You may know one of them, or even be one. They are divorced people, mainly women, who have taken on the care of their estranged spouse when he or she is facing serious illness or death. It is a surprising and, to some, a baffling development, but one that is significant enough for two researchers from the University of Missouri to look into. Alerted to their study by a recent feature article in The Australian (“The ex factor” by Kath Legge, November 3, 2012) MercatorNet asked Drs Teresa Cooney and Christine Proulx about their findings so far.

Keep in mind as you read the interview that millions of baby boomers, who experienced record divorce rates in the wake of no-fault laws, are now ageing. Men in particular often end up alone and estranged from their children. A current spouse or partner (assuming there is one) friends or siblings may be unable or unwilling to commit themselves to a care-giving role. But for some “exes” their original marital commitment still means what it said.


Q. Marriage seems to create a lasting bond, even after divorce, for some women and men. What is the most powerful factor: the initial relationship? Having children together? Is there any evidence that the same is true of cohabiting relationships that break up?

A. We examined our 21 interviews trying to uncover factors that “predicted” women’s willingness or motivation to care for an ex-husband. There appeared to be a variety of factors that predisposed them to this situation. One similarity in the stories of many women was remaining geographically proximate to their ex-husbands, post-divorce. (This was not necessarily a decision made to stay near the ex-spouse—they just didn’t appear very mobile) This proximity seemed to increase the chances that they would occasionally have contact with the ex, and in some situations it facilitated the ex’s continued role in their lives. In fact, one woman said that in retrospect she wished she had moved far away, because she thought that would have forced her ex to develop other relationships and come to count on other people.

A common reason women gave for assuming care of the ex was “the children”. Some women believed that their adult children’s lives were too busy or that they had issues of their own to focus on, so the moms wanted to relieve them of the responsibility of caring for their ill father. Some thought the children wouldn’t be willing to do the care, given the ex-husband’s past poor relationships with the children following divorce. Others wanted to facilitate a more positive relationship between their ex and the children (or grandchildren) before he died—so in that way they did the caregiving for their children. Children appear to be a major factor in all of this, though we did have a few cases where women provided care despite not having had children with the ex-husband.

Why is it women who are more likely to maintain the relationship post-divorce — in particular the end-of-life caregiving? Is this just the result of role-conditioning that will eventually disappear with the prevalence of gender equality in relationships and family roles?

For this study, we purposefully sought to study only women who were caregiving for an ex, because those are the situations we had been alerted to by medical professionals. We would imagine that there are men who do this same thing (we’ve been told of some cases from professionals at the Alzheimer’s Association, for example), but our guess is that it is more common for a woman to care for an ex, and we suspect that will continue to be the case for several reasons.

One reason, as you noted, is that women are most often socialized to care roles—both in the family and professionally. Though we see more men staying home to care for children today than in earlier times, and more men are pursuing nursing degrees, etc, these are still largely female-dominated roles, and that is not likely to change anytime soon. Even in non-divorced families, it is uncommon for men to take on caregiving, with the exception of men who care for their wives. If a woman is unmarried, she is likely to turn to a child (typically a daughter or daughter-in-law), or a sibling or other relative. Men who are unmarried are almost equally likely to name a child as a potential source of help as they are to name a professional caregiver service (this is research done by Ward and Spitze out of SUNY-Albany).

What we also know from other research and saw in our study is that after divorce, men’s family ties, both to their children and family-of-origin, become much more vulnerable than those of women. Many men still rely on their spouses to be the “kin-keeper” and to facilitate their relationships with children and family—even their own families. Plus, in cases where divorce is associated with problem behaviors, like addiction or abuse, which is not uncommon, family relationships may also be compromised, leaving men few options for care. One other reason is that the average life span of men is shorter than women, raising the possibility that men will need care sooner than women might.

Taking on the care of a dying ex-spouse seems a very selfless thing to do. What is in it for the care-giver?

Good question! We only know what these women told us, of course, but in many cases it did appear to be a selfless act. As we said, many women did it for their children, and it is not uncommon for mothers—of any age, to act so unselfishly when it comes to relationships with their children. There were very few women in our sample who took on the role because of lingering feelings for the ex-husband—or out of feelings that he had no one else who would do this and they felt it was the morally right thing to do. A couple of women noted that they had some guilt about their ex-husbands’ conditions; at least a few noted, for example, that maybe these men would not have ended up in such bad straights had they not divorced them. Most women we interviewed did not regret their choice to provide care to their ex-spouse.

Is a woman more or less likely to do this if: a) she left her husband, b) he left her, c) they broke up by mutual agreement?

It is hard to tell for sure given the small sample we had. We had women from all three of those scenarios, and all were providing care. There were only a couple of caregivers who stated that they had not wanted the divorce, so in the vast majority of cases from our sample, the decision to divorce was either initiated by the woman or was mutual. 

It does not really seem strange that people who once loved each other enough to marry — and especially, have children — would want to be reconciled before death takes one of them. Is terminal illness the perfect no-strings-attached opportunity?

