Archive for October, 2008

We wished things had turned out different. They didn’t. History and personalities brought the drama of our aging parents to its only logical and painful conclusion. But as Linda Kriger points out in her heart felt article entitled Seeking Forgiveness (http://www.forward.com/articles/14255), the death of a parent hardly ends the trauma or internal dialogue that haunts us following a “bitter ending.”

My father and I parted on similar terms, incommunicado and mutually sorry about our biological connection. As James Joyce reminds us in The Dead, the departed usually prove more formidable after their gone. My father was no exception.

I have danced for years with the guilt, anger, and loneliness of the events surrounding his death. The fact that our relationship was never right from the beginning offered no comfort. Even his blatant failings, alcoholism, violence, and a perverse perfectionism were not enough for me to bid him a final and much needed adieu. Instead, my post-death relationship with him had all the qualities of emotional quicksand. I schemed and struggled only to sink deeper into complexity and emotional confusion.

Like all adult children who suffer bitter goodbyes, I found myself circling the issue of forgiveness but never getting it to stick once and for all. Having had zero nurturing from him during my childhood, it seemed next to impossible to find the emotional release I needed.

But as Kriger discovered, it’s never too late in the game to make one more pass at finding relief. My only word of caution is that these bitter ending are hardcore Greek tragedies of accommodation not assimilation. We can’t muscle away the trauma or will it into submission. These are first and foremost familial dramas that must be accommodated. The best we can do is orchestrate a “survivor’s compromise” that allows them to be who they need to be and finally gone.

I was recently asked by a large medicare provider how my work on the developmental tasks of seniors could be used by their patient advocates with a predominately low income population. I thought is was an excellent question, and here is what I said.

In my experience, financial hardship demands an inordinate amount of time and energy just to understand and manage control issues. The battle to make sure you have food, shelter, and medications is a fulltime job. Understandably, your senior services professionals will spend the majority of their time helping your members think about and chose the best “control plan” based on the immediate circumstances. Poverty is unto itself a twelve-step program, one stressful day at a time.

Aging and diminished health create overwhelming complexity for seniors. This makes them feel confused, isolated, and out of control. Your senior services professionals can help simplify this complexity and become an essential “health management” partner for your members.

One aspect of the “control plan” they can offer is to help your members understand how they can control their health. They can choose to prevent new medical problems, slow down the progression of existing medical problems, and prevent complications. These are profound choices that give your members a way to control the quality of their lives as well as reduce their financial burden.

Intertwined in the control-focused conversations with your members, your senior services professionals will find an abundance of legacy moments. Despite the demands of just getting by, every senior is an active participant in an “involuntary life review.” This means they are sorting out their life story. It is a powerful current that is seeking an occasion to be expressed. It not a matter of high-functioning or low-functioning. We all want to feel our life mattered; we all want to tell our story.

Your clients will be telling your senior services professionals stories about their health issues. These stories will offer up ready-made on ramps for legacy questions about their family, their lives, and their dreams. While you won’t be able to solve their low-income problems, you can assist them in thinking about and telling their story. And in the telling you will find they have lived the heroic pilgrimage we all make through life. More important, you will offer them an empathetic ear and a rare occasion to “be known and recognized.”