It's kind of a cliche, and even grist for the stand-up comedy mill that personality changes happen during marriage..."Who are you and what did you do with my husband? And did you really cash in our IRA to buy a Corvette???"
Yes, mid-life-crises happen, and this manifestation is, hopefully, rarer than pop culture would have us believe.
But in the face of terminal illness, people do change. It's unavoidable - and here are some of the common causes:
- The illness itself can bring about physical and chemical changes that affect personality and mood
- Life becomes suddenly finite, and taking stock of the life one's lived can be disappointing
- Social connections can be reduced as mobility and energy decline, leading to the problems caused by isolation
- Medication can cause some pretty drastic side effects that can affect personality
First and foremost...if there is a drastic change in personality, especially one associated with a change in symptoms or medication, the doctor(s) have to be informed immediately.
That caveat aside, how does the caregiver cope?
First, it's important to differentiate between, generally, manic and depressive changes.
Manic changes can seem like almost a blessing - who would not want their terminally ill spouse to be happy? But there's a dark side of recklessness, and it's most often expressed financially. The 'live for the moment' attitude can lead to outlandish purchases, especially over the Internet, and more difficulties and heartaches down the road than there should be.
Depressive changes are more 'expected; someone who's dying isn't really supposed to be delighted about it. But there is a balance between a situational case of the blues and a real mind-numbing depression...and there is a point of no return beyond which that depression takes hold as something of a habit.
And that is a miserable place to be. For the patient, and for the caregiver.
What to do?
- As a caregiver, maintain your own life to the degree possible. You are not dying as well; you are taking care of a loved one who is and your life will go on. That may seem unlikely, and thinking of it may feel disloyal, but it's the truth...and would your husband or wife want you to die with them? Maintain your friendships and interests in any way you can. Don't sacrifice yourself on your spouse's funeral pyre.
- Keep a journal of your spouse's emotional state. It may seem coldly clinical, and even like spying, but it can be invaluable for a health-care professional to cross-check it against the proces of the illness and the medication regimen. You can't fix, or at least minimize a problem if you can't see it.
- Watch your finances closely. If you see unusual spending habits, that might be a sign of a developing problem
- Try to maintain as normal a social schedule as you can. Your mate may not be up to going to a dinner party, but dropping by and then leaving before the meal is served (with a word to the host beforehand) can keep alive the sense of community we all need.
- Go to church, or, if your spouse can't, attend 'TV' church (and be regular; don't channel-surf). Maintaining a religious tradition is a huge help in keeping a person part of a wider world.
- AND ABOVE ALL, REMEMBER, DEAR CAREGIVER...THIS IS NOT ABOUT YOU. WHILE YOU MAY BECOME THE TARGET OF ANGER OR DESPAIR, IT'S NOT SOMETHING YOU BROUGHT ON. THIS IS ABOUT AN ILLNESS, AND THE DIFFICULTY IN FACING DEATH.
And yes, if you're wondering, I have changed. I will share those changes another time.
What can you add, in terms of strategies for coping with personality change?
Marley update...he's received a lot of support, but STILL NEEDS HELP TO BE SAVED.
WE ARE MAKING A DIFFERENCE! From a thousand signatures to OVER 160,000!
If you have a mment, I'd like to ask you to visit Change.org to consider a petition to free a 'death row dog' who has been separated from his family for ten months over a misunderstanding. Marley was saved from Afghanistan by a US serviceman; please help make sure this story doesn't end in needless tragedy! Marley's gotten a lot of support...but he still needs our help.
If you can, please do leave a comment. I am trying to answer all, and I am failing, but please know this - I read and treasure each one.
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Below are my recent releases on Kindle -please excuse their presence in the body of the blog. I haven't the energy to get them up as 'buttons' in the sidebar. You can click on the covers to go to the Amazon links.
I have a friend whose husband is terminal. I think I've mentioned them to you before, Andrew. She tells me of how different her husband can be from month to month. Recently, the medication he's on is working well for him and he's more engaged and mentally sharp than he's been since being diagnosed. This kind of threw my friend for a loop because she didn't think she'd ever see "that guy" again. But there are no guarantees how long that clarity and engagement will last. So she savors every second of it.
ReplyDeleteThanks so much for your insight on this, my friend. It's probably one of the harder challenges a couple must face, I'd say.
Beth, please pardon my delayed reply...I think your friend has exactly the right idea, to enjoy and reinforce every moment when 'that guy' is back.
DeleteIt is a terribly hard challenge; I do have some insights into how I have changed (and Barbara has enlightened me on others) and that is the subject of a future essay.
When I have the nerve.
Andrew, Your words show real understanding and give much needed insight and encouragement to those who are weary but love the one they are caring for.
ReplyDeleteDebbie, thank you so much for this, and please forgive my tardy response.
DeleteAnd thank you so much for being here!
Always good. Sent you something for the critters.
ReplyDeleteSusan, I thank you more than I can say.
DeleteYou're creating quite a resource here, Andrew. A legacy of hope is just part of what you leave behind. Blessings and prayers, for you and Barbara.
ReplyDeleteJune, thank you! I am struggling with how to leave it in a coherent form, for whatever help it may be to others. Not an easy task, and I have few 'good' hours in which to do it.
DeleteAnd please pardon my delayed reply. Bad week.
Andrew, I always appreciate your posts. Your practical take on the aspects of terminal illness and caregiving have really opened my eyes, and given me a better understanding of how to approach terminal illness/caregiving. I hadn't considered the personality changes that can come about as a result of a terminal diagnosis.
ReplyDeleteThank you, Andrew.
jeanne, thank you for this. The personality changes can be one of the hardest things for a caregiver to handle, and I don't see how one can really approach it without an eternal, transcendent view. I just don't!
DeleteThank you so much for being here, and please pardon the tardy reply.
Always helpful counsel here, Andrew. Would Barbara ever consider writing a guest post? Sure would love to meet her ...
ReplyDeleteThanks, Linda! I doubt she would write one; she might be willing to put down some thoughts for me to transcribe. She's in Management now, and way busy, really!
DeleteThanks so much for being here!
When my mother was terminally ill she had a personality change and became mean to me. Fortunately my husband worked at a nursing and retirement home and told me he'd seen the same thing happen to other people on the same meds, but it was hard not to take it personality.
ReplyDeleteI meant to say personally but spell check changed it.
DeleteActually, Jan, 'not to take it personality' kind of resonates with me!
DeleteAnd yes, it is hard. I'm not the same person Barbara married, and while I'll go into that in future when I have the courage, some of the changes are ones she wishes could be reversed.
None of this was ever easy, for anyone.
And I thank you so much for being here.
I have a friend whose husband is really sick. I haven't heard her say "terminally ill," but she's at home with him a lot and has written some about care taking. I plan to share this with her. Thanks for keeping it real, Andrew. This helps so many.
ReplyDeleteKim, thank you...the more experiences in home care are shared, the better.
DeleteThank you so much for being here!