Effects of Communication-Debilitating Illnesses and Injuries on Close Relationships: A Relational Maintenance Perspective

Abstract

A communication-debilitating illness or injury (CDI) presents significant challenges for patients as well as for friends and family. In a qualitative study of the effects of a CDI on close relationships, twenty-eight individuals with loved ones who had experienced a CDI were It's cruel that this was a person who was a great communicator. This was her forte and to watch that being robbed…it would have been better if she would have died or been blinded or deafened because this seems to be the cruelest hit. -Rachel, whose mother had a stroke.This comment from Rachel is indicative of the impact that serious health conditions can have on people's interpersonal relationships. More specifically, it provides a glimpse of what it is like to know and care about someone who has lost certain fundamental communication abilities.The theories and definitions that guide our understanding of interpersonal communication and interpersonal relationships assume that when people interact, they are capable of exchanging messages. Although communication skills may vary from person to person, the basic ability to express, receive, and process information is taken for granted as fundamental to relationships, especially close ones. Communication is what helps people to perform relationships (Burleson, Metts, & Kirch, 2000). But how are relationships maintained when communication abilities are lacking? Sometimes a person's ability to communicate is damaged or destroyed, such as in the case of certain injuries and chronic illnesses that involve physical or cognitive disabilities. With a few notable exceptions (Baxter, Braithwaite, Golish & Olson, 2002;Kemper, Lyons & Anagnopoulos, 1995;Orange, Ven Gennep, Miller, & Johnson, 1998) CDI: Communication-Debilitating Illness or InjuryThe sometimes sudden onset of a chronic condition can be a great disruption to everyday life, and a tremendous source of anxiety for the patient as well as his or her friends and family (Bury, 1982). The disruption of chronic illness can be further exacerbated when the condition involves a communication disability. The focus of this investigation is on relationships in the context of communication impairment, so our interest is in conditions that, regardless of other symptoms or trajectories, are characterized by a patient's altered ability to communicate. For the purposes of this study, the term communication-debilitating illness or injury, or CDI, is used to broadly identify a chronic condition yielding an incapacity to use language in a standard manner, and almost exclusively 1 describes the loss of an ability that existed prior to the onset of the illness or condition, or prior to the occurrence of the injury. A variety of illnesses and injuries can result in impaired communication, including, but certainly not limited to, stroke (Sundin, Jansson, & Norberg, 2000;, multiple sclerosis (Pring, 1999), Alzheimer's disease (Williamson & Schulz, 1990), and traumatic brain injury (Allen, Linn, Gutierrez, & Willer, 1994). Relationships and Chronic IllnessIn gene...

Uncertainty of Social Network Members in the Case of Communication-Debilitating Illness or Injury

“…Family and friends of CDI patients have also described making adjustments to the way that they interact with the patients to compensate for the communication disability (Bute et al, 2007). This research is similar to previous research which has indicated that people with chronic illness experience changes in their relationships and their interactions (Lyons, Sullivan, Ritvo, & Coyne, 1995;Wells, 1999).…”

“…Previous research has shown that a CDI presents significant challenges not only for patients but also for their non-caregiving family and friends (Bute et al, 2007).…”

Surrogate Decision Makers and Proxy Ownership: Challenges of Privacy Management in Health Care Decision Making

“…As the U.S. population continues to age, and rates of communication-debilitating illnesses and injuries (Bute et al, 2007) continue to grow, surrogate decisions makers will become increasingly common in both hospital settings. Clinicians and families must prepare to meet the challenges that accompany performing the surrogate role and the associated responsibility of proxy ownership.…”

“…Such incapacity is especially common among older adults and likely to increase as the population ages and diseases like dementia become more prevalent (Alzheimer's Association, 2011). In cases when a patient has a communication-debilitating illness or injury, family members or others close to the patient serve as surrogates for the patient (Bute, Donovan-Kicken, & Martins, 2007; Torke, Simmerling, Siegler, Kaya, & Alexander, 2008). Surrogates must provide crucial health and personal information to clinicians and are frequently asked to participate in making medical decisions on the patient's behalf.…”

How does difficulty communicating affect the social relationships of older adults? An exploration using data from a national survey

“…This finding suggests a decline in both the quantity and quality of positive social relationships. Reports from friends and family members of individuals with communication impairments report a change in the nature and content of communication, suggesting a decline in the quality of personal relationships which could increase the potential for loneliness (Baylor et al, 2011; Bute, Donovan-Kicken, & Martins, 2007; Heine, Erber, Osborn, Browning, 2002; Hétu et al, 1993; Scarinci, Worrall, & Hickson, 2008). Communication partners have reported that conversation becomes more practical and less intimate due to the “work” of communicating.…”