The New Old Age Blog: Older People Become What They Think, Study Shows

All of us have beliefs — many of them subconscious, dating back to childhood — about what it means to get older. Psychologists call these “age stereotypes.” And, it turns out, they can have an important effect on seniors’ health.

When stereotypes are negative — when seniors are convinced becoming old means becoming useless, helpless or devalued — they are less likely to seek preventive medical care and die earlier, and more likely to suffer memory loss and poor physical functioning, a growing body of research shows.

When stereotypes are positive — when older adults view age as a time of wisdom, self-realization and satisfaction — results point in the other direction, toward a higher level of functioning. The latest report, in The Journal of the American Medical Association, suggests that seniors with this positive bias are 44 percent more likely to fully recover from a bout of disability.

For people who care about and interact with older people, the message is clear: your attitude counts because it can activate or potentially modify these deeply held age stereotypes.

The researcher who has done more than anyone else to advance our understanding of this is Becca Levy, an associate professor of epidemiology and psychology at Yale University.

In the mid-1990s, she began a series of experiments with older people in laboratory settings. The idea was to expose them subliminally to negative or positive stereotypes by flashing words associated with aging on a computer screen too fast for them to process consciously. Then these seniors were asked to perform a task.

Those exposed to negative words such as “decrepit” had poorer handwriting, slower walking speeds, higher levels of cardiovascular stress and a greater willingness to reject hypothetical medical interventions that could prolong their lives. Those primed with positive words such as “wisdom” did much better.

The experiments involved external stimuli, however, and Dr. Levy was interested in peoples’ subjective experience of older age. For that, she turned to a database of adults age 50 and older in Oxford, Ohio, who were followed for a period of 23 years, from 1975 to 1998.

Many had filled out questionnaires at the start of the study designed to elicit stereotypes about aging. This involved soliciting a “yes” or “no” answer to a series of statements like “things keep getting worse as I get older,” or “as you get older, you get less useful.”

When Dr. Levy looked at 660 participants, she found that those with positive age stereotypes lived 7.5 years longer than those with negative stereotypes. The research was published in The Journal of Personal and Social Psychology in 2002.

What might account for this finding? In her paper, Dr. Levy speculated that people with positive age stereotypes have a stronger will to live, and that this might affect their ability to adapt to the rigors of older age. Also, people with negative age stereotypes may have a heightened cardiovascular response to stress, with attendant ill health effects.

In other research using this data set, Dr. Levy established that people with positive age stereotypes were more likely to eat a balanced diet, exercise, limit their alcohol consumption, stop smoking and get regular physical exams, and that they had a higher level of physical functioning over time. Results were controlled for other factors like illness, gender, race and socioeconomic status.

In these papers, Dr. Levy hypothesized that positive age stereotypes are associated with a greater sense of control and that this enhanced seniors’ sense of self efficacy — their ability to remain captains of their own ship, as it were.

Her new findings about the impact of age stereotypes on older adults’ recovery from disability is an extension of this body of work. In this case, Dr. Levy and her co-authors followed 598 adults age 70 and older in New Haven, Conn., from 1998 to 2008. Disability was defined as needing help with basic activities of daily living like bathing, dressing and walking, and its onset was typically precipitated by an illness or injury.

Again, seniors with positive age stereotypes were much more likely to have good results and recover fully.

Dr. Marie Bernard, a geriatrician who serves as deputy director of the National Institute on Aging, said she found the report “quite intriguing” and that it confirmed her clinical observations in more than 30 years of medical practice. But she cautioned that it is a small study that needs to be replicated.

“What we really need to understand is the mechanism,” she said. “Is it something that is malleable and, if so, could we help people live longer, healthier lives?”

Researchers don’t have an answer to that yet. But many believe that part of the answer has to lie in tackling ageism – which is pervasive in our youth-oriented culture — early on, from earliest childhood.

“Even young kids have negative associations; they tell you that older adults are sick, slow, forgetful, no good,” said Dana Kotter-Gruehn, a visiting assistant professor in the department of psychology and neuroscience at Duke University.

Also generations need to be brought together so that “people can experience what it means to be an older person” and stereotypes can be dispelled, Dr. Kotter-Gruehn said. This has been shown to help change people’s stereotypes about race and homosexuality, she noted.

Closer to home, all of us who interact with older people can “think about how to reinforce the more positive aspects of aging,” Dr. Levy said.

“If all of us became a little more aware of the implications of our communications” — the tone of voice we use with seniors, the attitude we adopt, the use of loaded phrases or expressions, the extent to which we give older adults our full, undivided attention — “that would help quite a lot.”

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Report Blames BBC for ‘Chaos,’ Not Cover-Up, in Scandal

LONDON — A report into the sexual abuse crisis that has shaken the British Broadcasting Corporation was strongly critical on Wednesday of the editorial and management decisions that led to the cancellation of a broadcast last year that would have exposed decades of sexual abuse, some of it on BBC premises, by Jimmy Savile, who had been one of Britain’s best-known television personalities. Mr. Savile died at 84 in October 2011, weeks before the “Newsnight” program was scheduled to be aired.

The 200-page report by Nick Pollard, a former head of the Sky News channel who began his broadcast career as a BBC reporter, traced in detail what it described as “a chain of events that was to prove disastrous for the BBC.” Among other things, he blamed a “rigid management system” that had “proved completely incapable of dealing with” with the crisis that followed the program’s cancellation.

“The efforts to get to the truth behind the Savile story proved beyond the combined efforts of the senior management, legal department, corporate communications team and anyone else for well over a month” after the crisis broke, precipitated by a program earlier this year on ITV, Britain’s leading commercial broadcaster. “Leadership and organization seemed to be in short supply,” the report said.

The report was strongly critical of several news executives who were directly involved in the decision to cancel the Savile expose, including the “Newsnight” editor, Peter Rippon, and the two top executives in the BBC’s news division to whom he reported, Helen Boaden and Stephen Mitchell, all three of whom were suspended from their posts during the nine-week Pollard inquiry.

But it adopted a largely sparing tone in its review of the role played by the broadcaster’s former director general, Mark Thompson, who stepped down after eight years in the job in September and became president and chief executive officer of The New York Times Company last month.

The report’s criticism appeared to be aimed mainly at the broadcaster’s complex management systems, not on the actions — or absence of them — by Mr. Thompson and other top executives who presided over the BBC, its $6 billion annual budget and its 23,000 employees.

