Why Did God Choose Our Family for This Journey: Death and Dying
The realization that my mother was suffering from a cancer disorder known as leiomyosarcoma, cancer of the spinal cord, brought devastating news to my family. Initially, we had encountered a similar situation when my father was killed. However, my father’s death was quite manageable as it occurred suddenly and gave us no time to prepare, it only marked a huge loss to our lives. The situation with my mother was quite difficult in that we had no idea of what to expect in the coming days. Despite the many stages of death and learning how to deal with it, trying to help my family through each stage created a significant challenge.
These challenges were prevalent in aspects that never crossed my mind; that I would one day assist my mother in making life decisions that entailed financial arrangements, funeral arrangements, headstone selection; where to hold the funeral, as well as the people to invite even before she passed away. This created hindrances in that I went through a challenging time where I suffered sleepless nights worrying about my mother and how she was feeling about the whole situation. I wondered how her own death would affect her children and grandchildren as well.
In this paper, I will discuss the various steps involved in different stages of death and dying. This will be characterized by personal experience from the encounters my family and I went through. This will be followed closely by an analysis of the process of grief and mourning that we encountered at different times and stages. Additionally, the paper will bring out the role of the funeral and how after-death rites should be carried out and handled. This will be coupled with my role and that of my mother in terms of her right to die. I will also discuss the living wills/ termination of life support systems that will be incorporated in dealing with my mother’s situation. The last part of the paper will bring out aspects of the hospice care centers for the remaining days in my mother’s life. The journey will kick off with the various stages of death and dying.
This point in time marked a period my sisters and I would never have expected the news that was about to become a reality. We realized that my mother had been visiting Dr. Jack King, a family practice doctor, for a check-up on pains in her lower back. Dr. King insisted that she probably had a disk that was out of place and thus referred her to a chiropractor who would assist her in case of any adjustments. The chiropractor conducted several tests on her and concluded that it was not a disk that was out of place. He also suggested that my mother needed to go back to her doctor for more tests. Ongoing back to Dr. King, he carried out various tests that included an MRI that indicated that there was a mass on the bottom of her spine. This saw Dr. King referring my mother to Dr. Headley for a biopsy on the mass.
This was followed by setting up an appointment with Dr, Headley who performed the biopsy. After this, the doctor informed us that it was not cancerous and my mother would be fine. However, the pain in my mother persisted and she tried all sorts of medication as well as acupuncture in order to relieve the discomfort. This called for another visit to the doctor after the pain had persisted for a few months. My sisters and I took her to a different oncology doctor, Dr, Charles Zinn from Penrose Hospital in order to acquire a different perspective. Dr, Zinn examined the MRI and decided to conduct another biopsy.
This brought the realization that it was a malignant tumor, which he would try to remove through surgery. This was the first time my sister and I realized that my mother was suffering from the leiomyosarcoma of the spinal cord. She went through with the surgery and Dr. Zinn gave us very discouraging news that none of us wanted to hear. He informed us that the tumor could not be removed due to its location and that we could try to fight it off through radiation and chemotherapy. This was accompanied by more devastating news where he informed us that without these treatments, my mother would only live for six months.
This entire situation created disbelief in all, where my mother, sisters, and I were still in complete denial of the diagnosis given by the oncologist Dr. Charles Zinn. I could hear the fear in my mother’s voice as she was trying to understand why she could not have another surgery on the lower back to remove the tumor and then possibly more chemotherapy and radiation in order to kill off the cancer cells that may be left. After digesting the painful news, my sister and I had to accompany her to the next appointment in order to determine what we would all have to do for her. I took it upon myself to schedule a second and third appointment with other oncologists in Colorado Springs.
Apparently, the results were the same with each one of them. The next step in my mother’s treatment involved another surgery in order to remove the parts of the tumor on the base of her spine that they could take without damaging the spine. My sisters and I decided not to deal with the cancer outcome thoughts until after the surgery was complete. During the surgery, we all sat together pondering over the fun times we had and expected to have with our mother. This helped calm our nerves and bring about positive thoughts on the times ahead.
