‘The balance in our relationship has changed’: everyday family living, couplehood and digital spaces in informal spousal care

ABSTRACT Building on an ethnographic approach, this study aims to explore how the notion of couplehood and family life is understood and negotiated in everyday life by older carers and their spouses. Inspired by Morgan’s perspective on the doing of family life, and Hochschild’s analysis of emotion work and feeling rules, the article shows how the process of becoming a carer/care recipient creates a new life situation for couples. The findings show that gendered tasks of family life such as housework and financial responsibilities change between spouses, and new practicalities emerge. This in turn changes the power balance between the spouses and how they do couplehood. The findings also reveal how the participants’ sense of we and I are negotiated to do family life, with regards to their health, sense of moral obligation, personal autonomy, love and caregiving. A sense of social isolation is apparent, and social media, apps and online games are sometimes used to create digital spaces in which participants can maintain connections with friends and children, find solitude and regain energy by getting a temporary pause from spousal informal care. Such strategies enable couples to find balance and a sense of autonomy in their lives as a family.


Introduction
The door to the apartment opens and Agnes, a woman in her mid-70's, invites me in. Her husband, Ivar, is sitting in the living room with a walker in front of him. Ivar smiles and says hello. Agnes explains that Ivar is about to be picked up by the home care staff. He is going to the Meeting Point where older people can meet and socialize. Agnes seldom leaves the house. She is too worried that something will happen to Ivar if he is home alone, and besides, when he is away there is always housework to do. Agnes sometimes feels a bit isolated. She says that she and Ivar don't talk to each other as they used to. Instead, she tries to text daily with their grown-up children, sharing pictures and things. That helps. Their son has also bought them a tablet and sometimes Agnes plays an online quiz game through which she met a new friend. They play the game together and send messages to each other. Agnes smiles when she talks about her new friend.
This observation describes a meeting with an older Swedish couple in which one spouse (Agnes) provides care and support to the other (Ivar). The observation touches upon several changes in the couple's everyday life due to Ivar's detoriating health, and how this has impacted their relationship, household and the ways in which they socialize.
Although the ultimate responsibility for the care of older people in Sweden rests with the municipality, it is common for people 65 and older to provide care and support to a spouse (Abellan et al., 2017). According to the National Board of Health and Welfare Sweden (NBHWS) (2014), this type of care relationship is also more time-consuming than, say, providing care to a parent (see also Pinquart & Sörensen, 2011). Spouses who provide care also report worse physical health and substantial financial and social consequences for informal care relationships (NBHW, 2012;Fast, 2015). As suggested by Keating and Eales (2017, p. 154) however, whereas economic and health consequences of caring have been thoroughly documented, still 'the consequences for carers' social relationships remains fragmented and underexplored' (see also Bauer & Sousa-Poza, 2015). It is therefore suggested, given the widespread evidence of the importance of these relationships and concerns about the sustainability of informal (family) caring, that further explorations are needed (Keating & Eales, 2017).
Although scholars have tended to focus on either the carer or the care recipient, there are some studiesin, for example, the field of chronic conditionsthat have focussed on dyadic and relational interventions (Stockwell-Smith et al., 2018), and others that have explored the dynamic of carer/care recipient relationships (Hellström et al., 2007;Nolan et al., 1996). Kaplan (2001), for example, discussed the extent to which spouses feel that there is still a we in their relationship or if this has evolved into a sense of I due to caring practices. In their study, Lüdecke et al. (2018) looked at the factors that predict the outcomes of family care of older people, with a particular focus on the role of the relationship between the carer and the care recipient. They found that if the care was provided by a spouse or partner, after one year the care recipient was less likely to be cared for by another person or be in residential care. They interpreted the result in relation to other research showing that spouses often regard caring for a partner as a marital duty (cf. Gallagher & Rickenbach, 2019;Pinquart & Sörensen, 2011).
This article builds on an ethnographic study, consisting of interviews with and observations of older Swedish carers and their care-receiving spouses. The aim of the study is to analyse and explore the notion of couplehood and how family life is understood and negotiated by carers and care recipients in everyday life. We are interested in how older couples talk about their relationship and how a spouse's detoriating health may have impacted their relationship. The aim of the study was addressed with the help of the following research questions: RQ1: In what ways (if any) does the transition to spousal caring impact the organisation and practicalities of family life?
RQ2: In what ways do the participants talk about their relationship and the notion of couplehood?
RQ3: In what ways (if any) can the participants' use of Information and Communication Technology (ICT) be understood in everyday life while being a carer and a care recipient?
