Shortly after the post from Sheila’s dissertation on the “well spouse”, a reader asked whatever happened to the suggestion that caregiver syndrome be classified as a reimbursable “ psychiatric” diagnosis. In fact, there is a code:
F43.0 Acute stress reaction
or: R45.7 State of emotional shock and stress, unspecified,
which is the code also used for battle exhaustion and other extremely stressful situations.
In one sense, it is an honorable recognition of the daily struggles of caretakers of we ill or disabled. On the other hand, it is an example of not fully appreciating what people like Sheila must bear for years, even decades. Researching combat fatigue, I discovered that the American Army determined about 180 days of battle was the limit of most soldiers’ endurance before they were significantly at risk of acute stress reaction. Imagine how many days or even decades of “battle” Sheila is exposed to and wishes to survive, in all respects, intact.
Take the day before and after Bodhi’s death during our holiday “vacation “. Family we love from out of town were staying with us and she was preparing breakfast, lunch, and wonderful dinners. Of course, I had my ongoing infection which required additional daily help from her to manage. She cleaned up Bodhi’s accidents and changed the absorbent pads he used in his last week. On Monday we called roto rooter to take care of a clog we thought was due to the usual suspects-roots, the two giant Norwegian maple out front. That seemed to work.
But Tuesday as people took showers and Sheila did an unpleasant load of laundry, and I could only sit beside Bodhi, water started seeping up from the shower drain, across the bathroom, and into the bedroom. Every beach towel was laid on the floor. And then the washing machine stopped working.
Eventually another sewer service did the job right, the appliance guy figured out the washer, Sheila amazingly cleaned the floors, and gathered up all the wet towels into huge plastic bags. At the same time, she was, of course, grieving in anticipation of the vet’s last visit. And my infection was not knocked out requiring a intravenous antibiotic emergency room visit 4 days later. Imagine her concern.
Of course, some people are in much tougher situations. But the emotional and physiological consequences of such stressors over the long term can be quite similar. The body eventually becomes exhausted in its attempts to maintain balance under threat and health problems, perhaps worse, and depression and anxiety can set in.
So Sheila does her best to maintain a positive attitude, calm, and patience while still keeping a beautiful home, working as a therapist, being a loving and generous friend, Nana, mom, and wife. Later there’s more I’ll say about other consequences of illness upon the “well spouse” and the importance of acknowledging their needs as well as those of their ill partners.
Now I can only say, at this moment, Lou Gehrig’s words upon his retirement from baseball due to his ALS, “today I consider myself the luckiest man on the face of the earth” that she is my wife and sorrow and compassion for the unavoidable weight of my illness she so gracefully carries.