Chronic Illness

More magazine (Celebrating Women 40+) just arrived in the mail. I was curious so I thumbed through it casually although it belongs to my spouse. My concern peaked when I read the following:

Increasingly, a diagnosis of chronic illness occurs in mid-life. Women in their forties and fifties are particularly vulnerable to a range of disorders, including auto-immune diseases (rates of many have doubled and tripled in recent decades); back pain (which hits a third of women between 45 and 64); arthritis (affecting 26 percent of women between 40 and 60); and cancer (afflicting about 200,000 women between 40 and 59). In all, nearly 133 million Americans deal with a chronic health condition. "Illness requires so much extra time and labor-between medical appointments, insurance bills and health regimens, the need for rest, or just added time for the smallest things, like taking a shower or getting dressed," Ross says. "Meanwhile, the healthy spouse often has to take on more of the to-do list for home and family life. People can get caught up in just doing and plowing through."

Many marriages disintegrate under the pressure. In the general population, the lifetime divorce rate is roughly 50 percent; for chronically ill people, the rate is 75 percent, according to one often cited statistic. That number, extrapolated by some advocacy groups from the National Health Interview Survey data, is not universally accepted, but the dozens of experts I interviewed for this piece agree that an unusually high percentage of chronically ill patients are divorced, and that illness is often the precipitating factor. Among the dozens of women I spoke to were a few who added a heartbreaking twist: that although the relationship with their spouse had fallen apart, they stayed married for the health insurance. Too ill to work, they knew they couldn't qualify for any other kind of coverage.

"As if it weren't enough to face the terrifying things happening to her body, a woman has to cope with her feelings of loss and fear about her future-and on top of all that she has to manage her spouse's feelings," says Susan McDaniel, PhD, professor of psychiatry and family medicine at the University of Rochester. "It's too much to ask of one person."

We know this is a two-way street as husbands also become afflicted with chronic illnesses severely testing their spouse. The More articles (February and September 2009 www.more.com) told stories about wives who were suffering, whose husbands had to add care giving to their daily lives, and how they coped with it. Unfortunately, some do cave in under the strain and head for the divorce court.

No doubt this potentiality has something to do with the traditional wedding vow: "'til death do us part." Marriage vows should never be taken lightly. Nor can we predict if or when tragedy will strike, or how we will react. Yet it is possible to not only adjust but thrive while doing so.