Hospice During the Holidays
Many of the huge and multiple challenges facing friends and family when someone is in hospice become larger during the holidays. Whether it’s Christmas or Passover, or a host of other gatherings intended to be celebratory, being with family and friends is even more difficult when someone is dying during special times. Thinking and planning in advance can help.
Humans are flawed and families are collections of humans, often with much more in common than just shared genes. Family gatherings can ignite conflict; the larger the gathering the greater the potential for flare-ups.
I come from a long line of bossy women. Get two of us in the same room at the same time and sometimes sparks will fly!
But understanding this in advance is a wonderful prevention. By this I mean if you recognize the possibility of a flare-up, you can minimize the flames.
The mix of old age, dementia, past history and a person at the end of life make family gatherings terribly difficult. Many issues are, at core, control issues. Relinquish control as often as possible. Even folks with Alzheimer’s are entitled to choices—even bad choices.
Especially during times that are supposed to be festive and harmonious, let grandpa have pie, even with his diabetes. (Perhaps bring a sugarless one!) Hide the alcohol and make everyone go without, if one person is at risk of a making major scene if unlimited alcohol is available. Refrain from forcing grandma to wear what you think are appropriate clothes; after all, it really doesn’t matter.
Check in with yourself as to what is important and what is not. For an old person near the end of life, the pleasures from dessert or wine or a summer gown on a winter night offset any risks. This is true regardless of age.
I remember a man in hospice who wanted one last beer (or probably a sip) before he died. The hospice nurse denied him “because he’s on morphine.” There is no reason in the world why a dying person on morphine cannot have a beer. Or snuggle in bed with a loved person. Or smoke a cigarette.
Keep the conversation pleasant. It is easy to switch the tone of a conversation, especially if the person has dementia. When grandma wants to know where her husband who died last year is, ask her “how did you meet granddad?”
If a person is disagreeing with you, accept it gracefully. If dad brings up that awful car wreck that was your brother’s fault, change the subject to an enjoyable one. “What was your favorite car?” This is not the time to disagree or drag up old disasters. Indeed there are very few times when it is actually productive to do so.
It is axiomatic in schools of social work that all families are dysfunctional—it’s just a matter of degree and coping skills. At first I was unwilling to agree with this pessimistic assessment, but over the years I have come to concur.
At my family reunions we explicitly do not discuss politics, religion, or home schooling. Everything else is fair game to talk about—including sex and drugs! The important topics are love, history, and shared lives.
Jeannette Franks, PhD 