Happily married for 43 years, Bill and Julie Penick initially blamed the stress of losing their New Orleans home in Hurricane Katrina for the discord that cropped up and then stuck in their marriage in the fall of 2005.
But as laundry piled up, meals were overlooked and social engagements forgotten by Julie, their marriage became strained in ways the couple had not experienced during their decades together as working parents raising three children, or later as retirees who enjoyed traveling and spending time with grandchildren.
"I was very confused, mixed up," says Julie, 65, a retired teacher. "We were having arguments."
Says Bill, 68, a retired lawyer: "We had gone through the wringer after Katrina, and we were both kind of depressed. We lost our house -- a lot of important things to us were destroyed.
"Things were going a little haywire."
It wasn't until they sought marriage counseling in summer 2006 that the counselor suggested more than stress and depression were gnawing away their relationship. She recommended that Julie be evaluated by a neurologist. By that December, the diagnosis was Alzheimer's.
Rising to the challenges
When they realized a medical condition was involved, it was both shocking and a weight off their shoulders, they both say. "I think we were both kind of stunned by it at first," Bill says. But after the initial grief ebbed, Bill says, the diagnosis actually brought the couple together.
The Penicks' experience is not unusual, experts say. Undiagnosed Alzheimer's can shake the foundations of even the best relationships, says Lon Schneider, professor of psychiatry, neurology and gerontology at the University of Southern California Keck School of Medicine.
But once a couple receive a diagnosis and are able to address the symptoms, many rise to the challenge. "When there's an illness like this, things happen. Marriages change," Schneider says. "Sometimes they fall apart, but more often, couples grow closer in ways we wouldn't expect."
Paul Solomon, clinical director of the Memory Clinic in Bennington, Vt., where Julie Penick gets care and participates in a clinical trial, says most couples initially feel a huge sense of relief when diagnosed despite the accompanying sadness.
"When a husband realizes it's not that his wife doesn't love him anymore or is being difficult, but that she's got a medical problem, it can take a great weight off," Solomon says.
Bill Penick is among nearly 10 million people in the USA, many of whom are spouses, who care for someone with some form of dementia, such as Alzheimer's, according to the Alzheimer's Association.
Schneider says sometimes men whose wives get Alzheimer's actually flourish in a care-giving role, despite the physical and emotional toll it takes. "For many it may be the first chance they've had in a long marriage to reverse roles and take care of their wife," he says.
In the Penick house, Bill handles most of the household chores, such as the shopping and cooking, now that Julie can no longer manage on her own. Julie says the fact that he does it with such grace touches her.
Solomon says observing some married couples and how they cope throughout Alzheimer's can be striking. "There are some relationships that are so strong and the caregiver really does heroic things. They'll take on 24-hour care," Solomon says. "No one can do that for very long. Sometimes we have to give spouses who are forgetting about their own health and needs permission to take time off," he says.
Get informed, plan ahead
In the long run, Solomon says that if or how a marriage weathers an Alzheimer's diagnosis ultimately depends on the nature of the relationship to begin with.
But if couples educate themselves, plan ahead financially, take advantage of counseling and support groups along the way and accept help from others, the challenges of Alzheimer's on a marriage can be less stressful and isolating, Schneider says.
Still, Julie already has trouble sometimes with utensils -- a harbinger of a time when she may rely more heavily on Bill for the most basic of needs. But for now, Bill says: "She can still enjoy a good joke, a funny movie, friends. We just take one day at a time."
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