Mr. Thompson has said that he was not briefed about the “Newsnight” investigation before its cancellation, was not involved in canceling it, and did not know about the allegations of sexual abuse against Mr. Savile until the report about the cancellation appeared on ITV, a commercial competitor of the BBC.

The Pollard report, examining and quoting from testimony given by Mr. Thompson in London earlier this month, appeared not to directly challenge his account.

At one point, Mr. Pollard reviewed a sequence of events that involved a freelance reporter for The Sunday Times of London e-mailing questions to Mr. Thompson’s corporate address earlier this year seeking access under Britain’s freedom of information law to any communications involving the canceled Savile program between Mr. Thompson, Ms. Boaden and other BBC News executives — a point at which Mr. Thompson’s critics have said he should have learned about the allegations against Mr. Savile that were at the heart of the “Newsnight” investigation.

Mr. Thompson has said that the request was handled by members of his staff who had access to the e-mail account, and that he was not involved in the BBC’s rejection of the reporter’s request, which was referred by his staff to the BBC’s press office. Mr. Pollard accepted the explanation, saying in the report: “Mr. Thompson told me that he had no knowledge of this request. I accept this.”

The report described “a level of chaos and confusion” in the decisions that led to the program’s cancellation in November 2011, and in the events that followed, which culminated in the resignation last month of George Entwistle, who succeeded Mr. Thompson as the broadcaster’s director general in September. Mr. Entwistle quit after less than two months in the job amid the furor that erupted when “Newsnight” broadcast a program that wrongly identified a former politician, Alistair McAlpine, as a pedophile who abused boys at a children’s home in Wales in the 1970s and 1980s.

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Poland Finds It’s Not Immune to Euro Crisis

WARSAW — The Fiat factory in Tychy, Poland, has long been considered one of the most productive auto plants in Europe, often singled out for praise by the Italian company’s demanding chief executive, Sergio Marchionne.

Rafal Klimkiewicz/The New York Times

The assembly line at Fiat's Tychy factory in Poland, shown in 2009. Fiat recently announced layoffs at the factory.

Polish workers “always responded whenever I asked,” Mr. Marchionne said at the Paris Motor Show in October. “I feel an exceptional responsibility to the people there.”

So when Fiat said recently that it would lay off a third of the work force in Tychy, or about 1,500 people, it was a harsh reminder: Even with the healthiest big economy in Europe, Poland cannot escape the Continent’s economic downturn.

Polish growth is expected to slow to as little as 1.5 percent next year, according to World Bank estimates, from 2.1 percent this year. That still compares favorably with the neighboring euro zone, where most countries are either in recession or just barely growing. With a gross domestic product of €369.7 billion in 2011, according to the European data agency Eurostat, Poland ranked ninth among the 27 E.U. countries, just below Belgium and a rung above Austria.

During much of the region’s debt crisis so far, Poland has counted itself fortunate that the troubles began before the country had joined the euro currency union. By being part of the E.U.’s common market, but not bound by euro strictures, Poland has been one of the Continent’s rare economic good-news stories. But the deceleration in Polish growth, which has prompted the central bank to begin a series of interest rate cuts to stimulate the economy, has underscored the country’s exposure to slumping euro zone consumer markets.

The country’s long border with Germany, and its own skilled, low-cost labor force, make Poland an attractive place to make heavy consumer goods like cars and home appliances. General Motors’ Opel unit, suffering from many of the same maladies as Fiat, has a plant in Gliwice, though it has not announced job cuts there. Bosch, Whirlpool and Electrolux all make household appliances in Poland for the European market.

The country’s slowing growth is likely to put pressure on Polish leaders to address some underlying problems, notably an overbearing government bureaucracy.

“Luckily, we are doing quite well so far,” said Jan Krzysztof Bielecki, a former prime minister who now advises the current prime minister, Donald Tusk, on economic issues. Speaking at a recent conference co-convened by the International Herald Tribune in Warsaw, Mr. Bielecki added, “We still have some space for improvement.”

Yet, despite the economy’s slowing velocity, Warsaw remains a fount of optimism, with ambitions to be a regional financial center. The city somehow manages to seem cheerful, even with its legacy of drab Soviet-era architecture.

In downtown Warsaw recently, as a light snow fell, skaters pirouetted at a temporary ice rink set up in the shadow of the Palace of Culture and Science, a monstrous high-rise building built by order of Josef Stalin in the 1950s.

“I really believe Warsaw is becoming the capital of Central and Eastern Europe,” said Hanna Gronkiewicz-Waltz, mayor of the city. “In these difficult times Warsaw offers not only dynamics but stability.”

Although Vienna emerged as the gateway to Eastern Europe after the end of the Cold War, Warsaw has since surpassed it by some measures — like trading volume at the stock exchange.

And economic success has translated into political prestige. When European leaders accepted the Nobel Peace Prize on Dec. 10, Mr. Tusk, the prime minister, sat next to Chancellor Angela Merkel of Germany, the most powerful leader in Europe.

Poland remains a source of profit for companies in Western Europe that badly need them. “For us it’s really a bright spot in the European market,” said Anna Wiosna, manager of strategy development for the Polish unit of Hochtief, a German construction company that has upgraded Warsaw Chopin Airport, among other large projects.

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The New Old Age Blog: In the Middle: Helping Unhappy Couples

A post on Monday discussed the forces that can make an older couple’s good marriage suddenly go bad — an array of subtle, and often-misunderstood, mental, physical and emotional factors that can upset the equilibrium of even the happiest marriages.

Now we have consulted marriage counselors and geriatricians to find out what caregivers — either the grown children of the couple, or one of the spouses involved– can do to help restore peace and balance to these relationships. The experts consulted uniformly agreed that even older people can at least take steps to reduce tensions and improve their relationship, even if they cannot actually change. (Really, who can, at any age?)

“Even though the situation may seem overwhelming, take heart,” said Dr. Gordon Herz, a psychologist in private practice in Madison, Wisc., who specializes in neuropsychology and rehabilitation psychology. “Couples who have been together for 60 years tend to have worked out ways to manage conflict – or they wouldn’t still be together.”

Retreat to a neutral corner

When grown children see their parents fight, many want to run and hide. But those who are assuming an increased caregiving role often feel impelled to jump in and “fix” the problem, as they do with the other caregiving issues.

If you are so inclined, experts speak with one loud voice to advise: Don’t!