In the article, we will use the terms carer and care recipient when talking about our participants. Although these terms may imply that the care has a certain direction (something that is given and received) we use the terms in a more heuristic way, understanding them relationally (Kenny et al., 2020). To us, being a carer and care recipient is understood as something that is negotiated, produced and experienced relationally between spouses.

Background
Thus far, scholars have tended to focus on either the experiences of the carer or the care recipient in research on informal care. It is however widely acknowledged within the field of family sociology, as well as psychology and in health sciences, that both spouses and their dyadic relationships are impacted by one partner becoming ill or in need of care for whatever reason (see for example Morgan, 2011;Noller & Karantzas, 2012;Bookwala, 2016). In their study about older caregiving couples, Monin et al. (2017) for example asked whether spouses' sense of well-being and health was associated with their (and their partners') relationship satisfaction, and if so, how. The study indicated that carers and care recipients with lower relationship satisfaction showed greater depressive symptoms and lower self-reported health (see also Daley et al., 2017;Hooker et al., 2015;Strömberg & Luttik, 2015).
Not only are couples' understandings of their relationship affected by their provision and receipt of care; also, couples use different strategies to maintain their couplehood and family life (Hellström et al., 2007;Riekkola et al., 2019). Kaplan (2001), in her research based on 68 interviews with spousal dementia carers, revealed how her participants experienced different degrees of couplehood, stretching from 'till death do us part' to 'unmarried marrieds' (see also Olson, 2015). In so doing, she broadened the typology of the ways in which couplehood is understood. The affective relationships and its consequences is also discussed by Dragojlovic and Broom (2018) who looked at the relational dimensions of care through the lens of the lived experience of suffering. Positioned within critical body theory and phenomenology, this study revealed, among other things, how moral and emotional questions are negotiated in relation to care for others and the ways in which this practice is lived and felt. Similarly, Olson (2015) is interested in the sociology of emotion and identity among spouses caring for a significant other living with cancer. Adopting a longitudinal approach, this study showed how caring, couplehood and sense of agency are constantly negotiated and changes over time. For example, in relation to the carers' and care recipients' living situation, their health status and capabilities.
In terms of couplehood and gender, informal care in family life has often come to be associated with women and femininity (see Wallroth, 2016), although men are increasingly becoming carers who provide support to their significant other, in Sweden and other countries (Sand, 2014;Milligan & Morbey, 2016;Hellström et al., 2017). Scholars have for example used quantitative measures to describe the demographics and gendering of informal family care. Kim et al. (2017) examined the effects of primary stress factors reflecting the duration, amount, and type of care on the depressive symptoms of spousal caregivers over a two-year period, concluding a need to further incorporate couples' relational dynamics and gendered experiences in personal care (see also Penning & Wu, 2016;Litwin et al., 2014;Sharma et al., 2016). There are also qualitative studies focusing on informal care and couplehood. In an extensive qualitative study consisting of 152 interviews with 20 couples Hellström et al. (2007) for example explored strategies used by spouses in order to live positively when one partner had dementia. The study showed how the participants aimed to maintain the quality and closeness of their relationships through what the authors calls a 'nurturative relational context', highlighting the active role of both partners in sustaining couplehood (see also Kaplan, 2001;Bielsten, 2020).
To meet the challenges that carers and care recipients face in their everyday lives and family practices, scholars have also debated the merits of different services (Boots et al., 2014). This research has increasingly focused on ICT-mediated support for selfcare, disease information and coping with the illness trajectory (Carretero et al., 2015;Hanson et al., 2007;Magnusson et al., 2002). At the same time, older people do not always engage with digital technologies and may therefore fail to take advantage of the support provided, a fact that has not always been fully appreciated. In their research, Olsson et al. (2019, p. 58) used the concept of 'ICT literacy' to describe 'the ability of senior citizens to use, manage, assess and understand technology in a way that matters for their everyday use'. It has also been suggested, however, that the scholarly debate on the digital divide has failed to address the divide that older people themselves create as they position themselves in relation to others, when describing how and why they engage with digital technologies (Kania-Lundholm & Torres, 2015). In fact, research shows that technological development has affected men and women differently and that technologies are not to be understood as neutral and value-free in relation to gender (Balka et al., 2009;Trauth et al., 2016). Other research takes a wider approach to the meaning of ICT in the everyday lives of older people (Hamblin et al., 2017) and the opportunities it can provide regarding supporting social relationships (Bergström & Hanson, 2017).
