Summer 2010

My Marriage or My Mom!
By Linda Fodrini-Johnson, MA, MFT, CMC
Aging Well
Vol. 3 No. 3 P. 34

It pains me to see individuals putting their most intimate relationships on the line for parent care needs. Yes, loving can pull us in more than one direction at the same time. I have been a sad witness in observing “overcaring,” well-meaning, loving individuals lose marriages in which they have invested years because they spent all their time and emotional energy on the family caregiving call.

This call has come to more than 44 million people and as baby boomers age, that number will only increase. Recently, I talked to a woman in her 40s who is trying to balance her marriage and her career to care for a mom in the early stages of dementia. The good news is that she is reaching out for resources and professional guidance that will help her retain the “precious” balance needed in the journey of aging-parent care.

One half of those over the age of 85 have an organic dementia that presents a challenging and time-consuming journey for family members. Older adults over the age of 85 are the fastest-growing segment of the U.S. population, so as the years progress, more of us will need the help and support that many believe only family can provide. In some cultures this is paramount, which makes bringing in community services or hired help a taboo, causing those adult children more stress as they think of breaking a cultural tradition or religious obligation.

Marriage has its normal cycle of challenges—new baby, new job, moving, healthcare changes—but with the current economic and housing downturn adding stress to relationships, imagine what it would be like to lose a job, have your home in foreclosure, and a mom in the early stage of Alzheimer’s. The mother who is calling many times each day asking insignificant questions or wanting a caregiver to come over because she is scared receives all the primary attention and emotional energy the caregiver has. Answering Mom’s calls seems doable and can easily become just the distraction that shelters that caregiver, for a time, from all the other stressors that seem insurmountable.

When we find ourselves in unstable situations like those described above, it is natural for us to do what psychologists call “triangulate.” To triangulate is to find a third party or focus to make the situation—in this case, the marriage—more stable. This may sound strange, but when the heat of a marriage in trouble is put on hold so the focus can be a child or, in this story, an aging parent, it can make the marriage appear more stable. Whatever was out of balance in the marriage prior to the new focus gets stuffed, buried, and/or lies beneath the surface. However, it does not go away. It can be festering like a sore, resulting in the death of the relationship when it surfaces.

The problem with this strategy, which often is unconscious, is that one of the people in the relationship, usually the one who is not the son or daughter of the elder needing care, is not having his or her needs met. This person often feels guilty for having needs when he or she sees the amount of care the in-law requires. Because of this guilt, the individual doesn’t ask for more from the caregiving spouse. This can, and often has, end up with the noncaregiving spouse suffering a stress-related illness, seeking a relationship outside the marriage, or finding relief in drugs or alcohol. As you can imagine, this only makes even worse what wasn’t working well in the relationship prior to the caregiving.

What should couples do when the burden of parent care hits them? How does one keep a balance and give the energy and emotional response to those who need it without injuring anyone, including the primary caregiver?

All individuals who find themselves in caregiving roles need to take inventory of what gives their lives meaning and purpose. They need to be sure they have allocated the time to give to other individuals (eg, spouses and children) and life pleasures (eg, art, music, and travel). This often translates into reducing the time given to all interests but not giving them up or sacrificing them in order to have the honor of giving care to a parent whom you love and/or have a legal obligation to oversee. This actually means hiring care or being direct with other family members in asking for help in sharing the caregiving role.

A friend and her husband whose parents had all remarried talked to me a few years ago about how to take care of five of the elders who had care needs. I was able to assist them in prioritizing who needed what type of care first and how to arrange for the necessary services. While they didn’t talk to me about their marriage, they later told me how the caregiving had taken its toll. Their story had a happy ending and they once again found the time to give to one another and begin to live the retirement they had envisioned.

I wish I could have made the journey easier for those whose marriages didn’t survive elder parent care.

Urge your patients and clients to learn about resources and get the professional support they need. Encourage them not to wait for the problem to end. If that has been their style, another dilemma will just replace the one being used as an excuse to avoid caring for the marriage and themselves.

A better way caregivers can care for another without regret or guilt is to balance responsibilities with self-care and attention to their marriages. Support groups are great ways to get the permission caregivers need to say “no” to someone who is needy and to say “yes” to their marriages, health, and careers. Loving is often doing what is needed and not only what is wanted. Caregivers just can’t be everything to everyone else without losing themselves.

— Linda Fodrini-Johnson, MA, MFT, CMC, is a professional geriatric care manager and licensed marriage family therapist. She is president of the National Association of Professional Geriatric Care Managers and founder and executive director of Eldercare Services, providing comprehensive geriatric care in the San Francisco Bay Area since 1989.