Spiritual Health / Spirituality

Our concern and love for our family members does not end with their deaths. Unless we had unresolved issues with them, we want them to be happy and content. We may feel especially concerned about family members who had difficult lives or a hard time in dying. We hope that in death they will have the peace and happiness they could not find in life.

Thoughts about what happens to our family members after death may bring up questions about the universe we live in. Is our universe friendly or not? Does human life have purpose and meaning? If we are religious, we may wonder whether God is loving or punishing, or what is God’s purpose for our lives.

Our answers to such questions affect how we feel about what follows death. Some people find comfort in religious answers about the afterlife; many religions provide pictures or maps of life after death, and often describe rewards and punishments for the way people lived on earth. Other people may feel abandoned by God, or feel religions do not provide the answers or comfort they are seeking during this challenging time.

Some people believe that mortality helps to make life meaningful – that if we lived forever we would not recognize what a gift life is, or feel an urgency to find a way to live meaningfully. Some say that death does not destroy the meaning in life – that what someone creates in living and dying continues to influence the world after they are gone. However, other people’s ideas about how death relates to the meaning and purpose of life will not necessarily satisfy us. Each of us must explore for ourselves questions about the meaning of life and death.

If we believe that the universe is friendly or that God cares about us, we may trust that even in death our family members will be cared for well, or will remain part of nature's web of life. If we believe that life has meaning, we may be able to accept their death as part of life; that is, if we sense that there was a purpose in their lives, we hope that the meaning of their lives is not wiped out by death. If we feel disconnected from the universe’s web of life, or experience God as demanding, harsh, or distant, we may have more difficulty facing death with trust, acceptance, and hope.

Perhaps you can discuss death and the meaning of life with a trusted friend. Such a conversation may be difficult to begin, but it may give you new ways of looking at things. If you have found comfort or strength in a religious tradition, you may want to talk with a religious leader from your faith community about your questions and anxiety. Another option is to talk to a professional counsellor, social worker or hospice volunteer.

You could create a private ritual that honours your connections with family members who have died. Such a ritual is effective if it contains these elements:

• Remember and give thanks for the person who died.
  If you are able to involve family members, you can share favourite memories of the person. Pictures or mementos can help you connect with the spirit of the person. Whether your reminiscence brings laughter or tears, love or anger, it becomes another step in your grieving process. If no one is available to share with you, set aside a special time to remember and give thanks alone.
• Release the person into the care of God or to the wider expanses of the universe.
  You could do this by offering a prayer for the person. An alternative is to write out your wishes and hopes for the person in death, and place them somewhere that has special meaning for you or the person.

You can find additional suggestions for helpful rituals, in this article:
Rituals to Comfort Families, especially the section "Rituals after a death in the home".

You may also find helpful guidance in this book by Deepak Chopra:
Life after Death: The Burden of Proof

Your mother may be struggling with defining who she has become within her increasing physical restrictions. It is very difficult to be an observer of the suffering that comes with such a struggle.

An important first step is to ask your mother and her health care team if she has any symptoms that affect her comfort. Uncontrolled symptoms such as pain or shortness of breath can be so overwhelming that they become the main focus of the person’s life, and may cause someone to say they want to die. They can change a person’s emotional and spiritual state, and affect overall quality of life. Addressing physical symptoms will not make everything suddenly better. However, it may allow your mother to focus on her emotional and spiritual struggles.

As your mother's ability to care for herself declines, she may struggle to define herself in a new way. When her health suddenly worsens or she hears that her illness is advancing, she likely will experience a range of emotions. She may say she feels numb, sad, helpless, disappointed or angry, to name just a few possible emotions. You and other family members may have similar feelings. All of these reactions are normal. There really are no specific words that will alleviate the distress of the situation, but you can bring your mother much comfort just by being physically present.

With all the changes your mother has experienced she may be distressed or overwhelmed by her situation. This may make you feel helpless. It is one of the toughest parts of witnessing someone who is struggling with thoughts of life and death. It is important to understand that there is really nothing you can do to fix the situation. If your mother cries, this is a time to show your love and support. Hug her, hold her, and let her know you are there for her. Crying and feelings of sadness are very normal response to serious illness. If her feelings become severe she may be depressed. Ask her health care team to watch for signs and symptoms of depression, so they can manage any that occur. Let her team know if you notice any changes, such as trouble eating or sleeping, or loss of interest in daily activities or the things that used to bring her pleasure. Articles in this section describe common symptoms, including depression, that may arise as illness progresses:
Symptoms

The most important thing you can do is to be attentive to your mother and let her know you are there to support her. Often the most helpful thing you can do is to listen to her express her thoughts and feelings; listening is an excellent way to show you are attentive to her needs and available to her. It may also help you to determine if she needs help from the health care team in solving some of the issues she faces.

