Home > Aging, Behavior, Early recognition > Dementia and Marital Strife

Dementia and Marital Strife

I’ve worked for a number of years now in various nursing homes.  On several occasions, I’ve encountered couples who have been married for over 50, 60, and even 70 years.  I’m always overwhelmed by the feelings these wonderful people have for each other, and go out of their way to provide care as they are able.  On one occasion, I was asked by the staff of a facility to help them find a way to get one of their residents, a woman in the latter stages of dementia, to eat.  I spent a couple of days watching her husband of 67 years, who came in every day at lunch and painstakingly coaxed and encouraged his wife to take a few bites, instinctively using strategies that I had worked hard to learn and develop.  And, in turn, this woman’s trust for her beloved husband was so strong that she was able to function in a way that few had thought possible, for quite a long while.  I did give the husband a few suggestions, but in the end I instructed the staff to watch what he did, and try to do the same when they fed the woman.

But I’ve also encountered couples who seemed to do nothing but bicker with each other, endlessly and about the smallest thing.  It seems strange that two people who have lived together for 50 years and more, suddenly find fault in everything the other does.  But, apparently this is not at all an unusual phenomenon.

One important consideration here is whether this argumentative behavior is new to the relationship.  There are some couples who seem to thrive on the bickering.  None of the arguments are severe, and they always seem to blow over very quickly.  But then there are those couples who have never had a harsh word for each other, who suddenly seem to find fault in everything their spouse says or does.  Then again, sometimes the key is with those who are observing (and commenting on) the situation.  Sometimes an adult child, who has assumed a caregiver’s role, is suddenly immersed in her parents’ marriage and seeing it in a new way.  The marriage may not have changed, but the level of the caregiver’s involvement in it has.

If the level of contentiousness in the marriage actually is something new, there could be a number of different reasons for it.  One could be the onset of mild cognitive impairment in one or both spouses.  Some of the earliest signs of MCI are emotional changes — anger, anxiety, and depression.  Memory and abstract thought can also begin to be problematic.  And sometimes these early signs of cognitive decline can be so subtle that they are not recognized for what they are.  For example, a man may become reluctant to participate in the hustle and bustle of holiday preparations, because he is afraid of becoming embarrassed when he forgets someone’s name.  His wife may misinterpret this as laziness and stubbornness on his part.

Mild cognitive decline can sometimes be accompanied by suspicion and paranoia.  A wife may begin to think her husband is having an affair because he repeatedly neglected to pick her up from work.  Closer examination revealed that he was forgetting how to get to her workplace, and wandering around until he saw something familiar.  Another early symptom of cognitive difficulties, hoarding, can also cause discord in a marriage.  Since a person with mild cognitive impairment often has good and bad days, it can seem like a person is malingering or engaging in behaviors on purpose.

Other chronic illnesses can have a negative impact on mood as well.  Diabetes and other health conditions can produce depression and other personality changes, and medications taken for these conditions can produce side effects that have the same result.  Diabetes and arthritis can produce neuropathy and/or joint pain that makes touching and other forms of physical intimacy painful.  Changes in a couple’s life circumstances can also produce changes in mood and thought patterns.  Retirement, the death of close friends, the loss of independence due to physical and/or cognitive difficulties, and other things, can all lead to other changes.

(Read the article that inspired me here.)

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