For Alzheimer's kin, tangled emotions
Ailing loved ones' relationships with other patients can be very hard for spouses. But they can also be comforting.
MELVILLE, N.Y. - For those who have watched their spouses suffer the ravages of Alzheimer's disease, seeing the loved ones then become romantically linked with fellow patients can be wrenching.
But it's not uncommon, experts say.
"It's really not unusual at all," said Gisele Wolf-Klein, the chief of geriatric medicine at Long Island Jewish Medical Center in New Hyde Park, N.Y.
Sandra Day O'Connor, long considered a role model as the first female Supreme Court justice, could now be considered a role model for her acceptance of her husband's new relationship in a Phoenix nursing facility, Wolf-Klein said.
Their son told an Arizona television reporter this week that John O'Connor, 77, who has had Alzheimer's for 17 years, is having a romance with a woman named Kay, whom he met after moving into an assisted-living center.
"Mom was thrilled that Dad was relaxed and happy and comfortable living here and wasn't complaining," Scott O'Connor told KPNX of Phoenix. His parents have been married 54 years.
Such friendships evolve frequently in a nursing-home setting, many experts said, where patients become more engaged with the people they see every day than with their families.
"Alzheimer's patients pretty much live in the moment," said Barbara Vogel, program coordinator for the Neuwirth Memory Disorders Program at the Hillside Geriatric Center in Glen Oaks, N.Y. "He's living in a different environment; his wife, his life - that's all old, it slips away."
Relationships among patients who have lost cognitive skills, memory and judgment - but not necessarily their physical health or their need for companionship - often bring them solace. Although that may be difficult for spouses or children to accept, counseling can help them come to terms with "the long, drawn-out loss that they're experiencing," said Alana Rosenstein, a social worker with the Long Island Alzheimer's Foundation.
"A lot of the caregivers are just pleased that the person is happy and comfortable," Rosenstein said.
Those relationships can range from hand-holding and having meals together to physical intimacy, experts said. Since the patients often regress to a younger self, the pairings sometimes take on the trappings of youthful courtship - pulling out chairs, dancing together.
Some will respond to a quality in another person that reminds them of their wife or husband - even when they may no longer recognize the actual spouse. Or, Rosenstein said, the healthy spouse is seen more as a caregiver or authority figure, while the fellow patient is more like a peer.
"The spouse is the person who is reminding them to take their medication, is taking care of the pills, that concrete kind of thing," she said. "The person who also has that kind of impairment is just there in the moment with them, and it's not about those day-to-day responsibilities."
As long as both families understand that Alzheimer's is not just about a loss of memory, but also a loss of judgment, the matchups may be therapeutic.
"The challenge for both families and professional caregivers is to develop a level of comfort with a situation, particularly since it is not clear whether the partners are competent to make those decisions," Wolf-Klein said.
But generally, once families have made the devastating decision to place an Alzheimer's sufferer in a facility, they have let go of the spouse or parent's former self, Vogel said.
"I think they're resigned that they lost that person, or the person that they knew, already," she said. "And I think if you really love somebody and they're happy in this new situation and they have somebody who gives them some comfort and companionship, how could you not be happy for them?"