The impact of admission of a spouse with dementia in a care home on spousal relationships

Abstract

This research focuses on the experience of older married couples who placed their wives or husbands with dementia in a care home. This study seeks to understand how institutionalisation influences the marital relationship as perceived by the non-affected spouses. The life-course perspective and social exchange theory provided the theoretical background for this research. Fifteen husbands and wives, over the age of sixty-five years; who have been married for fifteen years or more and who had their dementia afflicted spouse residing in St. Vincent de Paul Long-term Facility for at least six months, were recruited. This study took a qualitative approach adopting Interpretative Phenomenological Analysis. Semi-structured, face-to-face interviews with open-ended questions resulted in thematically analysed transcripts. Emergent themes highlighted conflicting feelings for the spouses in which positive feelings were contrasted along uncertainty for the future. Participants reported there efforts for maintaining connection with their institutionalised loved ones through continued spousal caring, despite the challenges posed by the disease itself, physical separation and healthcare provision. Spouses portrayed a commitment towards their life-long partners and their religious beliefs of a sacramental marriage. Furthermore, they expressed how they derived meaning and coped with their current living situation both within and outside the care facility. In view of the absence of local research on marital relationships in later life vis-a-vis institutionalisation, this study provided an understanding on the experiences of this group of spouses with institutionalised partners suffering from dementia amidst the Maltese context. While this study replicates some findings elevated from previous gerontology research particularly from a psychosocial perspective in relation to institutionalisation, it also provides new directions for future research. Important recommendations stemming out of the research include the development and implementation of educational and clinical policies underpinned by relational-centred care frameworks and strategies that appreciate the uniqueness of every couple in order to promote their positive well-being.