Understanding the impact of dementia on spousal relationships: A qualitative study with female spousal carers of people living with dementia

<b>Background:</b> Dementia does not merely affect individuals, the carer and the person living with dementia, but also has a profound impact on their spousal relationship. As such, this study aimed to gain a deeper understanding of how dementia affects spousal relationships with a focus on interpersonal (i.e. relationship adjustment, communication engagement and emotional connection between two individuals) and intrapersonal (i.e. loss of self within the context of relationships) dynamics using a qualitative approach. The study also explored how carers adapt to such relationship challenges in the context of dementia care.<b>Methods:</b> A phenomenological approach was used to capture the subjective experiences of female spousal carers, who regularly support their partner living with dementia. A total of nine semi-structured interviews were conducted.<b>Results:</b> <i>Relationship adjustment</i> theme highlighted how learning to acknowledge role shifts from a spouse to a carer is critical for carers to manage relationship difficulties. <i>Emotional connection</i> theme demonstrated the importance of reminiscing about the shared history between dyads to cope with feelings of loss of affective intimacy. <i>Communication engagement</i> theme revealed carers' need to learn a new way of communicating due to the decrease in meaningful communication and two-way interaction. <i>Sense of self</i> theme highlighted the importance of self-compassion to overcome feelings of self-loss and isolation.<b>Conclusion:</b> Findings suggest that improving the relationship between female spousal carers and their partner living with dementia may require targeted interventions addressing different factors. Such interventions can include a couple's life story approach to enable couples to reminisce about their shared experiences, interactive communication training to enhance meaningful engagements, and a psychological approach such as compassion-focused therapy to overcome emotional challenges and facilitate self-compassion.