The French film Amour is a touching, realistic window into the world of a committed marriage in which one partner has suffered a stroke.
The elderly couple are music lovers, their apartment chock-full of music books, records, and CDs, plus a concert-size grand piano. Yet the film has no musical score, just the mundane sounds of everyday life. The couple’s need to cope with change is so profound that the music of life fades, replaced by the clinking of forks against plates, sweeping away crumbs from the kitchen table, or shower noise as a caregiver washes Ann’s back. The story gently unfolds, depicting the couple’s commitment and love as the outside world shrinks, startlingly magnifying their life lived in three rooms. There is no shaking of fists at their plight, no angry outbursts from either partner.
How Stroke Affects Marriage
When giving talks on how stroke affects marriage, I say, “When one partner has a stroke, both partners have a stroke.” The stroke survivor grapples with the loss of bodily function, speech, and often dignity, and the caregiving spouse must come to terms with the magnitude of the change in their lives.
A stroke can alter two people’s lives in an instant. For the person with the stroke, simple tasks suddenly become difficult or impossible. For the person’s partner, life revolves around the stroke survivor’s needs, requiring many adjustments.
And while stroke (like any chronic medical problem) affects marriage, it can also open a gate to improving communication and building and strengthening skills that were taken for granted.
Empathy on both sides is needed for the marriage to survive. Learning new ways to communicate fondness and appreciation serve as protective factors. Building new rituals of connection and remembering the positive aspects of your marriage before the stroke are necessary to keep your relationship healthy.
Coming to Terms with Suffering
While stroke can create strain, frustration, and distance in your marriage, coping with its effects is an opportunity to reset your priorities and goals. You may be able to strengthen your marriage as you and your spouse work together on common problems you will face. It is by accepting the limitations that life imposes on us that we can overcome them. As we learn to carry our burdens well—in the yielding and in the striving—we become whole.
Viktor Frankl was a psychiatrist who survived the Holocaust; his parents, brother, and pregnant wife did not. In his remarkable memoir, Man’s Search for Meaning, he discusses how people face unavoidable burdens. Why did some crumple beneath the horrors of the death camps, while some comforted others and gave away bread?
“When a man finds that it is his destiny to suffer, he will have to accept his suffering as his task; his single and unique task. He will have to acknowledge the fact that even in suffering he is unique and alone in the universe. No one can relieve him of his suffering or suffer in his place. His unique opportunity lies in the way he bears his burden. . . . The way in which a man accepts his fate and all the suffering it entails, the way in which he takes up his cross, gives him ample opportunity—even under the most difficult circumstances—to add a deeper meaning to his life. It may remain brave, dignified, and unselfish. Or in the bitter fight for self-preservation, he may forget his human dignity.”
I do not mean to minimize the great accommodations that must be made in marriage when a stroke occurs. But there is a phenomenon seen in marriage counseling that often predicts good prognosis; therapists term it “glorifying the struggle.” This describes a couple that comes to therapy with a crisis, but they can talk about how they see the struggles that they have gone through as ways to grow and that they can grow together. The likelihood of that couple being able to keep their marriage whole and strong is better than when there is bitterness and resentment toward their marriage struggles.
Of course, sometimes caregivers can’t look after a stroke survivor at home. In Amour, the husband was the caregiver until he could no longer tolerate bearing her pain for her. In the United States, if a caregiver is no longer available and/or funds have run out, the best option is a skilled nursing facility (or SNF in the medical jargon). But in many families, life must go on: living together, but with tremendous challenges for both partners.
Ways to Cope When Stroke Strikes
Here are some issues to consider in coping with the aftermath of a stroke.
1. Spousal support: This is a powerful aid to stroke recovery for several reasons, including a spouse’s ability to improve the stroke survivor’s mood and increase physical and social activity levels.
2. Role changes and division of labor: Most couples must change their usual division of labor. Tasks and duties that were previously performed by one spouse may need to be reassigned. Outside help should be considered when possible.
3. Emotional support: High levels of emotional support lead to the best possible recovery after a stroke, and support is most effective when it is seen by the stroke survivor as meeting his or her particular emotional needs. Empathy—your ability to see things from the other person’s perspective—is important for both partners. Even a stroke survivor with speech problems (aphasia) can still listen. To truly listen is a great gift, even when your replies are non-verbal.
4. Counseling and group support: Both partners can benefit. There are many great agencies that offer classes following a stroke, and ongoing groups to help maximize coping.
In the best of circumstances, marriage is challenging. When couples face chronic medical problems such as stroke, the marriage vows -in sickness and in health are tested to the limit. Compassion by both partners for each other, as so tenderly shown in the film Amour, is imperative to preserving love.
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Yokhantho says
It is difficult when the non affected partner start thinking that he /she is the victim, making the affected spouse more guilty and unwanted.
Glen says
This is an excellent excerpt on what is involved for not only the person who has suffered the stroke but for those around them that have had their lives impacted. My wife had a severe hemorrhagic stroke in the thalamus region of her brain, 3 other strokes as well as a heart attack. Life support for two months and a coma for three months. She survived. She cannot really talk (says a few words) will never walk again, is incontinent, has right side paralysis but it is still her. This all happened two years ago and she was 51. It has not been easy for my wife or our family but faith and love are what we have to move forward and accept that none of our lives will be the same again. We sacrifice our own needs in order to give the love and support that is needed to give meaning to not only our lives but to those who have suffered even more…………..the victim of a stroke. Helping someone comes from your inner soul, particularly when you love them. It is not easy but you persevere because that is life.
Dr. Susan O'Grady says
Glen, Your comment captures the reality of how stroke affects everyone in the family. And how love helps to soften the blow, and cope with the many changes required.
Lynn R says
My husband had a stroke in Sept. 2014. While in a rehab center,l he suffered another stroke and had to have brain surgery. His speech was not affected at all but he cannot walk w/out a walker. He is still in therapy but our marriage has suffered greatly. I gave up everything to take care of him. I think he has just given up. Does nothing but sit all day. I work full time so he is home alone. Not sure what is going to happen in our marriage. This is equally tough for both the stroke victim and the spouse (caregiver.)
Dr. Susan O'Grady says
Lynn, You are so correct that the impact of stroke is huge to the care-giving spouse, yet the stroke survivor gets the lion’s share of the attention. Compassion fatigue is a very real stress. It is important to determine if ‘his sitting around the house all day’ is depression, or stroke related, or a combination. I hope you are able to find good marriage counseling, or join a Stroke Support group in your area.
jim says
my wife had a stroke a year ago. we have been married 42 years. so after 41 years of marriage the last has been more caregiver. its been a very long year. what makes it really hard is that stroke effects the body and the mind, and the mind part causes the big grey area . no one knows exactly how this has effected my wife, so you cant figure out how to try to help her improve. its extremely depressing for me. she should be doing better but the mind thing hinders the progress. throw in some depression and it gets uglier. and once your out of the hospital and the daily grind sets it you are on your own. its a mind game for the survivor and the spouse. both people need strong will to survive the challenge at hand
Dr. Susan O'Grady says
Jim, Well said. Keeping strong in the face of these changes is important. And hard.