To conclude this section, there is currently a body of research, stretching from family sociology, to health and nursing science, that focuses on the ways in which spousal caring impacts on both the carer and care recipient, their relationship, and its gendered dimensions. As well, the potential support spousal carers can benefit from social services and the use of ICT. Across these disciplines, there seems to be a general understanding that further research is needed concerning the particularity of spousal caring and how mutuality of couplehood is understood in informal family care.

Analytical framework
Emphasizing the ongoing construction of families in the context of informal care, this study builds upon on the ideas of Morgan (2011), who developed a dynamic and sociologically informed theory and conceptualization of family practices and the doing of families/family life. More specifically, in this study, we are interested in the ways in which informal care is done between spouses and within families, hoping to gain further insights into how these practices impact relationships and family life, and possibly how such relationships change over time in relation to different support services or as one of the spouse's health condition changes/deteriorates (Nolan et al., 1996). According to Morgan, the doing of familiesthrough for example household tasks, caring, and social supportis formative for the construction of identities, and as such also connected to gender. Although such tasks historically have been associated with women and femininity, Morgan however emphasizes that men are not absent from caring work (p. 101). Therefore, when understanding the complexity of informal care, we need to look at spouses' participation in caring practices with their significant others as a relational practice and as a means for people to negotiate couplehood and (gendered) aspects of their identity, simultaneously.
Another, related, way of looking at family practices comes from Hochschild (2000Hochschild ( , 2003 and what she calls the development of emotional labour or emotion management. These concepts are intended to illustrate the reality of many jobs, such as daycare workers, eldercare workers, that are performed mainly by women. Hochschild is interested in how we relate to our own and others' feelings, and how the modern market economy affects our relationships and the way we view ourselves. According to Hochschild, we conduct emotion management in both our private lives and our working lives, but she distinguishes between the two by defining the emotion management we perform in working lives as emotional labour and the emotion management performed in our private lives as emotion work. Because of existing social norms about how to feel in different situations, she suggests that not only do we try to express appropriate emotions, we also try to feel the right emotions in relation to feeling rules (see also Ahmed, 2014). This means that a person can believe there are certain societal expectations regarding how one should or should not feel in particular situations (Hochschild, 2003, p. 95).
Emotion work in the context of informal care has been discussed in terms of the emotion work that carers perform so they can view themselves, and be viewed by others, as 'good carers', by managing both their own and their care recipients' feelings and expectations (Mac Rae, 1998;Simpson & Acton, 2013). Inspired by the works and perspectives of scholars such as Morgan (2011) andHochschild (2003) we will use these concepts and perspectives mentioned to analyse how carers and their spouses do family life and couplehood within the context of informal care in Sweden.

Research design
Taking an ethnographic approach, this study builds on interviews, observations and informal conversations with informal carers and their spouses. Following Hammersley and Atkinson (2007) we used a relatively open and exploratory methodology for the research, taking the perspective that the ethnographer is a fellow traveller on the journey in the everyday lives of the people being studied. Accordingly, 'it is expected that the initial interests and questions that motivated the research will be refined, and perhaps even transformed, over the course of the research' (Hammersley & Atkinson, 2007, p. 3).
A total of 9 older informal carers (3 men, 6 women) and 7 spouses (6 men, 1 woman) were recruited (mean age 73 years old). As inclusion criteria, participants were to be 65 years or older, fully or partly co-habiting. The initial aim was to include both carers and spouses in a couple. In two cases, however, we could only interview the person providing care, on account of their spouse's ill-health and limitations regarding verbal communication. During the recruitment process, different strategies were utilized. Firstly, carer advocates in municipalities were asked to help with reaching out to carers and care recipients in the south of Sweden. Several participants were recruited via this strategy. Secondly, a respondent-driven sampling strategy (Salganik & Heckathorn, 2004) was used where participating carers were asked if they knew anyone fulfilling the inclusion criteria (outlined above) who could be interested in participating in the study.
The participants in the study had been co-habiting for a period of time ranging from 27 to 61 years. Some care recipients had had their illness or had received a diagnosis for more than 30 years ago, while others had been ill for 'only' a few years (mean: 13 years). The amount of informal care provided differed among the participants, stretching from more practical help in the household, transport to more comprehensive personal, medical and emotional care and a strong dependence on the support of their spouse in everyday life (see also Ulmanen, 2015). All care recipients had chronic diseases, such as heart failure, stroke, Parkinson's disease and dementia. Among the participants, four couples also received a limited amount of home help from the municipality. Not all of the participants were full-time carers, but living together with the care recipient, a majority of them nevertheless experienced that their everyday life was coloured by a state of preparedness and an expressed difficulty with leaving the care recipient home alone among other things (see the first part of the findings section for further information). All of the participants were in heterosexual relationships.
