A Change You Might Not Expect

Emotional Care - March 31, 2013

One of the most challenging moments for me during my husband's illness was when I had to tell him that he wasn't allowed to do something. He wanted to drive himself to a doctor's appointment but I recognized that his disease had progressed so that his concentration was affected and he could not safely drive. It was a difficult conversation for both of us, I felt awful and he was understandably upset with me. He was a grown man, not a child; I was his wife, not his mother. Yet his disease suddenly cast this completely new and uncomfortable parent/child dynamic onto our relationship.

Dealing with a major illness or recovering from surgery or injury can often play havoc on the dynamics of existing relationships. Suddenly an adult child may find themselves reversing roles with their parent. Spouses may notice that their mutually supportive partnership has been replaced with an imbalanced relationship where neither person feels in control. Teenaged children may find themselves in the position of assuming more responsibility and care for a parent or sibling than would normally happen. Having healthy functioning emotional relationships is difficult for most families but when medical conditions are added into the mix it becomes even more complex.

While there is no "correct way" to handle these difficult changes because every situation is different, there are a few things I can recommend when you find yourself in this situation.

Start talking about it: It is important to talk openly about the change that is happening in your relationship. Acknowledging the change and your discomfort with it is key to finding a way to adjust to it. I found it helpful to preface comments or instructions with simple acknowledgments of the change. "I hate to sound like I'm being your mother, but I really think you shouldn't do ……" It can also help to sit down and talk about it when you aren't dealing with the problem in the moment. I would ask him how he wanted me to correct him or tell him when he should not do something. "I've noticed you're doing X and the doctor has said you shouldn't do that. So if I see you doing X again, how do you want me to remind you about not doing it?" You may find it helpful to seek the advice of a counselor or social worker who specializes in individuals in treatment for medical conditions. A professional neutral third party can help you negotiate an agreement on how you will handle these problems when they arise.

Pick your battles: Often a patient can feel like they have no control in their lives because the illness is taking away some of the control they once had over their bodies. Small things can make a huge difference in reasserting a sense of power and control. Sometimes it is just not worth it to insist on things being a particular way if it allows the patient to feel empowered. The best way to find the right path is to consider if allowing the patient to do what they want presents a safety hazard to the patient or others, or is going against medical advice. These are the situations where you must insist and intervene if necessary. Other times it may be better for all concerned to let the minor things go. For example, I insisted that my husband not drive when it was no longer safe for him to do so. However, I did not insist that he sleep in his bed when he wanted to sleep in the reclining chair in the living room. It made no sense to me why he would want to sleep in a far less comfortable chair but I think he liked being in control of these simple choices.

Get an outside opinion: It is difficult for both the patient and the caretakers to make decisions without emotions clouding the situation. When you reach an impasse on what is best, seek out advice from your physician or other medical professional. At one point I was insistent that my husband keep a rigorous schedule with a particular treatment regimen because according to instructions timing the doses was important. He preferred to have the treatment administered on a looser timeline. We discussed it with his nurse and she advised that it wasn't a problem to administer the treatments a bit off schedule from time to time. This allowed us to stop arguing about it and let a neutral, professional opinion determine the best course.

Coping with a major illness changes nearly everything in your life; the physical changes for the patient are only one small part of it. Expect changes in your relationships and family dynamics to happen. With a little patience, frank communication, and professional guidance you can adjust and adapt to these changes effectively.