by Cynthia Germain

For many couples, growing older happens side by side.

For years, you moved through life on fairly equal footing. You worked, raised a family, traveled, made plans, and divided responsibilities. You may have had the occasional illness or surgery along the way, but for the most part, neither person thought of themselves as the “healthy one” or the “one who needs help.”

Then something changes.

One spouse develops a chronic health condition. Mobility becomes more difficult. There is a serious illness, a fall, changes in memory, or simply a gradual decline that makes everyday activities harder than they once were.

Suddenly, two people who have spent a lifetime as partners may find themselves in very different roles. One becomes the person who needs more help. The other becomes the person providing it. That shift can be difficult for both.

The person experiencing health changes may struggle with the loss of independence or feel uncomfortable relying on someone who has always been an equal partner. The healthier person may begin taking on more – driving, cooking, household responsibilities, appointments, medications and decisions, often without ever consciously deciding to become a “caregiver.”
And somewhere in all of that, the relationship itself can begin to change. Perhaps one of the most important things couples can do is acknowledge that change.

Pretending everything is the same can sometimes make things harder. It is okay to talk about what has changed, what each person is worried about and what each needs. Those conversations may be uncomfortable, but they also create an opportunity to decide together how to move forward.

It is also important to protect the partnership whenever possible. When one person needs more help, it can be easy for every conversation to become about medications, appointments, meals or what needs to be done next. Finding ways to remain partners and friends matters. Watch a favorite movie. Sit outside together. Go for a drive. Share a meal with friends. Continue the small rituals that have always belonged to the two of you.

Another important step is to accept help before you are overwhelmed. Many couples are accustomed to managing life on their own and may resist asking others for assistance. But accepting help with transportation, meals, household chores, home maintenance or simply companionship can preserve energy for the things that matter most. Help does not have to mean giving up independence. Sometimes accepting a little help is exactly what allows independence to continue.

And the healthier person also needs permission to continue having a life of their own. That can be difficult. There may be guilt about going to lunch with friends, attending an activity or simply taking time away. Yet maintaining friendships, interests and time for yourself is not abandoning your partner. It is part of sustaining yourself for what may be a long journey.

Perhaps both people need to recognize that fair does not always mean equal. For much of a relationship, responsibilities may have been divided fairly evenly, but as health changes, one person may naturally carry more. The goal may no longer be to keep everything equal, but to find a new balance that respects the needs and abilities of both people.

“In sickness and in health” is a phrase many couples said years ago without knowing exactly what it might someday require. When that day comes, perhaps the answer is not simply to endure the changes, but to adapt to them together, to ask for help when it is needed, protect the relationship that existed before illness entered the picture, and continue finding ways for both people to have connection and joy.

Because even when health is no longer equal, the partnership can still be one of equals. It may simply look different than it once did.