Because of the design of our study, we are not sure about this, because all of our cases with the exception of maybe 2 or 3, involved hospice care (the place we sampled from), with very short (6 months max) durations of caregiving. So, you may be right— I’m not convinced though, that most people who have divorced and moved on in their lives (several of these men and women had remarried other people) have a deep need to reconcile before death. There seem to be plenty of people who are quite satisfied to move on and not maintain contact or recontact one another. Plus, few of these women we talked to said they took on caregiving to somehow rewrite the wrong in their past relationship. For some of them the care did seem to put things on a more positive (or at least neutral) note prior to the ex-husband’s death, but that was not a strong motive for the women.

This type of reconciliation seems extremely important for the children — that their family is healed in a sense. Have you studied the effects on the children involved?

We have not, but gaining their perspective is an issue that we have talked about pursuing in the future. I think you are correct that for some adult children, this may be a way of bringing peace to a family situation that was fragmented and conflicted. But, I do not think that was the reason most children had if they asked their mothers to help out with the ex-husbands’ care. In some of the cases where the children actually asked their mothers to help with care, it was more a result of the children feeling unable to take on that full responsibility on their own, given their own life circumstances.

While an outcome for some may have been family togetherness or unity, I do not think it was the main motive. Moreover, there were plenty of cases where the children were actually not in favor of their mothers taking on the care role; in these cases children either felt hostility toward the father for things that had happened in the past and felt he was undeserving of their mothers’ care, or some adult children just worried that the role was too much for their mothers to have to do. 

You must have heard some poignant stories during your research — could you tell us a couple of them?

I was most struck by those stories where children asked their mothers to come back to help with their fathers, and, as you noted, these mothers seemed so giving and compassionate to do so, even in some cases where the marriage had been abusive and terribly unhappy.

One woman shared how her daughter was actually doing the caregiving for the ill ex-husband, but now that her daughter has been diagnosed with cancer, Mom has come in to assist. This mother and her current husband now travel a good distance a few times a month to spend extended periods at her daughter’s home, helping both the daughter and ex-husband with care. This caregiver shared how her current husband willingly assists her, and thus provides both emotional and instrumental support in her care role. While we heard of a few cases of current husbands being understanding and supportive of their wives’ care for an ex-husband, this was the only situation where a woman actually told of her current husband helping out directly with the situation.

Another story that sticks with me involves a woman caregiving for an ex-husband who has a chronic, progressive condition that will likely linger for many years as he becomes increasingly debilitated, both physically and cognitively. Though he is now in a long-term care facility, she is the one responsible for overseeing his care and he makes daily demands on her for visits and to meet various other needs. Her daughters will not visit their father or assist with things due to a troubled history with him. This woman feels obligated due to the fact that she was married to this man, and despite his marital transgressions, she feels it’s morally right to assist him because he really has no one else in a situation to do it. She does not consider ever marrying again. When you look at her life, it is really being consumed by this man and his care demands. She is isolated, tired and unhappy, but totally committed to being there for ex-husband due to her strong feelings about what marriage meant to her.

Are there other findings you would like to comment on?

A finding that we have written about is how the role of the ex-spouse is socially ambiguous. There are no clear rules of expectations for what is appropriate behavior for ex-spouses to assume vis-à-vis one another. Therefore, these women are questioned and challenged a lot by others about assuming a role that requires so much devotion, time and energy to meet the care needs of someone they have divorced. Some are made to feel foolish or crazy as others challenge them about what they are doing. Some are told outright that what they are doing is not appropriate. So, as a result, many of these women tend to keep their circumstances to themselves—not talking about their caregiving situations, their feelings, and their needs. This can result in their feeling very isolated and unsupported at a time when they may need a great deal of support to sustain themselves and their care role.

Additionally, several caregivers pointed out to us that formal caregiving supports and services are not designed for persons with their family status, so they felt either unable to access services, or uneasy about using them. For example, the U.S.’s Family Medical Leave Act does not apply unless you are legally married to someone, or the caregiver and care recipient are legally related. So, some of these women tried to get time off from work to do the caregiving but were hassled by bosses when they made such requests. Or, after the death of an ex-husband, some of these women had trouble finding bereavement services, such as support groups, that felt welcoming to them or understanding of their grief. We are struck by how formal services and policies have not kept up with how families are changing, and the diversity of family forms that exist today.

Dr. Teresa Cooney is an Associate Professor in Human Development and Family Studies at the University of Missouri. She specializes in family gerontology and has focused much of her research on the impact of divorce on adult family relationships and aging. 

 Dr. Christine Proulx is an Assistant Professor at the University of Missouri. Her primary interests are in adults’ close relationships and adults’ social, mental, and physical wellbeing.

Dr. Teresa Cooney is an Associate Professor in Human Development and Family Studies at the University of Missouri. She specializes in family gerontology and has focused much of her research on the impact...