On some level, every adult child knows that they are going to lose their aging parents, but hope that it is in the nebulous future and not in the here and now that would require facing a loss of inestimable grief. How naive we can be to think that at any point we will be ready to cope with the loss of the people who have been central to our families and our lives. Even when terminal illness has unwelcomingly brought the thoughts of the death of a parent to the forefront and made the possibility no longer ignorable, we have hope that we will have just a little more time. But we are never ready – never. We long for one more minute. Yearn for one more brief phone call to talk about nothing in particular. We rail against the knowledge that there will be no more opportunities to say what has been left unsaid, ask for forgiveness for past behavior, offer grace for previous wrongs, and above all say “I love you” just one more time.
I’m a therapist, who has had clients who have died after a long illness and I have counseled family members who have lost precious loved ones. Intellectually, I understand grief and loss. I believe in the power of helping people to “die well.” I’ve read about the stages of grief and have observed clients vacillating along the continuum of the myriad of all possible responses to their loss.
I’m also a therapist who has just lost her mother. Has anything I’ve done professionally prepared me for my own personal grief? No – of course not. I primarily feel numb. I’m an observer to my own loss, recognizing my response to the trauma of her last days and the shock of her being gone forever. C.S. Lewis wrote about the death of his mother: “With my mother’s death all settled happiness, all that was tranquil and reliable, disappeared from my life. There was to be much fun, many pleasures, many stabs of Joy; but no more of the old security. It was sea and islands now; the great continent had sunk like Atlantis.” Same.
Nothing prepared me for my loss, but my experience has reinforced things I already knew. What we can do to help ourselves as well as our dying loved ones and focus on needs being met.
- Don’t leave anything unsaid. I was able to tell my mom some things I needed to tell her and I feel grateful for having that opportunity. Having this conversation with her prompted her to open up about some feelings that she needed to express. What a blessing!
- Recognizing and resolving any conflict, so that no one has any regrets. Ira Byock, a palliative care doctor, wrote in his book, The Four Things That Matter Most, that there are four basic messages a person needs to communicate at the end of life: I love you. Thank you. I forgive you. Please forgive me. My mom told me that she regretted not being more demonstrative with her feelings. I was able to reassure her that my siblings and I always knew and felt her love without needing more overt expressions of her affection.
- Satisfy any reasonable last wishes. My mom was a gambler. She loved playing poker, going to casinos, bingo, and buying scratch off lottery tickets. When she was first diagnosed with lung cancer, we talked about taking a family trip to Las Vegas. That trip never happened. No one’s fault – just with the treatment and her physical condition, it wasn’t possible because we waited too long. Doesn’t that tell us that we should grab every possible opportunity to fulfill wishes and goals while we can for our loved ones and ourselves because we never know when those opportunities will be lost.
- Find meaning in life. There are two main ways that people on their deathbeds find meaning: in the recognition of all of the people they have loved and who have loved them, and in the work that they’ve done that has contributed to the greater good. In some cases, contributory work will be obvious; in others, it may be less so. But, helping the dying to articulate what brought meaning to their lives will help them feel more at peace with their death. I didn’t have a chance to do this with my mom. My mom worked at a grocery store and I’m guessing she didn’t see her work as contributing to the greater good. However, she told me stories about how she helped customers, many of whom she knew for many years, and maybe her short conversations with them brought them joy. I would have told her that she was inherently funny and made people laugh even though she didn’t always mean to be humorous (that was the best part 😊). I would have told her that she was a loyal friend and that this character trait garnered her life-long friends. I would have told her that she loved and was loved well. I was humbled watching my stepfather care for my mom through her illness and am in awe of their love for each other.
- Be clear and confident about refusing unnecessary procedures to prolong life. The day before my mom died, the oncologist talked to us about doing a bone marrow biopsy and then the aggressive treatment that could be done to address the possible metastasis. Really? At least he was honest about the limited time such treatment would have added to her life, but it’s easy to see how people would be willing to agree to more treatment for those additional days, weeks, months, etc, but at what cost?
Can something positive come from loss? In 2001 there was a research study by Frantz, Farrell, and Trolley. The researchers asked people who had lost a loved one, what good things came of it. Four major themes emerged: people learned to appreciate the value of life, they felt they had become stronger (more independent, mature, self-reliant, and self-confident) after surviving the pain of loss, many became closer to their loved ones, and most said that they had done things that worked to make coping possible (interesting that the ones who reported the most successful coping found times to feel the pain of loss and at other times, found ways not to do so. They embraced and avoided grief at the same time).
So, I grieve and hope that I can continue to learn something and focus on the positive like I encourage my clients to do. Elizabeth Gilbert, the author of Eat, Pray, Love wrote, “Deep grief sometimes is almost like a specific location, a coordinate on a map of time. When you are standing in that forest of sorrow, you cannot imagine that you could ever find your way to a better place. But if someone can assure you that they themselves have stood in that same place, and now have moved on, sometimes this will bring hope.”