Never Have to Say Goodbye Again
A Harvard Health article
Maxim Cheerio
Coping With a Loved One'due south Terminal Illness
Nowadays, it'south more mutual to lose a loved ane to a lingering final illness than to a sudden death. Family and close friends, forth with the person with the life-limiting disease, now have much longer to face to the prospect of decease and say their goodbyes. This in turn has changed the grieving process to one with unique stages that are increasingly borne by families, rather than just individuals.
The long bye
Today, having a loved one live with a terminal diagnosis for an extended menstruation of time is fast replacing sudden and unexpected death equally the norm. Consider, for case, that ii thirds of those who are diagnosed with cancer currently have a five-twelvemonth survival rate.
The outcome of all of this is that decease has get less and less a sudden and unexpected effect. In its place has come a process that begins with a life-threatening diagnosis, proceeds through a catamenia of treatment (or treatments), and ends eventually in death. This procedure means that both the terminally ill individual and the family are increasingly confronted with the demand to "live with death" for a prolonged period of time.
Considering the nature of death and dying has inverse so dramatically, the way we grieve has also changed. The new grief differs from traditional grief in significant ways, not the least of which is that it includes the terminally ill person. In add-on, what has increasingly become a protracted process as opposed to an event not only leaves individuals to mourn but typically draws in the entire family of the dying person for months or fifty-fifty for years. This procedure has the potential to alter lifestyles and forcefulness families to face up issues that once were dealt with simply after the decease of the loved i. It can easily evoke bug from the past that were never fully addressed or resolved.
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Grief is a family unit matter
Grief today is afamily affair every bit much as information technology is an individual 1. What is needed is a new template—ane that is relevant to families and their feel. That is what nosotros nowadays here. This model is intended to be a road map that you and your family can turn to every bit you lot navigate your way through the current realities of death and dying. And past the manner, when we use the wordfamily, we include not only claret relations but all those who accept a significant connectedness to the person who carries the diagnosis.
The challenges that families must face when confronted with a terminal diagnosis of a loved one are complex. They include evolving new structures and dynamics equally the person they dearest slowly slips away. It means learning how to cope with setbacks and deterioration too as periods of seeming remission. Information technology means dealing with the complexities of extended grief, which can vesture individuals down and atomic number 82 at times to ambivalence or the unpleasant feeling nosotros get when we find ourselves wishing that the process would end. It means talking with a dying loved one near mortality and other problems that do not ascend when death strikes suddenly and unexpectedly. It ways learning to make infinite for extended grief in lifestyles that are typically busier than those of earlier generations.
Mayhap most of import, the new grief involves confronting family problems that may have been dormant but unresolved for many years. These issues typically reemerge equally families move past their initial reactions to a last diagnosis and are forced to interact and work together through a process of extended grief. Finally, it means moving forward together every bit a stronger family after a loved one passes.
Without understanding and without guidance in each of these areas, family members who are forced by circumstances to cope with prolonged grief are vulnerable to serious psychological consequences, including low, guilt, and debilitating anxiety. These circumstances tin even lead to physical illness. Whole families are vulnerable to rupture every bit a consequence of a resurgence of unresolved issues that are unearthed as a effect of a prolonged terminal illness in a loved one. Fifty-fifty loving couples may detect their relationships in jeopardy as a result of unwanted lifestyle changes. What families need now—and volition need in the future—is guidance for how to anticipate and bargain with such issues.
We are proposing hither a five-stage model for family unit grief. However, we want to caution readers not to expect that there volition be hard-and-fast boundaries separating these stages. While well-nigh every family unit will experience each stage, you should not expect one stage to simply end and another to brainstorm. On the opposite, anticipate finding yourself dealing with issues associated with more than one stage at any given fourth dimension. In addition, the stages vary in length and intensity, depending, for example, on the length of the terminal illness and whether there are any significant periods of remission.
Stage i: Crunch
The diagnosis of a concluding affliction or a potentially concluding illness creates acrisis for the family unit. It disrupts the family's equilibrium, but equally a rock thrown into the middle of a still pond disrupts its equilibrium. Factors that bear upon how you may react at this stage include:
- The history of as well as the current condition of your relationship with the sick family member
- Whether the loved one is a spouse, a parent or a kid.
- What your and the patient's past (and current) roles in the family unit are.
Anxiety is the well-nigh common initial reaction to the news that a family member is terminally ill. Yet, if your human relationship with the terminal family member has been strained or alienated, you may also find yourself feeling guilty, resentful, or angry. If the terminally sick person is a kid or young adult, anger at the seeming injustice of early on death may exist the dominant emotion shared by family members at this initial stage.
