Friday, March 12, 2010

Artificial Aging: The Developmental Implications of Dying Too Soon

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.

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4 Comments

  1. Comments  Patricia Grace   |  Thursday, 23 April 2009 at 3:20 pm

    David,

    Thank you for that powerful insight. All too often sibling rivalry robs us of the ability to forgive which in most cases allows us to heal.

    Patricia Grace
    Aging with Grace

  2. Comments  Dr. Mikol Davis   |  Thursday, 23 April 2009 at 10:51 pm

    It becomes a major challenge for all siblings to put their pasts resentments behind and come together to embrace the end of life. All too often in our work at AgingParents.com we find Adult siblings still holding on to past conflicts. This often robs them of fully participation in honoring the last and final act of our lives. Forgiveness is the Blessing to our families and ourselves.

    Dr. Mikol Davis

  3. Comments  Joy Loverde   |  Saturday, 25 April 2009 at 2:30 pm

    Interesting thoughts, David. Thanks for writing about sibling relationships – always a complex and fascinating topic.

    Your blog about the sisters reminded me of something I learned long ago from a wise friend. Witnessing my struggles as the younger sister, he said, “Do you want to be right or do you want to be love?” I have chosen love ever since.

    Joy Loverde
    The Complete Eldercare Planner (Random House, 2009)

  4. Comments  Elizabeth   |  Sunday, 31 May 2009 at 8:50 pm

    As an only child, and someone who took care of my mother until she died, I find this especially interesting.

    I learned there is a definitely “work” that needs to be done when someone is dying, and I guess it would be a bit of s different dynamic when the dying person is young.

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No Money: No Comment

I was recently asked what to do about aging parents who had little or no savings but refused to discuss any aspect of their “money issue.” It reminded me that our role as adult children is not necessarily about problem solving; it is about compassionate containment. So many of the issues we feel compelled to “fix” have no clear answers. The best we can do is sort out what to accept from what we can actually change. Here was the advice I offered:

The issue of money, like so many other issues in the last phase of life, is about control. The best way to approach it is to reframe money as means of maintaining control. Lack of money takes away control. This link http://www.dsolie.com/articles/reframing.html will take you to an article I authored on “communicating touch choices” that offers a practical strategy for how to do this.

You may also want to consider three strategies that will help you “hedge” your parent’s financial risk:

1. Buy a long term care policy with a two years home care/two years nursing home benefit. This assumes they will cooperative with the process (i.e. signing the applications and answering questions).

2. Start funding a dedicated “side fund” for expenses that a long term care policy will not cover.

3. If you parents own their home, become familiar with how “reverse mortgages work and when they make sense.

Lastly, you need to began discussions with local area agencies on aging to determine what, if any, community resources can assist your parents if they run out of money.

This is a tough end-game, especially if you parents don’t want to talk about. The article will help you frame your conversations. Be patient but persistent in your discussions about control and your desire to help them maintain it.