IHT Rendezvous: In London for the Holidays? Theatrical Gifts for Everyone on Your List

So who needs more possessions? The holidays afford the chance to give the gift of theatergoing, the kind of present that will be remembered (one hopes) throughout the year. With that in mind, what follows is a handful of London theater suggestions for the festive season.
Enjoy, and curtain up!

For parents (or grandparents)

“Singin’ in the Rain” at the Palace Theater should fit the bill, whether or not your grandparents (or parents, even) first saw the 1952 MGM film musical at the time of its release. Set against the backdrop of the uneasy transition in moviedom from silent pictures to the talkies, the Gene Kelly film has spawned multiple stage versions on both sides of the Atlantic, of which the director Jonathan Church’s current incarnation is by some measure the best of the three that I have seen.

Inheriting Kelly’s role as silent film star Don Lockwood, onetime Tony nominee Adam Cooper (“Swan Lake”) makes as charming and insouciant a leading man as you could wish for, and his own family must thrill at the larger-than-life facsimile of Mr. Cooper (sporting an umbrella, ‘natch) on view to passers-by in front of the playhouse. The production has time-honored songs (“Good Morning,” “Moses Supposes,” and the title number among them), nifty choreography from Andrew Wright and lashings of real rain. Go and get soaked! And I don’t just mean over that extra intermission gin and tonic.

Is that just too familiar a title, or you would you rather give the family a taste of next year’s likely Broadway biggie? In that case, the Royal Shakespeare Company’s buoyant and witty “Matilda” is a good bet, continuing strong in London at the Cambridge Theater even as its New York bow gets nearer. A child-oriented piece that possibly means even more to adults, Matthew Warchus’s production also offers a prime man-as-woman star turn, more on which below.

For lovers

“The Effect,” running in repertory at the National Theater’s Cottesloe auditorium through Feb. 23, represents an intriguing date-night theatrical prospect largely because it places the speedy bloom of passion at its feverishly pulsating heart. One frequently hears the term “meet cute” to describe (often sniffily) an adorable if unlikely impromptu meeting.

But initial concerns that this play’s Connie and Tristan might not rise above the shopworn cliché inherent in the above phrase are soon dispelled by the unexpected path forged by Lucy Prebble’s play, which lands its newfound couple in the world of pharmaceutical research where desire is not to be trusted. Is romance actually having its day, the play asks, or are such reactions merely drug-induced? Ms. Prebble seems to come down on something resembling the primacy of truly authentic feeling, but not before taking her audience on a wild emotional ride. What more could you ask from the theater – well, that and Billie Piper’s gorgeous portrayal of Connie, which ranks among the year’s best performances.

For students

You don’t have to be engaged in academia, of course, to enjoy the current Royal Court mainstage entry, “In the Republic of Happiness,” but it helps to be alive and alert to theatrical form when taking in the playwright Martin Crimp’s latest. And if students don’t fit that bill, who does? And as London’s – some would say the English-speaking theater’s – premier playhouse for new writing, the Court has the added appeal of the “cool” factor, and the further attractions of the downstairs café/bar don’t hurt, either.

Told across three scenes, the shifts between visual environments managed with characteristically easeful dazzle by the designer Miriam Buether, Mr. Crimp here anatomizes a world given over to self-obsession and self-improvement whereby our constant quest for happiness has resulted only in hollowing us out. Brainiacs in the house will enjoy making clear the connections that are implicit in writing that asks the audience to do some work and then pays off with an ending that recalls (in tone if not content) the finale to Robert Altman’s seminal film, “Nashville,” as a requiem for a benumbed society. Dominic Cooke, artistic director of the Court, has done a tricky piece proud, and those who don’t walk out – as quite a few did at the performance I caught – will stay to cheer and possibly even book to see the show again.

For gender-benders

You thought cross-dressing was confined to the British tradition of the seasonal pantomime, which demands that a leggy young woman play the principal boy and usually casts a man of some seniority as the principal dame? (Ian McKellen, of all distinguished folk, filled that latter bill for two consecutive seasonal runs of “Aladdin” at the Old Vic.)

Pantos continue to proliferate on cue across the capital, but the so-called “legit” theater, too, seems to have gone cross-dressing mad. Consider for starters Miss Trunchbull that armor-plated harridan of a headmistress in “Matilda.” David Leonard is doing the honors now, while original leading man (um, woman?) Bertie Carvel readies for his New York debut. Not to be outdone are Mark Rylance and the cast of the all-male productions of “Twelfth Night” and “Richard III,” now at the Apollo Theater following sellout engagements at Shakespeare’s Globe last summer, and Simon Russell Beale in “Privates On Parade” at the Noel Coward Theater sporting baubles, bangles and sometimes not much at all as Terri Dennis, the campest – and most irresistible – of military captains.

