Dear Abby: My friend's BF had a stroke. Does she care for him forever?

I believe that sort of commitment belongs to marriage. I would do anything at all to help my husband, for as many years as I had to. I would not have that level of commitment for someone I was not married to.

I think she should do her best to help him get assistance from others who are qualified to give it. This is not the same as leaving him-- it would involve time and effort, but eventually the bulk of the work would be done by others (home health workers, hired drivers etc.) freeing her to be the one who gives him emotional support. It might actually be better for their relationship if she doesn't turn into his caregiver.

I agree. It would definitely be a hard thing to have to walk away, but ultimately, if there were no plans of living together, let alone being married, then I don't think it would be appropriate to feel obligated to take on that responsibility.

I think she needs to take his disability out of the equation. Who in their right mind stays with someone who takes their frustrations out on them? Okay, lots of people do but it still isn't right. She needs to let him know in no uncertain terms what behavior is tolerable and what isn't. We all get cranky sometimes, but it sounds like it's become a habit for him to abuse her. Those people she's concerned about impressing with her loyalty are either her friends, and they will continue to be her friends, or they are people who already only think of her as someone they know as his girlfriend and haven't learned to care about her for who she is as a separate person, and they will dump her. In that case, she hasn't really lost much.

By the way, I've spent the last twenty-five years advocating for persons with disabilities. Some are creepy, some are angels, some are annoying, some are boring, some are manipulators, some are fascinating, some are real joys to be with...just like everyone else. As we age, we become more and more likely to become disabled in some way, and so do our loved ones.

I think your friend should have a heart-to-heart talk with her bf and his mother to air her concerns. I agree that if they are not thinking of marriage, there is no point to continue to be together. It appears he is getting abusive and taking things for granted. Your friend has only known him for a couple of years. Should leave him before it becomes her responsibility to take care of him for the rest of his life.

To answer your last question, dear Q; I have no idea what I would do in a situation like this, maybe you don´t know until you get there, I guess.
As I understand it, Vivian isn´t happy because of two circumstances - the feeling of guilt if she would leave him (and what others might think of her), plus she is also not happy staying in this relationship.
I really think she has to take this decision on her own, and whatever she decides to do, her friends should support her.
I know this dilemma myself, while it´s ongoing you see no way out of it, but in the long run you will (hopefully) feel you took the right decision. Maybe she could take a time-out, and get things in perspective?
Since this is a "poll", I vote for her to leave.
If she herself is not happy, I think in the long run her bf won´t be either.

That. Although of course depending on the nature of the disability, that could actually be the cause of character change.

I'm not personally fond of the notion that (mostly) women are expected to set aside their own life's goals and wishes and have the obligation to be the caregiver to their partner/children/aging parents/family. In the case of long-standing relationships or marriages it probably would be different (thinking of my parents, with whom a similar situation arose but only after nearly 40 years of being together - that's different, somehow), but even then: when circumstances change, you must be allowed to review your promises. Caring for someone out of sheer obligation will not contribute to your happiness.
I agree with 30 Roses that helping him to find other -professional- caregivers may alleviate such guilt as she would feel if she does leave.
It's a difficult decision, and I wish her strength.

Either she marries him and takes care of him for the rest of his or her life. Doesn't seem like an option.
Or she remains on the current footing and makes clear the man needs professional care (and therapy) and she will not be able to help him out for much longer. That may ultimately lead to an end in the relationship or not.

I speak as someone who has worked with older people for much of my career. Leave with kindness. Your friend's primary worries are guilt and social approbration. Poor dear. She can lovingly help set home care in place. Advise her to hire a geriatric case manager. This professional can evaluated the BF's situation and figure out ways to put appropriate care into place.

Your friend must not feel compelled to choose madonna or whore. Quarry, dear, do give her love through this difficult time. Geriatric case manager. The way to go.

This is one of those situations where, despite the good advice and good intentions of others, the only person who should be counted on to give the 'right' path to follow is the only one who is actually experiencing all the physical work, the time given, the mental gymnastics and the flood of emotions associated with the situation and who will have to live with the aftermath of that choice. Vivian.

For what it's worth...

I agree with others about getting professional help. Then, take it one step at a time. Getting help will alleviate some pressure on her, and hopefully give her the space she needs to assess the situation a bit more objectively.

I have a thought about the boyfriend too--he may indeed have had a character change, as stated above. However, he is rather desperate at the moment, and probably very frustrated at how his life has changed. Getting professional help is an act of love and respect for this man, not a cop-out.

