Elisabeth Kubler-Ross introduced her five steps of grieving for a loved one who has died four decades ago in her book On Death and Dying. A couple of new authors, Barbara Okun and Joseph Nowinski, have revised these five steps in light of our present day experience of dying which tends to be a more protracted process. As a geriatric care manager, I find myself spending more time helping caregivers prepare for the death of a loved one than helping them after death has occurred.
The very practical fact is that people simply do not die in the same way they did nearly half a century ago. We do not hear of folks just “dropping dead” as much as ultimately succumbing to a terminal disease from which they have been suffering for some time. Modern medicine has given us more warnings of life-threatening conditions and more tools to forestall the assault of terminal conditions like cancer or heart and lung disease. With that change in how we die has come a need to address the anticipatory trajectory of caregivers as they attend to an individual and as they prepare to say good bye.
Okun and Nokuski offer a psychological road map for caregivers anticipating the demise of a loved one in their book, Saying Goodbye: How Families Can Find Renewal Through Loss. The authors help readers to develop the communication skills to address the old family issues that will surface during the protracted caregiving a terminally ill individual will require. It is a self-journey handbook for the caregiver to address the inevitable emotional challenges they will face, and I recommend it.
An important counterpoint to the emotional navigation aid Okun and Nokusi offer is the guidance that Dr. Kevin Pho offers. In his blog posting, KevinMD, Dr. Pho offers advice on how to navigate what he calls the “medical maze,” how to interpret medical speak, ask the right questions, be proactive. For any of you facing these end of life passages, I strongly encourage you to check out both of these resources. We all need to be willing to “stop and ask directions.”
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.,geriatric care manager Chicago, geriatric care Chicago
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