Data were collected between December 2018 and June 2019. The interviews, which were semi-structured, covered specific themes, such as the carers' and care recipients' views about their relationship, well-being, gender, age, and the possible use of ICT. However, the pre-formulated questions were considered mainly as a starting point for conversation and the participants were also considered part of the construction of follow-up questions (Aspers, 2011). All of the participants were interviewed separately. The number of meetings with the participants varied between 1 and 3 depending on their availability. The meetings with the couples were generally three to four hours long and the interviews were between 0.32 and 1.45 h long. With the participants' permission, interviews were recorded and transcribed verbatim.
Ethnographic observations were conducted with the intention of gaining an understanding of the everyday family life of the participants. Observations made it possible not only to capture (and validate) what the participants expressed during interviews but also to contextualize their narratives and capture the environment, interactions, and emotions. Observations were documented through detailed field notes based on questions such as; What is happening?, With whom is it happening, or who is doing it? and how and why is it happening? (Aspers, 2011, p. 126). Observations were conducted during activities both in and outside the home. Field notes were also written after each interview.
In ethnography, data collection and data analysis are parallel processes and analysis starts during the formulation of the research problem (Hammersley & Atkinson, 2007). Atkinson explains: We bring ideas to the field as well as drawing them from our field data and our experiences. There is a constant, iterative process between data and ideas. Just doing fieldwork on the basis of 'exploratory' inquiry is not good enough. Exploring does not mean being directionless. (Atkinson, 2017, p. 4).
During the fieldwork, notes were taken about the meetings with the couples continuously, including not only empirical descriptions/observations but also theoretically as well as methodologically informed reflections. The more 'hands on' analysis of the data were initially derived from verbatim interview transcripts and the observational field notes, which we read repeatedly to ensure our familiarity with the data. The data were then sorted and coded into themes, looking for different patterns in terms of similarities, inconsistencies and/or contradictions among other things (Hammersley & Atkinson, 2007). As the study focused on couplehood in the context of informal care, this concept and previous research initially guided the process. This did however not mean that the data was sorted deductively. Rather, it was in and through a dialectal processmoving between data, the analytical focus on couplehood and previous researchthat the codes were thematized, so as to capture different aspects of couplehood and family life (cf., Back, 2007;Atkinson, 2017). In so doing, for example, we were able to unfold the different ways in which individual agency and autonomy were understood and negotiated among the participants in their everyday family life, as well as, when relevant, how such negotiations were connected to gender for example. Consequently, data was thus sorted, coded and thematized in both an inductive and deductive way, which as suggested by Emerson et al. (1995) can be described as abduction. But it was in the writing that the final thematization was set (Emerson et al., 1995), as one cannot ignore the significance of continuous reading and writing in ethnographic research (Hammersley & Atkinson, 2007; see also Back, 2007).
To ensure confidentiality, all names of places and people mentioned in the text are pseudonyms. Formal ethical approval to carry out the study was secured from the Regional Ethical Review Board of the University of Linköping, Sweden (Dnr 2018/ 410-31).

Changes in family practicalities and extended responsibilities
In this first section of the findings, we will briefly consider how the participants for this study talk about the ways in which family practicalities have changed due to one partner's increasing need of care from the other (RQ1). In doing so we will position the study in relation to previous research and at the same time establish a common ground for the conditions in which our participants negotiate and discuss couplehood.
One participant, Annelie (carer, age 65), who supports her husband Sten (age 68), talks about their previous division of housework and how this has changed: Annelie: Inside the house, I was in charge. I mean, for Sten to tell me what curtains to put upit wasn't worth it [laughs]. Or what other furnishings we should have, or if we should buy a new table or something. That was my area. He cooked [laughs] and took care of everything outside the house. He greased, shoveled and raked and anything else that was needed, oh yes. Painted things and fixed things.
Interviewer: And today? Annelie: No, well, he's tried, but it doesn't work out. Things never go very smoothly. Nowadays I do everything around here. I change the light bulbs, hammer in nails, replace wornout stuff, buy the groceries and cook the meals.
