Responding to Symptoms of Alzheimer’s Disease: Husbands, Wives, and the Gendered Dynamics of Recognition and Disclosure

Abstract

In this article, we analyze the process of redefining marital relations within the context of couples dealing with Alzheimer's disease and related disorders (ADRDs), drawing on intensive interviews with 13 caregiver husbands and 15 caregiver wives. Men were slower to recognize the symptoms of ADRDs, with social others usually bringing the problems to their attention. They often attributed symptoms to a less-problematic cause and engaged in extended normalization of their wife's condition. Women were quicker to recognize symptoms and often noticed subtle changes in their husbands but failed to take action quickly. They were reluctant to disclose their concerns to their impaired husbands, which might have protected the husband's masculine identity and served to maintain the wife's own sense of self in relation to him. We suggest that husbands were able to normalize because the wife's symptoms did not change marital authority dynamics, but authority relations were reversed by the illness for caregiver wives.

Negotiating the Joint Career: Couples Adapting to Alzheimer's and Aging in Place

“…While our data perhaps corroborate suggestions of a gendered dynamic to caregiving, including increased burden for wives [68], husbands more likely to normalize symptoms [69], husbands having more outside support available to them and less restrictive social activities [66, 69, 70], and problem-solving (male) versus hands-on emotional (female) coping [71], it is crucial to acknowledge the social determinants of health and cultural influences on beliefs, especially in such a small study, to avoid reductionist claims based on gender. …”

“…Likewise, these data may lend support to findings that relational aspects were more important for female than male carers [68], but they might also demonstrate the difficulty of challenging traditional gender roles for women [69] and/or caregiving wives' stronger concern with how other people perceive their husbands. Such “saving face” strategies have been reported elsewhere [66].…”

Caregivers’ quality of life in mild and moderate dementia

“…The differences in burden and depressive symptoms between caregivers who care for mild and moderate PwD may be associated with the caregivers' attitudes toward the disease. When the dementia diagnosis is disclosed, caregivers may experience initial difficulties coping with the disease, especially with changes in behavior, which may be a risk factor for increased caregiver burden and depression 22 . Another study suggests that as dementia progresses, the caregivers may experience little success in controlling the clinical aspects of the disease, which may lead them to believe that nothing will change, no matter what action is taken 23 .…”

Gender, citizenship and dementia care: a scoping review of studies to inform policy and future research

“…Other research shows that husbands and wives respond differently to signs of dementia in their spouse; with men being slower to recognise the symptoms than women, and women quicker to recognise subtle changes but failing to take action quickly (Hayes et al . ). Such work underscores the importance of incorporating gender into the design, delivery and evaluation of dementia care policies (Bamford ).…”