Guest post by Diana B. Denholm, PhD, LMHC
Author of The Caregiving Wife's Handbook: Caring for Your Seriously Ill Husband, Caring for Yourself
Terminal illness shatters lives and marriages. Fortunately, by following simple strategies you can learn to solve problems and quickly discover that your life and your marriage are not over! In The Caregiving Wife’s Handbook, you learn how to bring your marriage back--to uncover the love and caring you once experienced--as you discover options and choices to reclaim the closeness--and your loving bond. Learned communication is the key to these options and choices. It isn’t just talk!
Wives avoid discussing difficult issues with their husbands because they feel guilty, they're afraid it will upset them, they think it won't make any difference, or because they simply don't know how to do it! And that’s where the problems begin.
Do you experience common caregiver concerns? Mary and Mark are a very attractive retired couple. Mark is dying of Parkinson’s, and their advancing age makes it hard to handle the many unexpected changes that come their way. Watching her husband decline is incredibly difficult, yet she also has to deal with numerous concerns common to most caregivers. These include the day-to-day matters of her role in his care, her previous roles, her self-care, their ongoing lives, household management, sleep, sex and intimacy--all of which put strains on her marriage. Hygiene and appearance concern Mary, as they do many caregivers. Mark has lost a lot of weight, and his Parkinson’s caused his posture to deteriorate. Mary is concerned that others might think she’s failing in her “wifely duties” because he looks unkempt. So, she criticizes him, in front of others, saying he looks like he’s slouching in his suits. Mark, and everyone present, is deeply embarrassed--for both of them. Instead of having a private discussion, she inadvertently and repeatedly, breaks their intimate and loving bond.
Using learned communication methods resolves concerns. Noticing other people’s reactions and realizing what she was doing, Mary decided she had to make some changes. Using my book, she learned the Six Step Communication and Resolution Strategy allowing her to compassionately and effectively communicate with Mark. Here are the six steps:
Step 1. Bring it all out into the open--with yourself. Mary began with the 24-Question Planning Guide and wrote down, for her eyes only and without censoring herself, every concern or complaint she had about any area of her life. A typical list may include topics ranging from minor annoyances (Your ostomy bag smells bad. I can't take your complaining), to fears (How will I pay the bills after you're gone? You'll fall down if you don't use the walker), and everything in between (I'm sad we can't make love anymore. I wish I could get a break. I'm mad that you're still sneaking cigarettes. Your family takes me for granted).
Step 2. Choose your discussion topics. Next, Mary learned to organize her concerns so she could decide which things she would talk about with Mark. Four categories were all she needed: A--things I want to say but don't expect a response to; B--things I want to say but won't, because it won't make a difference; C--things I want to say but should only share with a friend; D--things I really need to talk about, know about, have resolved, or make a decision about. Category D are the topics you will discuss with your husband.
No topic is off limits, but the wording you use and the way you express yourself will determine the proper category. For instance, saying, “You really stink and I can’t stand being around you”, isn’t off limits, but would go into C--only to share with a friend or confidant. However, saying “I’m concerned about your hygiene” is fine for Category D and sharing with your spouse.
Step 3. Familiarize yourself with easy tips that make communication more effective. Here are a few simple tips and techniques Mary learned: not asking "why" (you really don’t want to know why your husband leaves the toilet seat up, you just want him to change his behavior and put it down.); letting him keep his opinion, while changing his behavior (It’s all right if he hates his medicine, as long as he takes it.); reflective listening, where you repeat back to him what he just said, instead of interpreting (If you interpret what he says, it will stop a conversation dead in its tracks); using "I" statements (It’s more effective if you don’t presume something about another person by using the inclusive “we”); speaking his language, which means structuring your statements in the way he will most easily understand them (If he's very reason- and logic-oriented, for example, you might ask him what he "thinks" about something, rather than how he feels.).
Step 4. Make a "talking date" with your husband. Using her new tips and tools, Mary set up a “talking date” with Mark. Rather than saying “We need to talk”–the phrase most men dread and which causes an immediate shutdown–Mary began, “Mark, I have some concerns about your appearance. I know I’m not handling that very well, so I’d like to talk about it. Would this evening be good, or would tomorrow morning at breakfast be better?” She used an “I” statement because, it wasn’t Mark’s desire to talk. Then rather than demanding the discussion on the spot, she gave two closed-end options, knowing that just asking Mark when they could talk probably would have been answered with, “Never!
Knowing that some settings are more conducive to good conversation than others, Mary picked a lovely location for their discussion. Depending on your loved one’s condition, you may need to choose a place such as your living room or the hospital chapel or solarium rather than going to a park or out for a boat ride.
Step 5. Prepare for the "big talk." Before you have your discussion, you need to complete one more step. Take some time for yourself, look at your topic list, and briefly run the discussion through your mind—focusing on ways to encourage mutual respect. Remember that this is not an adversarial activity. Instead, you and your husband are going to collaborate to resolve issues and problems, or to plan a course of action. Then put away your list and notes. Make yourself as calm as possible. Pray, meditate, or just sit quietly. Avoid caffeine, cigarettes, and sugar which can make you hyper, and alcohol or drugs, which can cloud your thinking.
Step 6. Have your talk, and create agreements. Having employed mutual respect and compassion in their discussion, Mary and Mark came up with several agreements about expectations for themselves and others. Agreements can be written down to include who will do what and when. This is particularly helpful with issues about family visits—“From now on, my family will only visit on Sundays, and only if we invite them." Occasionally, partners hit an impasse and have the option to agree to disagree on a topic in order to reestablish peace in the home. This is much healthier than continuing to argue over something that won’t change.
Now Mary has taken all the important steps on the path–the path to making life easier, and making her life and marriage work. She and Mark could now reclaim their loving bond. www.caregivingwife.com