Anticipating Grief

Death awaits us all, even if we avoid thinking about it. When diagnosed with a life-threatening disease or illness, however, we’re forced to acknowledge our own mortality.

“We’re faced with a new normal,” says Kathleen M. Wade, Ph.D., director of Social Work at the University of Michigan Health System and assistant dean for Hospital Social Work Services at the University of Michigan’s School of Social Work. Wade teaches about death, grief and loss. “With a serious illness, we begin to talk in terms of our own mortality.”

Some patients see this as a wake-up call, Wade says, a reminder to “prioritize what you do and who you spend your time with.” Others react with serious anxiety, sometimes spiraling into depression and grief.

Previous losses, lack of financial or social support and juggling multiple health conditions can make a new diagnosis especially difficult, Wade says.

Coping

The older we get, the more losses we’ve likely faced, Wade says. A new illness can trigger anxiety and depression in people who have experienced life-threatening conditions before, either their own or those of family or friends. Patients and their loved ones face a complex mix of emotions: the pain and possible devastation of illness, financial stress, the loss of independence and changes in relationships.

Patients who fare the best are those who get necessary care, maintain strong support and continue many of the same activities. Sadly, not all patients have that support, putting them at higher risk for isolation or neglect.

Support can be as simple as visiting a senior center or connecting with others online.  People with depression, or those who have stopped taking care of themselves, need medical and psychological intervention. The first step is calling a primary care physician.

A matter of respect

To maintain the patient’s morale, it’s essential that they be allowed to make decisions about treatment and how they life, Wade says.

“Show respect for the other person’s beliefs and values,” she says. “Don’t just swoop in with your own ideas.”

This is especially important with painful treatment, such as chemotherapy. Ensure that all health care professionals directly involve the patient and family in discussions and planning.     

“Loss of control is a huge fear,” Wade says. “It leads to feelings of helplessness and hopelessness.”

Be specific

“Serious illness creates both an opportunity and a challenge,” says Wade. It gives you a chance to get closer to your loved ones, but the trick is how to ask for — and give — help. Wade’s advice to friends: Be specific in your offers of help.

• Offer to take your loved one to the doctor. Stop at the drugstore for medicine. Find resources such as support groups or financial counseling. Or just provide good company. 
• If your spouse is sick, your roles will likely change, and you’ll need to figure this out together. “Be understanding and acknowledge that this is a new challenge for you too,” Wade says.
• If you need help, don't try to go it alone. “Remember that it makes others feel good to help you,” Wade says.

If grief and worry feel like too much to handle, HAP’s Coordinated Behavioral Health Management team can help. A clinical case manager is available 24/7at (800) 444-5755.

Advance directives

Plan for a medical emergency with an advance directive. Michigan has two kinds: the Durable Power of Attorney for Health Care and the Do-Not-Resuscitate Declaration. Henry Ford Health System has advance directive forms in several languages at henryford.com/adform.