Help For A Couple In A Knot

When you're tied up in a know, it's hard to make progress.

I am about to speak with an elderly couple (friends of a friend) -- the husband has both physical and mental health issues; the wife is taking it upon herself to be not just his primary, but his sole caregiver.  And the situation is not working for either of them.

My going-in hypothesis is that this couple's mental reality is lagging behind their current circumstances by about 10 years.  A situation not at all unusual for couples living with chronic health conditions that deteriorate slowly over time.

I'm guessing that he sees himself as still able to walk without a cane and make important decisions without consulting others.  He has fallen, and has had his impaired judgement lead to some very bad decisions.

I'm guessing she still sees herself as able to take care of him, their health care needs, the house, the shopping and cooking, the financial matters, the extended family, and more - just as she has always done -- with skill and energy.  She has not yet factored in that her energy is depleted by aging and stress, and the skills now required to do all this are beyond her ability, and beyond the ability of most any single individual.

But their emotional identities are out of  synch with their actual capabilities.  They are stuck in a knot, getting tighter instead of making progress.

They have read my book and want to speak to me as someone who knows about couples and illness.  I am asking myself - what are the critical questions I can ask them?  What is the best guidance I can offer them?  A few questions that came to mind are:

• "What is the one thing you think your partner would want you to do, that if you could, would make a big difference in his/her peace of mind?"
• "What can you do for him/her, that nobody else can?"
• "What do you imagine will happen if nothing changes?"

I remember an elder care manager telling me, when my parents were in their version of this situation, that I should get someone else to do the chores and deal with the medical systems; I should do what only I can do - the loving.

Perhaps the most important thing I can do for them is to understand.

I am interested in your advice and suggestions.