After hours of waiting, the doctor informed us that the cancer was eternal, which was followed by a full recovery by our mother. The doctor informed us that they had managed to get rid of the largest part of the tumor but could not get the whole of it due to its location and size. The most devastating news was that God was taking away the most wonderful person from us. This was followed by more sad news when the doctors informed us that our mother only had six months to a year to live. This added to the denial, in that none of us was willing to accept the results. This led to more urgency where I engaged in doing more research and treatments as well as locations that could treat the spinal tumor. This involved much consultation from God to heal my mother. However, the more research I did the more depressed I became.
This was characterized by more and more hindrances until I came across a treatment in Switzerland that could possibly save my mother’s life. The only problem with this treatment was that it was very expensive. This led to the next step where we had to accept the situation and move on. After all we had been through, we realized that we had been suffering from depression, anger, and frustration. We resolved to work on each stage at our own pace and be there for each other. Each stage in life controls each one of my family in such a different manner and we had to put our mother first. This involved respecting whatever she wanted and letting her live her life the way she wanted at least for the rest of it.
Observations and Reflections
Research has indicated that living close to power lines would bring about cancer and the situation with my mother actually proved the point. This created a sense of disbelief in that we all started wondering if there was anything we could have done to alleviate our mother’s situation. This was accompanied by doubts in terms of how we should have sought different opinions at the earliest stages. With the turn of events, we came to the realization that we should have never relied upon one doctor, especially on matters that affect our lives. In this case, relying on Dr. King proved to be pointless in that he never identified the tumor despite the many checks up he had conducted on our mother. We all started wondering if cancer had been found from the starting point could the situation be preventable.
According to Aiken, 2001, the different stages of death and dying create a sense of curiosity, which brings about the procession of stages and comes to a peaceful resolution. These steps include denial where people claim that they are not ready to die. Regardless of what the doctors say, the person or rather people involved will never accept that they would lose their loved one.
Before the appointment with Dr. King, my mother was experiencing lower back pains, which she attributed to constantly moving furniture and working around the house at her job. She would take aspirin to ease the pain but it would only go away temporarily. At times, the pain would get extreme and she would lie in bed crying, but she had to persevere in order to feed her children. This created much denial in that she could not come to terms with the fact that she had something extremely wrong with her. Every time she visited Dr. King, he would refer her to the chiropractor and acupuncturist to try different strategies of relieving her pain. This was followed by different types of exercises, crazy positions, and anything else the doctors would suggest. This saw my mother going through different challenges with her movements, diet, exercise, and mental stability. The doctors kept telling her that she needed to rest and avoid doing anything that could strain her lower back until they determined what was probably wrong with her. In a real sense, this only added to our stress as she was the only care provider we had.
After the doctors announced the news of our mother’s life expectancy, we all started going through different stages of death and dying. These stages were characterized by denial and anger upon my sisters, while I focused on pleading with God to change the situation. Dr. Zinn tried encouraging us with consoling words that we would go through different phases at different times and we had to welcome the behaviors and their meaning into our lives (Aiken, 2001). Each of us needed to understand the fact that we were going through things like depression, anger, denial, bargaining, and even acceptance of the situation. This situation made us realize that we were no longer in control of our lives or even death and thus we had no other choice. At one point in life, we all have to die a fact that drives people angry and helpless, especially when faced with a situation that we had to see our mother die. The sense of guilt builds up and you direct at everyone as it brings about a sense of loss of control, especially if you have endured a long illness (Aiken, 2001). These are the different stages in which people get to grief and go through different stages.
Applications in New Situations
Currently, my whole family is going through different emotional, spiritual, and mental feelings that are quite difficult to explain. For instance, during the day, my mother tried to kill herself due to the excruciating pain but we all had to stand strong (Aiken, 2001). This marks the other dynamic in the different stages of death and dying where emotions, mentality, and spirituality are brought out in different processes. It also characterizes a stage where the spirit of an individual drifts away from the immediate environment and attachments. The last stages of death and dying bring about the effect where the person starts withdrawing from the external world (Aiken, 2001). This creates a feeling where the patient or person involved starts detaching from the physical world or is less interested in things they initially found pleasurable. In my situation, we had started witnessing such instances and thus had to utilize each moment to the maximum.
