Saturday, July 2, 2016

"Anticipatory Grief"

Reading the newspaper the other day, I stumbled across a notice for a seminar being held called "Anticipatory Grief." While I was familiar with the concept, I had never seen this name for the situation. It really jumped out at me because it truly sums it up in two words.

Anticipatory Grief is just what it sounds like. Often, when caring for someone with a lengthy terminal illness such as dementia, you end up going through the grieving process while they are still alive. Some, so much so, that when their loved one finally dies, that they feel only relief.

Dementia of all types is a disease that can bring on this early grieving process. We already know how much of a toll caring for a loved one with dementia takes on the caregiver. Add in the fact that they are also grieving for the loss of who that person used to be and you have a tough and sad situation. It is so much that you are grieving that they have dementia or that they are slowly dying. A lot of it is grieving for what the loved one was and what you believe they could have been.

I have experienced this more than once. The first was when my grandmother was slowing dying due to dementia. I was very close to Grandma and my Grandpap. During my junior and senior high school years, I would spend the bulk of the summer at their home in rural northeastern Pennsylvania. I loved the calmness of the environment and the love that surrounded me. At home, my parents were working their way to a divorce and it was always a stressful place to be.  Grandma's was only a 3-hour drive away, but it seemed like an entirely different world. She could be a blast! She had a lot of joint pain, but would break out and dance the Charleston for me. She got me hooked on baseball while we sat out on the sunporch and listened to the Pirate games. I learned to drive their little tractor early on, then later Grandpap let me practice driving his car. Grandma never did drive.

Watching this woman's joy of living and her love for me and the rest of the family was a horrid experience. I spent a lot of the time in denial. I was not her primary caregiver, my mom was, but I visited often enough to watch her deteriorate in front of my eyes. Yes, there were fun moments, like the time my aunt had sent her chocolates and she hid them in her bra to prevent anyone getting to them before she could eat them all. Poor mom was cleaning her chest for a week. It was those chocolates covered with tiny candy balls on them and those balls hid in every wrinkle and fold for days! By the time Grandma actually died, I had already grieved enough that I did indeed only feel relief that she was no longer trapped in that body whose brain no longer functioned.

It was the same with my mother while she was slowly dying from dementia. One of the saddest days of my life was the day she finally forgot how to walk. I grieved for who she was and I was relieved when her body finally gave out. In between the deaths of Grandma and Mom, I dealt with my other grandmother dying, not of dementia, but with a variety of illnesses and multi-organ failure. Many extended family members thought there was something wrong with me, because at her funeral, I was not crying and looking sad. In fact, I was almost happy. They did not understand that I had already grieved for her and was happy that she was in a place with no suffering.

The only exception was when my favorite aunt, my mom's sister, also was suffering from dementia. This woman was my savior. She got me through a lot of my life issues, especially during my teenage years. At her house, I always knew I was loved. Yes, I was one of her caregivers through her dementia and watched her slip away from me and did go through the grieving process during that time. I sat for hours upon hours at her bedside after she was in the nursing home and hospital, but with her, after she died, I grieved all over again.

The seminar was being conducted at our local hospital by the hospital's chaplains. I would hope that it was going to address the guilt that many have after their loved one with finally dies, guilt that they are not grieving again. In many cases, the grieving does come back as you start remembering more and more about who they were and who they could have been. At least that was the way it happened for me.

I had no interest in attending their seminar. I already understood how it works and have done a lot of reading about the subject through the years. I have already discussed it with a couple different therapists. Now, with the loss of brain to mouth filters from FTD, when the pastors started offering their two cents worth, it is hard to tell what I might have told them!

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