Dr. Saul Ebema
Because of the complexities of the family system, make sure you have a good assessment of the family. A good assessment of the family helps to provide understanding in;
- The makeup of the family.
- Family values and beliefs
- Coping styles and abilities.
- Religion and philosophy of life.
- Previous experience with death and loss
- Characteristics of relationship with the dying person.
- Amount of unfinished business with the dying person.
- Mental health.
- Specific fears about death and dying.
- Previous experience with and personal expectations about illness and death.
- Family’s fears and current emotional state regarding patient’s illness.
Recognize the family as a system. Meet with the entire family together if possible. Assist the family in addressing painful feelings of anger, guilt and disappointment but also help them to recognize positive feelings of love and affection for their dying loved one and for one another.
Legitimize and normalize the feelings of the family members. This will help reduce anxiety. Help families realize that crying or being upset are normal reactions that need to be expressed. Ministers can help family members find new ways of coping with the impending loss. Encourage family members to express their feelings with the knowledge that emotions that are processed contribute to healing.
Affirm their love for the dying person. They need to understand that their suffering has meaning. Point out that they hurt because they love the dying person. Identify their feelings and call sorrow what it is- hard and painful. This will help normalize their reactions to these feelings.
Provide a calming presence. Do not panic during their outburst. Help them realize that, although it is painful now, it will not always be like that. Let them know that their present reactions are normal and there is hope of a time when the pain will be less.
Help them to recognize the joys and the pleasures that are available. Too much sorrow so soon can create detachment from the dying person while there is still some satisfaction to be gained their relationship with the dying person. Try to establish a personal relationship with each family member when and if its possible. Within their limits, help the family to express their anticipatory grief.
Maintain open communication. Help the patient’s family members identify and cope with the challenges and demands of the living- dying interval. If possible, educate them about the emotional challenges and coping mechanisms available. Refer family members with evidence of pathological responses to illness and death to appropriate mental health professionals and resources.