Debbie Caine a Limited Licensed Professional Counselor (LLPC) in private practice at Trinity Family Counseling Center. She completed her Master’s degrees in Clinical Mental Health Counseling from Oakland University, and works with individuals, couples, families, and groups across a range of presenting issues.
When someone we love is diagnosed with a terminal disease it can evoke all kinds of emotions. Terror and visions of painful treatments and eventually even death can shake our entire world. Receiving a terminal diagnosis is a devastating blow, not only to the patient themselves, but also to the family. We can imagine how frightening the diagnosis must be for the patient, but quite often, we underestimate the emotional toll the disease will take on the loved ones.
For family members it means fighting with feelings of helplessness and fear of losing their loved one while simultaneously hoping for a cure or prolonged life that often requires debilitating treatment. Oftentimes watching a loved one suffer can be even more difficult than enduring the suffering oneself. When families find themselves confronted with this circumstance, their coping strategies fall into one of two categories - an all or nothing approach.
Some individuals choose not to talk about the diagnosis or in some cases, refuse to even acknowledge the fact. They go on with their lives as if the diagnosis does not exist and everything is fine. Conversely, other people attempt to manage their anxiety by becoming hyper-vigilant and centering all aspects of daily life surrounding the diagnosis. Both approaches are difficult to manage for the duration. Families can greatly benefit from a patient professional counselor who is able to honor the journey of individual family members. The counselor does this by asking questions that encourage discussion about some of the common challenges that families face when coping with the diagnosis.
It is important to keep in mind that each family member has his or her own individual and unique relationship to the person with the terminal disease. Some feelings and dynamics are positive, and some are negative and can include old baggage and unfinished business such as wounds or secrets from the past. Talking to each member of the family makes them feel as if they are not alone and that they can handle things one day at a time. It is important to provide opportunity for each family member to express what the person and the relationship means to them. A counselor can best serve the family by providing a safe space for whatever needs to be vented, without judgement.
Care-giving is often one of the most difficult, emotional and divisive issues faced by families with a loved one who is ill. Family members must work together and navigate their way through some tough terrain.
Some questions at this time may include:
What kind of care is required?
Can my loved one be cared for at home?
Who will provide the care? Family? Home health? Hospice?
Many families become quickly overwhelmed with all the details and the amount of decisions that are forced upon them. There are so many decisions to be made and no way of knowing the outcomes of each one of the choices. Families may disagree about what kind of treatments and the type of care their loved one should receive and forget that if possible, the choice resides with the patient.
Coping with the Unknown
A terminal diagnosis can sometimes be a strange kind of blessing because it provides loved ones with the knowledge that the end is coming. The most difficult aspect is the unknown - when. The fear is powerful, but the unknown can be debilitating. Facing a known outcome is certainly frightening, but at least there is little or no ambiguity. There are fewer choices to agonize over. There may be a greater feeling of powerlessness, but fewer regrets. Knowing the end is coming often encourages loved ones to say things they might never express otherwise, both to the person who is dying and to those who will be left behind.
A caring counselor can lead a family through the devastating time of coping and eventually losing a loved one to a terminal disease. They can provide a warm, safe environment and an objective, informed voice that would allow family members the opportunity to talk and face their fears and concerns. The counselor would be present and walk with the family through the journey so that they would understand that they are not alone.