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HEART DISEASE: FAMILY MATTERS
Recuperation can be a bumpy ride for a patient’s spouse, family and social and collegial network. The patient who is recuperating from a cardiac event is particularly changeable emotionally in terms of anxiety, sadness, low mood and anger. We have to remember that the mood of the significant other is changeable as well, but usually for a shorter time and less severely. But not all get off so lightly. There will be a stronger emotional response if the spouse or any family member is the “symptom bearer” on behalf of the patient. This means that it is not the patient but the family member who takes the brunt of being emotionally reactive in the family. Of course, much will depend on the actual physical state of the patient. Things go more smoothly if the patient is medically stable, or at least “stably unstable,” which means that symptoms do occur but are recognizable and are deemed not serious by the physician. As well, a lot depends on the people involved?the patient and family members?and the relationships between them. Many relationships are not flexible enough; they function well when things go relatively smoothly, but a cardiac event can disturb the emotional equilibrium of a relationship. As we pointed out in spouses can become overly involved with the patient’s situation, which can be manifested as overconcern, or “hovering over” the patient (“hypervigilance”). This situation can be highly distressing to the patient, robbing him or her of privacy and independence as the spouse or other family members watch every step and limit every activity. Following the aftermath stage, this behavior pattern usually subsides, but in certain cases it can continue, to the detriment of both patient and caregiver. If both spouses are symptomatic or troubled, a potentially dangerous “spiral” can occur, with each person feeding off the negativity of the other and making things worse. Almost all patients will go through the bumpiness of emotional reaction. However, significant others may experience a rough ride as well, especially if acceptable reliance of the patient on the spouse at the start becomes unacceptable dependence, continuing into the weeks, and especially the months, following the cardiac event.
*19/214/2*

