Dear Family Advisor

My husband refuses to listen to me or follow the doctor's advice. How can I be a caregiver if he fights me at every turn?

Last updated: Jun 27, 2009

My husband is recovering from back surgery and is currently in physical therapy. All the way through this process, he's argued with me, avoided taking his medication, and ignored the doctor's instructions. Now he won't do the "homework" his physical therapists recommend so he can get well and eventually return to a normal life.

I'm worn out from arguing with him. I don't like to tell people what to do, and I'm a strong believer that we're responsible for our own bodies -- and lives. But his refusal to follow doctor's orders has a great impact on my life. How can I convince him to get on board with his treatment plan and stop rebelling like an unruly teenager?

Boy, you just nailed what it's like to be both spouse and caregiver. Our husbands don't want to take orders from us; they often think of themselves as the "strong" one, the provider. (Although I do know plenty of women who have always ruled the roost!) Some husbands may not like anyone, especially their wife, calling the shots. But as you point out, his choices affect your life, too.

I'm sure he's rebelling because he's scared. He doesn't want to feel helpless, and by controlling whether he takes his medication or does his treatments he's saying, "I'm still in charge of my own life." I encourage you to help him find someone nonthreatening to talk to. Does he have a good friend, a brother, or a buddy that he could get together with? Having a friend to relax with could help soften his mood. Just arrange a get-together for the two of them and let them find their own way.

Also consider that your husband might be depressed. Depression commonly follows a illness, particularly a surgery. This doesn't necessarily mean he needs prescription meds. He might just need to work through it himself, see a psychologist -- but don't rule out medication. We all need help now and then, and this period in his life could be a real blow to his ego. In many respects, he's had to let go of who he was -- his career, the health he had as a younger man -- and that's tough. Give him time.

You might also try a different tactic: Stop fighting his behavior. You don't need to be his mother, the bad guy, and the schoolmarm all rolled into one. The truth is, you can't live his life for him. Once he figures out he doesn't have to resist you, he just might start toeing the line. Let's say he only does half his treatments; it's better than none, and being able to make the choice gives him a sense of autonomy. Also consider whether he has understandable reasons for resisting. Maybe his meds make him feel nauseated or his treatments are painful. Really listen to him, and encourage him to bring up problems with his doctor.

As much as you love him and want him to recover, you have to separate yourself enough to be able to go on. Contrary to belief, we aren't joined at the hip, and each person must take accountability for himself"”body, mind, spirit, and especially personal choices. Because you want a partner, not a baby, it's important to disengage to some degree. Stay active and keep up your friendships and activities -- don't let caregiving diminish your world too much. Sign up for a class, call a girlfriend -- even consider a part-time job or volunteer position. You don't need to stand over your husband handing him his meds and begging him to do his exercises.

No doubt, you've faced other hard times in your marriage, and you figured your way through those. Every couple has their own way of doing it. Maya Angelou has a great saying: "We teach people how to treat us." So does the old saying, "If nothing changes, nothing changes." If you want a different result, then you have to say and act differently"”and stick with it"”otherwise, you'll fall back into old habits. You want to get to the place where you're working together, perhaps a place of compromise.

I bet as soon as his treatment stops being a painful bone of contention, he'll start to come around. He sounds like he'll pull out of this and that it's possible that both of you can return to your normal lives. Later, you may have to caregive again, but save some of your energy for when that time comes. Plan a trip for a few months down the road, reenter your vibrant world, and try not to dwell on the frustration at hand. Keep your heart tender. Remember that you and your husband have long been a team and can meet this challenge together.