How can I deal with my personal grief around the failing health of my client?

1 answer | Last updated: Sep 30, 2016
Scoobie asked...

I have been a caregiver for someone for several years now. Hospice was called in a few weeks ago. At this point death is likely to occur within the next week or maybe a little more/less. I know that this is what my patient wants and they are at peace with events and have even said they are ready to go now. In my head I can accept that, but my heart is torn to bits. How do I deal with my personal grief and still be there for the family to lean on as well? I am finding this so hard. You get so close to someone when you are taking care of them, and gradually begin to care for even their most intimate needs. It is just so hard to see the loss of dignity that is inevitable. I am hurting so much, its so hard for me to express myself and what I'm feeling,it just hurts. How can i deal with this emotionally because i feel like I am falling apart? It is just so hard to know that I can't do anything to stop it, and I wish I could. I feel so helpless.

Expert Answers

Audrey Wuerl, RN, BSN, PHN, is education coordinator for Hospice of San Joaquin in California. She is also a geriatric trainer for the End-of-Life Nursing Education Consortium (ELNEC), which promotes education in geriatric nursing and end-of-life care.

Being a caregiver is one of the most difficult, and most rewarding, jobs you may ever have. It takes a very special person to do what you are doing, so first let's realize that fact and work on ways to help you, the caregiver, deal with these unfolding events.

Some caregivers place unreasonable demands on themselves as they try to provide the very best care for their patient. Some, also, blur the lines or boundaries between being a caregiver with being a friend or "one of the family." This is natural and does not make you a bad person. When family or the patient looks to the caregiver for support, the one doing the caring can become more involved than they planned. This can add to what we call caregiver stress. Caring for a patient at the end of their life can be physically as well as emotionally challenging. Without even knowing it, you can take on the problems and stressors of the patient and family, and develop caregiver burnout.

Here are some ways to help you cope:  Accept your own limits"”don't try to do it all  Schedule your work (your care) in a realistic manner; some things can wait; being present and providing active listening for your patient means so much  Be in tune with your body"”it's O.K. to feel sad as dying is sad"”and give yourself permission to cry  Seek a support group as not everyone will understand your feelings or grief  Take care of you. You cannot care for others if you are not strong yourself!  Remember to find humor in life (and death) and laugh more. Laughing allows a boost to our immune systems  Realize you are only human, and you are doing the best you can.

Care giving can provide satisfaction and a sense of fulfillment. It can also cause fatigue and disillusionment for the caregiver. Remember, it is a privilege to be with a person at the end of life"”to be in that intimate place "before death." So, what is really important is: standing back and recognizing the challenges and joys and learning to find a balance between the two.