'In this together' or 'Going it alone': Spousal dyad approaches to Alzheimer's

Spouses provide the majority of care for individuals with Alzheimer's disease (AD). The qualitative literature suggests that couples adopt one of two perspectives in their accounts of AD: a We/Us approach where couples describe experiences as a composite whole or an I/Me approach where couples describe themselves as experiencing the impact of AD separately. Little is known about how these perspectives relate to the individual characteristics of either affected party. This study investigated the experiences of dyads taking both approaches. Eleven spousal dyads were divided into I/Me (n=5) and We/Us (n=6) groupings based on qualitative analyses completed as part of a larger project. Diagnosed individuals were given measures of cognitive and functional ability and caregivers completed anxiety, depression, burden, relationship satisfaction, and positive aspects of caregiving measures. We found no significant differences between groups on patient cognitive or functional ability, or caregiver anxiety, depression, burden, or relationship satisfaction. However, We/Us caregivers expressed more positive aspects of caregiving than I/Me caregivers. These findings suggest the I/Me approach is not associated with differences in variables of patient cognitive status or functional ability or caregiver emotional health, perceived burden, or relationship satisfaction. Caregivers taking a We/Us approach, however, were able to identify more positive aspects of caregiving. This may be related to mutual compassion, a characteristic of the We/Us approach, which may be protective.