Trying to act as emotional broker between your parents can backfire. (Now they tell me! Suffice it to say that after one such effort my sister said to me in not exactly the friendliest tone, “Well, that went well, didn’t it?”)

“It’s better if your parents can find somebody else to talk to than you,” said Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and the author of “Overwhelmed: Coping With Life’s Ups and Downs.”

Don’t give up on marital therapy

“Marital therapy for individuals over 65 years of age is difficult, since habits of a lifetime are deeply ingrained,” stated a study in The Canadian Journal of Medicine, one of the few in the medical literature about marital therapy among older people.

“Yet, in a sense, marital therapy is more crucial for the elderly than for younger patients,” the study continued. “At a time when they are least adaptable and most vulnerable to stress and are entering perhaps the most difficult period of their lives, the elderly must learn new methods of relating and coping” because of the physical and mental changes described in our earlier post.

There’s another reason learning to cope with life changes as a couple is even more critical for older couples: Unlike younger couples, the elderly are rarely in a position to leave the marriage and start over.

Help at least one spouse get counseling

What if only half the couple is ready to seek counseling? Not a problem, therapists said. “You want to help the part of the couple that is suffering,” said Dr. Elaine Rodino, a therapist in private practice in State College, Penn. “The other person may still be the curmudgeon, but I think of it as the law of physics: When you change one aspect of the formula, things change in the total.”

When dementia affects one of the spouses, therapy can help the caregiving spouse learn coping techniques, “which can reduce the marital discord and stress that can make conditions, especially cognitive difficulties, worse,” said Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine.

Consider the general practitioner or internist

If the couple won’t see a marriage counselor or therapist, can a family doctor be of any use? The experts had mixed responses.

Many pointed out that general practitioners have neither the time nor the training to offer much relationship help, unless the origin of the problem is exclusively physical. Others thought they could be of use, if given a little direction from the family.

“I encourage the kids to talk to the doctor in advance and let him know something is going on – signs of depression or other problems the parents won’t talk about,” advised Dr. Dale, adding that a consultation with a geriatrician who is more familiar with problems of the aging might be even more productive. “Then the doctor can say, ‘Gee, you sound really frustrated or down — are there any reasons we can explore?’”

Don’t overlook the importance of intimacy

“Mutually stimulating sexual relationships need care and feeding by both partners at any age, but especially in the geriatric years,” according to a study on marital therapy for the elderly. “The need for physical contact, warmth and touching perhaps reaches a peak in this age of loneliness, decreased self-esteem and poor health.”

Forget the idea that elderly couples are too shy to talk about intimacy, insisted Dr. Rodino. “I saw a couple in their 80s, the husband was getting penile injections at the doctor’s office, and then they hurried home to have sex.”

But Dr. Rodino does concede that for older patients it is especially important to focus not only on sexual function and performance, but on “touching, and non-intercourse sexual relations; I help them rekindle the affection and emotional closeness,” Dr. Rodino said.

Address any neuropsychological issues.

To find out whether the sudden marital conflict may stem from early mental cognitive impairment (M.C.I.) —or to rule M.C.I. out and find the real source of trouble — make sure the spouse obtains a full neuropsychological evaluation. If it is M.C.I., “it convinces everybody that there is more than just abstinence, it’s not a personality problem — and they need to address it,” said Dr. Dale.

Don’t overlook simple solutions

“Sometimes a memory problem is something simple, like low Vitamin B12, that is easily fixed,” said Dr. Dale. “Or hypothyroidism, which is quite common, can affect memory.”

In that case, doctors administer synthroid, a thyroid hormone replacement that Dr. Dale said is “very safe, with almost no side effects.” Other changes in behavior can also be the result of a simple problem or be remedied by a change in medication. Don’t assume the worst.

Put an end to the blame game

Help reframe the problem. “Even if dementia is involved, let them know it’s not that their partner hates them, it’s that he is having cognitive changes,” said Dr. Linda Waite, director of the Center on Demography and Economics of Aging at NORC/University of Chicago.

“When you re-frame it like that, it’s easier for the spouse not to take it personally and not blame themselves and feel it’s something they did,” said Dr. Waite. “It can make a difference.”

A 2009 study in the journal Gerontologist supports this notion: “Care partners likely would benefit from strategies aimed at reducing self-blame, enhancing coping skills … and communicating effectively with the person with M.C.I and significant others.”

Separate the anxiety

Divide and conquer — time away improves time together.

“Older couples, especially those with disabilities, spend way too much time together,” said Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program. “It would be a problem for any couple.”

Caregivers can best help by arranging for an activity or outing that each spouse can do separately so they can return to each other refreshed and more cheerful. “That can help a lot,” said Dr. Gwyther.

Dial down the tone

For spouse caregivers, it is important to watch not just what is said, but how it is said. In any relationship, tone influences our interpretation of what our partner says. Those with M.C.I. will especially react to tone, rather than the substance of the exchange, Dr. Dale said.

“Ratchet down the emotions, repeat things calmly,” Dr. Dale said. The person with cognitive problems doesn’t know he asked the same question five times — he only knows that you sound angry at him for no reason he can fathom. One spouse’s anger fuels the other’s, and pretty soon there is a fight or withdrawal.

Zero tolerance for violence

If a spouse becomes violent, “that’s an entirely different issue,” said Dr. Schlossberg. “Call in an expert on family violence” or the police.

Help them help others

Nobody likes feeling dependent and having to ask for help. Finding a way to have your loved one volunteer, help others and continue to feel useful can improve moods and marital interactions – even if M.C.I. is involved.

With one couple Dr. Gwyther saw, the wife was not only “driving her husband nuts because she was asking him the same questions over and over,” but she could no longer drive and deliver food in a mobile meals program as she used to. “So her husband agreed to be the driver — and she took the meals to the doors,” Dr. Gwyther recalled.”It made her feel good to continue to do that — and it made them feel good to do it together.”

Caregiver, heal thyself

You have heard it a million times here and elsewhere but, unlike us, this advice never gets old.

If you are exhausted from caregiving, you are bound to be cranky, and that will make everybody around you edgy and irritable, too — especially the spouse who requires your care. Taking the time to look after your own health and engage in activities that bring you pleasure can go a long way toward reducing stress and reestablishing a peaceful balance in a marriage.

How have you coped with tensions in your marriage — or in your elderly parents’ marriage, as you care for them in their old age? Share in the comments below.

Read More..

