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Learning to be a better caregiver

How marriage counseling helped a couple through stroke recovery

The longer couples live, the higher the chances that either one or both of them will become seriously ill and require special care. Over the years, both Bruce Gruemmer, 78, and his wife, Anne, 68, have learned to adjust to caring for each other, but it wasn’t always easy.

The Winston-Salem, North Carolina, couple have been married for 21 years, but they still struggled sometimes to get along as one or the other coped with a major illness. In fact, Novant Health arranged for the couple to have marriage counseling earlier this year, while Bruce was recovering from a stroke. It’s in keeping with Novant Health’s philosophy of caring for the whole patient – not just treating the illness itself. The couple have learned a lot in their life journey. Here are some lessons that may be helpful to others.

Caring for Anne

In 2010, Anne was diagnosed with leukemia, and shortly afterward received a bone marrow transplant. Her treatment lasted for eight months, and she dealt with recovery and setbacks for another year. A few key moments resonated with them:

For Bruce, there was the time he realized he was Anne’s “total caregiver,” 24/7.

“You really have a lot of responsibilities – it was like having two or three full-time jobs,” Bruce said. For the first time, the household duties fell entirely on his shoulders. During this period, while they were in the process of buying a new house suitable to Anne’s needs, they got into a car wreck and totaled their vehicle.

With Anne’s weakened immune system, other ailments followed, including pneumonia and shingles. She had to be hospitalized, and after returning home, hooked up to oxygen. She also needed physical therapy.

Given her fragile state, Bruce feared that he would do something to accidentally harm her. But over time he adjusted.

“He was very organized,” Anne said. “He wrote everything down, he had all my medications lined up on the table and knew all the times for when to take each one.”

Both learned how valuable emotional support is in recovering from a major health event. Bruce set up a site for Anne on CaringBridge.com to update everyone on her progress. Anne received an overflow of letters, support, and prayers from her online visitors.

“What I learned as a caregiver was that it was so important to keep her in communication with friends and family,” Bruce said.

“He wrote on that every day,” Anne said. “That really helped with my recovery.”

Caring for Bruce

Seven years later, the Gruemmers were grateful to continue enjoying life together. But early one morning last May, Bruce woke up sweating profusely, and knew something was wrong.

Anne drove him to Novant Health Forsyth Medical Center, where specialists confirmed that Bruce suffered a stroke.

Bruce eventually moved to the medical center’s rehab unit, where he received therapy to begin regaining his motor skills. Other complications from the stroke included sleep apnea and thickening of the blood, which an oncologist monitored in case of complications.

On the day he went home, Bruce said, “they rolled me into the wheelchair and I was pretty discouraged.” He received home health care for two months and continued to get rehabilitation and outpatient care.

Strains on their marriage

After Bruce got sick, the couple struggled with delegating overall care and decision-making authority to Anne. Jessica Bruno, a therapist in Forsyth Medical Center’s rehab unit and a licensed marriage counselor, met the couple and learned about their challenges. After talking with her, the two agreed to go into counseling with Bruno.

“We talked to (Bruno), because there were some issues,” Anne said. “I needed to take more control over his care than he was willing to allow me to do. And so it was a total shift in dynamic.”

When Anne needed to step up and initiate major decisions, Bruce, who had been the longtime head of the household, resisted. This in turn would upset Anne. And the cycle would repeat itself.

Bruno said that “role reversal” is a common hurdle among patients she sees, even those who have been married 30 or 40 years. “Very often we have male patients who have spent decades as the leader of their households suddenly feeling not only like they are a burden, but also like their wife is ‘hovering,’” she said. “Talking about these issues out in the open allows them to recognize what is going on, and work as a team toward resolving it.”

Bruno helped the couple navigate this shift in roles – even in the small ways, like administering Bruce’s medication, or allowing Anne to oversee his diet.

“It’s important to not get frustrated with yourself,” Bruno said of stroke recovery. “What I can do is help you find something that’ll take your mind off things: reading, working on an activity, attending a support group; anything that will help free up emotional energy. Even if we only experience this relaxed state of mind for a few minutes, we are making progress in the right direction.”

Over time, things got better between Bruce and Anne. He’s learned to listen and accept her opinions. She’s learned to be a more diplomatic communicator.

Bruno offers hope for others experiencing similar challenges. “I always ask during couple sessions, ‘How long have you been married?’ It forces this couple in crisis to go way back to the easy days and think, ‘What is it about this person that I fell in love with?’ It also reminds them just how much they've been through.”

Moreover, “It triggers those memories that make them think, ‘I am strong, we did get through this, we have been married 30 years, and we will get through this together.’”

Physical therapy – more than for sports injuries

Bruce said everyone on his care team helped his recovery. “When I started (physical therapy),” he said, “they got me out of bed almost immediately.”

Bruce also credits his progress to his own determination to make small improvements, every day. “I would lay in bed and decide, ‘What am I going to do by myself today that I didn’t do yesterday?’ That was my process, and that worked pretty well. You’ve got to want to get better.”

Novant Health Martinat Outpatient Rehabilitation Center in Winston-Salem offers a wide range of physical therapy modules, including the Lowe’s Food Learning Lab to help patients practice everyday tasks like grocery shopping. The rehab center also has a driving simulator to help patients practice being back behind a steering wheel. Bruce regained his mobility by taking advantage of the variety of services and therapies.

Looking ahead, together

Bruce is pleased with his progress, and announced recently that he’d just gone grocery shopping by himself for the first time since his stroke about 4 1/2 months earlier — and was walking around for the first time without his cane.

“All things considered, I think it’s remarkable. I’m amazed at what I can do,” he said.

And finally, he’s looking forward to getting back to working on his golf game. When asked when he hoped to get back on the course, he replied confidently, “Probably next week.”

Novant Health strives to educate the community on all the benefits that physical therapy services bring to patients, for a wide range of medical conditions.  For more information on inpatient and outpatient services, click here.

Published: 1/10/2018