Caring for a Spouse in Later Life

It is an unfortunate fact that getting older is often accompanied by one or more chronic illness or condition. Older people are among the most frequent users of healthcare services—and that’s not because they have more time to visit the doctor. Equally unfortunately, health and social care services around the world are also becoming more stretched by the growing demand. This means that family caregivers are taking on more caring—and often that means spouses.

Many people view taking care of their spouse as “part of the deal”. After all, marriage vows traditionally included the line “in sickness and in health”. However, taking care of your spouse can also have profound implications for your relationship and your own health—and these in turn can have implications for the care that you provide. This page explains more about these implications, and how to manage.

How Common is Caring for Your Spouse?

It is hard to get a handle on how common it is to provide care for your spouse.

One study found that half of adults aged 50 and over had nobody to rely on except their spouse. However, it is not clear how many of those adults had genuine care needs at the time, or were responding to a question about who would provide care if it was needed.

The World Health Organization estimates that nearly one in five adults in Europe provides care for a family member, neighbour or friend. We also know that in England, men who are providing care are more likely to be caring for a spouse, with around one-fifth of male carers doing so. Women are more likely to be caring for another friend or relative, usually parents or parents-in-law, or more than one person.

Just to complicate matters, whether someone is actually providing care can also be disputed. A study across Europe found that whether a spouse is providing care is only agreed between both care provider and recipient in around half of cases. The Office for National Statistics suggests that men may describe cooking or cleaning—work often, and traditionally, done by women—as “caring”, when women may simply see that as part of sharing a home with another person.

It is therefore probably best to say simply that we know that some people are caring for spouses, and that this may be more or less onerous in individual cases.

What are the Main Challenges of Providing Care for Your Spouse?

There are both emotional and practical challenges to providing care for your spouse.

Emotionally, having one partner in the role of caregiver and the other as care recipient changes a relationship. From being equal partners, one person is—usually suddenly—put into a position of dependency. This can be hard to navigate for both partners. The care recipient may feel guilty about “being a burden” on their spouse, and the care provider may feel both obligated and angry at having to take on the obligation.

Practically, it is worth understanding that many people providing care for a spouse or other person are still working. They are therefore trying to juggle work—either full-time or part-time—with their caring responsibilities. This is particularly true for men, with more than two-thirds of male carers also working.

People caring for a spouse are also more likely to experience depression, anxiety and financial worries than other people of their age. This can make it harder to continue caring. One study found that where both partners had care needs, they were both more likely to have unmet needs, compounding their problems.

Can You Prepare for Providing Care for Your Spouse?

It is difficult to prepare for exactly how you might need to provide care for your spouse, because none of us can see the future.

It is, however, possible to make the situation slightly easier by talking about the possibility ahead of time.

If you have discussed how you will cope, and, indeed, what you will do, it is easier to make those decisions either together (ideally) or separately if your spouse is no longer able to be involved. For example, if you have agreed over many years that you do not expect or want each other to provide care, then you know that you need to involve outside carers, or use residential care. You do not need to feel guilty, because you know this is what you both agreed.

Our pages on Talking About Death and Planning for Death and Incapacity may be helpful in starting these conversations.

What Can You Do to Help You Cope with Providing Care for Your Spouse?

Both academic research and anecdotal evidence suggest that there are several very important steps that you can take to help you cope with providing care for your spouse. They include:

1. Giving yourself time to accept the changes in your relationship. Care needs often arise quite suddenly, precipitated by a change in circumstances such as a stroke, a fall, or a diagnosis of illness. Carers are pitched into caring without time to think through the situation. Giving yourself time to accept the changes that this will bring, and often to grieve your relationship, is essential.

2. Asking for help. It is common for both statutory agencies and healthcare professionals, as well as friends and family, to assume that you are coping unless you say otherwise. It is therefore essential to ask for help—and preferably long before you have reached any kind of crisis. Even if caregiving is or was your profession, and you think you know exactly what you are taking on, remember that you are older than you were, and you have not had to care for someone 24/7. Get all the help that is available, from as early as possible.

3. Taking a break. If you can’t get additional help on a permanent basis, at least get someone to give you a break periodically. If you can, go out by yourself, or even away for a few days, and have time off. It will do you the world of good.

4. Informing yourself about your spouse’s condition. You are likely to be taking on not just caring responsibilities, but also the role of advocate for your spouse. Learn about their condition, so that you understand what is happening. This is likely to reduce your stress considerably.

5. Including your spouse in decision-making where possible. This may be challenging if your spouse has a cognitive impairment, but someone who is physically frail can usually engage with decisions about their care. They may even surprise you with what they suggest should happen. In particular, they may well have far more regard for your health than you do, and be better able than you to accept that you can no longer provide care for them.

6. Looking after yourself. When you are providing care for someone, it is easy to forget about yourself. However, you need to make sure that you are eating well, getting enough sleep, and doing at least some exercise, even if it’s only gentle walking. If this means you need to ask other people to help, then do it.

7. Being prepared to move on and make the hard decisions. It is never easy to admit that you can no longer cope. You may feel like that is not part of the deal with a marriage: that you signed up for ‘till death us do part’. Unfortunately, though, it could be your death if you make yourself physically or mentally ill trying to keep caring when it is no longer possible. Don’t do this to either of you.

A Final Thought

Providing care for your spouse can and does change your relationship.

It can be immensely challenging, but it can also bring you closer together.

However, it is much more likely to have that effect if you don’t try to do everything, or keep going for ever. Ask for help, both professional and personal, and make sure that you have the support you need, including through residential care or nursing homes if necessary.