family dynamics and arthritis

When Arthritis is a Family Affair

Alberta Dillihay’s children began urging her to stop working soon after her 2010 rheumatoid arthritis (RA) diagnosis. Stress from her job as a public works supervisor in a busy office 45 minutes from her home, combined with finding the right arthritis treatments, could affect her health, they argued.

“I was and am glad they were concerned and want to help. But sometimes it’s frustrating because you feel you’re being treated like a kid,” says Dillihay, 63. “You can still do what you need to do.”

When a mom has arthritis, the family dynamic often changes. “That means who’s in charge shifts, as does who’s taking care of whom,” says Eve Wittenberg, PhD, a senior research scientist in the Center for Health Decision Science at Harvard University in Boston. “There are downsides, but there can also be huge satisfaction to changing a relationship with a child or partner; the ability to let others help can strengthen bonds,” says Wittenberg, who studies family dynamics in chronic illness. She and Nancy Ruddy, PhD, a clinical psychologist at Montefiore Health System’s College of Medicine in New York City, offer this advice. 

The overprotective family

“Oftentimes people become overprotective because they don’t have enough information about the person’s condition,” says Ruddy. Take them to doctor appointments to learn about your condition and how it affects you. People with unpredictable conditions like arthritis cope better when they feel in control, so families should let them make their own decisions, “even if that means doing things that are uncomfortable,” Wittenberg notes. Dillihay, for example, kept her job for several more years before eventually retiring early.

The everything-is-normal family

Even adult children can struggle with the idea that mom has limitations, says Wittenberg, and a family in denial may appear uncaring. A family talk with mom’s rheumatologist can help everyone understand her condition and limitations and how they can help.

The family with young children

Chasing and carrying kids and days when arthritis flares and patience runs short are challenging. “Communicate with your partner and to childcare providers [including older children] so they understand your limitations,” says Ruddy. Tell kids why mom may have off days, so they know they’re not the cause, and be ready to respond to those who might act out or who take on unrealistic responsibilities. “Develop a solid support network,” she adds. “This could be extended family, friends or professional help if you can afford it.”

The mom who struggles to ask for help

“If a family member was hurting, would I want them to suffer in silence or would I want them to say, ‘Hey, I’m having a rough day and could use help with X?’” Ruddy asks. “Empower your family by telling them what they can do to help you.” That’s something Dillihay learned. “I realized there are times when everyone needs to ask for help,” she says. “Now that I understand that, it makes a big difference in my life.”


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