Wednesday, April 8, 2015

Dementia and Consent: Husband Accused of Raping Wife Who Has Alzheimer's

I caution you not to rush to form an opinion about the issue raised by this case of a man accused of raping his wife who has Alzheimer's and was deemed unable to provide consent.  Think about what comes up for you as you consider this case.
"A former state lawmaker accused of raping his wife in a nursing home is forcing an Iowa court to confront a little-discussed question of aging: When is a person suffering from dementia unable to consent to sex?
The case centers on Henry and Donna Lou Rayhons, both 78, who got married seven years ago in a union that seemed to offer a second chance at love for the two, who had both been widowed. But their domestic routine of church activities and political functions unraveled as Donna’s health began to fail.
Last year, Donna Lou Rayhons was moved into a nursing home because she was suffering from dementia and Alzheimer’s disease.
A family conflict developed over how to care for her, culminating in a meeting in which the nursing home staff told her husband that his wife was no longer mentally capable of legally consenting to have sex.
State prosecutors say Henry Rayhons – then a long-serving Republican state representative – ignored that message. On Wednesday, he will stand trial for sexually assaulting his wife, who died in August. The charges were filed days after she died.
Many older couples experience the hardships of illness, mental decline and living apart, but what happened with the Rayhons has little precedent. Experts could not recall another rape case that happened because a previously consenting spouse could no longer legally acquiesce....
When the charges were first filed, Henry Rayhons’ family released a statement.
'Donna’s location did not change Dad’s love for Donna nor her love for him. It did not change their marriage relationship. And so he continued to have contact with his spouse in the nursing home; who among us would not,” read the statement, which went on to call the charges “illogical and unnatural.'
The crux of the case is the question of Donna Lou Rayhons’ ability to consent. Iowa law defines an act as sexual abuse in the third degree if the two parties are not living together as husband and wife and if one person “is suffering from a mental defect or incapacity which precludes giving consent...”
Here are some complexities that came up for me.  Not answers - more questions:
  • I have spoken to couples living with Alzheimer's and several said that physical contact - presence, affection, sex - is often a channel of connection when words are not available.
  • If he forced himself on a resistant partner, that's clearly a violation.
  • Is it equally a violation if she did not indicate either approval or rejection?
  • If she reciprocated - does that imply consent? Or are any of her decisions and responses suspect because her mental faculties are impaired?
  • If she is deemed unable to consent, does she get any say in any of the treatments that are recommended?
  • At what point, and how is she declared unable to consent?  I'm guessing there is a clear area, and a lot of gray area.
What are your responses to this situation?

Friday, April 3, 2015

Sometimes It Takes A Dog

It's been too long since I've posted anything on this blog.

I've been slowly, too slowly, creeping out of a pain relapse that started four months ago.  I can just about see blue sky over the rim of the crater I've been in.

When I'm having a relapse, well, everything relapses.  Including writing blog posts.

It took a few doses of intermittent pain relief and hope, plus finding this amazing video that says so exquisitely what needs to be said about the power of love between partners and the consuming agony of loss to return me to writing.

Wiley lives at Lockwood Animal Rescue Center, a sanctuary for wolf-dogs.  Wiley barely escaped death at an animal control facility before arriving at Lockwood.  Wiley is now part of a program where he provides support and therapy to war veterans.

Thursday, January 22, 2015

Couples Getting Healthier Together

From an article in Medical News:


"People are more successful in taking up healthy habits if their partner makes positive changes too, according to research published in JAMA Internal Medicine today (Monday).

Scientists at UCL funded by Cancer Research UK, the British Heart Foundation, and the National Institute on Aging looked at how likely people were to quit smoking, start being active, or lose weight in relation to what their partner did.

They found that people were more successful in swapping bad habits for good ones if their partner made a change as well.

For example, among women who smoked, 50 per cent managed to quit if their partner gave up smoking too at the same time, compared with 17 per cent of women whose partners were already non-smokers, and eight per cent of those whose partners were regular smokers.

The study found that men were equally affected by their partners and were more likely to quit smoking, get active, or lose weight if their partner made the same behavior change....."

Have you found this to be true in your relationship?  Do you and your partner support each other in developing better health?

I have found that my partner and I do indeed support each other in exercising regularly.  But the influence doesn't extend much beyond that.  We continue to stick to our own patterns in other areas, like eating habits.

And when it comes to dealing my pain relapses -- he suggests, but I do it my way.  Do you and your partner influence each other when it comes to dealing with illness and pain?

Monday, January 12, 2015

Help for Someone Drowning

I received the comment below on my blog posts entitled:
Caregivers and Suicide.   The author is drowning in her efforts to care for her two seriously ill parents; and this is taking a toll on her relationship with her partner.

My guess is that many of you can relate to her situation -- whether you are caring for parents or a partner -- the experience of losing yourself and your lifeline is a familiar one.

Do you have any stories about your own experiences and thoughts about how to cope you can share with Anonymous and with all of us?

Here is Anonymous' comment:
Anonymous said...
I can relate. I have become physically ill from caretaking. Parents in 80's .mom beginning of dementia. Dad is 88 and barely going. We are at a breaking point. I cannot afford nurses, she chased any we had because she was so combative. She is combative to me. She now took several heart attacks and may become bed ridden. If I lose my job, we will lose our house. My fiancé is at the end if his rope. Our relationship is in trouble. I can't afford for them to wipe us our financially but she needs residential skilled care. I am physically becoming a fatal stroke case and I need help badly.

