Dear Abby:Wife With Sketchy Memory Depends on Husband for Help

[cereta]

DEAR ABBY: When my wife was 17 (she's now 54), she was in a car accident. She and her three friends were high and drunk. She suffered two skull fractures, which have affected her memory. She thinks it's my job to remind her of things and becomes angry to the point of hitting things when I don't do it. I feel her schedule is her responsibility. But when I tell her that, she claims I am not being "supportive." -- UNSURE IN THE SOUTH

DEAR UNSURE: In successful marriages the division of labor is usually "each according to his ability, each according to his need." Your wife's schedule should be her responsibility, and if your wife were irresponsible, I'd agree with you. However, because she suffered a traumatic brain injury, she may be unable to be as organized as you are and need your help. That said, "hitting things" when she becomes frustrated is not appropriate, and she needs to find a less threatening and destructive way of venting.

Comments

[cereta]

1. I am not thrilled with the totally irrelevant mention that your wife and her friends were high and drunk at the time of the accident. It smacks of making sure we know that this was All Her Fault. I know from living with someone with anger issues, so I was kind of inclined to be sympathetic, but this did not help.

2. It should probably go without saying that she should have a neurologist and mental health expert as part of her life if economically feasible, but it's said. I am not a psych*, but she might benefit from Dialectical Behavior Therapy on the temper and frustration issues.

3. The two of you together could try using technology to its fullest. I'm not a TBI patient, but I am forgetful, and I've found that using Google Calendar + my phone is enormously helpful. You can set multiple reminders for appointments and tasks, easily make things weekly/monthly etc. She might also benefit from a bullet journal. The organization of the journal itself helps a lot.

All this can fall under "teach a woman to fish." If you, LW, invest some time in researching, learning, and helping her learning tools, you won't have to be her Google Calendar. You may have to set it up for her every month, but you won't have to remember day-to-day things. You will have to remember Abby's basic advice: this isn't about her ducking responsibility. She needs help. You need to find some way to make that help tolerable to you, or, I guess, decide if you can do this, because from what little I know of TBIs, it's not going to get better as she gets older.

[the_rck]

I rather suspect that the TBI issues have already been getting worse. The letter writer doesn't say how long they've been married, but it's been almost forty years since the accident. Did the letter writer know about the issues before they married? If so, I'd argue that helping with them was part of the commitment. How long have they been married? If the marriage is recent, how did the wife deal with this stuff before? If the marriage is older, well, the same question still applies.

Also, how long has this been an issue? If it's relatively recent or has been getting noticeably worse/different, then seeing a neurologist is absolutely and immediately necessary. (Though, yes, possibly not economically feasible. Although, it sounds like the wife might qualify for disability which would mean some level of health care coverage.)

[cereta]

These are all good points.

[vass]

I rather suspect that the TBI issues have already been getting worse.

This. And people with previous brain injuries are at increased risk for dementia later on. I don't know offhand whether that includes being at increased risk of the dementia having an earlier onset, but it might. And brain injuries can also flare up worse if you're sick or stressed.

Did the letter writer know about the issues before they married?

And did he live with her before they married? If not, maybe he didn't know what her day to day looks like, or how bad a bad day is.

If the marriage is recent, how did the wife deal with this stuff before?

He didn't say, and it's a short letter, but it may be that he doesn't like how she dealt with this stuff before. Maybe she's handling it badly, or maybe he doesn't understand her disability and expects more than is possible. Possibly she's just chronically disorganised and panicked as a state of life, and is unable to meet the basic standard he thinks is acceptable. Or unwilling, but a lot of abled people who are unfamiliar with disability have trouble with the concept that "as good as it gets" might be way lower than "normal". In which case if he isn't willing to adjust his standards (which it's okay if he's not) then they are not compatible as a couple.

She might need a higher level of support than she's getting. And he doesn't have to be her aide (ideally someone else should be, someone not part of her family) but if she needs help to do the things then if she doesn't get that help then the things aren't gonna get done.

Also, the hitting thing might not be under her control, depending on what parts of her brain were injured. It might be the part that lets her inhibit impulses. In which case if she's injuring herself or scaring him, maybe she could carry around something soft to hit.

[shirou]

Google calendar was also the first thing that occurred to me. There is technology to help with this problem! Use it!

I agree with you that the inclusion of the fact that the wife was drunk and high at the time of the accident was unnecessary, but otherwise I'm sympathetic with the LW. The wife is not handling this situation well. It is appropriate for her to ask the LW for help, but that doesn't give her carte blanche to fully unload her responsibilities and anger on the LW. My impression from the letter -- which may be an omission, intentional or not -- is that the wife isn't doing anything to handle her memory problems (Google calendar, sticky notes, to-do lists, etc) and instead is putting the entire responsibility for her schedule on the LW and getting angry when he doesn't live up. I'm not surprised the LW would come to resent such a move and adopt a "not my problem" attitude after some time.

I can't speak for the LW, but in his shoes, I would have no problem helping my wife make up the difference if she were doing what she was capable of. It would be a team effort. But I don't get the "team effort" vibe from the letter. I get a "one person, two jobs" vibe, and that I would have a problem with.

[left_turns]

Yeah, I was sort of hesitant to comment because I really feel where the letter writer is coming from. My mother doesn't have the anger issues, but she's having terrible memory issues, even though tests they've done show nothing unusual. But her response to it is to tell me that I "have" to remember things for her, which... no, honey, I don't. You need to write things down, and check the messages on your answering machine, and put things in your calendar. This is something where it's not inappropriate to ask for help, but you don't get to voluntell people into being your brain.

[commodorified]

I also know from living with anger issues, and yet I had the same reaction: dude, she's not being brain-injured AT you.

I feel like the LW is asking the wrong questions. The right questions might be more along the lines of:

A) Can I live with this?
B) If not, can we fix this?
C) If not, what now?

[lilysea]

An occupational therapist can help your wife develop skills, enhance function, manage symptoms, and overcome barriers to achieve a better quality of life.

Please make an appointment with an OT experienced with brain injury today!

[vass]

This. (If she hasn't already, which she might. OTOH, it might be time for a review appointment. Or she or LW might need the reminder that if the OT she saw was crap, it's okay to look for another OT.)