Process of Grief And Mourning
Towards the last stages of the life of our mother, she was not able to communicate effectively, which left us devastated in different stages of grief and mourning. This was marked by mixed feelings where we all felt numb, depressed, and did not want to do anything else other than salvage our mother. We found ourselves mourning her even before she had passed away. My elder sister was the hardest hit by the situation to an extent that she could not even join the rest of us in the room. She mostly felt devastated due to the fact that she did not have enough time to make it up to our mother for all she had put her through during her younger years (Aiken, 2001).
My younger sister Janie on the other hand was suffering the same situation of depression and numbness in that she thought that it was something that needed attention there and then. Janie even thought that not going to see our mother at the hospital, it would prevent her from dying. She just held on to the thought that mum would return home like she always did. I on the other hand had come to terms that she was actually leaving us since I was always at the hospital beside her, albeit the fact that I to some extent felt depressed by the whole issue. I always told my mom that everything was going to be just fine but I had to face it, it was high time I let her go and move on to let her legacy continue in our memories.
Observation and Reflections
We all had to come to terms with the fact that we were all different and had to face the situation as it came. This brought about different stages of mourning and grief where our elder sister became more engaged with her children and had to be a mother to all of us due to the guilt of not spending more time with our mother at the end and during her younger years. Janie on the other side became more depressed and withdrew to her own world. She drew closer to her husband Matt and her children. Well, let us not consider the fact that I was also involved and I became more depressed and physically destructed. I had no good support system at home like my sisters, and therefore I fell into a routine of taking care of my daughter while leaving everyone else out of my life. I kept myself busy by working on projects and other activities that would keep me off the thought.
Formation of Generalization
Death is nothing that can never be evaded as it happens to everyone. The difference comes in through the way people handle it within their own mental and physical aspects. According to Kübler-Ross & Kessler (2007), the vast repertoire of behaviors occurs under four general categories that range from an emotional response, physical sensations, altered cognitions, and behaviors. The emotional response brings about sadness, fatigue, depression anger, guilt, and anxiety. This is also characterized by disorientation in common and altered senses of perception where people may experience delusions in fears from hidden enemies and feeling invincible (Kübler-Ross & Kessler, 2007). Additionally, there may be cognitive responses that may bring about depression and anxiety, which eventually turn into denial of death. It is also characterized by a period where the bereaved may encounter sleepless nights or social withdrawal and avoidance of situations.
The mourning stage creates four tasks that include accepting the loss, working through the pain and grief, adjusting to your environment without the deceased, and emotionally relocating the deceased and moving on with your life. This creates a difficult situation where people find themselves doing different things other than the family members. Each of these situations creates a reflection on the person (Kübler-Ross & Kessler, 2007).
Application in New Situations
The situation my sisters and I faced brought about the realization that grief and mourning require each person to go through the step they are already in and help each other in dealing with that certain stage of grief. Going through each step is so different because my sisters went through sadness and depression while I was going through dealing with life and trying to move on because we are all different people emotionally (Kübler-Ross & Kessler, 2007). I worked on the final arrangements, which I believe further contributed to my grief process. We all learned that we must be patient and learn to embrace the stages and the emotions of the other family members.
Funerals or After Death Rites. What Is Your Choice?
The preparation for my mother’s funeral was a process that I would not wish to my family member. I was in charge of arranging all the small details, such as where to hold the funeral, when, and the funeral home and finances. My sister and I settled on Evergreen Funeral Home, after which I went to the funeral home and talked with one of the staff members to decide on which one to use. My mother decided she wanted to be cremated, and I informed the gravesite director that we would use the plot my mother had purchased years ago. Before she died, our mother’s last wishes were that she wanted to be cremated, which had to be respected in every respect. This was later followed by going to the place where they sold the headstones where I had to decide on what size, shape, and price my mother would have wanted. After this, I needed to go back to the funeral home to make the funeral arrangements where I worked with the funeral director to decide on the date, time, minister, flower arrangements, and newspaper announcements.
