Monday, October 19, 2015

Coping with the Impending Death of a Loved One

by Lizzy Miles

One of the most stressful aspects of losing a loved one is the time period where you know they will die soon, but you don’t know when it will be. The waiting period can be wrought with a range of emotions from sadness to anger to guilt.

Forgive Yourself

Guilty feelings are normal. When a loved one is dying, you may question your decisions related to their treatment. You may wish you would have spent more time with them. You may wish you would have handled the relationship differently.

Whatever your guilty feelings are, if you think it will make you feel better, you can apologize to your loved one. Even better, forgive yourself. The past cannot be changed, and feelings of guilt can lead to chronic stress.

Forgive Your Loved Ones

When your loved one is dying, you may feel anger at them for leaving you. You may feel anger that this situation was not expected, and life did not turn out the way you both had hoped. You may be mad that life is not fair.

Another common situation that happens during an impending death is feelings of anger towards others for not providing equal levels of caregiving and support. These feelings are normal, but can add to a person’s stress levels.

You may find that the feelings of forgiveness can bring peace of mind.

Keep a Notebook

When someone is dying, there are a lot of practical matters to address. Oftentimes, thinking about to-do lists leads to insomnia. Carry a notebook with you to record your thoughts as you remember things that you need to do throughout the day. This may help to reduce the racing thoughts.

Write in a Journal

The death of a loved one is a profound emotional experience. Journal writing can provide an emotional release for feelings that you do not want to express to others. Because a journal is private, journal entries can also reveal insights into repressed emotions.

Explore Expressive Arts

Expressive arts are forms of expression beyond journaling that aid in processing emotions. There is an entire field of study devoted to the therapeutic value in creative expression. The focus of the activity is on the process, rather than the end product.

Talk about Practical Matters

One of the stressors of coping with the death of a loved one can be the practical matters of how you are going to adapt to the tasks that your loved one may have performed.

For example, if your loved one was the one who took care of the bills, you may want to get the information on how to complete the tasks. This knowledge that you will be able to continue without them may provide a small degree of stress relief.

Ask Questions

The desire for information varies from person to person. Some people want to know everything, others would rather not hear the details. Medical professional take their lead from the family.  They provide information about the impending death, but they may refrain from telling you everything that they know. If it would be helpful for you to have more information, do not hesitate to ask.

Understand that some questions are difficult to answer. Prognostication is the estimation as to when a person will die. Even for experienced medical professionals, this is sometimes difficult to answer, as each individual is unique.

Watch Your Health

Research has shown that stress can impact the immune system. If you are feeling intense stress, take time to assess how you can take care of your health. Often when people are sitting vigil at the bedside of a loved one, they may not take time to breathe deeply, eat or sleep. All of these activities are important to maintaining good health.

Take a Break

When the dying period is prolonged or the loved one had an extended illness, an individual can feel overwhelmed by the situation. It is okay to step away for a while to take care of yourself. If you are the caregiver, ask for someone else to give you a break.

Some people are afraid to step away from the bedside of a dying loved one for fear that the person will die while they are gone.  Sometimes, however, that is the way the loved one would prefer it.

If you are meant to be there at the time of passing you will be. If you are not meant to be there, your vigil may actually delay the person’s dying. It does not mean they love you any less. Some people would prefer not to die in the presence of their family, and choose to die when the family steps out of the room.

Ask for Support from Staff

If your loved one has hospice care, there are several hospice team members that might be able to provide you additional support. All hospice teams have social workers who are trained in counseling. Additionally there are non-denominational chaplains and hospice volunteers.

If you are in a hospital setting, there are usually similar resources available to provide emotional support, if you ask for it.

Ask for Support from Friends

It is normal to feel like you are all alone when your loved one is dying. Your friends may not know that you need their help. If you feel overwhelmed, initiate the call to a friend and ask for their support.

Notify Extended Family and Friends

Sometimes an untapped resource for coping can be extended friends and family of your loved one, or your own extended family. In some cultures the extended family is much more in touch than in other cultures.

For cultures where the extended family is not in touch, there is still the possibility that these family members or friends would like the opportunity to say goodbye.

By notifying these family members prior to the death rather than after the death, you may elicit additional emotional support for both yourself and your dying loved one.

Share Memories

While the dying process can be a sad time, it does not have to be. Use this time to share memories with your loved ones. Even patients that are non-responsive are thought to still have their hearing intact.

Your loved one may not be able to respond, but that should not stop you from talking to them. Tell them the impact that they have made on your life and who you are as a result of knowing them. Share your favorite memories with them.

By talking about your memories you will be shifting your focus from the sadness of the moment to joy of your relationship with this person.

Enjoy the Silence

When the dying process is extended and you run out of things to say, it is okay to just "be." Meaning is in people not in words and sometimes there are no words to express how you feel, and that's okay.

Lizzy Miles, MA, MSW, LSW is a hospice social worker in Columbus, Ohio and author of a book of happy hospice stories: Somewhere In Between: The Hokey Pokey, Chocolate Cake and the Shared Death Experience.
Lizzy is best known for bringing the Death Cafe concept to the United States. You can find her on Twitter @LizzyMiles_MSW 

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