Strangely, I have an acquaintence in a very similar situation. First of all, I have to say the opinions shared here have been thoughtful, relevant, and respectful. Ultimately, no matter the circumstances, is this relationship evolving? They are not married, have not 'committed' themselves completely to eachother, so if the dynamics of the relationship change - so might the status... It is not fair or right in any way for him, his mother, or his collegues to expect her to continue on like this. It is such a sad situation. Heartbreaking. I think (now this is my personal opinion) that he should 'set her free' - especially if he truly cares for her.
The fate of this relationship should not hinge entirely upon her...he should have his say too.

But is that really the case, or only what they are thinking is true? What is Vivian doing that could not be done by food delivery services, paid drivers, home health aids, social workers etc.? Not to devalue her assistance, but I think others could do these tasks. Institutionalization is a last resort, surely.

Also, I have worked with a lot of stroke patients (I'm a PT) and I can attest to the fact that a stroke can cause personality changes -- due to actual physical damage to the brain, not just due to stress from the resulting negative life changes (though there is that, too.)

I've known people in similar situations, so here goes:

One couple had been together a few years, but did in fact live together. He was paralyzed in a motorcycle accident. She tried to stick by him, care for him, and they did manage for a few years after the accident, but in time he felt like he was a burden to her and they split up.

The other couple have never been married, but have lived together for ages, together probably close to 30 years already and have seen each other through strokes, heart attacks, liver surgeries, broken bones, etc.

Another couple were college sweethearts, she came from a broken home and was not interested in marriage, but after college they lived together. Nearly everyone in his mothers family had died of a rare and aggressive cancer. In his early 20s he was diagnosed, they continued to live together and she saw him through the end although she never married him even though he would have done it in a heartbeat.

Considering they aren't married and don't even live together, nor live in the same city, have never thought about marriage, I think it's okay for her to back away. It's fine if she wants to be a good friend and do the best she can to help him out when she can. She doesn't have to walk away completely and end the relationship altogether, but I think it's really about how she see's the level of commitment and love between each other. They sound more like occasional companions and friends than people in a committed relationship. She needs to have a heart to heart talk with him and hash things out about what she is willing to do and not do and about he treats her. Strokes do affect personalities and certainly he must feel a great deal of frustration at his slow/incomplete recovery on top of that. If she is going to continue to care for him, it needs to be out of love or else she will just start resenting him and he will certainly feel it as well and everything will eventually break down.

Wow, this reminds me a little of the old "Friends" episode where Phoebe was searching for the ultimate selfless act, the thing you do for someone that brings you absolutely no gratification. There's a line between selflessness and, this is a little too strong of a term, but masochism. Know what I mean?
It does sound to me, as well, that this is a relationship more of convenience. I, too, wonder if she is really the "tipping point." Does she feel this way herself, or is she being pressured into feeling this way, and is beginning to believe something that isn't true?
I'm sure the bf is feeling devalued, depressed, and panicky, among other things, all as a result of the stroke; of course most people desire companionship and he might feel that he doesn't have much to offer (like, why would anyone love me now?) so he's maybe struggling to keep Vivian around (and after two years he probably knows which buttons to push with her.) Not that he'e a mean person, but that he's sort of in "fight or flight" mode. And so is your friend. For him, I, too, think therapy is in order and some spiritual guidance, as well.
So this brings me to the time frame, which is that the stroke happened several months ago. Vivian wants, it sounds like, to move on and is waiting for someone to tell her to stay. I feel she has exceeded the call of duty and the longer she does stay the harder I think it will be to leave. Quarry, you mentioned she likes to travel. Maybe she should take off for a couple weeks, or longer; take a break. Get some fresh air and some perspective. Then the bf can get some perspective, too. And if a two week break doesn't seem like a possibility for either of them, well, she should make it happen, regardless. If the bf (or his mother, I'm curious how much influence she has in all this) can't suffer to let her take a small break, then there's her answer.

Some nursing homes are nice, it is not always a terrible choice. My inlaws are in a great place where they have their own apt, yet care and help is available. They have made lots of friends there, too. It was their choice, they like it. (I have edited the rest of my post because after reading what you wrote below, it changes my opinion of the situation. At any rate, these two had no commitment of any kind before this happened.)

Yes, it can be simple, but your friend just keeps getting in deeper and deeper. I'd stay out of it Quarry.

This is Vivian's question to answer. It's gut check time, she needs to look into her heart, and answer this question. Advice is good, but she need's to advise herself in this matter. She knows the right thing to do. She need's to do a little soul searching to reach the answer to this question. Not easy I'm sure. With all the decisions that we have to make in life, I think we all have to weigh things, and when we do make a decision, I think the key is to make it, and don't look back, and make sure It's our decision.

