Saying Goodbye

Nowadays, losing a loved one to a lingering terminal illness is more likely than a sudden death. Family and close friends now have far longer to face up to the possibility of death and say their goodbyes, along with the person with the life-limiting disease. In turn, this has turned the mourning process into one with distinct phases that are progressively borne by families rather than just people.

The long goodbye

Today, for an extended period of time, having a loved one living with a terminal illness is rapidly replacing sudden and unexpected death as the norm. For example, note that two-thirds of those who are diagnosed with cancer currently have a survival rate of five years.

The effect of all this is that death has become less and less an abrupt and sudden occurrence. A phase that starts with a life-threatening diagnosis, continues through a treatment period (or treatments), and ultimately results in death has come into its place. This process suggests that the need to "live with death" for an extended period of time is increasingly faced by both the terminally ill person and the family.

Since the essence of death and dying has changed so drastically, it has also changed the way we grieve. The new grief varies in significant ways from conventional grief, not least of which is that the terminally ill person is involved. In comparison to an accident, what has gradually become a prolonged process not only leaves people to mourn, but usually pulls in the dying person's entire family for months or even years. This mechanism has the power to change lifestyles and push families to tackle problems that were once resolved only after the loved one's death. It can quickly invoke problems from the past that have never been answered or resolved entirely.

Grief is a family matter

Grief is as much a family matter today as it is an individual one. A new template is what is needed, one that is applicable to families and their experience. That is what we're here to present. This model is meant to be a road map to which you and your family can turn as you find your way through the latest death and dying realities. And, by the way, we consider not only blood ties when we use the word relatives, but all those who have a significant link to the person who is diagnosed.

When faced with a terminal diagnosis of a loved one, the difficulties that families must face are complex. They involve new systems and dynamics changing as the person they love slowly slips away. It means learning how to deal with losses and regression, as well as obvious remission times. It means coping with the dynamics of prolonged grief that can wear down people and often lead to ambivalence or the awkward feeling that we get when we find ourselves wanting to end the process. It involves talking to a dying loved one about mortality and other concerns that do not happen abruptly and unexpectedly when death strikes. In lifestyles that are usually more busy than those of earlier generations, it means learning to make room for prolonged grief.

Perhaps most importantly, the current grief involves addressing family conflicts that for several years may have been latent but unresolved. Typically, these concerns reemerge as families step through their initial responses to a terminal diagnosis and are driven into a period of prolonged mourning to communicate and function together. Lastly, when a loved one dies, it means going on together as a stronger family.

Family members who are compelled by circumstances to cope with prolonged grief are vulnerable to severe psychological effects, including depression, remorse, and crippling anxiety, without understanding and without guidance in any of these areas. Such conditions can also contribute to physical illness. As a consequence of a revival of unresolved problems that are discovered as a result of a prolonged terminal disease in a loved one, whole families are vulnerable to rupture. As a result of unwelcome lifestyle changes, even loving couples can find their relationships in jeopardy. Guidance on how to predict and cope with such challenges is what families need now and will need in the future.