Deciding to Divorce a Spouse With a Chronic Illness

Many years ago, Eda, in her late 30s, came to therapy to work on “relationship issues.” She began by telling me that she had recently divorced her second husband when he was diagnosed with multiple sclerosis. He had become depressed and unable to work but was not yet physically impaired by the disease, other than a slight limp. She told me she wasn’t willing to live with a partner with a progressive, chronic disease. She asked me if I believed that she had abandoned him (and their vows). In fact, I did have that judgment, as a reflex, but quickly saw that she would not have been able to care for her husband. Perhaps divorcing him at this early stage of his illness would allow him to find someone who would both love him and be willing and able to care for him as the disease progressed. As it turned out, he did meet and fall in love with a nurse. She lived with him and cared for him for the next 35 years until he died.

Divorcing someone with a chronic health condition or terminal illness presents unique challenges and considerations. The decision is deeply personal and complicated. Every marriage and every situation is different, so the answer is not black and white. Consider the following factors with compassion and empathy, for your ill spouse and yourself. Here are potential issues to think about as you make your decision.

1. The emotional and psychological consequences: Divorce is almost always a life crisis, but when a spouse is suffering from a chronic illness, their coping may already be depleted. The ill spouse may panic in fear of how they will be cared for, or respond with anger at the perceived abandonment. The spouse who initiates the divorce may have conflicting emotions, including guilt at leaving their spouse at a difficult time.
2. Communication and support: Open, honest communication between you and your spouse is crucial before making your decision and may help you identify your frustrations and unmet needs caused by the illness. You may be able to problem-solve these with the help of a therapist or social worker who specializes in chronic illness and, thus, avoid divorce.
3. Individual needs and happiness: Take some time to reflect on your own needs, goals, and happiness. Chronic illness can undermine a healthy relationship and lead to a toxic dynamic. Self-care is important. Divorce may be a reasonable decision if you prioritize your own personal growth, happiness, and fulfillment.
4. Exhaustion and burnout: It is common that caregivers become exhausted and burned out. Aside from the imbalance and strain in the relationship, your mental health may suffer. Whether you divorce or not, look for caregiver support groups in your area and join one as soon as possible.
5. Exploring options and alternatives to divorce: Before deciding to divorce, explore your alternatives. This is the best way to prevent later regrets or guilt. These options might include additional medical treatments, support services through social service agencies, or even adaptive technologies. Would your spouse benefit from living in a supportive community that would include health care, meals, etc.? This may be one solution to avoid divorce. Couples counseling may also help strengthen your relationship with tools that could lighten the load that feels so overwhelming.
6. Long-term prognosis: Educate yourself about the prognosis and trajectory of your spouse’s illness. Some chronic diseases are manageable, while others may worsen over time. This way you may be able to predict future challenges that you would face if you did or did not divorce.
7. Financial implications of divorce and quality-of-life changes: It is important to fully understand your finances and the financial impact on your quality of life. Chronic illnesses come with a need for chronic care: medical expenses and ongoing or increasing treatment costs. How will medical bills and expenses be handled after a divorce? What will the impact be on your health insurance, disability benefits, and the division of assets and liabilities? You and your spouse will need a divorce settlement that gives you both at least basic financial stability. Are the physical, emotional, and financial strains imposed by the illness sustainable in the long term? Think about how to balance your well-being with your commitment to support your spouse.
8. How to continue to parent your children (child custody arrangements): If you have children, the questions of custody can become more complicated. The court may need to assess the ill spouse’s ability to care for the children. While a divorce can be very hard for children, the impact of an ill parent who is limited in their ability to parent makes the divorce even harder for children. Consider support for your children through the transition as they work through their emotions. Another consideration is that the healthy spouse may resent taking on more caregiving time, and if you feel this way, do find a therapist to help you with your emotions, too.
9. Care and support systems (medical and community): If you currently care for your ill spouse and decide to divorce, new caregiving arrangements will be needed, especially if the ill partner needs help with activities of daily living or medication management. During a divorce, community support systems often break down. So, it is important to maintain those relationships (for both of you) and connections with friends, family, and support groups, especially during the period of separation, divorce, and the subsequent year. Often, this support for the ill spouse comes in the form of scheduled visits, shopping trips, help with meals, etc.
10. Legal considerations: Divorcing someone with a chronic illness will have unique legal considerations, which may vary in different jurisdictions. The court will likely address issues related to medical decision-making, alimony or spousal support, disability benefits, etc. The court may also order the establishment of a trust or guardianship for the ill spouse’s care. It is critical to consult with an attorney who has experience in navigating the complexities of divorcing a chronically ill spouse.

Every divorce is different, jurisdictions vary in divorce law, and each situation is unique. Divorcing a spouse with a chronic illness makes the divorce more complex, and you’ll need help to tailor your divorce to your and your spouse’s specific needs. So you should seek advice and guidance from experienced health care professionals, therapists, financial specialists, and lawyers who understand the challenges of your divorce situation.

Should you decide to divorce, rely on this team of professionals to guide you through a divorce with respect, compassion, and integrity.

© Ann Gold Buscho, Ph.D. 2023