“In Sickness and in Health”

Abstract

The spouses of patients with brain tumors face extraordinary stresses. As the disease progresses, the patient undergoes profound personality and behavioral changes, may lose control of bodily functions, and, with the loss of cognitive function, may not recognize the spouse. The course of the disease is complicated and unpredictable, and as the patient deteriorates, he or she often requires 24-hour supervision. Recognizing the needs of spouses who care for brain tumor patients at home, the Neuro-oncology treatment team at Memorial Sloan-Kettering Cancer Center initiated a group to provide practical and emotional support for them. The group, which lasted for 18 months, helped facilitate the patients' home care and reduced the spouses' anxiety and depression, as conveyed by the spouses' verbal reports and their reluctance to terminate the group. The authors attribute the profound meaning of the group to its members to therapeutic factors that are unique to the interpersonal nature of most group processes. These factors include universality, altruism, information, and the instilling of hope. The authors also attribute the group's success to the fact that it served as a “transitional object” for group members undergoing the painful process of losing a loved one in piecemeal fashion by providing a surrogate for the dying spouse and thereby easing the members' transition from spouse to widow or widower.