The New Old Age Blog: In the Middle: Helping Unhappy Couples

A post on Monday discussed the forces that can make an older couple’s good marriage suddenly go bad — an array of subtle, and often-misunderstood, mental, physical and emotional factors that can upset the equilibrium of even the happiest marriages.

Now we have consulted marriage counselors and geriatricians to find out what caregivers — either the grown children of the couple, or one of the spouses involved– can do to help restore peace and balance to these relationships. The experts consulted uniformly agreed that even older people can at least take steps to reduce tensions and improve their relationship, even if they cannot actually change. (Really, who can, at any age?)

“Even though the situation may seem overwhelming, take heart,” said Dr. Gordon Herz, a psychologist in private practice in Madison, Wisc., who specializes in neuropsychology and rehabilitation psychology. “Couples who have been together for 60 years tend to have worked out ways to manage conflict – or they wouldn’t still be together.”

Retreat to a neutral corner

When grown children see their parents fight, many want to run and hide. But those who are assuming an increased caregiving role often feel impelled to jump in and “fix” the problem, as they do with the other caregiving issues.

If you are so inclined, experts speak with one loud voice to advise: Don’t!

Trying to act as emotional broker between your parents can backfire. (Now they tell me! Suffice it to say that after one such effort my sister said to me in not exactly the friendliest tone, “Well, that went well, didn’t it?”)

“It’s better if your parents can find somebody else to talk to than you,” said Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and the author of “Overwhelmed: Coping With Life’s Ups and Downs.”

Don’t give up on marital therapy

“Marital therapy for individuals over 65 years of age is difficult, since habits of a lifetime are deeply ingrained,” stated a study in The Canadian Journal of Medicine, one of the few in the medical literature about marital therapy among older people.

“Yet, in a sense, marital therapy is more crucial for the elderly than for younger patients,” the study continued. “At a time when they are least adaptable and most vulnerable to stress and are entering perhaps the most difficult period of their lives, the elderly must learn new methods of relating and coping” because of the physical and mental changes described in our earlier post.

There’s another reason learning to cope with life changes as a couple is even more critical for older couples: Unlike younger couples, the elderly are rarely in a position to leave the marriage and start over.

Help at least one spouse get counseling

What if only half the couple is ready to seek counseling? Not a problem, therapists said. “You want to help the part of the couple that is suffering,” said Dr. Elaine Rodino, a therapist in private practice in State College, Penn. “The other person may still be the curmudgeon, but I think of it as the law of physics: When you change one aspect of the formula, things change in the total.”

When dementia affects one of the spouses, therapy can help the caregiving spouse learn coping techniques, “which can reduce the marital discord and stress that can make conditions, especially cognitive difficulties, worse,” said Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine.

Consider the general practitioner or internist

If the couple won’t see a marriage counselor or therapist, can a family doctor be of any use? The experts had mixed responses.

Many pointed out that general practitioners have neither the time nor the training to offer much relationship help, unless the origin of the problem is exclusively physical. Others thought they could be of use, if given a little direction from the family.

“I encourage the kids to talk to the doctor in advance and let him know something is going on – signs of depression or other problems the parents won’t talk about,” advised Dr. Dale, adding that a consultation with a geriatrician who is more familiar with problems of the aging might be even more productive. “Then the doctor can say, ‘Gee, you sound really frustrated or down — are there any reasons we can explore?’”

Don’t overlook the importance of intimacy

“Mutually stimulating sexual relationships need care and feeding by both partners at any age, but especially in the geriatric years,” according to a study on marital therapy for the elderly. “The need for physical contact, warmth and touching perhaps reaches a peak in this age of loneliness, decreased self-esteem and poor health.”

Forget the idea that elderly couples are too shy to talk about intimacy, insisted Dr. Rodino. “I saw a couple in their 80s, the husband was getting penile injections at the doctor’s office, and then they hurried home to have sex.”

But Dr. Rodino does concede that for older patients it is especially important to focus not only on sexual function and performance, but on “touching, and non-intercourse sexual relations; I help them rekindle the affection and emotional closeness,” Dr. Rodino said.

Address any neuropsychological issues.

To find out whether the sudden marital conflict may stem from early mental cognitive impairment (M.C.I.) —or to rule M.C.I. out and find the real source of trouble — make sure the spouse obtains a full neuropsychological evaluation. If it is M.C.I., “it convinces everybody that there is more than just abstinence, it’s not a personality problem — and they need to address it,” said Dr. Dale.

Don’t overlook simple solutions

“Sometimes a memory problem is something simple, like low Vitamin B12, that is easily fixed,” said Dr. Dale. “Or hypothyroidism, which is quite common, can affect memory.”

In that case, doctors administer synthroid, a thyroid hormone replacement that Dr. Dale said is “very safe, with almost no side effects.” Other changes in behavior can also be the result of a simple problem or be remedied by a change in medication. Don’t assume the worst.

Put an end to the blame game

Help reframe the problem. “Even if dementia is involved, let them know it’s not that their partner hates them, it’s that he is having cognitive changes,” said Dr. Linda Waite, director of the Center on Demography and Economics of Aging at NORC/University of Chicago.

“When you re-frame it like that, it’s easier for the spouse not to take it personally and not blame themselves and feel it’s something they did,” said Dr. Waite. “It can make a difference.”

A 2009 study in the journal Gerontologist supports this notion: “Care partners likely would benefit from strategies aimed at reducing self-blame, enhancing coping skills … and communicating effectively with the person with M.C.I and significant others.”

Separate the anxiety

Divide and conquer — time away improves time together.

“Older couples, especially those with disabilities, spend way too much time together,” said Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program. “It would be a problem for any couple.”

Caregivers can best help by arranging for an activity or outing that each spouse can do separately so they can return to each other refreshed and more cheerful. “That can help a lot,” said Dr. Gwyther.

Dial down the tone

For spouse caregivers, it is important to watch not just what is said, but how it is said. In any relationship, tone influences our interpretation of what our partner says. Those with M.C.I. will especially react to tone, rather than the substance of the exchange, Dr. Dale said.

“Ratchet down the emotions, repeat things calmly,” Dr. Dale said. The person with cognitive problems doesn’t know he asked the same question five times — he only knows that you sound angry at him for no reason he can fathom. One spouse’s anger fuels the other’s, and pretty soon there is a fight or withdrawal.

Zero tolerance for violence

If a spouse becomes violent, “that’s an entirely different issue,” said Dr. Schlossberg. “Call in an expert on family violence” or the police.

