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What is your view of letting go? Does it feel like letting go is giving up?
When my oldest son was 4 years old, a dilemma played out for me each time I took him to the neighborhood playground. How high should I let him climb? I believe in letting a child explore his own physical limits. I stood on the playground, my hand on the metal monkey bars, and my gaze fixed on him. And I let him climb, never saying anything, afraid to suggest fear, unwilling to let my own anxiety keep him from doing what he thought he could do. And what pleasure I felt when I heard the triumph in his voice, “Look how high I am, Mom.” One of the other Moms commended me for my ability to let go. Did she think I wasn’t afraid? I was more frightened to teach him fear, so I let go when I could. And he went.
CASE
Flash forward to 2 weeks ago at work. I stood in the hall with Nancy, the daughter of my patient Frank. She was taking a short break from her vigil, allowing her mom to have some private time with her father. Frank’s disease had progressed faster than anyone expected. He’d gone from being at home and doing his own ADL’s to delirious and combative alternating with somnolent and withdrawn in a few short days. He was hospitalized for shortness of breath and intermittent confusion.
“What should I do about my kids?” she asked. Her children were a 7-year-old boy, and a 10-year-old girl. Their grandfather lived close to them and was a regular presence in their lives. Only 2 days earlier he welcomed them to his hospital bedside, asking them about school, their friends, and what they had been up to. But on this day he shifted from agitated and nearly unresponsive back to combative. Nancy said, “Do I let them see Grandpa like this, or is it better if I keep them away?”
I paused to gather my thoughts. “What have you told them so far?” I asked. She said she had told them Grandpa was dying, but when she did her son got very angry. Both kids understood he was dying; yet at the same time they hoped he would last longer. Her son was very specific in his questions: “Will he live until I grow up?” No. “Will he live until Christmas?” No. “Will he live until the summer?” No. “Will he die soon?” Probably. He expressed disappointment that because his sister was older she had had more time with him. “It’s not fair, Mom.” His anger was not just about his grandfather dying, it was about missing out on having more time with him.
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JOIN THE CONVERSATION What is your view of letting go? How do you handle matters when patients or family members feel letting go is like giving up?
Go to the bottom of the article to comment and share your thoughts about counseling patients and their family members in the final stages of life.
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