Distancing From The Dying

Dear Barbara, there's a phenomenon I see every so often when I'm doing hospice care. A close family member, a spouse, parent, or child, will totally back away from the dying process, sometimes to the extreme of not being with the patient at all. Then, when it's all over, they totally fall apart. The situation becomes all about their grief and loss. How would you deal with this?

There are so many reasons for this kind of behavior and each individual situation requires a different approach. I think fear keeps some family and significant others from being with their  person as the end of life approaches. They are afraid of what dying and death will look like so they stay away. Here we can help by teaching about the dying process, offering support and guidance. Our function with most of our families is to neutralize the fear around dying and death that they bring to the bedside. Yet sometimes no matter how supportive and instructive we are, we do not reach the individual.

There is no perfect relationship. There are good times and difficult times.  Sometimes the difficulty we have with the person that is dying keeps us from being at the bedside. We are uncomfortable, angry, hurt, and often unforgiving. We find it easier to avoid, rather than confront, whatever has come between us, so we stay away. Then, when death comes, the guilt we carry because of those unresolved issues compounds our grief.

I have noticed that what seems like disproportionate grief is often the manifestation of a troubled relationship. Following the death we sublimate all the difficulties and elevate the person to “sainthood”. With that elevation, we tend to verbalize how wonderful this person was and what a huge loss it is for us now that they are gone.

How can we help them? By gently reminding them no one is perfect, no one is all good, always agreeable, always meets our needs. Help them understand it is okay to be upset with someone who is dead. Also suggest that they write a letter to the person that died. Put in writing everything they would like to say or have said and didn’t, positive and negative. There is something very powerful in writing, the funneling of our thoughts to paper. Then --  burn the paper. Watch all the feelings that were put on paper, all the tears shed, the anger told, disappear into smoke and ashes. Release so you can move forward.

Something more about Distancing From the Dying~

As I always say, Knowledge Reduces Fear.  If, perhaps, we could have the "distancer" read Gone From My Sight or watch NEW RULES for End of Life Care, their fear would be reduced and they could be a part of their loved ones dying process.  It would be so much healthier than distancing and regreting.

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