Monday, December 22, 2014

When Illness Turns Your Relationship Upside Down

When we were interviewing couples living with illness for our book (In Sickness As In Health: Helping Couples Cope with the Complexities of Illness), one phrase we heard over and over about the impact of illness on the couple relationship was:

"A partnership of equals becomes one of patient and caregiver."

Pre-illness, each partner does have roles he/she plays in the relationship.  One person may deal with the financial while the other deals with the emotional.  One person may be the planner, while the other is the spontaneous do-er.  And of course these roles are not immutable.  They are preferences, and either person can most likely undertake any role - but each person has his/her comfort zone.

Illness disrupts the established order of routines and roles.  The ill parter may not be able to buy the groceries, keep the household budget, or even keep working.  The well, caregiving partner takes on not only these extra chores, but may also need to help the ill partner manage the physical and emotional impact of illness.  The well partner may need to help the ill partner dress, bathe, get to doctors' appointments, while also boosting the ill partner's hope and holding the ill partner when he/she despairs.  And while taking all this on, the well partner is also coping with his/her own overload of exhaustion and anxiety.

So how can a couple whose equilibrium has been overthrown by illness and replaced by an imbalance of dependency still be a partnership of equals?

Here are some suggestions:

  1. The ill partner should try to stay as close to "normal" as possible.  Do what you can do, while taking care of yourself so you don't overload and wind up paying for the exertion.
  2. The well, caregiving partner, as hard as it may be for some, needs to ask for help.  That help can be in the form of having friends/family/others pitch in to do chores like laundry, meal preparation, chauffeuring.  Helpers can also carry some of the emotional load - yours and the ill partner's - by sitting and listening.
  3. While the ill partner may not be able to do activities, she/he can try to be emotionally present and supportive to the caregiving partner.  Often being is more important than doing.
  4. The well, caregiving partner should not get so caught up in doing that he/she neglects the being part.  If both partners can be emotionally present for each, other loads will feel lighter.

The illness can foster a relationship between partners that is one of an overfunctioning well partner taking care of a dependent ill partner.  If the partners can find that emotional connection that binds them, they can each do their part to sustain it, as equals.  This is one way of restoring the balance illness upsets.

Of course, not all partners can find that emotional connection.   It may never have been strong enough or may have weakened over the years and turned to animosity.  Ot the long haul of chronic illness may have eroded it.  What can partners in this situation do?

One approach may be to try to rekindle that emotional bond.  Some couples find that illness has the power to slice through the resentments and the noise and help the them focus on the essential - the love they shared and the compassion they can still feel for each other.  Working with a therapist can help.

Others who don't find love when they search their bedrock may need to buoy themselves with the love and support of friends and family.  Filled with this support, the partners may be able approach each other with kindness, if not love.

How have you been able to be both partner and caregiver/patient?  Have you found a way to hold onto a relationship with you partner that is balanced, or has illness made that too difficult?  I'm interested in  your experiences.

Wednesday, November 26, 2014

Thanksgiving Flare Up

It seems that my pain tends to pick the holiday season to remind me of its presence.  I have learned not to call these episodes relapses, but rather to call them flare ups.  The connotation is that if something can flare up, it can slide back down.  Whereas relapse implies defeat.

Thanksgiving requires gratitude.  My inbox is filled with messages from airlines, charities, clothing stores, shoe stores -- all letting me know what they are thankful for, mostly for my patronage.  So, how can I find something to be thankful about while in the middle of a relapse....oops, I mean flare up.

I recently read a blog post that contained this gem:
"...once you reach a level of healing, no matter the intensity of the flare, your body can, and will get back to that level."

This solves my gratitude dilemma. I am miserable and yes, angry, that I am having a flare up.  But I am indeed grateful that I know what it's like to be without pain, for months at a stretch.  And I am hopeful that I will get back to that place of ease.

I am, of course, thankful for my sweetie, Richard.  He is the one who reminds me that "that was then (unrelenting pain) and this is now (mostly OK, with some flare ups )."  

I wish you all Thanksgiving with a lot to be thankful for.  And I'd be interested in hearing what brings out your gratitude.

Thursday, November 13, 2014

Being Together.....Apart

Richard is on the west coast; and I am on the east coast.  And of course, my pain picks the week we are apart to exercise its right to flare up whenever it wants.

Richard is an essential part of my coping strategy.  I can just be in pain with him without having to pretend I'm doing fine.  He asks me, "How are you?" I answer, "Not good."  I don't say that to my work colleagues or my outermost friends (my innermost friends I tell).  To them I say, "Not so bad," or "Pretty OK."  I don't want to have to explain anything to them or accept their sympathy.  It's easier not to tell the truth.

I also count on Richard to remind me that this is just a flare up and not a cataclysm.  That I now have tools at my disposal for coping with pain that I did not have ten years ago.  He needs to remind me of this because when I have a flare up, time collapses, and my pain PTSD awakens.  And ten years ago becomes ten minutes ago, and my fear in the present is overburdened with memories of the darkest times when pain had no limits.

And I count on him to make me laugh and to annoy me and to be so sweet that I get overwhelmed.  He is my bedrock, and it's hard to have pain visit when my bedrock is 3000 miles away.

But then I remember that bedrock doesn't get lost when there's geographic separation.  Bedrock is ubiquitous.  Bedrock persists and can support me, no matter where or when.

And Richard sends me texts throughout the day - telling me about the ham and cheese croissant he ate, and about the small red dog who looked like our old dog; and that he is sending me his strength and love to lean on.

How do you and your partner manage to cope with illness when one of you is away?  How do you be together when you're apart?