Last week, a man came to my clinic to attend his wife’s hospital appointment, as she is now bedridden and unable to talk.
The woman had end-stage Alzheimer’s disease and her husband has been the main caregiver for the past ten years. They used to attend my clinic together and it was very painful to see her condition deteriorate, especially that her symptoms started when she was only 55 years of age.
She had younger-onset Alzheimer’s, which is more devastating as the patient is often still working and has young children. The man gave me the usual update describing her sleep patterns and occasional agitation. Towards the end of the session, he said, “By the way, I got married last week."
I froze for a second, trying to hide my shock, anger and disappointment. As a professional, I knew I could not show these feelings or pass judgment. So I smiled and replied in as natural a tone as possible, “Congratulations.” That was all. Not “Congratulations, that’s wonderful news” and certainly not “I’m happy for you.” Inside, I pictured his wife in her bed, eyes searching for the man she still loved and adored, even if she could no longer call his name.
After the consultation, I kept thinking about what had just happened. On one level, it felt like a betrayal. How could someone who had shared decades with a partner move on while she was still alive?
But on another level, I reminded myself that caregiving for a person with advanced dementia is exhausting and emotionally draining.
Many caregivers of people with dementia describe a sense of 'ambiguous loss', the person they love is physically present but psychologically absent. The relationship changes from that of partners to something more like nurse and patient.
In some cases, the caregiver’s social and emotional needs go unmet for years. Loneliness can be profound, and the idea of companionship, conversation, and even romance can become an irresistible pull.
I can understand that people can be divided on this issue.
Some of them view this man’s decision to move on as selfish and disloyal, while others believe it’s a natural human need for connection.
In some traditions, marriage is a sacred bond 'till death do us part' in the physical sense, while in others, the emotional and relational death of a marriage may be seen as reason enough to start anew.
In the end, my role as a psychiatrist is not to judge but to understand. This man had cared for his wife for a decade, sacrificing his personal life in the process. He still visited her, paid for her care, and ensured she had comfort and dignity. His remarriage did not erase his years of devotion.
This encounter reminded me of the quiet struggles of caregivers that are often unseen. It also made me reflect on how love changes over time, sometimes in ways that challenge our ideals and our comfort.
Alzheimer’s doesn’t just steal memories, it steals shared dreams, conversations, and the simple intimacy of a life lived together.
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