Too many men, what about the women? Get in line for return tickets for Phyllida Lloyd’s all-female “Julius Caesar” at the Donmar: the London play that boasts by some measure the most swagger in town.

For someone you hope never to see again

“Viva Forever!”, at the Piccadilly Theater: Gift this one, scored to the back catalog of the Spice Girls, to someone from whom you hope to part company: trust me, they’ll never speak to you again.

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DealBook: Upstart Exchange in $8.2 Billion Deal for N.Y.S.E.

8:39 a.m. | Updated The owner of the 220-year-old New York Stock Exchange on Thursday agreed to an $8.2 billion deal that would give control of the longstanding symbol of American capitalism to an upstart competitor.

NYSE Euronext said that it would sell itself to the IntercontinentalExchange for about $33.12 a share in cash and stock. The combined company would have headquarters in both ICE’s home of Atlanta and in New York.

The takeover signals the revival of consolidation within the world of market operators, after a wave of deals dissipated amid concerns over antitrust and nationalist sentiment. ICE itself had partnered with NYSE Euronext’s main rival, the Nasdaq OMX Group, in an $11 billion hostile bid for the Big Board’s parent, only to see that offer blocked by the Justice Department.

NYSE Euronext itself had sought to combine with Deutsche Börse, creating a global giant in the trading of derivatives. But that merger was stymied by European antitrust regulators.

Thursday’s deal is expected to run into fewer problems. ICE and NYSE Euronext have little overlap: the former focuses on the trading of commodities like energy products, the latter on stocks and derivatives.

Indeed, while the New York Stock Exchange, with its opening bell and floor traders, has been the public image of a stock market for two centuries, it is NYSE Euronext’s businesses in the over-the-counter trading of derivatives — including the Liffe market in London — that is the main attraction in the merger talks.

As part of the deal, ICE will consider spinning off NYSE Euronext’s European stock market operations.

Shareholders of NYSE Euronext would own about 36 percent of the combined company.

ICE’s chief executive, Jeffrey C. Sprecher, would keep that role in the newly enlarged market operator. NYSE Euronext’s chief, Duncan L. Niederauer, would be president.

Both companies relied on armies of advisers. ICE was advised by Morgan Stanley; BMO Capital Markets; Broadhaven Capital Partners; JPMorgan Chase; Lazard; Societe Generale; and Wells Fargo. It received legal counsel from Sullivan & Cromwell and Shearman & Sterling.

NYSE Euronext was advised by Perella Weinberg Partners; BNP Paribas; the Blackstone Group; Citigroup; Goldman Sachs; and Moelis & Company. It was counseled by Wachtell, Lipton, Rosen & Katz; Slaughter & May; and Stibbe N.V.

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Letter from India: What Saves India — and Holds It Back

NEW DELHI — The Election Commission of India is a very serious body that does not believe the world will end this Friday, a workday. The commission is instead preparing for a more certain event in 2014: the general elections that will place a new government in Delhi, an event that has the potential to be cataclysmic to some. Recently I heard a financial adviser who was recording a group of children singing Christmas carols in a beautiful garden warn an insurance executive: “The stock market will collapse.”

His is a common view. With the reputation of every major political party battered in the public imagination following a string of corruption scandals, he predicted that the next government would be an unstable coalition assembled by too many political parties, with nearly everyone having a say.

There are more political parties in India than there are models of automobiles, which is a reason why the job requirements of a political journalist here do not include an ability to name all the parties. The 2009 general elections were contested by more than 364 parties. It would seem that such a situation is a problem, and it is. Yet it answers, to some extent, the frequent questions of the urban elite: What saves India? Why is there no violent revolution on the streets with angry young men cutting down the rich and burning the silver sedans? Considering the oceanic gap between the middle class and the poor that makes even the act of eating a burger in public somewhat embarrassing, how is it that the elite have never been separated from their heads?

Could it be that what saves India is politics? Can this be true even though every incident of large-scale violence in the country has been politically ordained? The nation gives its citizens plenty of reasons to take to the streets and disrupt what the wealthy regard as normal life. But the fact that most Indians have political representation has denied them the critical mass of excuses to release their rage through sustained violence. The nation’s politicians are the inadvertent but effective shock absorbers of Indian society.

All political parties claim to represent the poor, and they really do, because the poor are the most enthusiastic voters. But the poor are not a monolithic group. There are groups, grouses, castes and rivalries within them, and they are each represented in Indian politics in very specific ways.

