# Chronic illness and disability in a relationship

> Long-term illness or disability can strain a relationship, and it can also bring a couple closer. Couples who cope as a team tend to report better relationships and wellbeing. Share the load by what each of you can do now, and revisit the split as things change.

Not reviewed yet: test content.

- **Long-term illness often strains a relationship,** and for some couples it also brings them closer.
- **Coping as a team matters:** couples who cope together tend to report better relationships and wellbeing.
- **Support can slip into criticism or control** over time, so it's worth noticing early and raising it kindly.
- **Share the load by what each of you can do now,** and review the split whenever symptoms or abilities change.
- **Look after the partner who doesn't have the condition too,** because their health and self-care can wear down.

## How does chronic illness affect a relationship?

Often it puts strain on a relationship, and for some couples it also brings them closer. On the strain side, chronic illness is linked with lower relationship satisfaction and with caregiving burden for the partner who doesn't have the condition [1]. As an illness goes on, a partner's ability to be supportive can wear down, and critical or controlling behaviour can increase [1]. Caregiving can also change how partners relate in distressing ways, especially where the relationship was already struggling [2].

The other side is just as real. Serious illness can challenge how you communicate and who does what: some couples grow closer, while others find less intimacy and more conflict [3]. Couples facing advanced illness have described caring for each other as a positive and natural part of being together [4].

What seems to matter most is coping as a team. Couples who report supportive, shared coping also tend to report better illness management, better physical and emotional wellbeing, more constructive communication and greater relationship satisfaction [5]. How satisfied someone is tends to be predicted more strongly by how they see their partner's coping, and your coping together, than by how they see their own [6]. These are links, not proof that coping together causes better outcomes. In couples coping with cancer, programmes for couples have had small benefits for both partners [3].

Some things to try:

- Talk about the stress of the illness openly and regularly, as something you're both dealing with rather than one person's problem.
- Ask each other how you feel the two of you are coping together.
- Notice whether support is slipping into criticism or control, and raise it early and kindly.
- Name the good parts of caring for each other as well as the hard parts.

## How do you share the load fairly when one of you has a long-term condition?

Share it by what each of you can manage now, and expect that to change. Partners often take on more household tasks as a spouse's abilities change, and many find this natural and positive. The difficulty is less about taking over and more about not taking over too much: judging when to step in and when to let the other person do what they can [7]. Some couples with advanced illness stayed stable by sharing the caring and the day-to-day tasks, each taking a larger share when needed [4]. Being able to coordinate, reflect and adapt helped them stay independent [4].

Here is what to try:

- Review who does what from time to time, especially when symptoms or abilities shift, rather than setting it once.
- Agree together when to step in and when the partner with the condition keeps going.
- Talk through what each of you can manage and where your limits are, including the limits of the partner who doesn't have the condition.
- Protect that partner's own time to eat well, sleep, exercise, see friends and do things they enjoy. Illness often moves personal care onto the healthy partner, and caregiving is a recognised source of strain [2]. Their own health and self-care can slip over time [1].
- Build a wider circle of support, such as friends and family, before you reach a crisis point. External help is often treated as a last resort, but a wider network can take pressure off and ease isolation [4].

It isn't clear yet which method of dividing tasks works best, so treat any split as something to try and adjust. Couples whose coping is shared tend to be more satisfied with their relationship, and partners who actively engage together report lower distress [5].

> **Try this together:** Take ten minutes this week to each write down what you can manage on a good day and on a hard day, and what you'd like the other to take on or leave with you. Compare notes, agree one change, and put a date in to review it.

## When to get more help

Living with a long-term condition, or caring for someone who does, can be stressful for both of you.

For a worry about your mental, physical or sexual health, see a doctor.


## Common questions

### How do we keep our relationship from becoming only carer and patient?

Talk about the illness as something you're both dealing with, not one person's problem. Name the good parts of looking after each other as well as the hard ones. Keep some time and activities that have nothing to do with the condition, so you stay a couple as well as people managing a health issue.

### How can the partner who doesn't have the condition avoid burnout?

Protect their own time to eat well, sleep, exercise, see friends and do things they enjoy. Agree together which tasks the partner with the condition keeps doing, so one person doesn't take on everything. Build up support from friends and family early, rather than waiting until things feel unmanageable.

### How can we get support from family and friends?

Start before you reach a crisis point. Tell people plainly what's going on and what would make a difference, such as a regular meal, a lift or an hour of company. A wider circle takes pressure off the two of you and can ease the isolation some partners feel.


## Sources

1. Review and meta-analysis of couple-oriented interventions for chronic illness. Martire and others · Annals of Behavioral Medicine · 2010 https://doi.org/10.1007/s12160-010-9216-2
2. In Sickness and in Health? Physical Illness as a Risk Factor for Marital Dissolution in Later Life. Karraker and Latham · Journal of Health and Social Behavior · 2015 https://doi.org/10.1177/0022146515596354
3. A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Badr and Krebs · Psycho-oncology · 2013 https://doi.org/10.1002/pon.3200
4. Caring for each other: A rapid review of how mutual dependency is challenged by advanced. University of Warwick https://warwick.ac.uk/fac/sci/med/research/warwick-applied-health/apc/publications2021/caring_for_each_other_a_rapid_review_of_how.pdf
5. Dyadic Coping in Couples: A Conceptual Integration and a Review of the Empirical Literature. Falconier and Kuhn · Frontiers in Psychology · 2019 https://doi.org/10.3389/fpsyg.2019.00571
6. Dyadic coping and relationship satisfaction: A meta-analysis. Falconier and others · Clinical Psychology Review · 2015 https://doi.org/10.1016/j.cpr.2015.07.002
7. Living with a spouse with chronic illness - the challenge of balancing demands and resources. Eriksson and others · BMC Public Health · 2019 https://doi.org/10.1186/s12889-019-6800-7

Source: https://coupletools.com/learn/chronic-illness-and-disability-in-a-relationship