Even if some of the participants exemplify a less gender-based division of housework than that described above, the women interviewed generally reported that they had the main responsibility for the housework and the children, while the men interviewed recounted taking responsibility for more practical things such as the car and the household finances and performing a breadwinner role. This is also in line with previous research that shows that women continue to perform the vast majority of the care of children and housework globally (Levtov et al., 2015). When family life transitions into senior spousal caring, however, the relationship takes a new path, and previous gendered tasks performed in family life change. Touched on above are not only previous capabilities and the division of work between Anneli and Sten, but also how a gendered contract between spouses is re-made (Morgan, 2011;Isaksen, 2005).
Besides changes in (gendered) tasks in family life, the transition to spousal caring also entails the emergence of new and expanded everyday life practices. One such practice concerns the performance of intimate and personal care, such as medical treatment (see also Ulmanen, 2015;Eurocarers, 2016): In the morning Ove needs helphe wears incontinence pads and they're very difficult to put on. That's the first thing I have to help him with. After that, it [a device] has to be preparedyou have to clean the hose that fits into it and then plug in the medicine container. Then I increase the dose of the medicine, and in the evening I reduce it. He has difficulty doing that by himself. … So, I fill it up with a new dose of the medicine, turn on the device and reprogram it. (Laila, age 76, spousal carer) Being a carer obviously brings special knowledge about the effects and technicalities of medical treatment and care. The carers are among other things providing not only emotional support, but they are also organizing and administrating the care provided (Rosenthal et al., 2007;Ulmanen, 2015). Previous research shows that becoming a carer is often a gradual and unreflected process (Erlingsson et al., 2012;Nolan et al., 1996) and that carers often view this process as a natural part of family life, of getting old and taking responsibility for one another (Colombo et al., 2011;ÓConnor, 2007). But even so, the predicaments of spousal caring practicalities/tasks also lead to a change of the (power) balance between spouses and how they view and feel about their relationship (Hochschild, 2003;cf., Morgan, 2011, p. 100). As such, and as shown they also can be seen as a 'central set of tasks in constructing gender identity and sexual difference' (Morgan, 1996, p. 101). This will be further developed in the next section.

Couplehood in transition
Providing care to and receiving care from a spouse clearly affected the dynamics of the relationship (RQ2) described by Laila, below: I don't know what to say! Of course you become like a nurse. You're not equal in that sense. Although it's nothing I think about. But of course it's a different balance. Since Ove is a bit dependent on me, there is different balance between us. But I think we manage pretty well. Or have so far at least. (Laila,age 76,carer) Even though Laila explained that she does not feel like or consider herself as a carer, she can see that her caregiving practices make her into sort of a 'nurse', which creates a sense of inequality in the relationship. This kind of reasoning is also expressed by some of the care-receiving spouses. Inge, for example, who has various impairments because of his illness(es), talked about his need for both care and autonomy: Clearly, there is a delicate balance between taking care of another person and (with good intentions) depriving that person of his or her personal autonomy. Inge is reluctant to accept the impact his wife's caregiving has on their relationship, how she understands him as a husband and his capabilities. He wants to feel that he can (still) accomplish things on his own and values the mutuality of couplehood, while acknowledging the importance of receiving spousal support. Borrowing from Hellström et al. (2007) he tries to take an active role, upholding a nurturative relational context when sustaining couplehood and autonomy, here understood in terms of feeling capable of accomplishing things by himself (see also Daatland & Herlofson, 2003). Being negotiated is thus not only the extent of the support/care needed and the emotion management that surrounds a life formed by informal care (Olson, 2015) but also (and more importantly) boundaries that concern autonomy, relational equity and the ways in which the spousal caring is carried out, understood and scrutinized by both partners. Conceptualizing autonomy as something relational also highlights the complexity of this experience/practice, as the same practices/interactions can be quite differently understood depending on which 'role/position' one has in the informal care relationship.
When participants talk about their relationship and couplehood, the notion of we and I is seldom a question of eitheror, but rather a question of both, at the same time. Even if one thinks that his or her role as the spouse has evolved into more than that of a carer, there can still be a sense of we being present. There is thus a more fluid understanding of the concept of couplehood (see also Førsund et al., 2015). Consider the example of Ingvar, who is living with Elsie who has dementia. They have been married for 61 years. During the past year, Elsie's condition has worsened and Ingvar cares for her more or less full-time. Ingvar explains that Elsie doesn't feel at home in their home and often doesn't recognize him. While this situation is extremely challenging, nevertheless Ingvar talks about it as something that can sometimes strengthen their bonds: Yeah, sometimes it can be like … let's say she wakes up and has wet the bed. She thinks it's really embarrassing, you know? But then I take care of it, and she'll comment, saying something apologetic like 'Oh, imagine that you have to do this!', and then we become a bit like … We think it doesn't matter. We tell each other that we'd rather do it, so we can still be together. So then it's like it's no problem and we're fine with it. But, of course, we've been married 61 years, so things aren't like they used to be [laughs].