The Dalits, who were once considered the untouchable caste and are now called “scheduled castes and tribes,” are represented by several parties. The most influential in northern India is headed by a woman who squandered her extraordinary popularity by amassing unexplained wealth and through a penchant for commissioning statues of herself. Her archrival is a party that represents the rural and semi-urban upper castes. And then there are parties for socialists who are afraid of foreign companies, communists who are Marxists, communists who are not Marxists and communists who don’t want “communist” in their party’s name.

Muslims, Sikhs and Christians all have their parties. Affluent farmers in the western state of Maharashtra also are represented. So are, even more specifically, sugar-cane farmers. Young people of Maharashtra who think migrants in the state capital, Mumbai, should be thrashed occasionally to keep them in their place have representation in a new political outfit. Their parents who agree vote for an older party.

A few decades ago in the southern state of Tamil Nadu, a party was formed for atheists, which naturally could not remain purely atheistic as it grew in numbers. Then a popular film actor broke away and started a party, ostensibly for the poor, that governed the state for many years. Then another film actor started a party, also for the poor. The interests of eunuchs in Tamil Nadu are represented by several parties.

A man in the same state has started a party for “lovers,” since they face harassment from conservative society, especially when they try to fondle behind catamarans on the beach. But he has yet to contest an election.

There is, of course, a powerful right-wing party for the Hindu business community and patriotic urban middle class, who have long wished for a “benign dictator” who will make the trains run on time, which they do anyway these days.

If none of these parties serves, there is of course the grand old Indian National Congress, which stands for everything and nothing. If the Congress isn’t good enough, either, there is a new organization that has risen from the rage of the educated middle class against political corruption.

But in this entire assembly of parties none represents the interests of women, who constitute more than half the population in a country where an unknown number of girls are killed in the womb and men deal with their loss of social power by committing violence against women. Substantial gender reforms cannot be enacted in India without antagonizing Indian men, and female politicians in major parties are reluctant to take that professional risk. Only a party willing to bet everything on women and uninterested in appeasing the men might stir the nation. Even some fathers of daughters might vote for it.

Manu Joseph is editor of the Indian newsweekly Open and author of the novel “The Illicit Happiness of Other People.”

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Irish Government Set to Allow Abortion in Rare Cases

DUBLIN — The Irish government said Tuesday that it was preparing to allow abortion under limited circumstances in an effort to comply with demands by the European Court of Human Rights to clarify the country’s legal position on the issue.

Cathal Mcnaughton/Reuters

A vigil was held in Dublin on Monday in memory of Dr. Savita Halappanavar, a 31-year-old dentist who died after being denied an abortion.

The proposed legislative and regulatory changes would allow abortion only in cases where there is a real and substantial risk to a woman’s life — as distinct from her health.

The Supreme Court ruled in 1992 that abortion was permissible when risk was present, but the government never passed a law to that effect.

Addressing Parliament after the announcement, Prime Minister Enda Kenny was at pains to emphasize that the proposals would allow abortion only in certain cases. He added that the threat of suicide could be among them.

The abortion debate has convulsed Ireland for decades, but calls for change reached a crescendo after the death of Dr. Savita Halappanavar, a 31-year-old dentist, in October. Dr. Halappanavar arrived at a Galway hospital in severe pain and was found to be miscarrying. Her fetus had a heartbeat, making termination of the pregnancy illegal under Irish law. She died of septicemia a week after admission.

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Irish Government Set to Allow Abortion in Rare Cases

DUBLIN — The Irish government said Tuesday that it was preparing to allow abortion under limited circumstances in an effort to comply with demands by the European Court of Human Rights to clarify the country’s legal position on the issue.

Cathal Mcnaughton/Reuters

A vigil was held in Dublin on Monday in memory of Dr. Savita Halappanavar, a 31-year-old dentist who died after being denied an abortion.

The proposed legislative and regulatory changes would allow abortion only in cases where there is a real and substantial risk to a woman’s life — as distinct from her health.

The Supreme Court ruled in 1992 that abortion was permissible when risk was present, but the government never passed a law to that effect.

Addressing Parliament after the announcement, Prime Minister Enda Kenny was at pains to emphasize that the proposals would allow abortion only in certain cases. He added that the threat of suicide could be among them.

The abortion debate has convulsed Ireland for decades, but calls for change reached a crescendo after the death of Dr. Savita Halappanavar, a 31-year-old dentist, in October. Dr. Halappanavar arrived at a Galway hospital in severe pain and was found to be miscarrying. Her fetus had a heartbeat, making termination of the pregnancy illegal under Irish law. She died of septicemia a week after admission.

