also troubled a frugal woman who shops at dollar stores.

As the months passed, "we could see the stress level affecting her," recalls her daughter Linda Fenlon. "The frustrating part was, we wanted her to have some independence, some quality of life. But she saw it as her duty in life to take care of him."

For four years, Betty Crierie rarely asked for or accepted her family's help, until a Wednesday last June. As she left her support group meeting, she remembers, "I got this funny feeling in my chest." It worsened on the 10-minute drive home. She called her daughter and said, "I'm calling 911. I think I'm having a heart attack."

'In sickness and in health'

Caring for a sick or disabled elderly relative exacts a toll -- physical, emotional, financial -- on any family member, but being a spousal caregiver brings particular challenges.

"Spouses are older and dealing with their own age-related health limitations," says Steven H. Zarit, a Pennsylvania State University gerontologist. The tasks they shoulder have grown more demanding: Family caregivers now administer arsenals of medications and undertake procedures, from wound care to dialysis, that were once the province of medical professionals.

Moreover, today's longer life spans, in which once-fatal conditions such as heart disease have become manageable chronic illnesses, mean that the "sickness" part of "in sickness and in health" can last for many years. Spouses determined to single-handedly honor their vows, says Suzanne Mintz of the National Family Caregivers Association, "are using their old rules to fight a new problem." [rc]

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PAULA SPAN is the author of "When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions." This article was produced in collaboration with Kaiser Health News. KHN is an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan health-care policy organization that is not affiliated with Kaiser Permanente.

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