Abstract
Many patients given a diagnosis of a long-term illness have to make substantial adjustments to their own lives, as do their partners. There is evidence to show that partnerships are subject to intense stress throughout long-term illness, and that the ‘unaffected partner’ may paradoxically be more affected than the patient. This paper provides evidence for this and for the need for couples to devise coping strategies right from the initial diagnosis through rehabilitation to share the burden as much as possible, and to avoid unilateral dependency. The paper considers the pressures facing the couple, and the range of healthcare and community supports for the couple wishing to use their relationship as a primary source of support in chronic illness. Certain illnesses are considered in more detail, and guidelines for good practice for clinicians working with couples who are sharing the load are given. Specific focus for the sexual and relationship therapist is also suggested.