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2012 Issue 2
CAREGIVER'S CORNER

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ASK THE EXPERT: Help for Caregiving Spouses

Dr. Sara Palmer, a psychologist and faculty member of the Department of Physical Medicine and Rehabilitation at Johns Hopkins School of Medicine, answers readers’ toughest questions

Dear Dr. Palmer,

My wife had a stroke that left her with severe aphasia, and communication is very frustrating. We used to love to talk about everything. Now I feel so lonely, even when I’m with her, and we are both unhappy. Do you have any suggestions?

• Talking seems so “natural” that we sometimes forget there are other ways to relate. Give talking a rest for awhile and try some non-verbal activities that you and your wife can enjoy together—listening to music, going to an art museum, looking at family photos, walking in a park, cooking—or other things you like that don’t require a lot of talking. Try to express yourself using actions, gestures, facial expressions, physical affection, and pictures as well as words. Schedule some regular “quiet times” when there is no pressure to talk so you can relax and experience simple pleasures like eating a good meal, snuggling or holding hands, or watching a beautiful sunset. This will help you and your wife to re-connect, build positive feelings, and start to feel happier.

Dear Dr. Palmer,

My husband had a severe stroke two years ago. At first, he couldn’t talk, walk or eat (he had a feeding tube), and he needed a bladder catheter. We hired an aide at night so I could get some sleep, but I was busy with his care all day long. I had no time to see friends or go to the senior center. Over the past six months, my husband’s improved a lot—now he walks with a cane, talks, and can stay home by himself. I have some free time again, but now I don’t know what to do with myself. I’m having trouble sleeping, and can hardly drag myself out of bed in the morning. I feel useless and sad. Why do I feel this way, when my husband is finally recovering? What can I do to feel better?

• It’s not uncommon to experience feelings of loss when your loved one no longer needs so much care—especially if you lost touch with friends and gave up your hobbies while you were a full-time caregiver. Caregivers are vulnerable to depression at every stage of caregiving, and your problems with sleeplessness, lack of energy, sadness and feeling useless are signs that you could be depressed. (Other symptoms include trouble concentrating, loss of appetite, hopelessness and thoughts about death or suicide.) You can ask your doctor to refer you to a psychologist or psychiatrist to evaluate your symptoms. Depression is fairly easy to diagnose and usually gets better with psychotherapy and/or medication. Once your depression is treated, you will be able to enjoy your husband’s recovery and begin to rebuild your own social life.

Dear Dr. Palmer,

It’s been about a year since my husband had a stroke. He is 45 and we have been married for 20 years. We had a good sex life before his stroke, but now he never touches me. I would like to get things going again, but I’m afraid he’ll get upset if he thinks I’m pressuring him. How can I bring up the subject tactfully?

• Many couples have a difficult time resuming sexual intimacy after a stroke. Your husband may be avoiding physical intimacy for any number of reasons—fear of another stroke, concern about whether you are still attracted to him, anxiety about sexual “performance,” memory or other cognitive difficulties, or depression. You can help by making the first move, and clearly communicating your interest. Let him know that you still want him as an intimate partner—by talking about your desire, by being physically affectionate, or by doing something romantic. Be positive and avoid complaints or criticism. Don’t worry about sexual performance—yours or his. Take it slow and enjoy whatever happens—kissing, caressing, touching. Encourage your husband to talk to his doctor if he is worried that sex might cause another stroke (which is very unlikely), if he has difficulty with sexual function, or if he is feeling depressed. There are treatments available for both depression or erectile dysfunction that may help him.

 

Do you have a question for Dr. Palmer? Please send your questions to amccraken@stroke.org.

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