Help them help others

Nobody likes feeling dependent and having to ask for help. Finding a way to have your loved one volunteer, help others and continue to feel useful can improve moods and marital interactions – even if M.C.I. is involved.

With one couple Dr. Gwyther saw, the wife was not only “driving her husband nuts because she was asking him the same questions over and over,” but she could no longer drive and deliver food in a mobile meals program as she used to. “So her husband agreed to be the driver — and she took the meals to the doors,” Dr. Gwyther recalled.”It made her feel good to continue to do that — and it made them feel good to do it together.”

Caregiver, heal thyself

You have heard it a million times here and elsewhere but, unlike us, this advice never gets old.

If you are exhausted from caregiving, you are bound to be cranky, and that will make everybody around you edgy and irritable, too — especially the spouse who requires your care. Taking the time to look after your own health and engage in activities that bring you pleasure can go a long way toward reducing stress and reestablishing a peaceful balance in a marriage.

How have you coped with tensions in your marriage — or in your elderly parents’ marriage, as you care for them in their old age? Share in the comments below.

Read More..

Bits Blog: What Instagram's New Terms of Service Mean for You

Instagram released an updated version of its privacy policy and terms of service on Monday, and they include lengthy stipulations on how photographs uploaded by users may be used by Instagram and its parent company, Facebook.

The changes, which will go into effect Jan. 16, will not apply to pictures shared before that date.

Facebook and Instagram have both hinted at plans to incorporate advertisements into Instagram’s application, although they have declined to provide details about how and when ads would be deployed. These freshly drafted terms give the first glimpse of what the companies might have planned. Here’s a quick rundown of what the new terms, the most significant changes in Instagram’s short history, could mean for users.

1. Instagram can share information about its users with Facebook, its parent company, as well as outside affiliates and advertisers.
Instagram said that the changes to its privacy policy are a means to help Instagram “function more easily as part of Facebook by being able to share info between the two groups.” The potentially lucrative move will let advertisers in Facebook’s ad network use data and information that users have shared on Instagram, like details about favorite places, bands, restaurants or hobbies, to better target ads at those users.

2. You could star in an advertisement — without your knowledge.
A section of the new terms of service, titled “Rights,” notes that Instagram will also be able to use your photographs and identity in advertisements. “You agree that a business or other entity may pay us to display your username, likeness, photos (along with any associated metadata), and/or actions you take, in connection with paid or sponsored content or promotions, without any compensation to you,” the new terms say. This means that photographs uploaded to Instagram could end up in an advertisement on the service or on Facebook. In addition, someone who doesn’t use Instagram could end up in an advertisement if they have their photograph snapped and shared on the service by a friend. Facebook already runs ads that make use of people’s activity on its site.

Marc Rotenberg, executive director of the Electronic Privacy Information Center, an advocacy group in Washington, said that the use of a person’s likeness in ads could run into some state laws protecting people’s privacy.

“Most states have laws that limit the use of a person’s ‘name or likeness’ for commercial purposes without consent,” Mr. Rotenberg said. “The legal purpose is to allow people to obtain the commercial value of their images and endorsements, which is a big issue for celebrities and others, but also a reasonable concern for Facebook users whose images are used by Facebook to encourage friends to buy products and services.”

3. Underage users are not exempt.
Athough Instagram says people must be at least 13 years old to sign up for the service, the new terms note that if a teenager signs up, they are agreeing that a parent or guardian is aware that their image, username and photos can also be used in ads.

4. Ads may not be labeled as ads.
In another section of the updated terms, the company says ads will not necessarily be labeled as ads. “You acknowledge that we may not always identify paid services, sponsored content, or commercial communications as such,” the company wrote.

5. Want to opt out? Delete your account.
The only way to opt out of the new Instagram terms is to not use the service. If you log into Instagram in any way, including through the Web site, mobile applications or any other services offered by Instagram, you agree to have your content used in ads. Instagram’s new terms of service say that “by accessing or using the Instagram website, the Instagram service, or any applications (including mobile applications) made available by Instagram (together, the “Service”), however accessed, you agree to be bound by these terms of use.”

Instagram addressed the changes on its company blog, saying that “nothing has changed about your photos’ ownership or who can see them.” In its blog post, Instagram said the changes would primarily help the company combat spam, which has plagued the application as it has swelled in popularity.

“Our updated terms of service help protect you, and prevent spam and abuse as we grow,” the company wrote.

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Poland Finds It’s Not Immune to Euro Crisis

WARSAW — The Fiat factory in Tychy, Poland, has long been considered one of the most productive auto plants in Europe, often singled out for praise by the Italian company’s demanding chief executive, Sergio Marchionne.

Rafal Klimkiewicz/The New York Times

The assembly line at Fiat's Tychy factory in Poland, shown in 2009. Fiat recently announced layoffs at the factory.

Polish workers “always responded whenever I asked,” Mr. Marchionne said at the Paris Motor Show in October. “I feel an exceptional responsibility to the people there.”

So when Fiat said recently that it would lay off a third of the work force in Tychy, or about 1,500 people, it was a harsh reminder: Even with the healthiest big economy in Europe, Poland cannot escape the Continent’s economic downturn.

Polish growth is expected to slow to as little as 1.5 percent next year, according to World Bank estimates, from 2.1 percent this year. That still compares favorably with the neighboring euro zone, where most countries are either in recession or just barely growing. With a gross domestic product of €369.7 billion in 2011, according to the European data agency Eurostat, Poland ranked ninth among the 27 E.U. countries, just below Belgium and a rung above Austria.

During much of the region’s debt crisis so far, Poland has counted itself fortunate that the troubles began before the country had joined the euro currency union. By being part of the E.U.’s common market, but not bound by euro strictures, Poland has been one of the Continent’s rare economic good-news stories. But the deceleration in Polish growth, which has prompted the central bank to begin a series of interest rate cuts to stimulate the economy, has underscored the country’s exposure to slumping euro zone consumer markets.

The country’s long border with Germany, and its own skilled, low-cost labor force, make Poland an attractive place to make heavy consumer goods like cars and home appliances. General Motors’ Opel unit, suffering from many of the same maladies as Fiat, has a plant in Gliwice, though it has not announced job cuts there. Bosch, Whirlpool and Electrolux all make household appliances in Poland for the European market.

The country’s slowing growth is likely to put pressure on Polish leaders to address some underlying problems, notably an overbearing government bureaucracy.

