Archive for April, 2009

A woman in her early sixties was dying of a terminal illness. Her parents were gone, which left a younger sister as her only means of family support. But there was long standing disagreements between the sisters that had left them distant and disconnected. Now the younger sister was struggling to do her best to help her older sister but was feeling frustrated, unappreciated, angry, and guilty. “What should the younger sister do?” a friend of the family asked me. It was a good question I had not considered before.

The main focus of my work has been on the developmental agenda of the last phase of life of older adults, the need for control and legacy. But what about the developmental agenda of a life cut short from its normal longevity? Does a terminal illness in younger adults usurp their normal developmental stage by superimposing the final agenda of older adults? I didn’t know, and that’s what I told the friend of the family.

I also told the friend of the family that under the circumstances, I thought it was worth considering. If I was right, the need for control and legacy had taken center stage in the older sister’s life. As with older adults, I suggested that the younger sister initially reframe her conversations and energies around control issues. Specifically, how could she help her older sister preserve control in a world where all control was being lost to such a devastating illness? This could give the sisters a common cause that might be the basis of a more effective partnership. The friend of the family shared this idea with the younger sister. “At this point, ” the younger sister said, “I am willing to try anything.”

“Anything” began to open a door. The older sister’s burden of fighting for control in the face of a terminal illness was in desperate need of reinforcements. Instead of being rejected, the younger sister’s overture to assist her older sister with “control management” was accepted. Their differences became less important and a new, more effective dialogue began to emerge. “Now what?” the friend of the family asked me Add legacy I told her. The door swung open.

The same legacy questions that opened up heart felt conversations between adult children and their aging parents offered the sisters a new, deeply personal way to communicate. Not surprising, the older sister’s life review took center stage, and with it came powerful remembrances, joy, regret, sadness, healing, and legacy. They were able to cover critical emotional terrain before the older sister passed away, being there for each other until the end.

I now believe that the last mission of life can come either on time when we are old or it can come “too soon” when are not old. Either way, it brings with it the overpowering need for control and legacy. Either way, it offers a way for all of us to partner with those who need understanding, care, and comfort at the end of their journey.