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Kodak to Sell Digital Imaging Patents for $525 Million

(Reuters) - Bankrupt camera maker Eastman Kodak Co agreed to sell its digital imaging patents for about $525 million to a consortium led by Intellectual Ventures and RPX Corp, a key step to ending its bankruptcy.

The photography pioneer said a portion of the payment will come from 12 intellectual property licensees organized by Intellectual Ventures and RPX Corporation.

A sale of the roughly 1,100 patents, which Kodak has said could be worth as much as $2.6 billion, has been a key element of the Rochester, New York-based company's plans to shift its focus to commercial packaging and printing from photography.

The agreements are subject to approval by the U.S. Bankruptcy Court in Manhattan.

The Kodak bankruptcy case is in Re: Eastman Kodak Co. et al, U.S. Bankruptcy Court, Southern District of New York, No. 12-10202.

(Reporting by Tom Hals in Wilmington, Delaware and Sruthi Ramakrishnan in Bangalore; Editing by Nick Zieminski)

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IHT Rendezvous: In Philippines, a Turning Point on Contraception

HONG KONG — There was both recrimination and celebration after the passage of a landmark bill in the Philippines on Monday, a measure that codifies sex education in schools and broadens access to condoms and birth control pills in poor and rural areas.

Versions of the bill had languished for more than a decade, as my colleague Floyd Whaley reported in The New York Times, because of staunch opposition from the Roman Catholic Church. About 80 percent of Filipinos are Catholic.

The reproductive health measure, locally known as the RH bill, passed in the House of Representatives by a vote of 133 to 79, with 7 abstentions. (The bill had earlier passed the Senate, 13 to 8.)

Opponents of the bill were furious that 62 members of the House had not shown up for the vote.

“There is still a burning question that needs to be answered: Where were the other congressmen in time of such a crucial vote like the RH bill?” said the Pro-Life Philippines Foundation, which called the bill “ungodly” and published a list of the “Judases” who did not vote.

“This is evil itself at work,” the foundation said on its Web site.

Catholic bishops have said they would work to defeat any supporters of the law in elections next year.

But Edcel Lagman, the congressman who sponsored the bill, played down those warnings, saying, “It’s more of a threat than a reality. The experience in other Catholic countries is once a law is passed on reproductive health, even the church supports the law.”

One of the congressmen who missed the vote was Manny Pacquiao, the acclaimed welterweight boxer and almost certainly the most famous person in the Philippines. He was elected to the House in 2010 to represent Sarangani, located on the southern tip of the island of Mindanao.

Mr. Pacquiao was knocked cold in a non-title fight in Las Vegas on Dec. 8, losing to Juan Manuel Márquez of Mexico. Three days later, on the floor of the House in suburban Manila, he spoke against the reproductive health bill, which was up for a preliminary vote. After receiving a rousing standing ovation from his fellow lawmakers, he said, “Manny Pacquiao is pro-life. Manny Pacquiao votes ‘no’ to House Bill No. 4244.”

A condensed excerpt of Mr. Pacquiao’s remarks:

In the dying seconds of the sixth round of my fight against Marquez, a single punch knocked me out. For more than two minutes, I was lying unconscious, motionless. My wife cried . . . my friends and fans cried when they saw me not moving at all. Some thought I was dead. They thought another life had been lost.

What happened in Vegas strengthened my already firm belief in the sanctity of life, on whether a person’s right to live in this world should be put in the hands of his fellow man.

One of the most outspoken opponents of the bill was Senator Vicente C. Sotto III, widely known as Tito. He wanted to block teenagers from obtaining contraception, arguing that it would encourage young people to have sex.

Another congressman, Romero Quimbo, called Miro, was in the hospital on Monday, suffering from dengue fever, although he got permission to leave briefly so he could vote for the bill. Afterward, he tweeted a photo of himself in an ambulance heading back to the hospital.

Amnesty International generally applauded the passage of the bill, although the group noted that the current version was “imperfect” because it required girls under 18 to have written parental consent before getting contraceptives.

“The Philippines still have a long way to fully respect, protect and fulfill women’s right to reproductive health,” said Polly Truscott, Amnesty’s deputy Asia-Pacific director.

The new bill does not affect abortions, which remain illegal in the Philippines.

The final version of the law can still be tweaked by legislators before it is sent to President Benigno S. Aquino III for his signature.

Mr. Aquino was vocal in his support for the measure, and his spokesman, Edwin Lacierda, said Monday, “The people now have the government on their side as they raise their families in a manner that is just and empowered.”

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Bits Blog: What Instagram's New Terms of Service Mean for You

Instagram released an updated version of its privacy policy and terms of service on Monday, and they include lengthy stipulations on how photographs uploaded by users may be used by Instagram and its parent company, Facebook.

