| Over 4 million Americans are affected by Alzheimer's disease (AD). Decades of research about spouse and family caregivers suggest that they are at risk for developing serious health problems due to the physical and emotional demands of the role. However, studies exploring how changes in the marital relationship affect caregiving spouses and their abilities to cope with and healthfully adjust to those changes are not as common in the literature.; The purposes of this grounded theory study were to explore with spouse caregivers the changes they experienced in their marital relationships because of AD, describe the challenges they faced, and to discover the process used by the caregivers to explain what was happening to them, their spouses, and their relationships over time. A theoretical sample of ten participants was necessary to achieve data saturation and redundancy. Intensive interviewing was used to elicit data and interview narratives were audiotaped and later transcribed for analysis. Demographic data were collected to describe the sample. Constant comparison was used to code and categorize emergent themes that provided answers to the research questions: (1) How do spouse caregivers describe the effects of AD on the marital relationship? and (2) What coping strategies do spouse caregivers use to manage the challenges of living with and caring for a partner with AD?; Guided by the conceptual perspectives of Modeling-Role Modeling and Attachment-Loss-Reattachment, the process of imposed detachment emerged as the grounded theory that captured the participants' descriptions of what happened within the marital relationship over time while caring for a partner with AD.; Relational statements that supported the meaning of this process emerged from grounded data comprising four thematic concepts: gone and not coming back, life with a stranger, getting through and wishing it would end. Two sub-themes of staying connected and living in the moment added to the explanations of "getting through".; The findings of this study, although limited by design and sample size, provide direction to future research studies involving spouse caregivers and suggest to clinical practitioners that healing interventions can be developed to support the needs of this special group of caregivers. |