Repeatedly touched upon in the narratives are the challenges of maintaining a sense of we and couplehood in a relationship that is no longer experienced as mutual. When the participants talk about their relationships some of them talk about different moments of closeness and a we, as exemplified above. In some cases, however, thoughts of divorce are present. Juni, for example, has felt over the years that she and her husband no longer share the closeness and mutuality that she thinks to signify a marriage. From her side, they are nothing more than friends. Juni also explains that she would probably choose to divorce if someone would help her to sort out the practicalities involved. Another couple, Ulf and Gerd, had also talked about a divorce, but when Gerd got ill Ulf decided not to proceed with a divorce. Ulf explains: I've seen people who've dropped out at this stage, when the spouse is in a wheelchair being wheeled around by two personal assistants … Whatever the relationship, I'm not sure I could have lived with it. Above all, I probably wouldn't have been able to look the rest of the world in the eyes. Probably Gerd's friends would have approached me and accused me of making her become the way she was or something like that. I think I was afraid of that, because I wanted to be good, you know? (Ulf,age 77,carer) It is evident in this study that in order to maintain a sense of couplehood, the carers especially perform emotion work (Hochschild, 2012). The carers often talked about a changed relationship and that their spouses, because of illness, had difficulty taking the needs of others into consideration. Hence, it would seem that doing family life as a carer necessarily entails putting oneself second in order to make things work. The care recipients, on the other hand, usually described the relationship in terms of gratitude and some form of dependence, which highlighted a new (potentially gendered) asymmetry/imbalance within the relationship.
Thoughts about being a 'good carer' and a 'good wife/husband' are also evident in the data. Marital obligations and perceived societal expectations and ideals seem to be important for couples to uphold in marriage (see also Lüdecke et al., 2018;Simpson & Acton, 2013). When discussing couplehood, several of the carers for example talked about a sense of moral obligation, a marriage contract, and in relation to this also about trying to feel 'the right feeling' in relation to their spouse. This also relates to Olson (2015) who suggested that caregiving spouses sometimes engage in emotion work to promote feelings of stoicism. Put differently, borrowing from Hochschild (2003), participants articulated, in different ways, how they try to manage their emotions and feelings, work on them and change them in certain directions and in alignment with certain ideals and perceived marital expectations. This is, however, not an easy task. Annelie, for example, described her and her husband's relationship more in the sense of I. She talks about her emotion work and her relationship with her husband: I've worked with older people. At work I've always been the supportive one, so to speaknot even once did I ever become irritated at any of the residents. But at home I do! And then I go around with such a bad conscience. Well, now I'll probably start crying as well.
(Annelie, age 65, carer). What Annelie describes above is the difference between emotion management at work and emotion management in private life. In relation to this, several of the participating carers described themselves as gradually becoming (transforming into) something similar to 'home care staff', 'project leader', 'nurse', 'housewife' or 'parent', rather than a husband/wife (c.f., Gallagher & Rickenbach, 2019). Such use of terminology correlates with Hochschild's (2000) ideas about the family/work crisis and processes through which the domestic sphere seems to gradually revert to work, becoming a place with 'too much to do and too little time' (see also Olson, 2015). Although several of the carers have developed a perspective whereby they look at themselves as having a more professional approach in relation to their spouse, it is not always possible (or desirable) to maintain such a perspective. Likewise, some care recipients try hard not to be viewed as care recipients by their partners, but rather as husbands and wives (Hellström et al., 2007;Milligan & Morbey, 2016). Thus, it is in the interface between a sense of (lost) relational mutuality and personal autonomy, and the professional sphere versus the private that we find our participants' ongoing negotiations and meaning-making of couplehood (Beard et al., 2012). Adding to this, negotiating the question of relational mutuality and reciprocity also involves feelings of loneliness and social isolation (Verbakel, 2014;Greenwood et al., 2019). As Annelie explains: I think you become alone in couplehood. I have no one to talk to anymore, when the two of us are sitting together. If we're just watching TV and I want to say something about a movie, then I just think, 'Why bother?' It just doesn't feel worth it. So you get very lonely, even though you have friends. Because of this I don't feel like inviting people over on Saturday evening, say, because I think they'll think it is boring that Sten just sits there and says nothing. So I haven't had anyone over for several years. (Annelie, age 65, carer) As evident in Annelie's description above, loneliness is described not only in relation to the spouse but to other relationships as well (cf., Rosedale, 2007;Greenwood et al., 2019). Annelie uses social media to communicate with friends she seldom meets in person anymore. She notes that it's not the same as meeting each other in real life and that she would prefer to have more varied forms of social contact. At the same time, social media and technology are seen as a way to ensure that at least she will not 'be forgotten', no one knowing if she is 'dead or alive', as she puts it. Relating to Turkle (2011), the use of ICT has thus to some extent become formative for her social life and how she looks upon her place in the world (see also Adler & Adler, 2011). This will be further developed below.