The changes, which will go into effect Jan. 16, will not apply to pictures shared before that date.

Facebook and Instagram have both hinted at plans to incorporate advertisements into Instagram’s application, although they have declined to provide details about how and when ads would be deployed. These freshly drafted terms give the first glimpse of what the companies might have planned. Here’s a quick rundown of what the new terms, the most significant changes in Instagram’s short history, could mean for users.

1. Instagram can share information about its users with Facebook, its parent company, as well as outside affiliates and advertisers.
Instagram said that the changes to its privacy policy are a means to help Instagram “function more easily as part of Facebook by being able to share info between the two groups.” The potentially lucrative move will let advertisers in Facebook’s ad network use data and information that users have shared on Instagram, like details about favorite places, bands, restaurants or hobbies, to better target ads at those users.

2. You could star in an advertisement — without your knowledge.
A section of the new terms of service, titled “Rights,” notes that Instagram will also be able to use your photographs and identity in advertisements. “You agree that a business or other entity may pay us to display your username, likeness, photos (along with any associated metadata), and/or actions you take, in connection with paid or sponsored content or promotions, without any compensation to you,” the new terms say. This means that photographs uploaded to Instagram could end up in an advertisement on the service or on Facebook. In addition, someone who doesn’t use Instagram could end up in an advertisement if they have their photograph snapped and shared on the service by a friend. Facebook already runs ads that make use of people’s activity on its site.

Marc Rotenberg, executive director of the Electronic Privacy Information Center, an advocacy group in Washington, said that the use of a person’s likeness in ads could run into some state laws protecting people’s privacy.

“Most states have laws that limit the use of a person’s ‘name or likeness’ for commercial purposes without consent,” Mr. Rotenberg said. “The legal purpose is to allow people to obtain the commercial value of their images and endorsements, which is a big issue for celebrities and others, but also a reasonable concern for Facebook users whose images are used by Facebook to encourage friends to buy products and services.”

3. Underage users are not exempt.
Athough Instagram says people must be at least 13 years old to sign up for the service, the new terms note that if a teenager signs up, they are agreeing that a parent or guardian is aware that their image, username and photos can also be used in ads.

4. Ads may not be labeled as ads.
In another section of the updated terms, the company says ads will not necessarily be labeled as ads. “You acknowledge that we may not always identify paid services, sponsored content, or commercial communications as such,” the company wrote.

5. Want to opt out? Delete your account.
The only way to opt out of the new Instagram terms is to not use the service. If you log into Instagram in any way, including through the Web site, mobile applications or any other services offered by Instagram, you agree to have your content used in ads. Instagram’s new terms of service say that “by accessing or using the Instagram website, the Instagram service, or any applications (including mobile applications) made available by Instagram (together, the “Service”), however accessed, you agree to be bound by these terms of use.”

Instagram addressed the changes on its company blog, saying that “nothing has changed about your photos’ ownership or who can see them.” In its blog post, Instagram said the changes would primarily help the company combat spam, which has plagued the application as it has swelled in popularity.

“Our updated terms of service help protect you, and prevent spam and abuse as we grow,” the company wrote.

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The New Old Age Blog: In the Middle: Helping Unhappy Couples

A post on Monday discussed the forces that can make an older couple’s good marriage suddenly go bad — an array of subtle, and often-misunderstood, mental, physical and emotional factors that can upset the equilibrium of even the happiest marriages.

Now we have consulted marriage counselors and geriatricians to find out what caregivers — either the grown children of the couple, or one of the spouses involved– can do to help restore peace and balance to these relationships. The experts consulted uniformly agreed that even older people can at least take steps to reduce tensions and improve their relationship, even if they cannot actually change. (Really, who can, at any age?)

“Even though the situation may seem overwhelming, take heart,” said Dr. Gordon Herz, a psychologist in private practice in Madison, Wisc., who specializes in neuropsychology and rehabilitation psychology. “Couples who have been together for 60 years tend to have worked out ways to manage conflict – or they wouldn’t still be together.”

Retreat to a neutral corner

When grown children see their parents fight, many want to run and hide. But those who are assuming an increased caregiving role often feel impelled to jump in and “fix” the problem, as they do with the other caregiving issues.

If you are so inclined, experts speak with one loud voice to advise: Don’t!

Trying to act as emotional broker between your parents can backfire. (Now they tell me! Suffice it to say that after one such effort my sister said to me in not exactly the friendliest tone, “Well, that went well, didn’t it?”)

“It’s better if your parents can find somebody else to talk to than you,” said Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and the author of “Overwhelmed: Coping With Life’s Ups and Downs.”

