INTRODUCTION: 7 August 2023
The article that describes our journey over the past three decades is the context for this essay (see "Our Journey" page in the top dashboard). I definitely recall acute feelings of loss at several steps along the way: when Mike was put on disability, when palliative care was recommended, and when he was admitted to hospice. Although his condition continued to decline, he was discharged from hospice after two and a half years. Re-evaluation was requested, but hospice care was deemed not appropriate. I find myself trying to navigate an emotional balance, without extreme highs or lows.
GRADUAL GRIEF
By Gail K. Kachnycz; 11 March 2021
Chronic illness
is a series of losses, and each is grieved in turn. First, with the
identification of a diagnosis, there is the loss of the state of good health
that the person previously enjoyed. Additional symptoms, and each decline in
functioning, is a need for an adjustment of perspective which is quite often
coupled with an emotional response. When death finally comes, the family or
caregiver might actually experience a sense of relief.
An unexpected
death usually brings feelings of shock, disbelief, and an overwhelming sense of
loss. There may be deep emotional pain. The survivor may feel numb. Mourning a
loss is different for every person. There is no right or wrong way to grieve.
In chronic
illness, the affected person and caregiver or family may experience feelings of
loss over time. This may be gradual, or may be attached to specific signs of
decline: a person with dementia does not recognize family members, a diabetic
requires an amputation or needs dialysis, the doctor says, “We can only manage
symptoms, no cure is possible,” or “We don’t expect improvement,” or “You may
want to consider hospice.”
Each decline
initiates a new period of mourning, but remaining in an acute stage of grief is
unsustainable. Life goes on, with bills to pay, cooking, laundry, and so forth.
Eventually, there is an adjustment to the new normal. However, the person may
find that they are protecting their emotions from extreme highs or lows. This
is a natural coping mechanism. This may be a sign of “Compassion Fatigue” and
indicate that the caregiver needs some time and means for self-care.
When death finally
comes, it may seem to others that the family or caregivers have only a brief
period of bereavement and recover rather quickly. Quite the opposite is true.
The family/caregivers have been grieving for months or years as they watched
their loved one slowly slip away from them. At last, the process reached the
end, and the family can say their goodbyes and move forward. This is not to say
that the funeral, burial and settling of affairs will not be difficult, but at
least closure can take place.
Grief is not an “all or nothing” process. Especially since chronic illness is ongoing, the ill person and their family will find that happy events and silly situations are also taking place. This is the nature of life. In 1859, Dickens had it right as he penned A Tale of Two Cities:
It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way—in short, the period was so far like the present period that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only.
Those dealing with chronic illness can immediately empathize with those who are encountering the same struggles. Their support and comfort to others rings true.
“…we can comfort those
in any trouble with the comfort we ourselves receive from God.”
2 Corinthians 1:3-4
However, happy events and positive growth are taking place at the same time. Recognize these opportunities and celebrate them. Just as we mourn with those who mourn, we rejoice with those who rejoice (Romans 12:15). We can do this not by ignoring the effects of chronic illness, but recognizing that although there seems to be no end in sight, ultimately there is something beyond what we can see.
“Therefore we do not
lose heart. Though outwardly we are wasting away, yet inwardly we are being
renewed day by day. For our light and momentary troubles are achieving for us
an eternal glory that far outweighs them all. So we fix our eyes not on what is
seen, but on what is unseen, since what is seen is temporary, but what is
unseen is eternal.” 2 Corinthians 4:16-18
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