Digital spaces, care and couplehood
Moving on to RQ3, in this section we will focus on the ways in which ICT is understood by the participants as a means of handling their situations as carers and care recipients and the challenges this brings on couplehood. The observation below exemplifies how one of the participants uses the computer: In the data, the participant carers used ICT and technology, to varying degrees, for documenting their spouses' vital signs and weight (loss), checking online medical reference books, reading other carers' posts about specific illnesses, and more. To this end, ICT constitutes a support sometimes referred to as digital care (technologies) in the care context (Finken & Mörtberg, 2014). The fact that ICT services can support older people's and carers' everyday practicalities does not, however, mean that they are primarily discussed and understood that way by carers and their spouses themselves (Fang et al., 2018).
In fact, when talking about ICT with the participants, their initial response was often that they did not use technology 'that much'. Some of them were quite skeptical regarding technological development, suggesting that people tend to become dependent on their devices: Anja: No, I never learned how to use a computer. But the tablet is easy. It's easier and that's what I expected. But it actually feels like you're being forced to. It does. I think.
Anja: Yeah, but you know how they're always saying 'Go online', eh? … Yes, but that's all there is! If you need to know when they're coming to pick up the garbage, 'Go online'. If you need to know whatever you need to know, 'Go online'. (Anja,age 71,carer) Anja describes her struggles with an overly digitized society. This understanding is also exemplified in Reneland-Forsman (2018), who suggested that older persons sometimes have to give up things that they previously engaged in because the activity has become digitized. To this end, and in terms of ICT as a support service for digital care, activities provided by the public care services were not that prominent in the data. Instead, when discussing ICT they expressed other areas of use that were connected to everyday life and social activities (cf., Adler & Adler, 2011;Peek et al., 2016). Gunnar, for example, describes himself as a computer illiterate. Like some of the other participants, he initially explains that he doesn't use technology that much, but goes on to explain that he does use his tablet, to maintain a hobby. He has always been interested in sailing and sailboats. Sadly, he had to sell his own boat last year, when he realised he couldn't manage it anymore. Now he and his wife, Karin, sit in their living room, with a view of the sea, and watch the boats as they pass by. Via an app they can receive information about the passing boatstheir destinations, cargos, etc. The app enables Gunnar to maintain his interests and allows the couple to engage in a joint activity, a doing that creates a sense of unity between them. In this way, the use of ICT becomes part of their joint emotional life and sense of couplehood (Turkle, 2011;Blusi et al., 2013).
Besides being a means of maintaining hobbies, participantsespecially the carerstalked about technology as a means of maintaining contact with family and friends (as briefly touched upon in the previous section) (see also Hänninen et al., 2018;Salin & Laaksonen, 2019). Agnes, whom we met in the introduction, seldom leaves her home, but keeps in contact with her children and friends through social media (cf., Deters & Mehl, 2012). When meeting Agnes she exhibits her tablet, which she uses a lot to play games. She demonstrates her favourite game, an online quiz game that is played with others. Through this game, she found a new friend, which has helped her to cope with her feelings of isolation and loneliness: And now it's been three years since we met. We play this game every day. We also text each other, and she sends me flowers on my birthday and I send flowers to her. We are just like siblings, you know? (Agnes,age 78,carer) Every morning Agnes and her friend have online conversations about what's happening in their lives. It is evident that this opportunity has been facilitated by her interest in a simple online quiz game. The use of ICT as a means of getting a temporary break from caring and being able to focus on something else is also expressed by others. Juni, for example, talked about online activities both as a way of maintaining contacts with family and friends and as a means of passing time. In addition, when her husband sat in his 'computer corner' she felt that she could relax from her caring activities and leave him at home to conduct errands. Following this, the care relationship and the emotion work being conducted within the participants' sense of couplehood can thus be understood as emotionally challenging, and in relation to this, the use of ICT is sometimes seen as a space in which such feelings can be dealt with or paused from.
