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An Alzheimer’s affair: The good, bad, and ugly

Should we be surprised that Sandra Day O’Connor is not jealous of her husband’s recent affair with a fellow Alzheimer’s patient? TODAY psychiatrist Dr. Gail Saltz looks at how this is no ordinary case of infidelity.
/ Source: TODAY contributor

It was recently revealed that Sandra Day O’Connor’s husband, John, has struck up a romance with a fellow Alzheimer’s patient after moving into an assisted living center. The retired Supreme Court justice says she isn’t jealous of “the other woman” — rather, she's just glad that he is comfortable. Psychiatrist Dr. Gail Saltz provides insight into this turn of events.

It is likely that more than a few people are wondering why a married man in an assisted living home would strike up a sudden romance and even more so why his wife may not be very upset about it. This is a psychologically complicated situation. While Alzheimer’s disease does ravage memory, mood and the ability to care for oneself, it does not necessarily interfere with libido or the need for intimacy.

This is why, in fact, it is not that unusual for people living in either assisted living or a nursing home to “find love.” Particularly in the phases of the disease where patients have an awareness of their declining state, they may long for companionship to make them feel connected, understood and alive. Few things make one feel more alive than romance, and when you know at some level that you have a terminal illness, the desire to battle back your fears of death with feelings of vitality and excitement are great. Romance is a good defense against anxiety about mortality. It is also not unusual for a person in an assisted living situation to feel “abandoned” by their spouse, even when they also understand that their spouse could really no longer manage to care for them at home. Such feelings of abandonment can lead to a strong desire to connect with another to nurture their own feelings of hurt. In addition, Alzheimer’s can affect one’s judgment and ability to consider the consequences of one's actions. It is likely that John really does not perceive at this point that he is betraying Sandra and also likely that she understands this.

Caring for someone with Alzheimer’s is incredibly stressful and difficult. Watching the man you love slowly but surely lose his mental faculties is excruciating. Having to constantly be vigilant and watchful is exhausting and “caregiver burnout” is more the rule than the exception. The caregiver often becomes fatigued and depressed. Anything that lifts that burden may be welcomed — even your husband having an affair. The wish to see your impaired partner happy and not feel that all their happiness is dependent on you, is enough to make you accepting of some situations that would never have been acceptable before.

The truth is, we as a society are still not very good at helping couples dealing with Alzheimer’s disease. We need better systems of evaluating both the patients and the caregivers for depression. We need to teach better systems of managing symptoms. And we need more support systems so that caregivers can get a break in an otherwise overwhelming task. No doubt, the O’Connors have done the best they could under very difficult circumstances. While Sandra was one of the most important judges of this century, this is a situation where we best not judge her or her family. Alzheimer’s is a ravaging disease that attacks the organ we prize most — our mind.

Dr. Gail Saltz is a psychiatrist with New York Presbyterian Hospital and a regular contributor to TODAY. Her latest book is “Anatomy of a Secret Life: The Psychology of Living a Lie.” She is also the author of “Amazing You! Getting Smart About Your Private Parts,” which helps parents deal with preschoolers’ questions about sex and reproduction. Her first book, “Becoming Real: Overcoming the Stories We Tell Ourselves That Hold Us Back,” was published in 2004 by Riverhead Books. It is now available in a paperback version. For more information, you can visit her Web site, .