It was an exhausting phone call from my brother from Hong Kong. It was the discussion about the sudden death of one of the distant relatives. He stayed in proximity to the dying person, observing and assisting in day to day activity and listening to his every talk. He described that deceased person as a hero and embraced until the last moment and departed happily. Now his assessment of the incinerated person’s animus is heavily infested by religious optimism and positivity. This talk, in fact, led me to think that how people react to if they are known to their death.
This talk brought back my memory from the time I spent with my cousin. He was diagnosed with a rare bone cancer- Ewing’s Sarcoma, atypical and aggressive form. I was in the final year of medical school, and this diagnosis was more of a curiosity for me than understanding about underlying emotions and pain he might be experiencing. I remember the day when his MRI showed metastasis in the lung and the oncologist broke the news of catastrophe. I was still disconnected and interested in learning about the tumor and its treatment. At one point, I uttered the extremely insensitive sentence that “ oh well; he is going to die anyway!” The total absence of empathy! I feel pain and heavy heart every time I remember that behavior. I totally missed the valuable lesson in my life.
Nowadays, I wonder anyone with known impending death and having limited time, to spend with loved ones, How they would respond to the situation? I do not have any extreme experience to spend time with a person who is dying, maybe because I am not that brave to face, but I started reading and listening to people with first-hand experience. Here is the information, I learned through discussion with patients, their relatives and literature reviews.
Keep a check on the flow of grief.
In the event of impending death, there are varied and extensive emotions are at play in patients and immediate family, ranging from but not limited to anger, shock, denial, numbness, intense sadness, guilt, anticipatory grief. These are emotions present at distinct times in stages for the different length of time. The magnitude of the event itself is enough to bring on these events. Try to keep a check on these emotions. Reach out for help. Bring bereavement therapist in the early stage of the end of life. Keep loved ones and friend within a reach. Try to develop a hobby and the most important is to use (pain) medications to keep life comfortable.
Allow people to soothe you.
It is equally hard to let individuals in your personal life and to reach out for help. Once you overcome the subconscious hurdle, it becomes easy to let an outsider in and their objective perspective. This phenomenon is equally true for the family members who care. They need help to deal with their emotions. Feel free to word about death, and it is totally illogical that talking about death can bring it faster and more pain. Engage more with loved one’s life. Ask your mom, dad, brother, sister, or spouse what has been most meaningful with their lives and what are their largest joys and greatest sorrows, call it a practice of a life review.
Amend misunderstandings of a lifetime.
Described in words and analyze emotions. Take an opportunity to talk to relatives and loved ones that how you comported oneself. Straighten misunderstanding, feelings, and regrets by bringing the talk to the table and engaging directly with the person involved. Amend anything comes into your head, make apologies to anyone who may have misunderstood the intentions. Never miss a chance to express love and tell the significant one that how much you love. This is one of the many ways to anticipate the loss. It is about the ability to say anything, sharing fear, frustration, anger and not afraid to say good-bye.
Tough discussions and decision making, involve the patient.
Start dying person involved in the aspect of the rest of life, including treatment decision making, hospice and comfort care, end-time wishes and funeral arrangements. It is important to have an honest conversation about the progress of a disease and about inescapable. Some discussions are harder to start with, but it is important to set the table. The family members, the healthcare workers, and doctors have to come up with innovative ways to bring up those talks. Often times light humor can bring a smile also sets the table for serious discussion.
Better disease management and earlier hospice care have changed the sentimental landscape of loss and bereavement. At the same time, strong emotional support to the dying person and family member aided by spiritual help can improve the overall journey until the end.
If I made any positive difference in your thoughts, please share, share and spread!