Living with a memory-impaired spouse: (Re)cognizing the experience

Spousal caregivers are the most vulnerable of all caregivers to the stresse s associated with the caregiving role, yet they are the least likely of all caregivers to utilize formal support services. This low use of services is poorly understood. To develop insight into this issue, this qualitative st udy explored how spousal care givers made sense of the personal experience of living with a memory-imp aired partner. The goal was to better understan d the interface between this personal experience and the use of formal supp ort services. Information was gathered through the use of unstructured inte rviews with 14 spouses, most of whom had turned down available formal suppo rt services. Analysis of their transcripts revealed the availability of fou r discourses, or story-lines, for framing the experience. These included tw o competing story-lines which were used to structure individuals' caring ac tivities and two other competing story-lines which provided the framework f or judging one's personal competence within the experience. This paper exam ines these four discourses and highlights how each influences the meaning a ssociated with the use of formal support services. This analysis makes visi ble the multiple and sometimes contradictory meanings that service use may have for spouses caring for a memory-impaired partner.