Hmm. No, it sure isn't. I'm sort of baffled.
Going back over your op.... Which is she more concerned about, the possibility of bf being institutionalised, or her reputation, should she leave him? I mean it in this way-- if anyone the two of them collectively worked with know anything about their relationship and situation, I'd be willing to bet that they would not blame her a bit for getting on with things, especially after all this time. I'd also bet the group as a whole is probably not overly vindictive. (The one or two in every crowd don't count and have bigger problems of their own, anyway.) We have a tendency to think others think more of us than they actually do. Again, it's not as if she's contemplating leaving a terminal spouse, and it's not as if she's been unfaithful. But also again-- the longer she stays, the more mired in it she will become.
Maybe she doesn't want to admit to anyone (herself included) that she really wants to stay and take care of him. Maybe her feelings run deeper than she's willing to admit (or that he does not reciprocate.) I think she's choosing not to decide, at this point.

Therapy together and separately, if she feels that strongly committed to the relationship. She needs to follow her own heart, but she might need help in sorting that out. Guilt is crippling.

Except it's not similar. I also suspect there is more going on here than meets the eye and this lady has a history of dysfunctional relationships. Agree with those who suggested personal counseling.

(Edited my post above considering new information.)

Taking care of parents vs. a two-year bf aren't similar, at all. I agree that there are probably personal issues deeper than we, who don't know either person, can reasonably speculate on. Your last post is really telling, Quarry, sounds like your friend's got inner turmoil beyond simply whether or not to be this man's caregiver (I imagine two ex-husbands will do that to a person). Count me in among those suggesting counseling. Maybe she could use some spiritual guidance, as well.

Oh man. She can't bear to hurt him, even after the manipulative move he pulled on her. Well, it's a tough situation for everybody concerned. I sure hope they will be able to work everything out for the best for both of them. You're a good friend, Quarry, to even involve yourself this far. (((hug)))

It sounds to me like he's over-dependent on her and determined to keep her trapped in this relationship.

Maybe I'm missing details, but I can't see, for example, how it could be impossible for him to get his meals from _any_ source whatsoever other than her. I'm sure that it makes him feel well-cared-for to have her driving down with food, and I'm sure that he doesn't want it to stop. But that doesn't mean that he actually needs it.

And, similarly, if he can afford diamond rings and trips to Italy, he can probably afford someone to take him to meetings occasionally. Again, I'm sure that he doesn't want her to stop taking him to those meetings, but that doesn't mean that he actually needs her to do so.

And, again, if he can be without her for the length of a trip to Italy, how can it be that he _cannot_ get along without her permanently?

It sounds like the biggest thing that keeps her tied to him is the "knowledge" that without her, he will be institutionalized. That makes me doubt the validity of that fact.

If he proves his independence, if it becomes clear that there isn't a threat of him being institutionalized, then I expect that she will leave him, because she's with him because he needs her. So he has every motivation to prove his helplessness, and no motivation to arrange to be able to care for himself.

Maybe I'm mean and hardhearted, but it sounds to me like he knows that his helplessness is what keeps her helpless, and he's going to press that for all it's worth.

And, well, to me that means that he's not a good man. He sounds like a desperate man who needs to keep this person tied to him, against her will. And that's just not good.

Editing to clarify a point: Even if he does need her - for example, even if his money is running out and he will be institutionalized if he doesn't have her as a permanent free full-time nurse - no obligation exists here. They're not married, and this is not a true engagement, and I see no other form of a lifetime commitment, and she doesn't _want_ a lifetime commitment. In my opinion, the logical action is for her to extract herself from this obligation, whether she does it slowly and gently, or abruptly.

Quarry, I'm sending you another extra large (((HUG))) just because.

And welcome, ChickenFreak!

Ultimately it's Vivien's decision. If she's still with her BF, then she's chosen, for now, to stay with her BF. I won't second guess her reasons. But I'll add a few other points.

If the BF is o.k. for several days at a time without Vivien there, then his support system is sufficient to keep him out of an institution. She's adding to his quality of life by providing companionship, support, and assistance with things that the professionals don't cover. But without her he might choose a group home of some kind for the additional companionship.

Besides the possibility of permanent personality change from the stroke, there's also the possibility that his anger is a reaction to his situation that will change as he adjusts. It's natural to resent those we depend on, especially when we know they may choose to leave. Natural but not inevitable. My wife already had multiple sclerosis when we married 34 years ago. We have been through these kinds of adjustments more than once.

Just to clarify - I was suggesting personal counseling. I don't think I saw anyone say couple's counseling, maybe I missed that.