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Families Cope with the Dying Person as They Usually Do, Only More Intensely

 

All the passages below are taken from the book “Final Journeys: a Practical Guide for Bring Care and Comfort at the End of Life” by Maggie Callanan. It was published in 2008.

 

Everything I’ve said about the dying person’s unique coping style is true for the family as well. Mom might be the busy one, always on the move, efficient, practical, no-nonsense, the true boss of the family. Dad, on the other hand, may be the quiet, steady, reserved dreamer who withdraws into himself when the going gets tough. Then there’s the sister who is shy, easily anxious, hesitant, dependent, and needy. Perhaps the brother is boisterous and outgoing, a party animal, kindhearted, but usually too focused on his own life to be aware of others’ needs. At ninety, Grandma’s once vibrant personality has been dimmed by her physical compromises and by her failing hearing and sight. She has moved into a solitary world of old memories and dreams, cradled and rocked in her favorite chair. And don’t forget Aunt Tillie down the street, whose image of what life should be is frozen forever back in the 1950s.

And now all these good people are thrown together on a journey none ever would have chosen, each contributing his or her unique talents, and each needing different things to sustain them. Imagine the many ways this might play out. Will they share a loving, bonding experience, or will the family splinter in turmoil, frustration, fear, anger, and rage (all signs of early grieving)? All this can be doubly confusing because the dying process brings out the best and the worst in people— often simultaneously.

How do you navigate this necessary but difficult interplay between relatives and the dying person? When I begin to work with a new patient, I often sit the family members or friends down and ask them to describe each other: their personalities, their strengths and their weaknesses, and their difficulties. What fulfills and nourishes them? How have they handled crisis in the past? How do they think they might handle this crisis and this upcoming loss?

Their responses are interesting— usually humorous kidding; sometimes touching validations; often a comfort in being understood, foibles and all, but loved anyway. And doing this exercise has already contributed subtly to their teamwork and support of each other.

Then I explain the behavior pattern we hospice workers know so well: people handle this ultimate life stress as they have handled other great stresses— but in an intensified way. Mom might now go into a frenzy of sterilizing the house and alphabetizing the over-the-counter remedies in the medicine cabinet, while Dad might become obsessed with the Learning Channel and taking long naps. A sister may become increasingly anxious and agitated and develop a vague rash and sleep disturbances, while her brother steps up his drinking and partying and is rarely at home. Aunt Tillie might become frightened about the pain pump and fuss about these “newfangled devices” and what they cost, while Granny, sensing the turmoil around her but unable to hear and understand it, increasingly withdraws into her dream world.

Helping all the participants to understand this behavior is very helpful, not only as a means of validating the uniqueness in each family member and working successfully with those differences but also in anticipating and preparing for the challenges that lie ahead. If some level of understanding and compromise is not attained, the players may come into conflict with each other as clashes of needs and styles occur. Imagine how long Dad, who is escaping into his solitary relationship with a show on animal cloning, will tolerate Mom, who is driven compulsively to vacuum under his feet, then polish and rearrange the furniture in the TV room.

Now put a dying person in the middle of such a scenario— maybe another son and brother. Perhaps he is silently raging against the injustice of a death too young, trying to understand what’s happening to his rapidly failing body, frightened or concerned about how the family will get along without him. Perhaps in his well days he was a detail-oriented scientist, self-motivated, needing a lot of his own space, nourished by his voracious reading, intricate model building, and long solitary hikes. Now he is increasingly confined to home, often bored, more and more dependent on other people, but snappish or sullen when they try to help him.

Are any of these people or their reactive behaviors wrong? They may be unpleasant or uncomfortable, yes— but wrong? No. The rule of thumb is: as long as no harm is being done to self or others, the behavior is acceptable.

Everyone involved in this journey becomes like a planet hurtling around the family solar system, sometimes free to act as they need, but other times crashing into each other, causing more stress and upset. If for a moment each person could step back and see the whole picture, they would understand that no one is wrong for acting as they do. It’s just the unique way they were wired at birth. So the key is to allow yourself to be who you are and react how you do. At the same time, do that for each and every person involved. Support each other, but be respectful and stay out of each other’s way as well.

 

THE BOTTOM LINE

When dealing with major life stresses such as death and dying, families and friends cope as they usually do, only in an intensified way. Understanding this can prevent irreparable damage to or destruction of family relationships. [141-144]

 

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