Sunday, October 17, 2010

Love, Adultery, and Alzheimer’s

Living and managing Alzheimer’s is not easy, but living with beloved spouse with Alzheimer’s might be even more challenging. Just because the health partner always has a choice. I would like to present an article from The Wall Street Journal titled "Of Love and Alzheimer's" regarding the ethics of adultery on the part of spouses of Alzheimer's sufferers. I guess, there is no right or wrong answer to the raised question, and each one make his/her own choices to manage this situation and day-to-day life.


Sid loves his wife of more than 40 years, and has no intention of divorcing her.

But Sid, who is in his 70s, lives with her only three days a week in their Manhattan home. The rest of the time, he stays with another woman in her 60s with whom he has developed an intimate relationship. His grown children like her and approve of the arrangement.

The situation isn't as strange as it sounds.

Sid's wife has later-stage Alzheimer's disease. That places him among an increasingly visible group of people ranging in age from their 50s to their 90s who are finding romance outside of their marriages while continuing to care for spouses with Alzheimer's. (Sid asked that his last name not be used.)

Caregivers often face a stark choice: Either start an extramarital relationship and risk estrangement from friends and family—not to mention their own guilt—or live without a real companion for many years. The trend is prompting religious leaders, counselors and others to rethink how they define adultery.

Support groups of people caring for spouses with the disease are seeing an increase in people who want to recover the intimacy they had in their marriage. "This didn't get discussed much earlier, I think, because people felt embarrassed or guilty for wanting companionship," says Jed Levine, director of programs at the Alzheimer's Association's New York chapter. "We're seeing the issue come up more frequently now."

Alzheimer's causes "a profound loss—that of the marital partner," says Mr. Levine. While spouses may still feel their old bond in the disease's earlier stages, once it progresses, "that connection is lost, too," he says. "It's not sex as much as special friendship," such as being held at night, that well spouses miss the most, he says.
Alzheimer's robs patients of their memory and often changes their personalities radically. Some 5.3 million Americans have been diagnosed with the disease. While most are elderly, as many as 10% may be under 65, according to the national Alzheimer's Association in Chicago. Doctors say they are seeing a troubling increase in this "early onset" Alzheimer's. That compounds the dilemma for spouses, as average life expectancy in the U.S. now exceeds 77 years.

Support-group leaders say they have seen a number of caregiver spouses start relationships with one another. One woman in her 80s began a companionship with a man she met in such a group, and married him after her husband died, Mr. Levine says.

Caregiver spouses often agonize over breaking their marital vows, and whether seeking a new companion represents a betrayal of their convictions.


Religious leaders have come down on both sides of the issue.

"We have made the marriage vows 'for better or worse.' That holds in sickness or in health," says Richard Gentzler Jr., director of the Center on Aging and Older-Adult Ministries for the national United Methodist Church. "I recognize the pain of the wife or husband, but sexual [relations] would be adultery."

Richard Address, a Reform Jewish rabbi in New York who runs a Web site called Jewish Sacred Aging, says the longevity revolution has complicated matters. His site asks the question: "Is it still adultery if the spouse has Alzheimer's?"

Rabbi Address, who has counseled several well spouses, believes Jewish tradition can help find answers. His rabbinical students are researching whether Biblical precepts allowing additional partners can be adapted to take Alzheimer's into account.

Secular support-group leaders, for their part, strenuously try to keep members from judging each other, says Beth Kallmyer of the Alzheimer's Association.

"It's easy for the well spouse to become the second victim of Alzheimer's," says Richard Anderson, a board member of the Well Spouse Association, a national support network. "Many of the people who have joined our association are burned out. Their lives have become more than a little unbalanced. They become ill themselves."


A 2006 study published in the New England Journal of Medicine found that spouses of people with dementia and psychiatric diseases were more likely to die themselves within a year of the afflicted spouse's death, compared with similar cases involving colon cancer, fractures or heart problems.

Mr. Anderson, who works at the Kennedy Institute of Ethics at Georgetown University, says Alzheimer's can rob marriages of their essence: communication.

Adult children are often the biggest obstacles to a new relationship. They may accuse the caregiving parent of breaking apart a longstanding marriage, says Emma Shulman, a 96-year-old gerontologist and Alzhemier's researcher in New York.

Marriage vows are sacred but the physical and emotional loneliness of Alzheimer's disease is making some reassess what it means to be married. WSJ's Alicia Mundy reports.

The children's reaction "usually has to do with their own unresolved issues with their parents," she says. That can include "a sense of guilt that they haven't done more" to help their parents. Or, in other cases, children may feel they have carried all the burden of care, and resent that the well parent is seeking another companion, she says.

Sid, a former architect, says he waited several years after his wife's condition seriously deteriorated before he even thought about finding someone else. He remembers the day his wife, a history professor, suddenly exhibited what he later learned was a symptom of Alzheimer's. "We were in Europe in a field of lavender," he says. The fragrance was almost overpowering, but his wife smelled nothing. She was in her late 50s.
That was a dozen years ago.

"We have had more than 40 years of a wonderful marriage. She is my wife," he says. "When she was first diagnosed, I was unrealistic. I was always able to solve anything. But this time I couldn't." He put his wife though mental-exercise programs and into clinical drug trials, but she slipped away quickly.

After several years of caring for her, Sid says he became depressed and physically ill.

"Then I decided my life could not end like this," he says. His new relationship, which is possible because he has arranged for full-time in-home care for his wife, helps him feel less isolated.

Sid says the initial reaction from people in his support group a few years ago was horror—"It's adultery, you will go to hell," they told him. But recently, many of them have revealed they are looking for companionship, too.

His oldest son says that, at first, he was somewhat upset about the new friend. But he says he and his siblings soon accepted the relationship.

"Dad was sick, his mental health was going downhill. He has gotten better, physically changed," the son says. 

"As long as my mother isn't in any harm, and is being cared for, I understand. I'm a realist."

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