In this section we have shown that the use of ICT has some clear social dimensions that relate to the participants' understandings of family life and how they make things work. First, as often suggested by previous research, technology is understood in terms of facilitating health management and support, which in turn makes it possible (or easier) for some of the couples to stay together (Carretero et al., 2015;Magnusson et al., 2002). In one case the spouse providing care used an app to help to train the other spouse's memory, and in other cases carers (and other family members) helped their spouses operate the digital devices, acting as warm experts (Bakardjieva, 2005). Second, and more explicitly expressed, however, when looking at the participants' understanding of ICT, technology is understood in terms of their use of social media and different apps to maintain social connections and to cope with feelings of being unable to participate in different social activities. In other words, it is understood as a way to re-establish a sense of ordinary life, including friendships and personal interests. Third, as suggested by the participants, technology was also understood as a possible way to get a temporary pause from caregiving activities, and particularly for the carers, as a way to enter a digital space that could provide social and emotional care for oneself. As previously mentioned, this can be understood as a way of entering the online context to manage the complexity of autonomy within couplehood.

Conclusions
The aim of this study was to analyse and explore the notion of couplehood and how family life is understood and negotiated by carers and care recipients in everyday life. In line with previous research, this study shows how becoming a spousal carer and care recipient results in a re-arrangement of family practicalities, such as housework, finances and care. Adding to this, the distinction between what is considered the private sphere and the public is also blurred, as carers increasingly develop a sense of a professionalized relationship with their spouse. Consequently, when a marriage develops into or is formed by a caregiving/care-receiving relationship, the dynamics of power and personal autonomy also changes. We argue that the distinction between emotion work and emotional labour appears less clear when carers view themselves as becoming professionalized in relation to their spouses, affecting which emotions are managed and expressed (Morgan, 2011;Hochschild, 2003).
The participants' sense of we and I, their couplehood, is constantly being renegotiated in different ways, in relation to health, sense of moral obligation, autonomy, love, caring and identity. As institutionalized in the concept of couplehood, the idea of taking care of one another 'for better or worse' and the emotions attached to family life is expressed repeatedly among the participants. This means that although the sense of we is sometimes only maintained by one party (if any), the participants still feel obligated to act honourably, fulfilling such an ideal. They are, in this sense, trying hard to do family life and couplehood (Morgan, 2011), and in this process also navigating between certain feeling rules (that is, what they think they should feel) and emotion work (what they try to feel) (Hochschild, 2003).
In addition, as informal spousal caring may often involve everyday practicalities that more or less confine families to their homes, this study in keeping with previous research (see Carnemolla, 2018), highlights how care recipients' health is managed with the help of technology. Further, the study provides new insights regarding the role of technology within the everyday lives of older carers. Sometimes, and seemingly paradoxically, ICT is also used as a way to create a space for oneself, to achieve temporary respite from emotion work, to cope with the challenges involved in spousal caring and family life. What is being expressed, in a way, is that one needs to take care of the I in order to maintain a sense of We. Put differently, and building on previous research relating to ICT, older people and caring relationships (Magnusson et al., 2005;Blusi et al., 2013), ICT is understood as having the potential for the participants to simultaneously strengthen their sense of personal autonomy (reduce feelings of loneliness, doing what one wants) whilst maintaining their relational autonomy (being able to engage in joint activities). These motivations for engaging in technology use and seeking a digital space could therefore be understood to a certain degree as relevant elements in the spouses' ways of managing and balancing family life as carers/care recipients, and as husbands/wives. To this end, ICT is understood as potentially facilitating support and a temporary pause from caring practicalities, but it is however less understood as something which has the potential to necessarily solve all the strains and relational imbalance that sometimes follows with spousal caring.
There are limitations to this study. Due to the small sample size, it is not possible to make general recommendations concerning the whole population of spouses in the informal care landscape. Methodologically it was also challenging to capture rich data from the participating care recipients due to their reduced health status. Consequently, the participating carers were more able to discuss, analyse and reflect on the subjects touched upon in the paper. Nevertheless, despite these limitations, this study contributes to an increased understanding of the complexities of everyday family life, couplehood and the challenges placed on a relationship when spouses become a spousal carer and a care-receiving spouse and the potential role played by information and communication technology.