At times, it was quite overwhelming that I almost gave up but the fact that it was my mother I had to press on. After the funeral, the other task was to take the ashes to their final resting place. This brought about distinct emotions for my sisters and I, as we had to endure the pain and grief. My mother had wished that some of her ashes be spread with those of her mother and sister in Denver, Colorado, and the remaining ashes with her father, husband, and family in Colorado Springs. This took us some days as we found it hard to part with our dear mother and we had to do it without the knowledge of the gravesite director. We held a private ceremony where we spread some of the ashes on her sister and mother’s grave. My sisters and I felt privileged to honor our mother’s last wishes. The last wishes are very crucial but they also lead to devastating scenarios where my sisters and I had to leave the ashes.
Observations and Reflections
During the planning process for my mother’s funeral, I realized that I should have talked more with her about what she really wanted for her departure as well as her true feelings. We only talked about the fact that she wanted to be cremated even though it was her Catholic upbringing. We never got the chance to discuss her true feelings about the funeral arrangements that would happen or how to deal with all the bills that would come afterward. We discussed her feelings about her last rights and whether she felt like resuming her catholic faith. This point in time emotionally affected me in that I regretted not spending more time with her on the subject of her death when she asked instead of telling her that I did not have the time.
During this time, my mother wanted all of us to go back to the church and learn to forgive the events happening in our lives. Consequently, I would have given anything to help my mother through the challenges of death and her feelings with God, but at the same time, we were angry and had a sense of hopelessness (Kübler-Ross & Kessler, 2007). We could never imagine why God would take such a good person away from a family that had already lost so much. This is part of the stages of death and dying where bargaining with God becomes part of the strategy after denial and anger have come and gone. The last option becomes turning to God to ask for forgiveness for the blame and anger that emerge (Kübler-Ross & Kessler, 2007).
Formalization of Generalization
The loss of someone drives people to do things that they did not want to. The participant is taken away from his or her familiar environment and former role, and enters a different and sometimes foreign routine that they are forced to adjust to becoming familiar with. At times, religious beliefs play a role in the stages of death and dying in that it may hinder what the church believes. My mother believed that her body was not in the right condition and thus decided to be cremated even though it was against the beliefs of the church. The scattering of cremated remains on the ground or on the sea or keeping any portion of them for personal reasons is not relevant for the final disposition according to the directions of the Church.
Application in New Situations
Over the last couple of years, I have managed to apply my vast knowledge from taking care of financial arrangements for my mother after my step father died of leukemia, and my best friend’s husband died in Afghanistan. I managed to help them with emotional and daily tasks and apply my experience with funeral arrangements, such as plots, funeral homes, flower arrangements, phone calls, caskets, and the most important was helping her to emotionally deal with the daily situations. The task was a bit challenging in that I had to keep her on task to face the fact that she had lost a loved one. Similarly, I managed to hold my family together after my stepfather passed away. This created a devastating situation in that we were all aware that people who are terminally ill tend to withdraw, which indicates that they are aware of their own impending death. Our stepfather’s death occurred very fast, which was a relief for him but a calamity for the family (Kübler-Ross & Kessler, 2007).
Helping my friends and family members deal with the emotions of a funeral, especially with the sight of the casket and the urn kept me going in my daily tasks. The fact that they had someone there for them through the good and bad times helped me move on (Kübler-Ross & Kessler, 2007). This is very crucial in that most people during this time tend to mentally separate from the world. They also withdraw from the rest of society and hide their actual feelings. The fact that there is someone there for them helps them get through the situation and get stronger with time. It also helps them accept the loss and move on (Kübler-Ross & Kessler, 2007).
Right to die
The right to die emerged several times during the nine years our mother was suffering from cancer. Each year she would tell us that it would be the last one, but my sisters and I kept denying it. We wanted to give her some hope and something to live for, and we would try as much as possible to give her a better life. Severally, our mother had thought of ending her misery through overdosing herself but luckily, one of us was always there to give her medication. In some instances, she had even asked our brother-in-law for his gun to end her painful life. To some extent, we all thought it would have been an easier option and that it was her wish, but our conscience could not allow us. It had even gotten to a point where we asked the doctors to give her enough morphine to end her life in a quick and humane manner. Unfortunately, the doctors would only give her enough medication to make her comfortable in her final hours.