“Luckily, we are doing quite well so far,” said Jan Krzysztof Bielecki, a former prime minister who now advises the current prime minister, Donald Tusk, on economic issues. Speaking at a recent conference co-convened by the International Herald Tribune in Warsaw, Mr. Bielecki added, “We still have some space for improvement.”

Yet, despite the economy’s slowing velocity, Warsaw remains a fount of optimism, with ambitions to be a regional financial center. The city somehow manages to seem cheerful, even with its legacy of drab Soviet-era architecture.

In downtown Warsaw recently, as a light snow fell, skaters pirouetted at a temporary ice rink set up in the shadow of the Palace of Culture and Science, a monstrous high-rise building built by order of Josef Stalin in the 1950s.

“I really believe Warsaw is becoming the capital of Central and Eastern Europe,” said Hanna Gronkiewicz-Waltz, mayor of the city. “In these difficult times Warsaw offers not only dynamics but stability.”

Although Vienna emerged as the gateway to Eastern Europe after the end of the Cold War, Warsaw has since surpassed it by some measures — like trading volume at the stock exchange.

And economic success has translated into political prestige. When European leaders accepted the Nobel Peace Prize on Dec. 10, Mr. Tusk, the prime minister, sat next to Chancellor Angela Merkel of Germany, the most powerful leader in Europe.

Poland remains a source of profit for companies in Western Europe that badly need them. “For us it’s really a bright spot in the European market,” said Anna Wiosna, manager of strategy development for the Polish unit of Hochtief, a German construction company that has upgraded Warsaw Chopin Airport, among other large projects.

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DealBook: Sprint Reaches Deal to Buy Out Clearwire

Sprint announced on Monday that it had reached an agreement to buy the nearly 50 percent stake in Clearwire that it does not already own for $2.97 a share — a bump up from the $2.90 a share that was offered on Thursday.

The improved $2.2 billion offer, Sprint said, represents a premium of 128 percent over Clearwire’s stock price in early October before speculation emerged — following SoftBank‘s investment in Sprint — that Sprint would seek to buy out the wireless network operator.

Sprint already owns 51.7 percent of Clearwire. Buying the rest would give it full control over spectrum that it could use to build out its network.

Sprint is able to do the deal thanks to cash from SoftBank of Japan, which agreed in October to a $20.1 billion transaction to gain majority control of the American telecommunications company, which lags far behind the market leaders, AT&T and Verizon Wireless.

The deal would allow Sprint to expand its Long-Term Evolution network, which is based upon the same data standard used by the newest generation of smartphones. Clearwire owns spectrum that is similar to what SoftBank uses in Japan, potentially giving the newly strengthened Sprint more clout in ordering the latest devices.

The chief executive of Sprint, Dan Hesse, said in a statement: “Today’s transaction marks yet another significant step in Sprint’s improved competitive position and ability to offer customers better products, more choices and better services. Sprint is uniquely positioned to maximize the value of Clearwire’s spectrum and efficiently deploy it to increase Sprint’s network capacity.”

Clearwire’s board approved the offer based on the recommendation of a special committee of directors not appointed by Sprint. Clearwire also has commitments from Comcast, Intel Corp and Bright House Networks, who collectively own 13 percent of the voting shares, to support the deal.

Some of Clearwire’s minority shareholders believed that the company should hold out for a higher price, with one analyst calling for at least $5 a share. One of these investors, Crest Financial, said that it would try to block Sprint’s deal with Softbank if the earlier offer of $2.90 a share went through.

And another, Mount Kellett, had argued that based on what AT&T paid for roughly similar spectrum, Sprint should be paying at least four times as much.

But Sprint argued privately that its previous bid valued the network operator’s spectrum at about the same level that Verizon paid for spectrum that it acquired from cable companies, according to a person briefed on the matter. And Clearwire’s spectrum, Sprint claimed, is less clean and therefore less valuable, meaning that the company was effectively paying more than Verizon did.

Clearwire has struggled to to join the ranks of the biggest American cellphone service providers, despite bringing on big-name investors. Some of its previous stakeholders, including Google and Time Warner Cable, chose to sell off their holdings for a fraction of their purchase prices.

Agreeing to the deal announced Monday will help shore up Clearwire’s finances, at a time when it projected having enough cash to last a year or so and still faces significant debt obligations. Sprint has pledged to provide up to $800 million in interim financing to the network operator.

Citigroup and the law firms of Skadden, Arps, Slate, Meagher & Flom and King & Spalding advised Sprint. The Raine Group acted as financial adviser to SoftBank and Morrison Foerster acted as counsel to SoftBank.

Evercore Partners and the law firm Kirkland & Ellisa advised Clearwire. Centerview Partners acted as financial adviser and Simpson Thacher & Bartlett and Richards, Layton & Finger acted as counsel to Clearwire’s special committee. Blackstone Advisory Partners advised Clearwire on restructuring matters. Credit Suisse acted as financial adviser and Gibson Dunn & Crutcher acted as counsel to Intel.

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The New Old Age Blog: In the Middle: Why Elderly Couples Fight

George and Gracie (let’s call them that because using their real names would make them even unhappier than they already appear to be) are in their 80s and married for more than 65 years. Until recently they seemed to ride the waves that are inevitable in any marriage that spans nearly seven decades; through good and bad, they were partners and best friends.

But lately — ever since her hospitalization and his fall — they have been arguing more bitterly than usual (“Do you have to make such a mess in the kitchen?”), criticizing each other (“Why haven’t you dealt with the insurance company yet?”), withdrawing from each other, and generally making each other more miserable, more often than ever before.

This kind of degenerative relationship is not uncommon among the elderly in even the happiest marriages, marriage therapists and geriatricians said. But that is small comfort to either the couple in the middle of the maelstrom, or the children who care for them, as evidenced by a number postings on caregiver blogs. As some of the children have wondered there: “Why can’t we all just get along?”

Therapists and others who work with the elderly said the first step to addressing the problem is understanding where it came from.

“A key question is whether the marital bickering is part of a lifelong marital style or a change,” said Dr. Linda Waite, director of the Center on Aging at NORC/University of Chicago. Is it new behavior – or just new to the grown children who are suddenly so deeply enmeshed in their parents’ lives that they are only now noticing that something is amiss?

How much of the problem is really just the marriage style? “Some couples like to fight and argue – it keeps their adrenaline going,” said Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and author of “Overwhelmed: Coping with Life’s Ups and Downs.”