Don’t give up on marital therapy

“Marital therapy for individuals over 65 years of age is difficult, since habits of a lifetime are deeply ingrained,” stated a study in The Canadian Journal of Medicine, one of the few in the medical literature about marital therapy among older people.

“Yet, in a sense, marital therapy is more crucial for the elderly than for younger patients,” the study continued. “At a time when they are least adaptable and most vulnerable to stress and are entering perhaps the most difficult period of their lives, the elderly must learn new methods of relating and coping” because of the physical and mental changes described in our earlier post.

There’s another reason learning to cope with life changes as a couple is even more critical for older couples: Unlike younger couples, the elderly are rarely in a position to leave the marriage and start over.

Help at least one spouse get counseling

What if only half the couple is ready to seek counseling? Not a problem, therapists said. “You want to help the part of the couple that is suffering,” said Dr. Elaine Rodino, a therapist in private practice in State College, Penn. “The other person may still be the curmudgeon, but I think of it as the law of physics: When you change one aspect of the formula, things change in the total.”

When dementia affects one of the spouses, therapy can help the caregiving spouse learn coping techniques, “which can reduce the marital discord and stress that can make conditions, especially cognitive difficulties, worse,” said Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine.

Consider the general practitioner or internist

If the couple won’t see a marriage counselor or therapist, can a family doctor be of any use? The experts had mixed responses.

Many pointed out that general practitioners have neither the time nor the training to offer much relationship help, unless the origin of the problem is exclusively physical. Others thought they could be of use, if given a little direction from the family.

“I encourage the kids to talk to the doctor in advance and let him know something is going on – signs of depression or other problems the parents won’t talk about,” advised Dr. Dale, adding that a consultation with a geriatrician who is more familiar with problems of the aging might be even more productive. “Then the doctor can say, ‘Gee, you sound really frustrated or down — are there any reasons we can explore?’”

Don’t overlook the importance of intimacy

“Mutually stimulating sexual relationships need care and feeding by both partners at any age, but especially in the geriatric years,” according to a study on marital therapy for the elderly. “The need for physical contact, warmth and touching perhaps reaches a peak in this age of loneliness, decreased self-esteem and poor health.”

Forget the idea that elderly couples are too shy to talk about intimacy, insisted Dr. Rodino. “I saw a couple in their 80s, the husband was getting penile injections at the doctor’s office, and then they hurried home to have sex.”

But Dr. Rodino does concede that for older patients it is especially important to focus not only on sexual function and performance, but on “touching, and non-intercourse sexual relations; I help them rekindle the affection and emotional closeness,” Dr. Rodino said.

Address any neuropsychological issues.

To find out whether the sudden marital conflict may stem from early mental cognitive impairment (M.C.I.) —or to rule M.C.I. out and find the real source of trouble — make sure the spouse obtains a full neuropsychological evaluation. If it is M.C.I., “it convinces everybody that there is more than just abstinence, it’s not a personality problem — and they need to address it,” said Dr. Dale.

Don’t overlook simple solutions

“Sometimes a memory problem is something simple, like low Vitamin B12, that is easily fixed,” said Dr. Dale. “Or hypothyroidism, which is quite common, can affect memory.”

In that case, doctors administer synthroid, a thyroid hormone replacement that Dr. Dale said is “very safe, with almost no side effects.” Other changes in behavior can also be the result of a simple problem or be remedied by a change in medication. Don’t assume the worst.

Put an end to the blame game

Help reframe the problem. “Even if dementia is involved, let them know it’s not that their partner hates them, it’s that he is having cognitive changes,” said Dr. Linda Waite, director of the Center on Demography and Economics of Aging at NORC/University of Chicago.

“When you re-frame it like that, it’s easier for the spouse not to take it personally and not blame themselves and feel it’s something they did,” said Dr. Waite. “It can make a difference.”

A 2009 study in the journal Gerontologist supports this notion: “Care partners likely would benefit from strategies aimed at reducing self-blame, enhancing coping skills … and communicating effectively with the person with M.C.I and significant others.”

Separate the anxiety

Divide and conquer — time away improves time together.

“Older couples, especially those with disabilities, spend way too much time together,” said Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program. “It would be a problem for any couple.”

Caregivers can best help by arranging for an activity or outing that each spouse can do separately so they can return to each other refreshed and more cheerful. “That can help a lot,” said Dr. Gwyther.

Dial down the tone

For spouse caregivers, it is important to watch not just what is said, but how it is said. In any relationship, tone influences our interpretation of what our partner says. Those with M.C.I. will especially react to tone, rather than the substance of the exchange, Dr. Dale said.

