Monday, December 21, 2015

Startling Statistic About the Effect of Illness on Relationships

I just read some startling statistics.  I don't know if they're completely accurate, but they seem at least ballpark right.

In the general population, the rate of divorce is around 40%.  For couples living with illness, the rate jumps to 75%.

So the question is: Why is the rate of separation/divorce so much higher for couples living with illness?

There is the obvious answer.  Living with illness is hard for everybody.

True, but insufficient.  When we look at why living with illness so hard that it destroys the bonds of too many relationships, let's go beyond interpersonal answers and take a bigger systems perspective.

Our health care system is disease focused, not person focused, much less relationship focused.  Yes some hospitals and doctors are more patient-centered; but in too many you are still the breast cancer in room 120 or the Crohn's in room 347.  And even if you are called by name, the focus is on the body part and the disease, not on your experience or identity.  The aim is to cure the disease  -- which is essential.  But the aim should also be to heal the whole person, and that includes the primary relationship.

This does not mean that clinicians should start carry crystals along with stethoscopes.  It does mean that clinicians should support all of the patient's strengths -- this includes the caregiver, and the patient/caregiver relationship.  Too often the caregiver does not even get introduced and is left to sit in the corner.  And when was the last time, or any time, that the clinician said something like, "I know this is hard on both of you.  How are you coping together?"

And let's not forget that the health care system is overloaded and under-resourced and clinicians are expected to move on to the next patient every 7-15 minutes.  And that 25.3% of every health care dollar goes to administrative costs.  So clinicians are not supported, or trained, to care about the patient/caregiver relationship.

This all means that the full brunt of one of the most powerful of all life stressors, illness, falls squarely and entirely on the shoulders of the patient and caregiver.  There is little formal support from the health care system, and little governmental or societal support to help the partners.  Yes there are information, advocacy, even respite help.  But not enough to counterbalance the overwhelming 24x7 impact of illness on the patient and caregiver relationship.

No wonder the separation and divorce rates are so high for couples living with illness.


2 comments:

Yessi said...

Barabara,

I hope you don't mind me quoting your work in my next article :)

I think it takes a special (awesome) kind of partner to stick around. Someone who can communicate - a problem area for a lot of men. Being sick has been a blessing in disguise for me, because it has forced me to communicate, disclose, and be grateful in a way other gals my age may not be. That rubs off on my partner.

But I also need to be extra selfish. I don't know if I want to have kids due to my health issues and the chance of passing them on - and I refuse to be guilted by a partner for that decision. It's about survival now, more so that whether or not I'm with "the one." This is hard on my partner.

Living it, I can see how it is hard for people to make relationships work with illness. It's important for everyone to try to be as healthy as possible in areas that we have more flexibility - for some of us we can be mentally zen despite our physical handicaps and that is a beautiful accomplishment. For others, we can conquer our external worlds even though we struggle with mental disabilities.

Barbara Kivowitz said...

Thanks Yessi. Delighted to have you quote my writing (please send me a link.). I appreciate the ideas you express so well in your comment. Illness brings so many challenges into the relationship. But many couples we interviewed for our book about couples living with illness said that they reached levels of connectedness with each other they would never have achieved had it not been for the challenges of illness.