Soapbox

A marriage vow when spouse has dementia

Jennifer Small, left, and Tracy Broshar enjoy watching a soap opera on TV at their Sacramento home last year. Small was diagnosed with dementia at the end of 2012 and married Broshar, her longtime partner, in 2013.
Jennifer Small, left, and Tracy Broshar enjoy watching a soap opera on TV at their Sacramento home last year. Small was diagnosed with dementia at the end of 2012 and married Broshar, her longtime partner, in 2013. Sacramento Bee file

‘Until death do us part” is obvious when a person physically dies, but what about spouses who no longer recognize their partners due to dementia?

Caregiver spouses are, in effect, married widows and widowers. With the number of people suffering from dementia rising as baby boomers age, healthy couples must plan for when one of them will not recognize the other.

The plan? Create a compassion contract.

Marriage contracts are legally binding. They include an offer and an acceptance by competent persons having legal capacity, creating mutual obligations. The partner with advanced dementia can no longer uphold these responsibilities and, in a sense, has broken the contract.

Under societal norms and many religious teachings, however, caring for a spouse with dementia is the “for worse” part of the marriage vow.

Yet, people with dementia often pair up in memory-care facilities even though a well spouse is alive. On the other hand, pursuing a romantic relationship while one’s spouse declines due to a diseased brain causes guilt for many spouses and provokes disapproval from family and friends.

A compassion contract would state that each partner commits to ensuring, until physical death, that the best care possible is provided to his or her spouse. The well spouse is obligated to ensure the best all-around care is provided to the spouse suffering from dementia. The spouse with dementia permits his or her spouse to engage in a romantic relationship without guilt of betrayal or infidelity. For society at large, the contract serves as evidence that both partners wished for one another to have a well-cared-for and fulfilling life.

In the context of dementia, faithful and married may not be synonymous, according to Barbara Gillogly of Citrus Heights, a gerontologist and family therapist with 35 years of experience working with people suffering from dementia and their families. “The well spouse has a responsibility for the safety and care of the spouse suffering from dementia but may feel released from the wedding vows the ill spouse can no longer fulfill,” she says. “The well person still is whole and needs to know it can be OK to form new relationships.”

This dilemma of ethical vs. unethical, of devotion vs. self-interest can be mitigated through foresight and planning when partners are healthy. A compassion contract is needed.

According to the Alzheimer’s Association, 1 in 3 seniors will die with dementia. Knowing there is a probability of at least one spouse developing dementia, it is irresponsible not to consider the impact this will have on the well spouse.

A compassion contract is a mutual declaration of love. It eases guilt and silences disapproval. It puts the needs of one’s spouse first. It fulfills the vow of “in sickness and in health, until death do us part.”

Rebecca Graulich is marketing and development coordinator for The C.L.U.B., a Rancho Cordova drop-in respite center for people with dementia.

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