“Ratchet down the emotions, repeat things calmly,” Dr. Dale said. The person with cognitive problems doesn’t know he asked the same question five times — he only knows that you sound angry at him for no reason he can fathom. One spouse’s anger fuels the other’s, and pretty soon there is a fight or withdrawal.

Zero tolerance for violence

If a spouse becomes violent, “that’s an entirely different issue,” said Dr. Schlossberg. “Call in an expert on family violence” or the police.

Help them help others

Nobody likes feeling dependent and having to ask for help. Finding a way to have your loved one volunteer, help others and continue to feel useful can improve moods and marital interactions – even if M.C.I. is involved.

With one couple Dr. Gwyther saw, the wife was not only “driving her husband nuts because she was asking him the same questions over and over,” but she could no longer drive and deliver food in a mobile meals program as she used to. “So her husband agreed to be the driver — and she took the meals to the doors,” Dr. Gwyther recalled.”It made her feel good to continue to do that — and it made them feel good to do it together.”

Caregiver, heal thyself

You have heard it a million times here and elsewhere but, unlike us, this advice never gets old.

If you are exhausted from caregiving, you are bound to be cranky, and that will make everybody around you edgy and irritable, too — especially the spouse who requires your care. Taking the time to look after your own health and engage in activities that bring you pleasure can go a long way toward reducing stress and reestablishing a peaceful balance in a marriage.

How have you coped with tensions in your marriage — or in your elderly parents’ marriage, as you care for them in their old age? Share in the comments below.

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The New Old Age Blog: In the Middle: Helping Unhappy Couples

A post on Monday discussed the forces that can make an older couple’s good marriage suddenly go bad — an array of subtle, and often-misunderstood, mental, physical and emotional factors that can upset the equilibrium of even the happiest marriages.

Now we have consulted marriage counselors and geriatricians to find out what caregivers — either the grown children of the couple, or one of the spouses involved– can do to help restore peace and balance to these relationships. The experts consulted uniformly agreed that even older people can at least take steps to reduce tensions and improve their relationship, even if they cannot actually change. (Really, who can, at any age?)

“Even though the situation may seem overwhelming, take heart,” said Dr. Gordon Herz, a psychologist in private practice in Madison, Wisc., who specializes in neuropsychology and rehabilitation psychology. “Couples who have been together for 60 years tend to have worked out ways to manage conflict – or they wouldn’t still be together.”

Retreat to a neutral corner

When grown children see their parents fight, many want to run and hide. But those who are assuming an increased caregiving role often feel impelled to jump in and “fix” the problem, as they do with the other caregiving issues.

If you are so inclined, experts speak with one loud voice to advise: Don’t!

Trying to act as emotional broker between your parents can backfire. (Now they tell me! Suffice it to say that after one such effort my sister said to me in not exactly the friendliest tone, “Well, that went well, didn’t it?”)

“It’s better if your parents can find somebody else to talk to than you,” said Dr. Nancy K. Schlossberg, professor emerita of counseling psychology at the University of Maryland and the author of “Overwhelmed: Coping With Life’s Ups and Downs.”

Don’t give up on marital therapy

“Marital therapy for individuals over 65 years of age is difficult, since habits of a lifetime are deeply ingrained,” stated a study in The Canadian Journal of Medicine, one of the few in the medical literature about marital therapy among older people.

“Yet, in a sense, marital therapy is more crucial for the elderly than for younger patients,” the study continued. “At a time when they are least adaptable and most vulnerable to stress and are entering perhaps the most difficult period of their lives, the elderly must learn new methods of relating and coping” because of the physical and mental changes described in our earlier post.

There’s another reason learning to cope with life changes as a couple is even more critical for older couples: Unlike younger couples, the elderly are rarely in a position to leave the marriage and start over.

Help at least one spouse get counseling

What if only half the couple is ready to seek counseling? Not a problem, therapists said. “You want to help the part of the couple that is suffering,” said Dr. Elaine Rodino, a therapist in private practice in State College, Penn. “The other person may still be the curmudgeon, but I think of it as the law of physics: When you change one aspect of the formula, things change in the total.”

When dementia affects one of the spouses, therapy can help the caregiving spouse learn coping techniques, “which can reduce the marital discord and stress that can make conditions, especially cognitive difficulties, worse,” said Dr. William Dale, chief of geriatrics at the University of Chicago Geriatrics Medicine.

Consider the general practitioner or internist

If the couple won’t see a marriage counselor or therapist, can a family doctor be of any use? The experts had mixed responses.

Many pointed out that general practitioners have neither the time nor the training to offer much relationship help, unless the origin of the problem is exclusively physical. Others thought they could be of use, if given a little direction from the family.