Observations and Reflections
The last moments of a dying person are so painful that no one is willing to let go. For instance, in my case, my sisters and I realized that we were being selfish by wanting our mother to stay with us for a long time without considering her painful situation. She was battling with the pain just to be with us in her last few days, and it was her choice to give up. We were not willing to accept the fact that one day she would eventually succumb to the pain but none of us was willing to give up (Kübler-Ross & Kessler, 2007). The right to die was imminent for my mother and what we were actually supposed to do was avoid discounting the experience and orienting our mother to reality. Death to her was her reality and from the look of things, she was comfortable dying as it would have ended her misery. When my sisters and I tried so desperately to control our mother’s needs and beliefs, we were actually denying her the right to die.
Formation of Generalization
The right to die has currently drawn much controversy with proponents arguing that any form of termination of life, be it through, euthanasia or assistance from physicians would be suicide and murder. On the other hand, supporters claim that the right to die, especially to those who are suffering from terminal disorders would be justified (Kübler-Ross & Kessler, 2007). This is due to the fact that it would give them a dignified death that is humane and controlled. Religion also comes in between these arguments with claims that God is the giver of life and He is the only entity that has the right to decide who should live or not. This is coupled with the fact that God gets to decide whose life should be terminated.
Application in New Situations
With my mother’s situation, my sisters and I had to pull our resources together and hold the family as one. This involved bringing our brothers to face the reality that our mother was leaving us just like our stepfather had. In our father’s case, our brothers were worst hit by the situation in that they could not come to terms with the whole thing. They went through all the stages of death and dying, such as denial, disbelief anger, just to mention but a few (Kübler-Ross & Kessler, 2007). They would try talking my father out of dying and seek doctor’s assistance but the situation remained the same. I managed to pull them all together by giving them the reality of the matter. They came to terms with the issue of letting go of our father and similarly our mother. This meant granting them the right to die and moving on.
Living Wills/ Termination of Life Support Systems
The living will or termination of life support refers to a document that was very crucial in our mother’s situation (Kübler-Ross & Kessler, 2007). Loved ones or family members and friends should not be involved in making the decision for the people who are on the verge of death. Luckily, or rather by mere chance, our mother had a living will that stated that she did not wish to be resuscitated in case of terminal illness or accident. It was an amazing thing that she had such a document but it spared us the agony of having to decide for her (Kübler-Ross & Kessler, 2007). We had to respect her wishes during her final days and do what we knew was best for her. However, it was rather tormenting to give up on her and have the doctors do something to salvage her. If not for the living will, my sister June would have had the doctors give it their best shot to rescue our mother. We were both not for the idea that my mother should be kept on life support machines (Kübler-Ross & Kessler, 2007).
Observations and Reflections
According to what we had encountered in our mother’s situation, we realized why people do not want the living will in place. The presence of these documents means that there is nothing that can be done to salvage your loved one. However, it may also come in handy, especially to people suffering from terminal illnesses. It creates a sense of relief of the burden to the terminal person in having to make the decision on their own and not leaving it to their loved ones.
Formation and Generalization
There are various ways of making your final wishes known to healthcare practitioners, family, and friends. One of these ways is a living will that incorporates a written statement that expresses a person’s desires with regard to health care treatment if you become mentally and/or physically incapable of expressing those desires. This document can include instructions concerning the termination of life supports as well as other issues that the person may wish to be done for them after they pass away (Swanson, 2005). Another way includes a Health Care Proxy that describes a document, which allows the terminal person to designate a person to make health care decisions on their behalf if they are not in a position to do so. They can involve health care in order to keep that person healthy or involve the termination of life support. These documents are usually taken care of by a person entrusted to the terminally ill (Swanson, 2005).
Applications in New Situations
The fact that our mother had the living will bring about the realization that she never wanted to be resuscitated in case she passed away. This created the perception that it is the wish of the dying persons to make that decision as to their last thing that will take away the pain from their loved ones. During the last moments of the dying persons, they go through certain changes that drive them to do unusual things (Swanson, 2005). These unusual things include hallucinations that may be coupled with speaking to people who are not there. Additionally, there may be physical changes where the body faces difficulties in maintaining itself. This may bring about signs in the body where the temperatures and blood pressure may lower; the pulse becomes irregular and may at times increase or decrease (Swanson, 2005). Additionally, there may be increased perspiration, changes in skin color or diminished circulation, changes in the trends of breathing where congestion may lead to coughing. Similarly, the dying person decreases the mode of speaking and eventually stops at once. At this point, it would be appropriate to respect the terminal persons’ wishes and pull the plug to spare them from the agony (Swanson, 2005).
