“Family is who they say they are” That is that, family for some don’t just share the same blood, or are joined together by proceedings, but have friendships that run just as deep and considered to be family.
Death and dying is often times a part of my creative writing. But you know what’s hard? Dealing with loss and grieving in person. What’s most tragic is that we’re all going to be affected by it at some time in our lives including at one point with our own travel’s end. In my capacity as Nurse I’m much more comfortable being with, acting on and communicating regarding a client who is dealing with loss and grieving than I am when the person who is dealing with loss or grieving is friend, family, or me. I think that’s pretty normal.
So I thought I’d suggests, while written words don’t fail me here as spoken words might in the future, that if you’re faced with dealing with a family member who is dying, that you consider the “Four Gifts”.
This is a long post. But believe me, it’s worth it. Save it or share it if you like.
Interpreted from the writings of Elisabeth Kubler-Ross from a textbook, “Family members can be encouraged to write down their thoughts and feelings and to read them to the dying person, if appropriate, or simply to sit down one-to-one and talk from the heart. Likewise, clients can be invited to share these gifts with the important people in their lives. The gifts work both ways. When done with sincerity and simplicity, they invariably precipitate a healing shift in relationships.”
I’ll ask that if you read the four gifts that you read them in sequence, that they’ve been found to help many people feel better about what they are going through. If you’re in the situation where you feel you might use these, know it is normal to feel anxious. Role-playing can be helpful with say nursing staff if they are available. What you should do is to try these gifts straight from the heart and take the risk that some feelings will arise. That is ok and understandable in those circumstances.
1. Forgiveness (“I’m sorry”; “I forgive you”): The first step is to admit to the wrongs and hurts experienced at the hands of the other person. This can be frightening to do because it makes a person vulnerable to fresh injury. The other person may have no idea the speaker has been harboring a resentment or hurt, and may response with disbelief, defensiveness, or silence. The intention here is to forgive and release the hurt, and that must be the context in which this conversation takes place. Bear in mind two important caveats. One is that sometimes a face-to-face encounter is not possible (as when the client is sedated, comatose, or demented) and sometimes it is not advisable (as when there is conviction that this would cause more distress than it would relieve). In such cases, the effect can still be achieved by writing down the message and reading it to another person or simply by telling another, who acts as a stand-in for the client. The other caveat is that forgiveness does not mean that a truly injurious or abusive action has been condoned or accepted. It does not make a wrong right. What it does is signal a desire to let go of blame and anger, to release one’s heart from the chains of resentment. As such, it is a gift to the one who offers the forgiveness as much or more than it is a gift to the one receiving it.
The willingness to say, “I forgive you,” is accompanied by the question, “Is there anything I have done, or not done, for which I need to say I am sorry?” Being open to hearing about another person’s injuries and asking him or her for forgiveness is the other side of the coin of this gift. The art of giving and receiving forgiveness is rarely overt in many families, so most people have had no experience with this remarkably healing practice. They may feel awkward and phony using the words. Doubtless this practice entails taking emotional risks. However, it is the gateway to the other three gifts. Time is running out, and families know it. With some practice and encouragement, many take the chance.
2. Love (“I love you”): The second gift is to express love to each other. It is astonishing how many children have never heard their parents say, “I love you.” In many long-term marriages, these words have faded away, to be replaced by daily togetherness and the practical caring of a shared life. The end of life is a wonderful time for people to fully express what they mean to each other. Especially meaningful are the many memories of things learned from another, such as values, attitudes, and beliefs. Ultimately, the message is that all people are loved for being, rather than for what they have done or achieved.
3. Gratitude (“Thank you”): This is the moment to take the time to thank each other for what each has been in the other’s life. People look back over life together and remember the good times and the tough times. They can take out photo albums, show videos, reminisce, listen again to the client’s or family members’ favorite stories. Perhaps the rarest commodity in this culture is full attention; to receive a person’s undivided attention is precious. It is especially important to acknowledge the things that the patient took for granted. Many fathers and husbands have never been thanked for going to work every day for 30 to 40 years. Many wives and mothers would never expect thanks for all the laundry, mending, and help with school projects. Many exhausted caregivers weep when they are told they really are doing a good job and are appreciated.
4. Farewell (“Good-Bye, I’ll be okay”): Many people say that they hate good-byes. “I don’t do good-byes,” they may say. It is resisted for several reasons. Saying good-bye brings up feelings of grief and finality. Also, one hesitates to say goodbye before someone is actually leaving. It may appear to be rushing the person or even causing the departure. Yet when the final separation of death awaits us, the act of saying good-bye is deeply appropriate and meaningful. Survivors feel its absence when there was no chance to say good-bye and usually have to wrestle with it during bereavement. When one acknowledges the coming separation, one both gives and receives permission for the death to occur. The person who is dying knows that the loved one is facing the death and will survive it. The person giving permission loosens his or her grasp and begins to surrender to the inevitability of the death. The phrases one uses can be softened. “ I know the time will come when we’ll have to part, and these are some of my feelings and thoughts…” “I am thinking about having to go on without you, and I am going to make it.” “Thinking about saying good-bye makes me so terribly sad.” However one finds the words, this final gift is a way of acknowledging and honoring the importance of the relationship in one’s life and it should be encouraged and even rehearsed if necessary.
I have copied word for word out of the book, “Foundations for psychiatric Mental Health Nursing: A clinical Approach. Fourth Edition” by Elizabeth M. Varco. P.834-835. As noted above, the section was interpreted from the writings of Elizabeth Kubler-Ross whose work I felt was too important not to share.