Families in Crisis
Tom’s mother is 92. She has lived for the past several years in a beautiful care facility. As the years have passed her memories have slipped some and she doesn’t always remember who you are or that you last saw her yesterday. She has been comfortable and well cared for. Now she is in Hospice and quickly approaching the end of her days here on earth with her six sons and daughters.
I’m the outsider here. I didn’t know her at all. By the time I came into this family she, who was someone’s wife, who had been a nurse, who had raised six children, who was a woman with many of the same experiences I have had as a woman, was already gone. Dementia prevented me from getting to know her, that mother of Tom’s. All I can see is the shell of what is left and how a family in crisis is coping. Maybe there are lessons here to be learned and shared.
We live in Ohio. Tom’s mom, one sister and one brother are in California. His other sisters and brothers are spread out over the country. Not easy for visiting, even for the California siblings. Its a big state. And when Mom doesn’t know who you are or if you were just there, it’s hard to justify frequent visits. But that also leaves adult children dealing with guilt, feelings of being separated, and no closure.
Choices have to be made. I watched Tom struggle last week when his mom was admitted to Hospice. Should he go see her one last time? Should he try to be there when she died? Should he be there for his siblings? Were any of them going to be there or was she going to die alone. And if so, was that wrong?
We didn’t go. He talked with two family members who were there. He had seen his mom when we were in California two months ago when she was still “alert”. General consensus of two of the siblings was “why spend the money – she won’t know you are here.” They were leaving the next day. Thee are hard conversations to have, ones that still leave you second guessing your decision when you hang up.
What I see is, at this point its not about the mother who is dying. She is doing that on her own timetable (and God’s) by herself. Nothing any of her children do at this point will effect that. This is about the siblings, the family in crisis, coping with the impending death of their last living parent. What they do at this point in time may set the tone for their future relationships. Communication is essential, especially with everyone so far apart and with feelings so near the surface.
Last night Tom called the facility to get a report on his mother’s condition, which he has been doing for years, more frequently since her condition has deteriorated. He was told they couldn’t give him any information. Ok, look at this scenario, your mother is dying, you are on the other side of the continent, the nurses have always kept you up to date, and now no one can give you information? Emotions are already strained waiting for the final phone call that will let you know its over. And now you can’t get ANY information. Put yourself in those shoes.
It was a little tense around here. The answer from the person at the facility was, the sister in charge of decision making for the mother’s health care, had decided, before she left, it would be best for communication to come through one person and to limit the number of phone calls the facility had to handle. Certainly a valid choice – not the only one and not necessarily one I would have made but it was made and put into place. So what happened? What was missing was communication with other family members.
Upset and hurt feelings do not need to be a part of this dying/grieving process. I do not say this to be critical of the family member who made this choice. She is part of a family in crisis and a person in crisis does not always think of everything that needs to be done when a plan hasn’t been made in advance. They didn’t have a plan or talk about any of this before the crisis began. Everyone has known for years that Mom was going to die. She is 92 years old for heaven’s sake. The time to start talking about what was going to happen, who was going to be in charge, what is expected by the other family members of that person, who is going to be the chief communicator, etc ,is not a week before it happens.
Start talking NOW as a family. Involve the loved one in the conversation if possible. Tom’s mother, several years before the dementia set in, was aware that she would someday follow her husband into the Great Beyond. She could have been involved in letting everyone know what SHE wanted when those final days came. If a family can’t all gather together physically to talk about it then do a conference call if possible, put all the details in a letter and make copies for everyone and mail them, appoint a spokes person to get the information to everyone. Don’t wait until the crisis is in progress to handle the family dynamics. Have a plan. One of the resources available to help you plan is your local Hospice. You don’t have to wait until a family member is dying to access their resources. In fact the earlier you get information about Hospice and their role the easier the process is on everyone when the time comes to make that choice. They can even facilitate these family conversations.
Several phone calls and rather prickly conversations later the family is all back on the same page. Ruffled feathers have been smoothed, at least on the surface. However, it’s this type of crisis interaction that can leave families fractured and hurting well into the future.
Losing a parent is never easy. When both parents are gone there is a realization that the family will never be the same. Your own mortality confronts you as you are next in line to make the final trip. There is no generation standing between you and whatever comes next. We need all the DNA support we can get which is why its so important to remain a family. The crisis will pass. How the family comes out on the other side may well depend on how much planning was done in advance. Think about it.
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