“I encourage the kids to talk to the doctor in advance and let him know something is going on – signs of depression or other problems the parents won’t talk about,” advised Dr. Dale, adding that a consultation with a geriatrician who is more familiar with problems of the aging might be even more productive. “Then the doctor can say, ‘Gee, you sound really frustrated or down — are there any reasons we can explore?’”

Don’t overlook the importance of intimacy

“Mutually stimulating sexual relationships need care and feeding by both partners at any age, but especially in the geriatric years,” according to a study on marital therapy for the elderly. “The need for physical contact, warmth and touching perhaps reaches a peak in this age of loneliness, decreased self-esteem and poor health.”

Forget the idea that elderly couples are too shy to talk about intimacy, insisted Dr. Rodino. “I saw a couple in their 80s, the husband was getting penile injections at the doctor’s office, and then they hurried home to have sex.”

But Dr. Rodino does concede that for older patients it is especially important to focus not only on sexual function and performance, but on “touching, and non-intercourse sexual relations; I help them rekindle the affection and emotional closeness,” Dr. Rodino said.

Address any neuropsychological issues.

To find out whether the sudden marital conflict may stem from early mental cognitive impairment (M.C.I.) —or to rule M.C.I. out and find the real source of trouble — make sure the spouse obtains a full neuropsychological evaluation. If it is M.C.I., “it convinces everybody that there is more than just abstinence, it’s not a personality problem — and they need to address it,” said Dr. Dale.

Don’t overlook simple solutions

“Sometimes a memory problem is something simple, like low Vitamin B12, that is easily fixed,” said Dr. Dale. “Or hypothyroidism, which is quite common, can affect memory.”

In that case, doctors administer synthroid, a thyroid hormone replacement that Dr. Dale said is “very safe, with almost no side effects.” Other changes in behavior can also be the result of a simple problem or be remedied by a change in medication. Don’t assume the worst.

Put an end to the blame game

Help reframe the problem. “Even if dementia is involved, let them know it’s not that their partner hates them, it’s that he is having cognitive changes,” said Dr. Linda Waite, director of the Center on Demography and Economics of Aging at NORC/University of Chicago.

“When you re-frame it like that, it’s easier for the spouse not to take it personally and not blame themselves and feel it’s something they did,” said Dr. Waite. “It can make a difference.”

A 2009 study in the journal Gerontologist supports this notion: “Care partners likely would benefit from strategies aimed at reducing self-blame, enhancing coping skills … and communicating effectively with the person with M.C.I and significant others.”

Separate the anxiety

Divide and conquer — time away improves time together.

“Older couples, especially those with disabilities, spend way too much time together,” said Dr. Lisa Gwyther, director of the Duke Center for Aging Family Support Program. “It would be a problem for any couple.”

Caregivers can best help by arranging for an activity or outing that each spouse can do separately so they can return to each other refreshed and more cheerful. “That can help a lot,” said Dr. Gwyther.

Dial down the tone

For spouse caregivers, it is important to watch not just what is said, but how it is said. In any relationship, tone influences our interpretation of what our partner says. Those with M.C.I. will especially react to tone, rather than the substance of the exchange, Dr. Dale said.

“Ratchet down the emotions, repeat things calmly,” Dr. Dale said. The person with cognitive problems doesn’t know he asked the same question five times — he only knows that you sound angry at him for no reason he can fathom. One spouse’s anger fuels the other’s, and pretty soon there is a fight or withdrawal.

Zero tolerance for violence

If a spouse becomes violent, “that’s an entirely different issue,” said Dr. Schlossberg. “Call in an expert on family violence” or the police.

Help them help others

Nobody likes feeling dependent and having to ask for help. Finding a way to have your loved one volunteer, help others and continue to feel useful can improve moods and marital interactions – even if M.C.I. is involved.

With one couple Dr. Gwyther saw, the wife was not only “driving her husband nuts because she was asking him the same questions over and over,” but she could no longer drive and deliver food in a mobile meals program as she used to. “So her husband agreed to be the driver — and she took the meals to the doors,” Dr. Gwyther recalled.”It made her feel good to continue to do that — and it made them feel good to do it together.”

Caregiver, heal thyself

You have heard it a million times here and elsewhere but, unlike us, this advice never gets old.

If you are exhausted from caregiving, you are bound to be cranky, and that will make everybody around you edgy and irritable, too — especially the spouse who requires your care. Taking the time to look after your own health and engage in activities that bring you pleasure can go a long way toward reducing stress and reestablishing a peaceful balance in a marriage.

How have you coped with tensions in your marriage — or in your elderly parents’ marriage, as you care for them in their old age? Share in the comments below.

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