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End-of-Life Issues

Expert PhotoVincent Dopulos, MA, LPC, RDT, is a Licensed Professional Counselor and Registered Drama Therapist. His private practice in Montclair, NJ works with dying people and their families. He also has a specialization in working with children in both bereavement and loss resulting from divorce. At Saint Barnabas Medical Center Vincent coordinates the bereavement program for the pastoral care department.

My mother is obsessed with medical issues. I know that now that she is getting older (67) she is afraid of what lies ahead and her friends getting sick make it worse. It is now something she must talk about for hours every time I talk to her. She actually describes her friends by what tragedy they have had. "Mary--who's husband died" or "Larry--who had his leg cut off." We had to stop telling her about our doctors’ appointments because she would go online to find the worst possible outcome to an ailment. I don't know if this is anxiety, depression or normal and when we try to talk about it she becomes defensive and tell us we have no empathy for others. Help! 

Denise from MI

What you describe is common for folks in your mother’s situation. Her worries sound to be a pervasive condition that she is currently living in. This anxiety is difficult for everyone involved: for you and the other family members and certainly for your mother. It sounds as if her worries have moved into the primary concern of her life. When we find ourselves at this level of anxiety, our first concern is to find others that can at least understand, if not join us, where we are. A difficult piece of this situation is recognizing what she is saying is not untrue. The friends she is describing did have the ailments she cites. It is possible when people go to the doctor they will receive test results that reveal serious ailments. Often step one in finding a pathway to relief when older family members are experiencing anxiety of the level you are describing is to acknowledge the reality and the seriousness of their concern. This may not be an easy task. Different family members will have different abilities at different times to be capable of entering this world of worry and fear with her. It is often not a comfortable place for us to have to face the terrors another is describing. However, this sounds to be the first thing your mother is asking her family to do.

What she is obsessing on is a reality we all will face at sometime in our life. Right now, she is unable to find relief from it. The first step to relief is to be deeply and unconditionally heard and understood in that obsession. And unfortunately, this may not be quick. Sometimes it takes a period of time and revisiting fears for the person to feel they have been really heard and understood. The good news is this level of being heard and understood is a profound and meaningful form of loving between two people. When you feel your worries have been taken seriously, it means an important part of you has been taken seriously. What often results is a new level of intimacy and a deeper level of a loving bond. This is partly true for the very reason it is such a difficult task. But at some point she may well feel that her point of view has been heard and seen. Once that takes place, some conversations can happen that can bring her real comfort.

When people are experiencing fears of illness and loss they have deep concern on what is going to happen to them and how it will be handled by those they love. Conversations that center on what people want done or what preparations need to be in place may not be things we look forward to discussing. What they can provide though, is a sense of loving concern for people feeling vulnerable. Most importantly it can provide a sense of confidence that we will not be alone, no matter what happens. These are crucial elements to an older person’s sense of well-being, comfort and feeling safe and connected to those they love. There is no telling what the particular concerns your mother is having that are prompting these fears. But there is little doubt that trying every way possible to enter her world, to try to understand these messages from what her life is driven by and where it is leading will go a long way toward relieving the obsession she feels necessary to maintain.

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Q: How can I acknowledge everything my parent means to me before it’s too late?

When an aging parent begins the journey toward end of life we have to acknowledge for ourselves what is happening and say the things that need to be said. What is most important to communicate in these precious conversations? Voicing your feelings of love, any amends you want to make so that there will be no regrets and your appreciation for the kind of parent they have been for you. You may have said “I love you” a thousand times to them. Whether a thousand or never before, life is coming to an end, and now is the time to speak these words. What is called for here is a clear communication to your parent that you have loved them throughout the years, and you love them right now. If you are a man facing the loss of your father, please do not let him die without this. It is as much an attitude and a presence as it is a set of words. Say these words with the determination and clarity that men use when they choose to go into battle side-by-side.

We all carry regrets. Some are too painful to recognize. Some are never spoken of. What has happened between you and the parent who is coming to the end of his or her life, that you regret? How healing it might be for the two of you now if that event could be spoken of. Think about what it is that you want to make sure they know. Some event that seemed so important when it happened may have little importance now. If there are any leftover feelings about it, now is the time to let them know you have a free heart and you want the same for them. If there is anything you want to say you’re sorry for, now is a good time to find a way to gently mention that event and say to them simply: You know, I am sorry I did that. Do not explain why you did it or the circumstances or anything about it. Just clearly say: Dad or mom, please know I am sorry about that.

Now is also the time to look back and remember the things mom or dad did that made a difference to you. The more specific you can be, the better. Maybe it was the time you dropped the ball at your job and things looked bad for a while. You may have been scrambling hard to get it back together at the time. Maybe you didn’t mention it then, but you have never forgotten what your parent said in passing or that mom or dad was the only one who never lost faith in you. You’ve always remembered your parent saying: Hey, Tom, you’re gonna make it just fine. Small thing at the time, but somehow you’ve never forgotten it. Now is the time to make sure they know that small thing they said or did for you has stayed with you for years.

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