Chronic pain support from spouse may decrease well-being for some people

As people age, they often need assistance from their spouse or partner to manage their health problems. Though research has examined the emotional and psychological effects that this support has on the caregiver, less research has been conducted on how it affects care recipients, according to Lynn Martire, professor of human development and family studies at Penn State.

In new research by Martire and others in the Penn State College of Health and Human Development, the authors found that people who did not feel good about the pain-management support they received from a spouse or long-term romantic partner experienced more symptoms of depression and worse moods than people who felt better about the pain-management support they received.

The study was published in the Journal of Aging and Health.

“Almost everyone has times in their life when they do not want to accept help because it makes them feel helpless or because they think they do not need it,” Martire said. “But people who live with chronic pain need support over a long period of time. This research shows that if a person feels less supported or loved when they receive help, it can diminish their psychological well-being.”

In the study, the researchers interviewed 152 long-term couples over the age of 50 in which one of the partners had arthritis in their knee. In each couple, one partner provided instrumental support for the other—such as providing pain medication or physically helping their partner stand. Prior research indicated that emotional support generally has a positive effect on well-being, but the researchers said that instrumental support can have different effects on the recipient’s psychological well-being, depending on how it is received.

“Osteoarthritis in the knee can be a challenging condition,” said Suyoung Nah, lead author of this research and current Presidential Postdoctoral Fellow at the Virginia Tech Center for Gerontology. Nah conducted this research as a student at Penn State, where she earned a doctorate in human development and family studies in 2023.

“People with the condition will eventually need support managing their pain. What is more, they are likely to continue needing assistance managing their pain for the rest of their lives. The circumstances of knee osteoarthritis patients allowed us to understand how people’s perceptions of the support they received affected them immediately and over time.”

The researchers asked each couple what instrumental support was provided and then asked the recipient how they felt about the support they received. Most people reported positive feelings—like gratitude or being loved—in response to the help they received. A minority of respondents, however, reported negative feelings—like anger or resentment—in response to help.

Participants who reported positive feelings about receiving support were found to have fewer depressive symptoms, were more likely to experience positive moods and were less likely to experience negative moods.

Participants who reported negative emotions in response to support, however, were found to have higher levels of depressive symptoms, were more likely to experience negative moods and were less likely to experience positive moods.

After 18 months, the researchers surveyed the same couples again. People who reported a lack of positive emotional response to support at the start of the study remained more likely to experience poorer psychological well-being than people who responded more positively to the support.

According to Nah, this finding demonstrates the need for clinicians to provide interventions promoting communication between couples when one or both partners are receiving long-term instrumental support for pain management.

Martire previously found that couples typically do not have conversations about whether instrumental support is wanted or needed and how that support is received. The researchers said that communication about expectations and feelings related to care can improve the quality of life for the partner who needs care.

“My main interest is in late-life family relationships—especially couples—navigating chronic illness,” Martire said. “Most older adults have at least two or three chronic illnesses, so helping them find better ways to help each other is really important.”

Nah agreed and emphasized that accepting support can be complicated.

“Receiving care is not always beneficial to every aspect of a person’s life,” she said. “Additionally, it may be difficult for couples to discuss and negotiate care. As a society, we need to make sure that older people understand their partner’s needs and desires regarding care so that both partners can maximize their physical, emotional and relational quality of life.”