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 regretting.

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5 comments

barbara

Hi Tawnya, you have experienced so much death in your life, my goodness, more than most. Why you don’t cry? I don’t know but here are my thoughts: some people are criers and others, not so much. The showing and expressing of emotions is so individual, expressing our grief is individual also. Some cry, some show anger, some depression, some “tough it up" and move forward, some get physically sick, generally the emotions come out in some way.
Tawnya, I’ve learned a long time ago isn’t how many tears we shed that shows our grief; that no tears doesn’t mean we don’t care or don’t feel. It just means we are experiencing and expressing our grief in a different way, a way that works for us. Grief is about figuring out how to go on living. From what you have written it appears you have done that. My blessings are with you. Barbara.

Tawnya Albano

I have dealt with death on many levels, my husband(high school sweetheart) died in a car accident after only 3 months of marriage and while I was 3 months pregnant. That was 25 years ago, and I have never cried. Yes, it was/is life changing and very unexpected, as I was in the accident as well and experienced death, personally. I yet still haven’t broke down, as I guess an average person would do. I also lost my first baby, not the one I was carrying during the accident, as a still born after carrying him for 6 months. I never really cried. I lost my grandmother that raised me and I loved deeply, and have not cried. I lost my last daughter to SIDS and I did cry over her, but not to a degree an average person would. She was 4 days shy of her 2nd month of life. My step-mother is currently on life support, and I have yet to cry, although we know she will not make it through this, due to pre-existing health issues. My Dad tells me he wishes he had my emotional strength, but I still don’t know if it’s actually strength or the ability to shut feelings out. My Mom is also dying, due to an incurable disease and when I found out, I didn’t cry, which I still question . I ask myself how I am able to not hurt because of these life events. Is it emotional strength?

Alicia

Barbara.
Another way to look at Gillian’s grief is the two vastly different experiences; her father from a sudden heart attack ( not expected) and her mother’s death from vascular dementia (a long drawn-out process). Her father was an integral part of the family who was quickly taken away while her mother and her individual personality and relationship with Gillian) was slowly “stolen from her” day=by-day.
While it may be true that the numbing process which envelops Gillian at this this time may be the answer. However, I have noted in my 12+ years of hospice work as a chaplain/bereavement person that in the cases of long lasting disease process of vascular dementia and/or Alzheimer’s has slowly stolen the person (here it is Gillian’s mother) away from family members over the years. It’s not that the family goes not grieve at the end of a person’s life so much that death is “a closure” to the whole dying process. I have worked with hundreds of family members as they try to understand why “I’m not grieving right.”
The only “right way”to grieve is her way to grieve. Gillian may have for years cried every time she visited her mother and watched her mother’s dignity, memories and ultimately her life. She was grieving then. there will be grief now that death has come but it may take on a totally different aspect of what we professionals expect “grief” to look like following the death. Gillian may need that final “closure” to her grief/mourning but we professionals know she will carry the grief of her father and mother with her for the rest of her life – just in different perspectives.
On a personal note I find that I utilize many of your booklets in my work as chaplain and a bereavement counselor. Thank you for putting so much of who I say into an understandable way which reaches through my patient family’s grief and assists them in understanding what they are experiencing. I give you credit for walking with me while I walk the grief journey for a brief 13 month process.
May you continue to be blessed with your resources which assist us “in the field” and my God continue to bless you in your “ministry” and education on living and dying.
Blessed Be.

barbara karnes

Hi Gillian, I am sorry to hear of the death of your mother last week. In response to your question, are you in denial. I don’t know as I don’t know you or the details of your mother’s dying. What I can say is that since it has only been a week you are just numb. You are not really feeling anything. There will come a time when that numbness begins to wear off, when you will begin actively grieving. A week is just too soon to deeply feel your loss. At some point, weeks from now, you may wonder what is happening to you -that you are sadder, less in control than  you were now right after the death—that is when real grieving kicks in.
You might find my booklet My Friend, I Care helpful in understanding grief and the emotions that go with it. 
My blessings are with you. Barbara

Gillian Campbell

I lost my mom last week from vascular dementia disease. She was 79. I was very close to her, but I don’t r why I am not grieving as I did when my father passed of a sudden heart attack in 2001. Am I in denial?

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