Chaplain's Corner

Family.  In theory we all would affirm the importance of the family.  It is the foundation of upon which our society stands and we have seen how societal problems have developed as the family has begun to show signs of decay.  In every aspect of health care the importance of the family is readily recognized.  We encourage family members to attend the ER with a loved one who needs medical attention.  When a person is hospitalized, we are grateful when we see that the family is attentive and concerned and supportive.
 
In Long Term Care, when a person is admitted to a PCH much is done to understand the family dynamic and to support the family as this dramatic change one member’s place of residence has an impact on so many others. The death bed is a truly sorrowful place when there is no family to surround the dying one, to support and companion with the one near death to the very end.

But family can also be the source of great difficulty for those who work in Health Care.  There are times when families are divided over how a loved one’s health needs should be managed.  There are other times when the less than functional condition of the family that existed in the community is brought into the health care facility and our staff members find themselves serving as referees of the disagreements that ensue.

Take a family I worked with a few years ago.  Mom had had quite a severe stroke.  Her condition was grave and several important health care decisions needed to be made.  One of those decisions surrounded the issue of nutrition.  You see, the stroke took away the mothers ability to swallow so she was no longer to eat or drink to provide her body’s nutritional requirements.

As the Doctor worked with the family questions surrounding this matter arose; one of the members of the family was of the opinion that if Mom could no longer eat or drink, then it was God’s will that she die and this adult child was of the opinion that Mom should e kept comfortable, her symptoms managed but that her condition should be allowed to take it’s natural course – eventual death.

However, one of the other children asked the doctor if she could have a tube inserted into her stomach so that she could be fed and receive the water she needed to sustain her life.  This was a possibility and the debate ensued.  Eventually the tube was inserted, Mom’s life was maintained for several more years with the help of the feeding tube and the family remained divided until the very end as to which of the alternatives would have been best for their Mother.

In this case everyone was well intentioned, every one of the children dearly loved their Mom, each had very valid reasons for coming down on one side or the other of this decision and a divide that had existed over other issues was perpetuated with this one and even after much discussion with members of the health care staff, the opinions were set and the divide lived on.

However there was another case that I had the occasion to be involved with.  In this situation Dad was dying of cancer and although the battle had wages for several years.  A couple of his boys never bothered to come out to see him and provided virtually no support for him as he went through surgery, radiation and chemotherapy.  Now this wasn’t new, the boys hadn’t been involved with Dad for years and even though they lived within an hour’s drive of Dad, they never bothered to call or visit.

Then one day Dad took a turn for the worse and it appeared as if he was dying.  The family was called and along with other children, these two sons came to the hospital.  As Dad’s condition deteriorated, these two sons’ became increasingly preoccupied with Dad’s will.  Where was it, did anyone know what Dad had stated in the will?  Had Dad given anyone Power of Attorney?  Who was looking after his affairs?  A daughter who had been faithfully by her Dad’s side through this entire ordeal was visibly upset.  She pulled one nurse to the side and said, “I can’t believe it!  Bob and Dave could care less about Dad, but they sure have a lot of questions about his money and assets, is that all they care about?”

Well, she was right, they didn’t care about Dad and they never showed up to the hospital again, but after Dad died, a real battle broke out as they felt they were not getting their fair share from Dad’s estate.

I could recount many other stories of families and how they relate in the face of health crises.  But the point I hope to make is that waiting for the crisis to address these family issues rarely produces any amendment of the issues or the relationships.  Most of us wish our families were different.  Most of us contribute in some way to the dysfunction that exists in our families.  Most of us can justify or give reasons for why things are as they are.  Some of us have lost hope that anything will ever change in the dynamics of our families and have chosen just to live with the reality of what is.  Others will keep tying to change their family dynamics, keep appealing to the members who seem to be at odds to get together and work things out.

But the reality is that serious illness and impending death rarely provide a context for transformation and generally provide the opportunity for the old dysfunctions to find new and often hurtful expressions. So what are we to do when a health crisis strikes the family?

First, understand that all things being equal, your family members will in all likelihood behave in the same, predictable pattern that they always have.  Don’t expect the crisis to bring something better or improved from them.  And understand the same thing about yourself.  A crisis will not bring something different or better out of you, but you will in all likelihood respond to a health crisis in the family the way you respond to pretty much everything that happens in the family.

Second, understand that you have control over only one thing, your reactions to what happens.  You have no control over the circumstances of life; you have no control over what other people do or how they react, but you can choose to change yourself.  You are not forever and irrevocably programmed and helpless to change.  But the time for change is not in the face of a crisis, but when things are quiet.  Are you unhappy with yourself in times of family stress?  Then when things are quiet, begin to work on yourself.  Ask yourself, why do I respond that way?  Think about other ways to respond.  Imagine how you would like to respond.

Third, understand that you don’t need to be drug around by your emotions.  I am not advocating the suppression of your emotions, but recognize your emotions for what they: an accurate reflection of how you feel, but rarely an accurate reflection of what would be best under the circumstances.  Begin to practice experiencing your emotions, identifying what they are, but then choosing to act in a way that you believe is best, even if it is contrary to how you feel.

Family, sometimes we think we would be better off without it.  But like yours or not, one of the lessons we need to learn in life is to be self-controlled.  Self-control is not about being controlled by what others think or say or do.  Self-control is not having our responses directed by the reactions or lack thereof of others.  Self-control is about being in control of ourselves; our feelings, our choices, our actions.  When we can se self-controlled in our relationships within our families, things may still go crazy and the dysfunction may still exist, but we may be able to walk away not regretting our own actions and responses, and that would be good, wouldn’t it!