Staying After The Stroke

Why do families fall apart after a CVA? Strokes devastate those around them, not just the person suffering from this trauma, but the entire family. Each person plays a role in the dynamics of a family, and when suddenly one member changes, without discussion, warning, or preparation, overwhelming effects occur. In 1994, the US Department of Health and Human Services, as part of the National Health Interview Survey, found a 7.6 increase in the rate of divorce in adults with acquired disabilities. I have seen quite a few marriages and relationships crumble after a stroke. It is hurtful for all involved, makes depression even more likely, and to be honest until faced with the situation we don’t know if our relationships could survive such a drastic change.

Back to my question: why does the breakdown of relationship happen? I have a few speculations. After a stroke the person recovering will be more dependent on caregivers. They will often need assistance with even the basic tasks of living, like getting dressed, feeding themselves, and even once they recover function for these tasks there may be some residual impact, leaving the spouse different in personality. Even when my husband has a cold or the flu, the change in our interactions can be frustrating. The caretaker of our home, the man who is active, full of life and love for his art becomes lethargic, instead of being out on the snow taking photographs, or in his studio painting, he is in his recliner with tissues around, covered in blankets. I can deal, his illness is limited, but if there were no end in sight I imagine it could be quite the scary prospect for a marriage’s future. On another note, emotional support may be altered. The unwavering wife, the rock of the family, now has episodes of uncontrolled crying, and where does that leave her husband who used to lean on her? One of the most crucial aspects of change that contributes to the breakdown of relationship following a stroke is altered communication. Aphasia is very common, and so even the simplest words, phrases can’t be spoken, not to mention the fact that understanding of questions or conversation becomes difficult. Think about trying to talk to your husband, he just keeps repeating the same word, it seems like nonsense, and you can see that he is clearly trying to get a point across. Frustrating, right?

Now the question moves to what do we do with this situation. The problems outlined all contribute to a collapse of the family unit after suffering a stroke. Part of the problem lies on our inability to step out of traditional roles with our loved ones. Recognizing that the essence of the relationship has shifted is essential. Lack of communication can also must be dealt with by reframing, watching for gestures, facial expressions, and body language. The nonverbals will often tell you more than the jumbled words could ever convey, and communication is crucial to allowing parties adjust to a new relationship. The person who had the stroke has changed. Personality, characteristics that often define a person, may no longer apply. If the goal is survival of partnership then the mindset of all parties has to change, and preconceived expectations must be released. The advice I like to give is that a path less traveled has appeared. Do you navigate your way through the changing terrain, the rocks and boulders, to find the beautiful sunset at the peak of the mountain? There is no right answer for dealing with these devastating situations, but I have seen the most amazing couples emerge, maybe a little shaken, but stronger nonetheless, and not regretful for extending their love to encompass a different concept of what marriage can be. Are you a person who has taken on a great challenge such as this? Or do you know someone who has? Let’s talk. How did you/they cope?