Caregiving for a Spouse

When Strength Shifts: Sitting With the End Stage

By Marguerite Wolf, OT and Caregiver Coach

I sat in the room with them again this week.

A room I’ve visited before.

A room filled with art, music, tools, sketches, and love.

The Renaissance Man, a carpenter, musician, advocate and artist—a strong, brilliant, self-made man—is still here.

His sparkling blue eyes still yearn to communicate- he understands, feels -yet can only communicate with a piercing stare and a tear.

But the man who once built this very home with his own hands, who could fill a space with music, who moved with intention and strength, now struggles to move at all.

His wife—his partner, his teammate, and caregiving spouse—sat beside me asking me to help him move better.

We talked through what she already knew but didn’t want to admit.

Her strong, talented man with whom she shared a life with for 40 years is fading before her eyes.

The exercises that once helped preserve his abilities have become impossible.

Not just difficult.

Impossible.

He tries.

He gets frustrated.

He knows what he wants to do. His body won’t listen anymore.

And this is one of the most painful crossroads I see in caregiving.

When “working toward improvement” quietly shifts into “adapting for decline.”

We’re taught to fight.

To preserve.

To do something.

But sometimes, the most compassionate thing we can do is stop fighting against what is happening, and instead work with it.

That doesn’t mean we are giving up on them.

An elderly couple enjoys a serene afternoon by the lake, with the man playing guitar and the woman listening joyfully.

It means giving grace.

Grace to him, who no longer can.

Grace to her, who’s still trying to do everything right.

Grace to their shared history and story.

And grace to ourselves when we sit in the room and can’t fix it either.

Why I’m Sharing This

Because if you're facing this moment—where progress is no longer the goal, and comfort becomes the priority—you’re not alone.

It can feel like failure. It’s not. It’s reality.

And it’s love, just shaped differently.

There is still care.

There is still meaning.

There is still value.

Even if there are no more reps to count or steps to track.

Things a caregiving spouse or loved one can do

• Hold them. Touch communicates love even when words are hard.

• Share memories. Remind each other of moments that shaped your life together.

• Play music. Choose songs that carry meaning—favorites from younger years, wedding songs, or calming tunes.

• Surround yourselves with love. Invite in children, grandchildren, and close friends. Their presence can bring comfort and joy.

• Fill your home with your life together. Display photos, artwork, or mementos that remind you both of what you’ve built.

• Capture the moment—if you choose. Some families take photos of interlocked hands or small, meaningful gestures to preserve this stage of their journey.

• Make this time your own. There is no “right” way. What matters most is creating meaning in a way that feels special to you and your loved one.

Closing Reflection

Spousal caregiving asks more of the heart than most of us can ever imagine.

It is sitting with both the memories of who your partner has been and the reality of who they are becoming.

It’s holding love and loss at the same time.

But here’s the truth I want you to carry: the little things still matter.

Holding hands.

Sitting quietly with music.

Laughing at an old story, even if just for a moment.

These are not small comforts—they are the threads that keep your life together stitched close.

There’s no single right way to walk this season.

What matters most is finding the gestures that feel true to you and your loved one—whether that’s a photo of intertwined hands, a grandchild’s laughter filling the room, or simply being present in the quiet.

Love may look different now, but it is still love.

And it’s enough.

Gentle Reminder

If you’re walking this path, too—whether at the beginning or nearing the end—I invite you to join a community that gets it. 

Come sit with us in the KAREgiver’s Connect Facebook group.

There’s no pressure. Just presence.