Thursday, October 11, 2007

Practical Advice: How Can Couples Deal with Life, Illness, and Emotions?

Part 4 in a 6 part series on Relationship Roles and Illness (originally a 4 part series, but I realized there's a lot more to write)

On the practical side the couple can set aside a time outside of the turbulence to rationally discuss what strengths each person can bring to deal with daily life and medical demands. Illness forces so many unwanted burdens on us, we tend to feel overwhelmed and that feeling can constrict our sense of our own capabilities – for both partners. Doing can remind us of our capabilities and help us feel more a part of life.

Together, both people can write out a list of what needs to be done. I suggest that the ill partner then go first and state what he/she feels able to do (knowing that this can change and may increase or decrease daily). Can he/she shop for groceries? No. Can he/she arrange for groceries to be delivered (there are services like Peapod or Netgrocer)? Can he/she drive the kids to soccer? No. Can he/she call someone to arrange for transportation? The idea is to find some way for the ill person to stay engaged in the world and hold on to adult responsibilities – while accommodating to the real constraints imposed by illness. This may seem burdensome. But the more the ill person gives away, the more he/she fades away, and the stronger his/her relationship becomes with the illness.

The well partner does not have to pick up whatever remains on the list. The well partner also needs to assess what his/her priorities and capabilities are. He/she may need to work over-time and may not have the time or energy for cleaning the house or helping the kids with homework. And the well partner’s capabilities can also change on a daily basis. (btw -- Craigslist is a wellspring of services and goods).

After the well partner decides what responsibilities he/she can undertake, there will be leftovers. Then both partners think together, constructively, not blamefully, about how they can get help from an outside source to pick up these remainders. Can they hire a cleaning service twice a month? Will their insurance pay for a home health aide to bathe and give medication to the ill partner? Can friends, neighbors, and family be enlisted to prepare meals, chauffeur kids, drive the ill partner to medical appointments?

The most important part of doing this kind of chore/responsibility inventory is not the thoroughness of the list, but rather is the spirit of mutual caring the couple can bring to the conversation. If this activity is done with acrimony, then the efforts each partner makes will carry the extra load of bitterness. If the preamble to this activity is: “We are both having a difficult time. Maybe we’re trying too hard. Let’s, together, figure out how we can be easy on ourselves and make it easier for each other. Because I care about you.” – then the efforts made will be lightened by compassion.

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