The progressive symptoms of Alzheimer's can put stress on relationships, leaving caregivers to cope with the loss of intimacy and other aspects of adult romantic relationships, said Dr. Jason Karlawish, a professor of medicine and medical ethics and assistant director of the Penn Memory Center in Philadelphia.
"There's no question that this is an issue," said Karlawish. "But to a spouse who's struggling with this kind of issue, I would want to say after the patient has left this world, you want be able to look back and say you treated that person with dignity."
Zaven Khachaturian, president of the Maryland-based Campaign to Prevent Alzheimer's Disease by 2020, said that Robertson's logic could have parents abandoning newborn babies.
"After all, a newborn presents to the caregiver exactly the same set of caregiver burden," said Khachaturian. "Both the infant and the person with Alzheimer's must be fed, cleansed, they are highly emotional, sleep a lot, they have wrinkled skins. If neglected, they will die. Does this mean caregivers must abandon newborn infants because it is not convenient to take care of them?"
New technologies are making it possible to diagnose Alzheimer's disease earlier, while patients have the ability to understand the road ahead of them.
"I think this highlights the need for couples and families to have discussions early in any illness, and preferably before illness strikes so that person's decisions and preferences are known and respected," said David Loewenstein, a clinical neuropsychologist at University of Miami's Miller School of Medicine.
Robertson's advice was for a male caregiver. But sometimes it's the patient who wants to start a new relationship.
"I have seen both caregivers and patients enter into new relationships during the course of dementia. How they choose to handle it is up to them. All parties dealing with this disease suffer to some extent and deserve to find happiness," said USF's Smith. "Ultimately, the decision for any couple to divorce, for any reason, is a private and difficult one."
Some couples stay married but form new relationships, too.
"There are many spouses who are devoted to the affected person with Alzheimer's, and yet form new relationships as they also care for their spouse," said Sandra Weintraub, professor of neurology and a neuropsychologist at the Cognitive Neurology and Alzheimer's Disease Center at Northwestern University Feinberg School of Medicine. "It's hard to negotiate living with Alzheimer's disease but dictating what's good and bad is not useful.
"Every person needs to make their own decisions and to consider all parties involved. I sincerely hope the good reverend never has to have Alzheimer's to experience his advice first hand."
Tim King, spokesman for the Christian organization Sojourners, said Robertson's controversial statement was encouraging in at least one regard.
"I'm actually encouraged to hear someone like Pat Robertson say we're not really in a position to judge another person," King said. "I can't imagine the difficulty that a spouse would have to see someone go through that type of change and transformation. ... I don't know anyone who is in the position to judge another type of person who is having to make those type of decisions. It should never be taking lightly; it should never be an easy decision. Dealing with marriage is serious and making a big decision like that should be hard."
A representative for Robertson's network told the Associated Press that there would be no further comment on the matter.