When can he leave fiancée after a stroke?

Dear Prudence: I am 40 and until recently a single father. A little over 1 ½ years ago, I met a woman who totally changed my perspective on life. I'd never believed in soul mates, but she made me a believer. We could complete each other's sentences and had the kind of love I'd never felt for anyone. After six months we bought a house together, merged families, and I proposed.

Three months ago my fiancée had a major stroke and lost her speech and all function on one side of her body. She will likely never return to work or the life she had. She can now walk some and has regained some speech, but it is limited. Her arm still has no function.

This has created a future that I had not envisioned nor signed up for. Every day is a reminder of what once was, and so is a constant source of hurt and pain. I am committed for at least a year, which is how long I knew her before her stroke, to assist her in regaining as normal a life as possible. But I cannot envision going through the rest of my life like this.

I know she will be devastated if I leave, but I will be devastated if I stay. Additionally, I do not think it fair to my own child, who has a limited number of years remaining at home. This is a tragedy no matter what choice is made. I welcome your thoughts.

Prudence says: However long you're going to stay, make that time count. You say you want to help with her recovery, so you should oversee a recovery boot camp. Our medical system can be good at saving people's lives, but often these patched-up individuals are sent home to figure out the rest of their lives on their own. But for a stroke patient, particularly a young one, getting aggressive rehabilitation early is crucial.

I hope you two have a support system of friends and family who want to help; if so, put them to work. Have them investigate the best treatments in your area for aphasia. Have them see what kinds of rigorous physical therapy is available. (Good places to start are American Stroke Association, the National Stroke Association, and the Stroke Network.) Have someone be a point person to deal with the insurance company. Ask loved ones to stay with your fiancée so that you can get the respite you need to go out with friends, or go on a camping trip with your child.

What you're facing will be grueling, and it could be that your fiancée will remain severely disabled. It's also possible that a year from now she will be in a remarkably different place.

She learned to walk again and while she'll never be a concert pianist, that arm now works. At the time her marriage was on the rocks, but her husband came home to help. The reconciliation failed, she says, in part because she didn't want someone who was there, as he was, out of pity.

When I talked to her about your story, she had no words of condemnation for you. She said that you two being together for a little more than a year was pretty light for something this heavy, and she understood that it's particularly hard for a young person. There's a lot of pain for both the stroke survivor and the caretaker.

But three months out is too early to judge the extent of your fiancée's possible recovery. Even if you ultimately decide you can't stay in the relationship, you might be able to remain a close, supportive friend. You could also use a therapist of your own to help you work through what you can and can't do.

I hope in time the days get easier. And as they go by, keep checking in with yourself and ask, "What would I expect and want her to do if our situations were reversed?"