Sometimes the best judges of whether there is a problem are outsiders, said Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine. Pay attention if someone says, “‘Gee, Mom seems more argumentative or withdrawn than the last time I saw her,’” Dr. Dale advised.

If the tone or severity of the marital tensions seem new, then it is important to find out why. The causes could be mental or physical, doctors say.

On the mental front, increased anger and fighting could be one of the first signs of mild cognitive impairment, a precursor of dementia or Alzheimer’s, in one or both of the spouses, said Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program and Associate Professor in the Department of Psychiatry and Behavioral Sciences.

Dr. Dale concurs: “There is good evidence that the earliest signs of cognitive impairment are often emotional changes” — anger, anxiety, depression — “rather than cognitive ones” — memory, abstract thought.

But these early signs of cognitive decline can be so subtle that neither the spouses themselves, or their grown children, recognize them for what they are, Dr. Gwyther said. So husband and wife blame each other for the changes and allow feelings of hurt and resentment to grow.

Withdrawing from activities that used to give them pleasure can be a telltale sign of mild cognitive impairment – and can trigger anger and arguments.

“In one couple, the husband just didn’t want to participate in the holidays — the wife got angry and said he was being lazy and stubborn,” said Dr. Gwyther. But the truth was that his cognitive decline made all the activity overwhelming, and he didn’t want anyone to know that he was anxious about not remembering everyone’s names and embarrassing himself.

Suspicion and paranoia can also accompany mild cognitive decline and precipitate distrust and hurtful accusations. Dr. Gwyther recalled another woman who “called her daughter frantic because she said her husband dropped her at her chemo appointment, went to park the car, and didn’t return to get her.” The woman couldn’t imagine that her husband could possibly have lost his sense of time and direction, Dr. Gwyther added. She took it personally, complaining to her daughter that “your father doesn’t seem to care any more.”

Dr. Dale told of a spouse who accused her mate of infidelity because “she was convinced that when he was out grocery shopping he was really having an affair.”

Hoarding, an early symptom of mild cognitive impairment, can also create tension in a marriage. (For new treatments, see this recent post by my colleague Paula Span.)

When one couple came to a counseling session with Dr. Norman Abeles, emeritus professor of psychology and former director of psychological clinic at Michigan State University, the hoarding spouse finally said, “she did it because she thought that they would run out of money, even though there was enough money to go around.” Dr. Abeles said that incident led to her diagnosis of mild cognitive impairment.

Adding to the confusion, mild cognitive impairment (M.C.I.) comes and goes. “There are good days and bad days, good hours and bad hours,” said Dr. Gwyther. “Alzheimer’s and dementia don’t start on Tuesday — it’s a slow insidious onset.” But the diagnosis is becoming more common: The Institute for Dementia Research and Prevention predicts that 1 in 6 women, and 1 in 10 men, who live past the age of 55 will develop dementia in their lifetime.

“Spouses find it difficult to know when their partner with M.C.I. is acting differently (usually badly) due to the advancing illness or due to ‘willful’ personality issues,” said Dr. Dale, citing a 2007 study in the journal Family Relations exploring the problems this can create for couples.

Blaming is often easier than understanding. Another of Dr. Gwyther’s patients was furious at her husband for not filing their taxes. “He’s a C.P.A.,” she said. “How could we owe back taxes?” It did not occur to her that he might be unable to handle that task — and was too frightened about his deteriorating mental focus to let her know.

But as harmful as mental decline can be for a marriage, it is just part of the equation. Physical ailments – even those that seem completely unrelated to marital relations – “can upset the equilibrium of the marriage,” according to a study in the Canadian Medical Association Journal.

“Most men get angry at what’s happened to them when they get ill, women get angry and scared when he’s not what he used to be — so they fight,” said Dr. Schlossberg.

Chronic illnesses, like diabetes, arthritis and heart disease, can have a strong negative effect on mood, said Dr. Waite, who will soon be publishing a study on the subject. Diabetes is so often accompanied by depression that, Dr. Waite said, “one of my colleagues argues that that it is even part of the disease.”

And ailments can have an effect on a couple’s sex life — which can compound the marital problems, doctors said.

“Diabetes brings on neuropathy,” said Dr. Waite. “That means touching and feeling in sex is not as rewarding.” Without the pleasures of affectionate touching — whether a passing hug at the sink, or more — tensions can build. That’s why, if a couple is having problems with sex, they are more likely to have problems in the relationship — and vice versa, according to a 2007 New England Journal of Medicine study of sex and health among older adults.

Other changes in circumstances — retirement, shifting roles, the loss of autonomy, disparities in health and abilities — can wreak havoc. Losing independence can feel like losing oneself — and if you don’t know who you are any more, how can you know how to relate to your spouse?

“Fighting may come from a misguided notion that you can regain power by asserting it over your spouse,” said Dr. Schlossberg, whose observations are echoed in a 1984 study in the Canadian Journal of Medicine. “It doesn’t work, it’s false power – but they’ll try anything.”

The sheer exhaustion that can come from being the caregiving spouse is also bound to “make them stressed and angry,” said Dr. Waite. Not to mention guilty and resentful — never a prescription for happy marital relations.

“Part of the trap for the caregiver is the idea that you have to do it all, and the guilt you feel when you cannot live up to it,” said Dr. Gordon Herz, a psychologist in private practice in Madison, Wisc. Not surprisingly, resentment can soon follow, Dr. Herz added, because it’s hard to admit to anyone that, “‘this is too much for me.’”

What can outside caregivers — children or other loved ones — do about these golden marriages on the rocks? Should they intervene — or butt out? And can marital therapy help — or is it too late to change?

Share your thoughts and experiences — and tomorrow we’ll try to provide some advice from experts.

Read More..

The New Old Age Blog: In the Middle: Why Elderly Couples Fight

George and Gracie (let’s call them that because using their real names would make them even unhappier than they already appear to be) are in their 80s and married for more than 65 years. Until recently they seemed to ride the waves that are inevitable in any marriage that spans nearly seven decades; through good and bad, they were partners and best friends.

But lately — ever since her hospitalization and his fall — they have been arguing more bitterly than usual (“Do you have to make such a mess in the kitchen?”), criticizing each other (“Why haven’t you dealt with the insurance company yet?”), withdrawing from each other, and generally making each other more miserable, more often than ever before.