At this commencement phase of the new grief, all developed family members benefit from guidance issues such equally what to expect in terms of their ain emotional reactions, whom to seek support from, whom to share memories and emotions, with, and what to expect when they encounter with the dying loved 1 and other family members.
Phase ii: Unity
The reality of impending death has the effect of pressing family members to put even longstanding complaints or grudges on hold every bit they pull together to move into this 2d stage of grieving. This may be no problem for family unit members who accept no conflicted feelings or unresolved problems of their own with the loved ane, such as favored children. On the other paw, if you feel that y'all were always a less favored child (or the family unit scapegoat), yous should not be surprised if y'all feel a complex combination of emotions even as y'all strive to be a good squad fellow member.
In Stage 2, the needs of the dying become paramount. A major consequence for all family members in Phase ii is how they volition ascertain their roles with respect to 1 another and the terminally sick fellow member. If they do not give some thought to this—a situation that is quite common—they may rapidly find themselves having regressed into roles they played years earlier, as children and adolescents, but that they would not consciously choose at present.
In this 2nd stage of the grief procedure the family has much work to do, including:
- Choosing and working with a medical team
- Navigating the social services maze
- Pursuing and qualifying for entitlements
- Ensuring that critical legal work (wills, living wills, and so on) is completed
How the family organizes itself so every bit to complete these tasks can have powerful psychological and effects on each fellow member, depending on how comfortable each feels with the office he or she is playing.
Stage 3: Upheaval
The family will eventually enter this third stage of grieving if the process of dying goes on for some time, which it typically does today. At this betoken, the unity that characterizes Stage 2 begins to habiliment sparse equally the lifestyles of all involved, whether they recognize information technology or not, gradually undergo some significant changes. Whereas thoughts and feelings near these changes may take heretofore been put on the back burner, they can no longer be suppressed and begin to leak out. I such feeling is ambivalence, meaning mixed feelings that many people experience when the process of dying evolves into a protracted ane in which the loved one's overall quality of life slowly deteriorates.
Emotions such as guilt, anger, and resentment are likely to emerge in Stage 3. At this phase the virtually important event becomes beingness able tocommunicate honestly with other family unit members and with trusted loved ones. Suppressing thoughts and feelings nigh such upheavals can lead to strained relationships and eventually tin cause the entire family to fall apart.
Stage 4: Resolution
Equally a family unit moves into the fourth stage of grief, the terminally ill loved one's health is typically marked by gradual deterioration, punctuated perhaps by periods of stabilization or temporary improvement, and the effects of the prolonged grief procedure can and should no longer be ignored.
As they enter Phase 4, family members often find themselves having more memories—both good and bad—of past experiences which usually reflect relationships with the patient, these important memories are different, typically telling the story of how family unit members have viewed their place and role in the family. Oftentimes they betoken to unresolved issues. Some of these memories may evoke feelings of joy or nostalgia; others, withal, may evoke anger, jealousy, or envy. Others still cause feelings of pride or, alternatively, of shame and embarrassment.
Stage four represents an unprecedented opportunity, if families only choose to seize it. It is an opportunity to resolve longstanding bug, heal wounds, and redefine 1's role in the family—indeed, to alter a family member'due south very identity. Every family, as they say, has its share of skeletons in the cupboard. It is in this fourth stage of the grief process that the skeletons can be brought out of the closet, exposed to the light of the day, and cast forever into oblivion.
In particular, Stage 4 is a fourth dimension when the following can be addressed and resolved:
- Old rivalries and jealousies
- Long-held resentments
These ii issues stand in the manner of families being able to bond together as strongly as they could and love i some other unconditionally. Some family unit members, however, may react to this opportunity with feet instead of with enthusiasm. Rather than seizing the opportunity, they may endeavor to avoid facing these issues. However, facing upward to them offers the best opportunity for the family as a whole to movement on together to a happier future. In this way the process of family grief tin set the stage for growth and renewal for all involved.
Phase 5: Renewal
The final phase of grief actually begins with the funeral and the celebration of the life of the now-lost family member. This is a time of mixed emotions, to exist sure, including both sadness and relief. If the family has successfully negotiated the previous four stages, withal, this final stage too opens notwithstanding another door: to collective likewise every bit personal renewal. It tin exist a celebration of life as much as it is a marking of a loss. It can exist a time of creativity and planning, as the family decides, for example, how it volition commemorate anniversaries and birthdays.
As much as Stage 5 is a time for remembrances, it is as well a fourth dimension for looking frontwards, to revitalized relationships and to new family unit traditions.
Adapted with permission from Saying Farewell by Barbara Okun, Ph.D. and Joseph Nowinski, Ph.D. by arrangement with Berkley Publishing Group, a member of Penguin Group (USA), Inc.
Source: https://www.helpguide.org/harvard/saying-goodbye.htm
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