It is also helpful to say out loud that you are there to support her. Sometimes people don't say this clearly because they believe their support and intentions are obvious or understood. However, it is important to put your feelings into words. You could say something like this: "I love and care about you, and do not like to see you going through this difficult time. Please know that you are not alone. I am here for you whenever you need me." Such words are reassuring, and leave the conversation open to discussing emotional and spiritual struggles. If you feel uncomfortable starting a discussion, you may want to consider some of the tips in this article:
What Do I Say?

Your mother may find it hard to have such discussions with family. Ask if she is interested in talking with someone else. If she belongs to a faith community she may want to talk to her spiritual leader. Alternatively, her care facility may have a spiritual care provider or social worker on staff, or may be able to call on such people from the community.

In general, as your mother struggles with the changes in this phase of her life, you can be her advocate. Discuss your concerns with her health care team, and ask for their help in addressing these concerns.

It is common for a person to feel a range of emotions when they hear their illness is progressing and death is not far away. The person may feel numb, sad, helpless, disappointed or angry, to name just a few possible reactions. You and other family members may have similar feelings. All of these reactions are normal. There really are no specific words that will take away the stress of the situation, but there is much that you can do to bring some comfort to your wife.

When you see your wife crying and obviously distressed or overwhelmed by her situation, you may feel quite helpless. This may be one of the toughest parts of loving a person who is dying. It is important to understand that there is really nothing that you can say or do to fix the situation and automatically stop the tears. When your wife cries, this is the time to show your love and support. Hug her, hold her and let her know that you are there for her.

Crying and feelings of sadness are a very normal response in the face of an advancing life-limiting illness, but if you feel her sadness is becoming severe, seek help from your wife’s health care team. With all the changes your wife will experience, she may become depressed. Talk to her health care team if she has trouble eating or sleeping, or loses interest in daily activities or the things that used to bring her pleasure. Her team can manage such symptoms of depression. Also ask your wife or her team if she has any symptoms that affect her comfort. Uncontrolled symptoms such as pain or shortness of breath can be so overwhelming that they can change a person's emotional and spiritual state. Addressing physical symptoms does not make everything better, but it may allow your wife to focus on emotional and spiritual struggles. Articles in this section describe common symptoms, including depression, that may arise as illness progresses:
Symptoms

The most important thing you can do is to be attentive to your wife and let her know you are there to support her. Listen to your wife as she expresses her thoughts and feelings; listening is an excellent way to show you are available to her. It is also helpful to say out loud that you are there to support her. Sometimes people don't say this clearly because they believe their support and intentions are obvious or understood. However, it is important to put your feelings into words. You could say something like this to reassure and comfort your wife: "I love and care about you, and do not like to see you going through this difficult situation. Please know that you are not alone and I am here for you whenever you need me.” Such words are reassuring, and leave the conversation open to discussion emotional and spiritual struggles.

You could ask your wife if she has particular things that she wants to talk about, or if there are things that she does not want to talk about. You might ask what she is thinking about and talk with her about her fears. While there are no special words to make a person feel better, there are some words that are unhelpful. An example is something like this: "I know what you are going through." No doubt this is said with the best intentions, but it implies that you have been through the other person's experience and have felt the same things. This can be interpreted as minimizing that person's experience and feelings, and may lead the person to think there is no point in talking about them. Instead, you might say something along the lines of "I do not know how it feels to be in your situation, but I am here to support you." This article offers some tips on listening to and talking with someone facing death:
What Do I Say?

A spiritual perspective may help you and your wife find direction and perhaps even hope, as you deal with the challenges of your situation. It requires making room in the stories you tell about your lives to include the changes your wife’s illness has brought, and requires asking yourselves how you can live meaningfully with the changes. You will need to explore new ways of loving each other and seek a fresh awareness of your spiritual depths and resources. This is difficult work, and it can make you feel vulnerable or anxious at times. However, it can lead to a new and important chapter in your lives individually and as a couple. If you have a religious background, you may want to discuss whether it offers beliefs or practices that could help you now. However, some people find it difficult to embrace one particular religion at a time such as this.

You might ask your wife if she has any specific goals or tasks she wants accomplished, and how you might help her achieve them. She may want to resolve a long-standing conflict or settle some other unfinished business in order to feel peaceful. She may also have some thoughts about how she might leave a legacy. Are there important stories she wants to pass along? Does she want to share a family story or lessons she has learned with children or grandchildren? Research has found that people benefit from feeling they have passed along something significant to their loved ones. Although you might feel uncomfortable starting such a conversation, you could be pleasantly surprised by what you learn. If you have already had these sorts of conversations, you may just want to reminisce and review your life together. This can include stories about both the good times and times that were not as good.

You or your wife may find insight or comfort in one of these articles on the emotional and spiritual aspects of life-limiting illness:

• Living with Limited Time: Exploring Feelings
• Stress and Distress
• Spirituality and Life-Threatening Illness
• Finding Meaning and Purpose During a Health Crisis

This article has information you may find helpful as death approaches:
When Death Is Near