By Lynn Purnell Hagan, PsyD, LCSW
|The Enormous Loss|
|Common Physical and Emotional Responses to the Loss|
Caregiver stress has been widely publicized and studied. Many times, one might think that the stress of caregiving is lifted once the loved one has died. However, the risks to the caregiver can often carry on long after their loved one’s death.
Death brings finality and shock – no matter how well prepared one might be. All death is sudden, even when it is anticipated. For those who have provided care for the loved one for years – through illness and health – the shock and loss can sometimes be overwhelming. The loss often goes far beyond the actual death as well. Losses can relate to finances and income, home and living arrangements, a major change in living patterns and the consuming role of caregiver, which becomes void when the role is no longer needed. All these changes contribute to the feelings of depression and grief that follows.
But what happens when the former caregiver becomes so overwhelmed with the losses that he or she begins to suffer from major depression and threat of suicide? Often times, so much focus is on the person who is ill, that when death finally comes, many see it as a relief and the freeing of the caregiver from the demands of the illness. The enormity of the loss is sometimes overlooked or underestimated.
At this time, it is likely that the former caregiver is experiencing a profound loss of purpose and identity, much like that of “empty nest syndrome”. These caregivers suddenly find themselves in the midst of changing roles and responsibilities. No longer are they the caregiver, but rather the survivor, the one whom now can “get on with their life” as if all those years can be erased by this single event.
Feeling sad and lonely are part of the grieving process. Physical symptoms such as exhaustion, loss or increase of appetite, insomnia, tightness in the chest, shortness of breath and dizziness may arise.
Some of your emotional responses may include:
|shock||inability to concentrate|
|guilt||extreme feelings of worthlessness|
|anger||fear of “going crazy”|
These feelings are difficult but natural. However, if these symptoms become severe and seem to interfere with daily life, or if the former caregiver expresses thoughts or plans of suicide or expresses thoughts of death, it may be time to pay closer attention to what may be happening.
At these times, it may be friends or associates who first see signs of trouble. Ignoring the signs, and hoping that they fade with time, is not a good option. So, what should friends and families of former caregivers do if this situation arises? Some useful tips include:
- Accept and listen unconditionally, without judgment. Listen, but do not lecture. Accept what is said and take it very seriously. Individuals may use various terms or express themselves in muddled ways, about taking their own life, such as “I wish I could go to sleep and never wake up,” or “I want to see my mother again,” “The family would be better off without me,” or “I can’t live any longer without…”.
- Sometimes surviving caregivers may show their “happy” or “functioning” face to others, and mask their anxiety, depression, and loneliness. They may not want others to know how lost and vulnerable they are. For loved ones, be attentive and check on these survivors with care, compassion, and offer to listen and/or talk.
- Talk openly and honestly. There is stigma and shame attached to suicide and your loved one needs to know they can talk to you openly. This will also help you determine if they have a plan so you can pass the information on to their mental health professional. If they do not have a mental health professional, you can consult a mental health profession or suicide prevention hotline for advice.
- Do not preach or moralize. Suicidal people know already that killing themselves is considered wrong by society’s standards; they do not need to hear it from a loved one.
- Talk about thoughts and feelings and focus on the person and the problem. Talking about thoughts and feelings with a suicidal person lets them know that someone is trying understands the pain they are in, the hopelessness and helplessness that they feel.
- Help the person focus on solutions. Talk about how they have coped in the past. Help them increase their understanding of the alternatives to suicide. Evaluate and talk about what is needed to improve the situation.
- Follow-up. Do not try to handle the situation on your own! Seek professional mental health help. Ongoing treatment is essential. Learn the signs and symptoms of relapse and what you can do and what your loved one must do.
- Remember special occasions such as holidays, birthdays, and anniversaries (including the date of their loved one’s death). Make special plans on anniversaries or other significant dates and make arrangements for family or friends to provide social support.
- Take care of yourself and deal with your own feelings. Talk to a loved one or friend who cares and can give you the care and support you need.