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Sunday, May 25, 2014

How to prepare for the loss of a Caregiver?

Recently, a person on Facebook asked me the question showing in the title.
I mentioned that I will speak with a Psychologist and have him answer.
Below is his reply:

How to prepare for the loss of a Caregiver?

Preparing for the loss of someone close to you is difficult. Preparing for the loss of someone you rely on to help you maximize your own functional independence such as a caregiver is difficult and emotionally complicated.

The psychiatrist Elizabeth Kubler-Ross has conducted research and written a good deal on the topic of loss. Through her work, we have come to learn that experiencing loss typically involves a grieving process with a series of distinct emotional stages. These stages are as follows:

Stage 1 – Denial: This stage usually follows immediately after the recognition of a loss or following the recognition that a loss is imminent. One minute a loved one is present, the next they are gone. It is difficult for a person to believe that dramatic changes can occur so abruptly and unsuspectingly. Struggling to admit to yourself and others the reality of a significant loss is referred to as denial.

Stage 2 – Anger/Guilt: Typically, anger sets in when the survivor can no longer deny that a loss has occurred. The survivor may become angry with “the world” simply because of the cruel reality that loss exists and is unavoidable within one’s life. Anger an also be turned inward at oneself. This type of anger is usually highly illogical. For example, a person with MS might think “If only I didn’t have MS, my Caregiver wouldn’t have had to care for me and might have been healthy enough to have survived their own medical ailments.” Anger at oneself might then emerge. Feeling guilty also shortly follows. Guilt might emerge through various other illogical thoughts as well, such as “Having to care for me impeded the quality of my caregiver’s life”. In situations in whih a caregiver is a family member such as a spouse, it is common to think “It is my fault (because of my MS) that I couldn’t give my caregiver the kind of life they wanted” and similar such thoughts.  It is important to recognize that these thoughts and the associated negative emotions are illogical—it is never and individual’s fault for developing MS.

Stage 3 – Bargaining: The bargaining stage may be characterized by pleas to God for a complete to spare or undue the loss. For example, one might offer things such as, “If you don’t take my Caregiver away, I will make the world a better place in any way I can.”

Stage 4 – Depression: The moment of recognition of the inevitability of loss can be quite upsetting and an lead to or worsen a depression.

Stage 5 – Acceptance: When one acknowledges that things may never be the same, and when all the preceding feelings have been fully dealt with, then the survivor can come to terms with the loss.

Stage 6 – Hope: With acceptance comes the hope that although things may never be the same, life can still be fulfilling.
Not everyone goes through all of these stages after a loss, and the order in which one moves through the stages may not be the same. Also, it is common for one to go back and forth through the stages as they slowly move toward acceptance of the loss.
If you haven’t already picked up on this, what makes the pending loss of a Caregiver so incredibly complicated is that someone with MS has likely already dealt with or is currently dealing with these stages through some form of their own loss due to the MS (loss to some extent of physical functioning, roles, cognitive skill, etc.).  Moreover, the sense of guilt that can be a part of grieving a loss is only compounded through the loss of a caregiver, because someone with MS is vulnerable to feeling as though their condition in some way contributed to the loss of the Caregiver.

The first and perhaps most important step one can take in preparing for the loss of a Caregiver is to learn about the above grieving process and recognize it as normal.

Openly discussing one’s emotions with the Caregiver or another loved one is essential to healthy adaptation. Understanding one’s own emotions and sharing them with another is crucial in moving one toward healthy acceptance of a loss. Nonetheless, the process of grieving is never easy.

Take advantage of letting a caregiver know how much you care about them in advance of foreseeable loss. This can help with guilt and other negative emotions once the loss occurs. It will also help the Caregiver to recognize more fully the meaning and purpose of their work with you.

Look for ways to keep the spirit of the caregiver with you after losing him or her. In a sense, “memorializing” the caregiver in some way can help keep you close to them.

Seek professional help through counseling if you find yourself “stuck” in one of the above stages. Counseling can help you to process through the stages and move toward healthy acceptance.

Justin C. Koenitzer, Psy.D.
Licensed Psychologist

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