Responding to symptoms of Alzheimer's disease: husbands, wives, and the gendered dynamics of recognition and disclosure.

In this article, we analyze the process of redefining marital relations within the context of couples dealing with Alzheimer's disease and related disorders (ADRDs), drawing on intensive interviews with 13 caregiver husbands and 15 caregiver wives. Men were slower to recognize the symptoms of ADRDs, with social others usually bringing the problems to their attention. They often attributed symptoms to a less-problematic cause and engaged in extended normalization of their wife's condition. Women were quicker to recognize symptoms and often noticed subtle changes in their husbands but failed to take action quickly. They were reluctant to disclose their concerns to their impaired husbands, which might have protected the husband's masculine identity and served to maintain the wife's own sense of self in relation to him. We suggest that husbands were able to normalize because the wife's symptoms did not change marital authority dynamics, but authority relations were reversed by the illness for caregiver wives.