Terri Corcoran has been through the three stages of what she calls “spousal caregiving” and feels that she just narrowly sidestepped becoming codependent in her relationship with her husband.

“It’s easy to get into that codependency thing in the caregiver journey,” said Mrs. Corcoran, a 60-year old editor in Falls Church, Virginia. Her husband, Vince, began showing signs of a neurodegenerative illness one month after the couple married in 1999.

“In a marriage, when you first get a diagnosis that your spouse is ill, you are in the heroic stage,” Mrs. Corcoran said. “During this stage you think, ‘We’re going to beat this thing together!’” All of the focus is on the illness, she said, and this is when a family caregiver can begin to lose themselves.

“One of the issues can be a loss of objectivity,” said Dr. Josepha Cheong, a professor of psychiatry at the University of Florida College of Medicine who specializes in geriatric psychiatry. “A family caregiver needs to be able to determine what is in the best interests of the patient.” Dr. Cheong gives the example of a loved one with dementia who doctors recommend should stop driving. “The spouse is so invested in maintaining the patient’s self-esteem that they cannot support that,” she said.

There is no single definition of codependency, but it generally refers to someone in a relationship who is putting the needs of their loved one well above their own to the point that it negatively impacts their own quality of life.

As the reality of long-term in home caregiving sinks in over time, Mrs. Corcoran said that a spouse begins to burn out. “I was doing everything, and at the same grieving the loss of my husband,” she said, describing him as a strong and independent person before he got sick. Her husband’s illness was diagnosed as Fragile-X Associated Tremor Ataxia Syndrome in 2004.

“It was pretty horrible,” she said. “There was just so much to do and then when my blood pressure started going up, I knew I needed to get help and a nursing home was out of the question.”

Dr. Cheong said that family caregivers need to be on the lookout for their own depression, fatigue and anxiety. “Having either of these make the task of caregiving more difficult,” she said. “In my experience, the more depressed the family caregiver is, the more codependent they are.”

In 2005 Mrs. Corcoran made the decision to hire professional caregivers as her husband was physically and cognitively disabled to the point that she could not do everything for him anymore. She relied on her church and friends for support as well, and became an editor at The Well Spouse ™ Association,  www.wellspouse.org, a non-profit organization that offers support to spouse/partner caregivers.

“The goal is to adjust and pull yourself out, to have a separate existence,” she said. Mrs. Corcoran has two grown children, and her husband, now 72, (a widower when they married) has five grown children, yet she said there is no support from her step-children.

“I can get out of the house and have lunch with friends or see my three grandchildren now,” she said of having professional caregivers involved in her husband’s care. “I have a life for myself now.”

Although Mrs. Corcoran’s journey is that of a spousal caregiver, experts agree that family caregivers of all kinds—whether adult children caring for a parent, a parent caring for a child with special needs or spouses involved in home care for all ages—need to be aware of pitfalls such as codependency in their relationships.