care for elderly people

From the time we learn to walk, we learn to let go of what is recognized territory for us and try for a potentially greater reward. It can be scary too to take steps further away from near ones and known places and to live or die on our own. The decision can become all the more difficult if there’s someone who refuses to let us go.

It is the most difficult task to be the one who must let go of someone whom you hold dearly in your heart and precariously in your grip, whether it’s your child learning to walk or a very ill loved one whose lifetime is coming to an end.

Learning to walk is normal. And so is dying.

Humans have an innate desire to go on living. We are attached to loved ones, such as family members and friends, and even to pets, and we do not want to leave them. When we realize that the end of life may be approaching, certain emotions and feelings arise. The person who is ill will want to be with loved ones, and may also feel a sense of responsibility towards them, not wanting to fail them nor cause them grief. He/she may have unfinished business. For example, the person may or may not want to reconcile with estranged family members or friends. Fears arise, and may be so strong that they are hard to think about or even admit to: fear of change, of the dying process, of what happens after death, of losing control, of dependency and more. Both the person who is ill and the caregiver might also experience resentment, guilt, sadness and anger at having to do what neither wants to do, namely face death and dying.

Never underestimate the power of letting go. Likewise, never forget the price of holding on too long.

Our culture tells us that we should fight hard against age, illness and death: “Do not go gentle into that good night,” Dylan Thomas wrote. And holding on to life, to our loved ones, is indeed a basic human instinct. However, as an illness advances, it often begins to cause undue suffering, and letting go is indeed the greatest release for the afflicted.

As death approaches, many people feel a reduction in their desire to live longer. Instead, they sense it is time to let go. Perhaps, as in other times in life, it’s a sense that it’s time for a major change like one might feel when moving away from home, getting married, divorcing or changing to a new job. Some people describe a profound tiredness, a tiredness that no longer goes away with rest. Others may reach a point where they feel they have struggled as much as they have been called upon to do and will struggle no more. Refusing to let go can prolong dying, but it cannot prevent it. Dying, thus prolonged, can become more of a suffering than living.

Letting go requires, first, giving permission for a person to leave you. When a very ill person accepts his or her death and asks you to, don’t ask them to pay the price of your hanging on too long. The greatest gift you can give is to give them permission to die — their way, on their time. It can also be important for those of us who go on living. The power of letting go means no one becomes the victim of death. We become willing participants in life’s process, and that choice — that conscious decision to let go — is our role in it.

There are normal shifting emotions and considerations involved in holding on and letting go across multiple levels on both ends—the dying and the ones letting go. Exploring these issues ahead of time will allow a person with a chronic illness to have some choice or control over his or her care, help families with the process of making difficult decisions, and may make this profound transition a little easier for everyone concerned.

The opinions of the dying person are important, and it is often impossible to know what those beliefs are unless we discuss the issues ahead of time. In caring for someone with memory loss, it is important to have the conversations as soon as possible, while he/she is still able to have an informed opinion and share it. Planning ahead gives the caregiver and loved ones choices in care and is most considerate to the person who will have to make decisions.

Many people know when it’s their time to die. They feel it in their bones, wake up with a sudden understanding or feel it coming for a while. Old wives’ tales talk about elderly Eskimos setting out, away from the family, to die on some ice floe, or American Indians who head for the forest to die alone. It is also not uncommon for animals to separate, to go off quietly to die. There seems to be some instinct that guides them. There seems to be some need for peace, quiet and non-interference at the time of death. And everyone has the right to this solitude and release. Letting go, therefore, is sacrosanct.

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