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The pre-illness marital relationship as the context for wives caregiving for a husband with Alzheimer disease Bontinen, Kymberly


Wives caregiving for husbands with Alzheimer disease (AD) pursue the caregiving role within the context of their pre-illness marital relationships. A relationship-oriented approach to understanding informal family caregiving from the wives' perspective of their experience caregiving for their husbands with AD offers a new perspective to enable nurses to identify the caregiver's individual support needs. The purpose of this qualitative inquiry was to contribute to our knowledge of family caregiving by offering an understanding of the influence of the marriage relationship from the perspective of wives caregiving for husbands with AD. This research also endeavored to increase nursing knowledge regarding the wives' experience caregiving for husbands with AD within the context of marriage. This qualitative study is a secondary analysis of Dr. JoAnn Perry's (1995) PhD dissertation data. The secondary research method was guided by the principles of grounded theory and operated within the interpretive research tradition of symbolic interactionism. Symbolic interactionism framed the analysis to promote understanding of the influence of the wives' pre-illness marital context. The findings of this study revealed that the nature of the preillness marital relationship for wives caregiving for husbands with AD was formed by the wives' interpretation of their husbands' behaviour and the meaning they assign to it and their understanding of their interactions as a married couple. The nature of the pre-illness marital relationship influenced the wives' ability to (1) access internal support from the marriage experience, and (2) preserve a sense of couplehood within the caregiving experience. The concept of connection emerged as an important experience within the marital-caregiving relationship in the following two ways. First, connecting with the person describes the process by which the wives enacted their desire to preserve a sense of couplehood. Secondly, the marital connection appeared to be the wives' link to internal support from the past marital relationship experience. Connecting with the past was one way that wives could enrich their caregiver-care-receiver relationship and experience gratification from the wife-caregiver role. Further investigation is required to confirm the marriage context as an influence within spousal caregiving. The author's interpretation of the wives' narratives in this secondary analysis offers one understanding of the wives' marital-caregiving experience for husbands with AD. This research outlines implications for nursing practice, education, and research.

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