Strauss suffered serious health breakdowns on two occasions, in 1892 and 1907. At the age of 26 it was a chronic lung infection, at 42 a weakness of the heart muscles and in both cases excessive work was the cause. His father often appealed to his conscience: "We are very unhappy to see how you dash away with your health in the hope of making a fortune so that you can then devote yourself solely to composing. Do you think that you can create something intellectual with a weak body?" But the son was defensive: "Nobody ever became ill from working a lot, as long as you otherwise lead a responsible and sensible life, and that’s what I’m doing."

Pauline was the first person who got Strauss to take a genuine interest in his health, although even she could not stop the nicotine-shrouded nightly Skat games. She was also aware of the susceptibility of his lungs and insisted on two walks every day to counter the health effects of smoking. Not until the age of 75 did Strauss give up the habit, his mood promptly turning "filthy" for several weeks.

An hour before lunch and dinner Pauline would take her husband away from his work and into the fresh air. She also supervised a short afternoon nap as a letter from Gustav Mahler to his wife Alma makes clear: ‘Yesterday afternoon I visited Strauss. She met me at the door with: "pssst! pssst! Richard’s sleeping."

Richard Strauss never ate much but what he did, he ate with pleasure. He loathed long banquettes ("I starve at "luncheons” and "dinners"), but appreciated fine cuisine. However, his preference was, above all, for plain fare. He wrote precise instructions for Pauline and their faithful maid Anni, detailing what was needed and how it was to be prepared for his favourite dishes. These included untrimmed beef (G’schlader), steinpilz mushrooms with dumplings, kidneys and roast kidney. The composer’s "passion for sweets" included Anni’s vanilla cookies, punch cake and rosehip jam (probably the only jam ever honoured in an opera – once again in Intermezzo).

Pauline was a passionate cook who, upon her death, left a hand-written cook book with recipes from all over the world. She also enjoyed eating in fine restaurants and on special occasions such establishments delivered food to the Strauss home.
The solid social and family circumstances with Pauline may also have contributed to the mellowing of the "revolutionary musician" of the past, the rebel of Salome and Elektra. By this time his friend Hofmannsthal was already working on "our Figaro".