Cancer in a Dyadic Context: Older Couples' Negotiation of Ambiguity and Search for Meaning at the End of Life

Abstract

Ambiguity in the dying experience can be a major source of stress for older couples who must often balance the provision of care with respect for autonomy, aggressive treatment with quality-of-life, and individual with dyadic understandings and preferences. This study explores patterns of relationship, support, and communication in married or partnered couples where one partner is diagnosed with advanced and terminal cancer. Thirty-five older spousal/partner dyads participated in focused, semistructured interviews about relational aspects of their illness experiences. Faced with often uncertain and ambiguous circumstances, cancer patients and their partner caregivers describe the individual and dyadic processes that they have engaged in as they approach the end of life. Implications are highlighted for future research and practice with older adult couples at the end of life.

Living Better With Dementia: Strengths-Based Social Work Practice and Dementia Care

“…These findings confirm outcomes of other studies, including that living with illness has an impact on family systems (Robinson et al, 2005). Findings illustrated how when one member of a family suffers a chronic illness, a dynamic between the family members and the illness evolves, affecting functioning in terms of behavior and communication, and demanding structural adjustments to roles and expectations (Gardner, 2008). The idea that illness becomes a dynamic member of a family system was made evident in the findings in examples such as Isabelle's phone call.…”

Couple Meaning-Making and Dementia: Challenges to the Deficit Model

“…Building on this definition and applying it to those affected by late-life progressive cognitive impairment, Ellis and Astell (2008) proposed that the practices of care between intimate care partners also constitute meaning-making processes. Through the tasks of daily care, including visits to the doctor, paying bills, managing medications, dressing and bathing, talking, laughing, and touching, partners in life and care coconstruct a new identity and way of relating (Gardner, 2008). This new identity comes to embody a sense of couplehood for both members of the couple (Kaplan, 2001).…”

“…Not unlike conflict in other late-life scenarios, conflicts in dementia arise not only around mundane issues such as when to ask a relative to stop driving, but also around potentially more traumatic moments such as when, or if, to remove a relative from his/her home (Albinsson & Strang, 2003;Gardner, 2008;Michel, Pautex, & Zekry, 2002). In addition, dementia literature has explored the emergence of internal conflicts that arise when a caregiver feels unable to provide the necessary care to a loved one, or when a care receiver feels guilty about and diminished by requiring a high level of care (Albinsson & Strang, 2003;Semple, 1999).…”

“…Together, new roles and new ways of relating suggest the coconstruction of new selves (Graham & Bassett, 2006). The process of ongoing self recreation can strengthen intimate couple relationships, even when they are affected by chronic illness (Gardner, 2008;Rolland, 1994). Moreover, the dynamic co-construction of new selves has been shown to enhance wellbeing (Hellstrom et al, 2005;Perry & O'Connor, 2002).…”

«Die Welt nicht zu klein werden lassen»

“…So kann es beispielsweise bei den erkrankten Personen zu vermehrtem Bedarf an Ruhepausen und damit verbunden zu sozialem Rückzug oder Konflikten in der Familie kommen (Glaus et al, 2006;Hubbard, Illingworth, Rowa-Dewar, Forbat & Kearney, 2010). Bei Angehö-rigen kann zur bisherigen Rolle als LebenspartnerIn oder FreundIn die Rolle als pflegende Angehörige oder UnterstützerIn hinzukommen (Gardner, 2008;Jo, Brazil, Lohfeld & Willison, 2007;Williams & McCorkle, 2011).…”