Men, especially men in the 60s to 80s age group, encounter an unacknowledged and very often unrecognized cultural barrier when it comes to long-term, hands-on, intensive caregiving. They have been raised in an environment where women did the caregiving -- men just didn't. When faced with long-term caregiving, men either managed to get a woman relative (sister, daughter, daughter-in-law, etc.) to perform the caregiver role, or they gave up and put their loved one in some sort of institutionalized setting. Throughout their life, they are not taught, nor encouraged to learn how to be a caregiver -- how to cook, clean, bathe, dress and perform the myriad personal tasks of taking care of a totally dependent person.

Very often, when faced with this situation, men feel they are alone and unsure of themselves because they have had little or no contact with any other senior male caregivers. They also feel isolated, too afraid or embarrassed to admit that they need help, advice, support and reassurance.

It is such a relief for many men to come to the Men's Caregiver Support Group and suddenly realize they are not alone, they are not caught up in a diabolical plot that they can hardly comprehend. Men can discover there are many others who are sharing their same or very similar experiences and concerns. By joining with others "in the same boat," they get the much-needed reassurance that they can cope, that they are doing all the right things, or learn from other's experiences. As these skills improve, their confidence and sense of self-worth and esteem also improve. Importantly, men begin to lose their sense of loneliness and accompanying depression, thus becoming more empowered as caregivers and significantly improving the life of both the caregiver and the spouse.

A major issue -- and one very seldom addressed and almost never resolved by community resources, often even including close family connections -- is the issue of not just loneliness, but loss of intimacy, loss of closeness, loss of a life partner. It is not just sexual intimacy, although that is an important but unmentionable factor in a great many people's lives, but the loss of the very sense of being able to share and to feel the response to your expression of important concerns and tender thoughts, your deepest emotions and feelings. All these are left hanging in the air because your spouse has lost the ability to understand, to react and to share. It is, in many ways, like a late in life unrequited love.

A major part of the coping process for many men is the need to ultimately realize that things will never be the way they once were and that to survive, they themselves must change their attitudes, including their attitude toward their commitment and devotion to their loved one. Rather than withdraw even further from social contact with friends, they must learn to reach out to establish, or re-establish, contacts with old and new acquaintances and friends.

For their own survival and mental and emotional well-being, they need to actively develop their own social support network. They need to reconnect with others in a way that they can compensate for the loss of the loving companionship and intimacy they shared with their life partner, which most certainly means friends of the opposite gender. Male bonding is important, but for several million years it has not been able to replace the inherent and totally natural desire for close, responsive and supportive contact with a person or persons of the opposite sex. This is a very difficult issue for most men to face. They need the understanding, support and encouragement of their peers, people they like and respect, to give them the courage to break the often stultifying social pressure "to remain true," to "banish from your mind any thought of ever having a social, friendly, even personal, relationship with another woman not your spouse," as long as your spouse is alive. This is a serious and difficult issue for many men, especially men whose spouse has been unable to share their life for many years, and perhaps even having been separated by virtue of institutionalization of the spouse, for many months or years. Yet life goes on, and to survive in a healthy mental, emotional and physical condition, a man must come to grips with this reality. And that is where the warm understanding and non-judgmental support of his fellow male caregivers can provide the safe harbor where he can discuss his wants, needs and fears, and arrive at a solution that he is not only comfortable with, but one that empowers him, increases his self-esteem and improves his sense of self-worth.

Fousel was instrumental in establishing the Men's Caregiver Support Group at Southern Caregivers Resource Center, 3675 Ruffin Road, Suite 230. The Men's Group meets on the second and fourth Thursday of the month at 11 a.m. For more information call (858) 268-4432 or (800) 827-1008.