Hospice Care for the Dying
Hospice care is similar to palliative care in that the goals are to alleviate symptoms and improve the quality of life. On the contrary, hospice is appropriate when the life expectancy is either six months or less. When curative treatments are no longer working and/or a patient no longer desires to continue using them, hospice care becomes appropriate. After receiving the news from Dr. Zinn that it was just a matter before our mother would pass away, I knew immediately that we had to make a decision regarding the type of hospice care we would require.
Observations and Reflections
After observing our mother suffer from severe pain, it was imminent that a lot had to be done in terms of taking care of her. We thus had to decide on whether to take her home or keep her at the hospital where she would have received immediate attention in case the pains got worse. Hospice care significantly contributes to the quality of terminally ill patients in a way that makes their last days a bit comfortable (Swanson, 2005). However, hospice care requires much help from family members and friends in terms of mobilizing all the assistance they can get to provide the best care possible. In my mother’s situation, my sister and I came together to support her and grant her the last wishes. This was coupled with assistance from our brothers who were always there to ensure that she had the best time during her last moments (Swanson, 2005).
Formation of Generalization
Hospice care is very vital for dying people as well as their loved ones. It creates a platform where all the family members and friends may assist the dying person through the provision of care (Swanson, 2005). This is based on the philosophy that emanates from various ideas. These ideas include: no one should die alone, illnesses that limit life may bring about physical, spiritual, and emotional distress, which require quality professional attention and compassionate care. Additionally, hospice care should occur as a result of the idea that terminal illnesses affect the entire family who equally needs continuous support before and after the death of a loved one (Swanson, 2005). The care provided should include aspects, such as ensuring that the terminal person is correctly positioned on the bed, repositioning them from time to time, scheduling helpers who should check upon them on a regular basis just to mention but a few (Swanson, 2005).
Applications in New Situations
In catering for people with terminal illnesses, the aspect of care and support comes in handy in that it ensures that they are treated in a way that makes them comfortable during their last moments (Swanson, 2005). When our mother was in her last stages of death, we took turns to watch over her in order to make sure that at least one of us was there when she passed away. The situation is quite painful as you have to watch your loved ones go through a rough time and there is nothing that can be done to help them (Swanson, 2005). However, such situations require utmost understanding and care where you may be required to change their dressings, as there are changes in their bowel and bladder (Swanson, 2005). Currently, my sisters and I are well versed in such situations, as we had to offer similar assistance to our mother during her last days.
The journey my sisters, family, friends, co-workers, and I went through while dealing with my mother’s stages of cancer was the most life challenging thing anyone of us would ever have to deal with in a lifetime. While going through the stage of denial, anger, bargaining, depression, and acceptance, we learned that each of us would deal with cancer in a different style and at a different time. This brought about the realization that it is impossible to predict what a person will go through emotionally, mentally, and medically. Therefore, it is important that we appreciate each moment that we have and cherish it to the fullest.
The 5 Stages of Loss and Grief | Psych Central. (n.d.). Retrieved from http://psychcentral.com/lib/the-5-stages-of-loss-and-grief/000617
Aiken, L. R. (2001). Dying, death, and bereavement. Mahwah, N.J: Lawrence Erlbaum Associates.
Hospice Patients Alliance – Signs of Approaching Death. (n.d.). Retrieved from http://www.hospicepatients.org/hospic60.html
Kübler-Ross, E., & Kessler, D. (2007). On grief and grieving: Finding the meaning of grief through the five stages of loss. New York, NY: Scribner.
The Last Stages of Life | Kokua Mau. (n.d.). Retrieved from http://kokuamau.org/resources/last-stages-life
Preparing for Death. (n.d.). Retrieved from http://oldfashionedliving.com/dying.html
Swanson, J., & Cooper, A. (2005). A physician’s guide to coping with death and dying. Montréal, Que: McGill-Queen’s University Press.