The Effects of Chronically Ill Children on Marriage

Part 1 in a 4-Part Chronically Ill Children and Marriage Series

A number of studies have investigated the effects of a chronically ill child on marital satisfaction, with some indicating overwhelmingly
negative reactions. In this article, I address some ways in which couples, together with their families, can cope with the stress, role assignments, perceptions, and depression related to the care of an ill child.

The Exposure of Underlying Marital Problems

Unresolved, untreated, or unrecognized marital problems and/or depression that were present before the care of a chronically ill child became necessary are often intensified. Studies found that more women expressed general dissatisfaction with their marriages than men did, both before and during their season of care for a chronically ill child. However, most studies did not include input from husbands, who, when they were included, expressed general marital satisfaction and a lack of depression.

Marriages React in Different Ways to a Chronically Ill Child

The hypothesis that couples with a chronically ill child experience more marital dissatisfaction was not supported by the research of Quittner, Espelage, Opipari, Carter, Eid, and Eigen (1998). However, according to their study, many of the mothers scored higher on the depression scale than mothers with healthy children (Quittner et al., 1998). Many earlier studies on the effects of a chronically ill child on
the parents indicated that the effects were primarily negative. However, more recent research results indicate that, while some marriages will be negatively affected, others will remain the same or actually improve (Quittner et al., 1998).

The Need for Social and Psychological Support

An understanding of the psychological and social demands placed on all the members of the family of a chronically ill child must be considered and adjusted over time. However, most families concentrate on the medical aspects, in which they achieve excellently, but find themselves struggling in some of these other areas (Spilkin & Ballantyne, 2007). Even when the chronically ill child had sufficient developmental abilities, and could have been helped psychologically by a therapist, only about 20 % of the children in a particular study saw a therapist (Spilkin & Ballantyne, 2007).

Family members may also have to deal with the social stigmas, physical anomalies, and cognitive deficits of their ill child, in addition to their fears about the death of their child (Spilkin & Ballantyne, 2007). Moreover, the extreme collaboration required by all the family members can lead to exhaustion and frustration (Spilkin & Ballantyne, 2007). Studies also found that less time spent in recreation together decreased marital satisfaction and increased depression (Quittner et al., 1998). Despite this, however, according to Quittner et al. (1998), parents of chronically ill children spend more time playing with their child(ren) than other parents, who spend more time doing household chores (Quittner et al., 1998).

The Impact of Marital Roles

Mothers tend to become the primary caretakers of chronically ill children (Berge, Patterson, & Rueter, 2006). For women, role frustration and role conflict were associated with marital dissatisfaction, and parenting stress and role frustration were related to depression (Quittner et al., 1998). However, research by Quittner et al. (1998) indicates that once the roles for medical caretaking are established, they are very difficult to change. Mothers generally have a larger role in household maintenance than fathers and responded that they would like a fairer division of labor (Quittner et al., 1998).

Some women continued to work outside the home even though they were primarily responsible for child care. There is some indication that such outside work may also be a source of social support and self-esteem (Quittner et al., 1998). Studies indicate that role strain, depressive symptoms, and stress increase when caring for a chronically ill child (Berge et al., 2006). A study by Berge et al. (2006) indicated that a decrease in mothers’ marital satisfaction was influenced by their perceptions of the impact of their child’s condition. The severity of their child’s condition was a factor in decreased marital satisfaction for mothers. The stress of caring for a chronically ill child means that many mothers will experience poorer mental health than the fathers will (Sallfors & Hallberg, 2003).

Christian Counseling when Caring for a Chronically Ill Child

As a Christian counselor, I have witnessed the impact that caring for a chronically ill child can have on parents, and the strains that this can have on a marriage. However, much you love your child, this is a trying and challenging time and you need to be attentive to your own needs and those of the rest of your family. Christian counseling can provide a safe space in which to process all that is happening to you, and can give you the strength to face your challenges in a healthy way.

• Berge, J.M., Patterson, J.M., Rueter, M. 2006). Marital satisfaction and mental health of couples with children with chronic health conditions. Families, Systems, & Health, 24, 267-285.
• Cook, J.A., Hoffschmidt, S., Cohler, B.J., Pickett, S. (1992). Marital satisfaction among parents of the severely mentally ill living in the community. Amer J Orthopsychiatry, 62, 552-563.
• Quittner, A.L., Espelage, D.L., Opipari, L.C., Carter, B., Eid, N., & Eigen, H. (1998). Role strain in couples with and without a child with a chronic illness: associations with marital satisfaction, intimacy, and daily mood. Health Psychology, 17, 112-124.
• Sallfors, C., Hallberg, L.R-M. (2003). A parental perspective on living with a chronically ill child: a qualitative study. Families, Systems, & Health, 21, 193-204.
• Spilkin, A., Ballantyne, A., 2007). Behavior in children with a chronic illness: A descriptive study of child characteristics, family adjustment, and school issues in children with cystinosis. Families, Systems, & Health, 25, 68-84.