Medically Reviewed On: July 03, 2008

ANNOUNCER: Providing care for an injured, frail or sick loved one can be an overwhelming task. Caring for an ill spouse can present some exceptionally difficult circumstances.

LARRY SOSNOW: Caring for a spouse is a very different relationship than caring for a parent, because you're caring for somebody more of an equal. And it's a very, very difficult emotional challenge for a spouse to see the other spouse decline.

CAREGIVER: If I think about what changed the most, I wouldn't be able to pinpoint it. I think it's a total change.

ANNOUNCER: This woman, a clinical social worker was faced with the difficult decision of how to provide care for her 95-year-old husband. It was a subject the two of them had already discussed.

CAREGIVER: I felt that, sooner or later, we were going to have a problem of what to do, as we got older, and less able to take care of ourselves. So my spouse and I discussed whether we wanted to be in a full care community or whether we wanted to be at home. And we decided, jointly, that we preferred to be at home.

We needed help sooner than we had thought because, within months, my husband sustained a fall.

ANNOUNCER: Caring for a spouse may mean adjusting to a new normal. And all of the challenges and demands can take their toll on a marriage.

LARRY SOSNOW: The potential pitfalls in caring for a spouse lies in the very relationship that the husband and wife have for each other. If the wife-husband relationship is good to begin with and loving, there's nothing better than being a so-called "support" for the spouse. But if you don't have a good relationship and you find your spouse all of a sudden ill in a chronic terminal illness, you're going to resent caring for your spouse and probably that's where you should have an outside caregiver.

ANNOUNCER: Many health professionals feel caregiving should not fall squarely on the shoulders of a spouse.

LARRY SOSNOW: If the spouse has a chronic illness that's going to progress pretty rapidly, it's wrong for the one spouse to care for the other spouse and not be the mate, not be the wife or the husband and give them the proper social, marital support.

In many cases, the best that you can offer your spouse is to provide outside professional care, to bring in an agent who will provide the care, rather than you doing it yourself.

ANNOUNCER: If financial resources permit hiring outside help, it is important to set the right boundaries in advance so you know what to expect.

CAREGIVER: I think it's very hard to draw lines here between my responsibility, the caregiver's responsibility, and even the housekeepers responsibility, and I've struggled with where do you draw the line.

I think it would be very helpful for the spouse of the patient to get a job description.

I think that there needs to be orientation for the spouse. "This is what you can expect, this is what you can ask for from a caregiver."

ANNOUNCER: And for those who cannot afford outside help, there are several other options.

LARRY SOSNOW: There are many care choices available. In the community, there are many community service agencies that provide help. There are many faith-based programs, so you can start in the pastoral community and ask your minister or rabbi for help. They usually have many sources. There are many volunteer organizations. And there are many organizations that provide paid professional care. There are many sources of help, if you ask around.

ANNOUNCER: But for those who must take on the responsibility themselves, there are guiding principles.

LARRY SOSNOW: The advice that we would give to that spouse in becoming a caregiver is to get help from her pastor, from a confidant, from some type of professional counselor that can just give her some focus and center to the experience of witnessing a spouse in decline, to be able to accept that and, at the same time, provide the necessary care, whatever that care's involved.

CAREGIVER: I have very strong feelings that it would be very helpful to have a spouse support group.

Another piece of advice I would have would be don't sit home all the time. See your friends, see your family, do the activities that you used to do to the best of your ability, but don't stay home without taking care of your own needs.

ANNNOUNCER: Caring for a spouse can be a rich and rewarding experience. But it is also a tremendous responsibility. And it's not something that a spouse should feel obligated to do.

LARRY SOSNOW: It's not preordained that people have to be a family caregiver. That the caregiving process really is a grueling, difficult process. Certainly, it can be loving and have some spiritual side to it, but it's much better if you can experience the process as a child to your parent or as a spouse to your spouse, as opposed to being the caregiver.