How do I communicate gently with my girlfriend about caretaking stress and relationship reservations after a life changing diagnosis?

Question

I have been dating a woman who I love - Great personality and good looks. We have been dating for 8 months.

A while back, as a result of a sports accident, she suffered a complete SCI and is a quadraplegic going forwards. The accident happened after we met. She can't remain independent and needs a lot of help with daily activities - think activities of daily living (dressing, positioning, washing etc.). Also, there will need to be a lot of modifications to make our home fully accessible (removal of steps, widening of hallways , doors etc.)

As much as I love her, I am now having doubts about our future relationship. I may become her primary caretaker as neither of us live close to family and respite care is rather limited and costly. Caretaking is a demanding job of its own and given that I work full time at a demanding job (business travel, client facing meetings, overtime hours) , I don't know if I will be able to handle the demands and stress. As I work a client facing role, a fully remote WFH option is not feasible. I obviously cannot fulfill my work duties with company clients if my girlfriend cannot care for herself with activities of daily living (ADL) and has no one else who can. To give a few examples of what her needs are for ADL:

• Getting her out of bed
• Dressing
• Helping her wash and with personal hygiene such as teeth brushing
• Continence care
• Cooking
• Turning / positioning throughout the day

If no suitable care can be arranged and I end up being her primary caretaker, I may have to break up with her as a last resort if for example respite care cannot be obtained and I can't get any help from for example, family. What I don't want / fear:

• Working a full time job for 8+ hours and go home tired
• Attending to the ADL of my girlfriend
• Increased stress and fatigue costing me performance at work the next day.
• Vicious cycle repeats ad nausem.

I plan on discussing with her that I know her condition will require around the clock care and that such care will require a firm commitment. I plan on letting her know that I don't feel I am the best person to be her caretaker as my life style does not permit it and I want the best for her. In summary, I fear this message will make her feel my love for her is transactional and only when she is able-bodied. I don't want to appear unfeeling and crass The nature of the relationship has changed intrinsically.

• How do I discuss with her my thoughts about my reservations on future of our relationship given life changing diagnosis including possibility of separation?

• How can I emphasize I love her, but I can't fully see my self committing to a primary caretaker role without devaluing her / giving offense?

Answer 1

TLDR: Focus your conversations on the implications of her accident on your relationship, not just your part of it.

I intended to comment, but had to create a new anonymous profile for data privacy reasons, hence I can't.

After typing the answer, I realized it might be seen as a frame challenge since a lot of it is about how to handle the situation and not about the specific conversation you are asking about. I'll still post it since I think it deals a lot with how to communicate.

I was in a comparable situation in the sense that I was recently diagnosed with an incurable disease that will make me lose control over my legs and potentially other limbs over the next years. I also had extensive talks with my now ex-partner over this, so I feel I can offer some kind of insights.

Since you mentioned that you only want to break up as a last resort if there is no alternative to you being her primary caretaker, I would build up the conversation to this end. Talk to her honestly and constructively about how her life (and, by extension, yours) will change, what help she will need and what support systems there are. This will organically include talking about the kind (and amount) of support that you would be able to (or would have to) give her. At this point, you should be honest about what you are willing to do. This way, you can plan around your capabilities as well as her needs. Here, try not to flood the conversation with negative scenarios. Let her know that you ultimtely want to help her, and are having this conversation as a first step to figure out how the two of you can find a solution that you are both okay with. Be clear about your boundaries and explain how the additional strain on you will not only affect your mood, work and energy, but also in extension your relationship. If she can understand your view, you can ideally reach a conclusion about the future of your relationship together that you both see as reasonable, if potentially sad.

This conversation can show her that you are trying to support her and are still serious about making the relationship work.

This should also help you to identify if the additional strain on you is actually as hard as you think it would be. I don't know the specifics of your situation and don't know if the two of you already put exhaustive research into her needs, your capabilities and additional support systems. If not, a decent part of your doubts might be based on negative visualization and conjecture.

Having such a conversation requires a certain emotional distance from the issue. Depending on how long in the past the accident occurred, it might be a good idea to wait for some time until the initial shock of the life-changing event has settled.

EDIT

To answer OP's comment: In my specific situation, the topic of breaking up was reached dynamically by talking (and mostly thinking) about the aforementioned issues. It was ultimately her who explicitly stated the possibility of breaking up over it when we talked about the things we wanted from life and what would be possible for me in the future. It didn't feel very crass because I already had these thoughts on my mind, and it seemed like a reasonable, yet sad, option. I don't know you or your girlfriend, but I would imagine the thought of her disability impacting your relationship has crossed her mind, too. If you want to emphasize that you love her and don't want to offend or devalue her, show her that you didn't just make up your mind when you knew she would be more work but that you gave it a lot of thought and there's simply no realistic possibility in which you're both happy. If you didn't already have a long conversation about how her life will continue with her disability, giving her some time after having that conversation will probably help her to understand before you go for a breakup.

Finally, I just want to express my sympathies for the both of you. My answer might read like I'm trying to convince you to forget your doubts and stay on. That's not the case. I understand you have a tough conversation ahead and breaking up is a completely understandable reaction. All the best.