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Gender adjustments for Alzheimer's caregivers

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Allan Vann, Ed.D
Allan Vann, Ed.D

For quite some time, I was the only male in my Alzheimer's disease spousal support group. I quickly discovered that I could not resolve some problems for my wife, Clare, in the same way as some women were resolving similar issues for their husbands.

It's not a question of “who has it easier?” because both male and female spouse caregivers have a very difficult time. While everyone may have individual preferences, based upon observations in my weekly spousal support group and what I've read in my online support groups, there are some differences along gender lines.

Professional caregivers should be aware of these, and sympathetic to the challenges that family members and others face.

Here are some of the important differences that I have observed:

Getting dressed  at home — Eventually, people with Alzheimer's have difficulties getting dressed each morning, which becomes a time-consuming activity. For some, getting dressed each morning is difficult because of the need to locate and then choose what to wear.  For others, it may be difficult making an appropriate choice of clothing for that day's particular weather conditions.

To avoid wasting time each morning, many women in my group simply made those decisions for their husbands, setting out clothing for them to wear each day. When I picked out clothing for Clare to wear, she would say things like, “I don't like you doing that for me.  Stop trying to manage my life.”  

I tried asking Clare to select her next day's clothing the night before, but the next morning she would try on several other outfits before being happy with her choice. So one gender difference may be for male caregivers to allow extra time for women to get dressed each morning, and plan accordingly.  

Driving — Once a person with Alzheimer's stops driving, the caregiver must make an adjustment. If the person with the disease was the sole or primary driver in the family, the caregiver will now have to do all the driving, or rely upon on neighbors, friends, relatives, public transportation, taxis and car services.

More often than not, the female caregiver will now have to do more driving. My adjustment after Clare's diagnosis was relatively minor since I had already been doing all the driving when in the car together. As the lone driver, however, I had to become much more attuned to my body and surroundings. Fatigue, alcohol consumption, weather, road conditions, and possibly even problems driving at night may become new factors to consider when you realize your spouse can no longer help with the driving. 

Household Tasks  — Clare and I were both born in households where cooking and housework were considered “women's work,” but as members of the first “baby boomer” generation, we shared cooking and household tasks after we were married.

I now do all the cooking (or purchase meals from supermarkets and restaurants), and household tasks, necessitating an adjustment in how I spend my weekly time.  For the women in my support group, their main household task adjustment was learning how to do minor ‘handy man' projects in their home.

Financial and legal matters  — Many women I have met underwent a very steep learning curve to learn about and handle everything from overseeing their financial investments to making sure that all of their end-of-life documents are in order. This includes wills or trusts, living wills, healthcare proxies, and durable power of attorney when their husbands are diagnosed with Alzheimer's. Their husbands often handled these matters without their active participation.

Many female spouses say that meetings with financial advisors, accountants, and attorneys are stressful, sometimes overwhelming, and often confusing. For me, although my wife attended virtually every meeting about financial and legal issues, she always deferred to me to make all final decisions. I feel quite comfortable handing legal and financial matters completely on my own going forward. In these two areas, male caregivers may have it easier.

The bottom line  — Healthcare workers should inform Alzheimer's caregivers about upcoming adjustments to prepare for once their loved one receives an AD diagnosis. Regardless of gender, caregivers should take three important steps immediately: Join a support group, meet with an attorney who specializes in eldercare issues, and meet with a financial advisor.1

1.  “Three Important Actions for Alzheimer's Caregivers.”  Clinical Geriatrics.  October 1, 2013.  Access at:
http://www.clinicalgeriatrics.com/content/Three-Important-Actions-Alzheimer%E2%80%99s-Caregivers.

Allan S. Vann, Ed. D., has written numerous articles about caregiving after his wife was diagnosed with early onset Alzheimer's disease in 2009. A retired school principal, he maintains a personal blog as well.

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