The spouse of an injured worker can bring additional and complicating barriers to management of an injury.
a. The spouse resents that the full burden of the household now falls upon them
b. The spouse blames the physician(s), nurse case manager and adjustor for the burden that is now upon them
c. The patient permits the spouse to assume responsibility for everything from filling out a history form, to tracking medication, to interfacing with the insurer and providers
d. The spouse is often blamed by the patient for the burden now facing the household
e. The spouse assumes full financial burden, yet the patient may concurrently demand that the spouse not work and transport the patient to all visits.
f. While assuming full burden, the spouse is provided no physical affection nor verbal appreciation
Often the couple/family has lived an emotionally and financially precarious life with past conflict and unresolved problems. At the time of injury, the uninjured spouse consciously or subconsciously takes this opportunity to attack both the injured patient and those attempting to provide care and rehabilitation.
As with all such psychosocial factors, it is important to identify the existence of these spousal burdens, demands and conflicts. Often the patient will willingly, of not gratefully, discuss the relationship problems. Equally as often, the spouse, who seems so offensive, will be relieved to ventilate that which is bothering them.
However, with that said, both patient and spouse need to be reminded that it is the injured worker who is the patient, and the spouse can elect to be a facilitator of rehabilitation or an obstruction to recovery.