This kind of degenerative relationship is not uncommon among the elderly in even the happiest marriages, marriage therapists and geriatricians said. But that is small comfort to either the couple in the middle of the maelstrom, or the children who care for them, as evidenced by a number postings on caregiver blogs. As some of the children have wondered there: “Why can’t we all just get along?”

Therapists and others who work with the elderly said the first step to addressing the problem is understanding where it came from.

“A key question is whether the marital bickering is part of a lifelong marital style or a change,” said Dr. Linda Waite, director of the Center on Aging at NORC/University of Chicago. Is it new behavior – or just new to the grown children who are suddenly so deeply enmeshed in their parents’ lives that they are only now noticing that something is amiss?

How much of the problem is really just the marriage style? “Some couples like to fight and argue – it keeps their adrenaline going,” said Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and author of “Overwhelmed: Coping with Life’s Ups and Downs.”

Sometimes the best judges of whether there is a problem are outsiders, said Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine. Pay attention if someone says, “‘Gee, Mom seems more argumentative or withdrawn than the last time I saw her,’” Dr. Dale advised.

If the tone or severity of the marital tensions seem new, then it is important to find out why. The causes could be mental or physical, doctors say.

On the mental front, increased anger and fighting could be one of the first signs of mild cognitive impairment, a precursor of dementia or Alzheimer’s, in one or both of the spouses, said Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program and Associate Professor in the Department of Psychiatry and Behavioral Sciences.

Dr. Dale concurs: “There is good evidence that the earliest signs of cognitive impairment are often emotional changes” — anger, anxiety, depression — “rather than cognitive ones” — memory, abstract thought.

But these early signs of cognitive decline can be so subtle that neither the spouses themselves, or their grown children, recognize them for what they are, Dr. Gwyther said. So husband and wife blame each other for the changes and allow feelings of hurt and resentment to grow.

Withdrawing from activities that used to give them pleasure can be a telltale sign of mild cognitive impairment – and can trigger anger and arguments.

“In one couple, the husband just didn’t want to participate in the holidays — the wife got angry and said he was being lazy and stubborn,” said Dr. Gwyther. But the truth was that his cognitive decline made all the activity overwhelming, and he didn’t want anyone to know that he was anxious about not remembering everyone’s names and embarrassing himself.

Suspicion and paranoia can also accompany mild cognitive decline and precipitate distrust and hurtful accusations. Dr. Gwyther recalled another woman who “called her daughter frantic because she said her husband dropped her at her chemo appointment, went to park the car, and didn’t return to get her.” The woman couldn’t imagine that her husband could possibly have lost his sense of time and direction, Dr. Gwyther added. She took it personally, complaining to her daughter that “your father doesn’t seem to care any more.”

Dr. Dale told of a spouse who accused her mate of infidelity because “she was convinced that when he was out grocery shopping he was really having an affair.”

Hoarding, an early symptom of mild cognitive impairment, can also create tension in a marriage. (For new treatments, see this recent post by my colleague Paula Span.)

When one couple came to a counseling session with Dr. Norman Abeles, emeritus professor of psychology and former director of psychological clinic at Michigan State University, the hoarding spouse finally said, “she did it because she thought that they would run out of money, even though there was enough money to go around.” Dr. Abeles said that incident led to her diagnosis of mild cognitive impairment.

Adding to the confusion, mild cognitive impairment (M.C.I.) comes and goes. “There are good days and bad days, good hours and bad hours,” said Dr. Gwyther. “Alzheimer’s and dementia don’t start on Tuesday — it’s a slow insidious onset.” But the diagnosis is becoming more common: The Institute for Dementia Research and Prevention predicts that 1 in 6 women, and 1 in 10 men, who live past the age of 55 will develop dementia in their lifetime.

“Spouses find it difficult to know when their partner with M.C.I. is acting differently (usually badly) due to the advancing illness or due to ‘willful’ personality issues,” said Dr. Dale, citing a 2007 study in the journal Family Relations exploring the problems this can create for couples.

Blaming is often easier than understanding. Another of Dr. Gwyther’s patients was furious at her husband for not filing their taxes. “He’s a C.P.A.,” she said. “How could we owe back taxes?” It did not occur to her that he might be unable to handle that task — and was too frightened about his deteriorating mental focus to let her know.

But as harmful as mental decline can be for a marriage, it is just part of the equation. Physical ailments – even those that seem completely unrelated to marital relations – “can upset the equilibrium of the marriage,” according to a study in the Canadian Medical Association Journal.

“Most men get angry at what’s happened to them when they get ill, women get angry and scared when he’s not what he used to be — so they fight,” said Dr. Schlossberg.

Chronic illnesses, like diabetes, arthritis and heart disease, can have a strong negative effect on mood, said Dr. Waite, who will soon be publishing a study on the subject. Diabetes is so often accompanied by depression that, Dr. Waite said, “one of my colleagues argues that that it is even part of the disease.”

And ailments can have an effect on a couple’s sex life — which can compound the marital problems, doctors said.

“Diabetes brings on neuropathy,” said Dr. Waite. “That means touching and feeling in sex is not as rewarding.” Without the pleasures of affectionate touching — whether a passing hug at the sink, or more — tensions can build. That’s why, if a couple is having problems with sex, they are more likely to have problems in the relationship — and vice versa, according to a 2007 New England Journal of Medicine study of sex and health among older adults.

Other changes in circumstances — retirement, shifting roles, the loss of autonomy, disparities in health and abilities — can wreak havoc. Losing independence can feel like losing oneself — and if you don’t know who you are any more, how can you know how to relate to your spouse?

“Fighting may come from a misguided notion that you can regain power by asserting it over your spouse,” said Dr. Schlossberg, whose observations are echoed in a 1984 study in the Canadian Journal of Medicine. “It doesn’t work, it’s false power – but they’ll try anything.”

The sheer exhaustion that can come from being the caregiving spouse is also bound to “make them stressed and angry,” said Dr. Waite. Not to mention guilty and resentful — never a prescription for happy marital relations.

“Part of the trap for the caregiver is the idea that you have to do it all, and the guilt you feel when you cannot live up to it,” said Dr. Gordon Herz, a psychologist in private practice in Madison, Wisc. Not surprisingly, resentment can soon follow, Dr. Herz added, because it’s hard to admit to anyone that, “‘this is too much for me.’”

What can outside caregivers — children or other loved ones — do about these golden marriages on the rocks? Should they intervene — or butt out? And can marital therapy help — or is it too late to change?

Share your thoughts and experiences — and tomorrow we’ll try to provide some advice from experts.

Read More..