There are few jobs tougher than caring for seriously or chronically ill people. That’s true whether you’re a healthcare professional or the family member of a very sick loved one. But of all the difficult tasks you face—cleaning bedpans, changing sheets, helping patients cope with pain—fielding questions can be the toughest and most intimidating task of all. Questions that fall into this category may include “Am I going home?” (especially when the answer is “No, nor will things ever be the same again”)…“Will I recover from this condition?”…“And oh, by the way: Is there an afterlife?”
Here are ten things all caregivers should keep in mind when difficult questions are asked:
Let the person speak. When an ill person brings up subjects that make you feel uncomfortable it’s natural to want to squelch the discussion or rapidly change the subject. However, it’s very important to listen unselfishly and avoid responding with, for example: “Let’s not get into that right now. Can’t we discuss something more pleasant?” or “Do you really think it’s helpful to dwell on this topic?”
Know when (and how) to say, “I don’t know.” Whether the patient asks a spiritual or theological question that catches you off guard or she wants to know about the side effects of a medication, it helps to learn how to be noncommittal without seeming evasive. You don’t want her to think that you don’t care or that you’re hiding something, and you definitely don’t want to offer misinformation that might do more harm than good.
Don’t hesitate to call in spiritual help. Even for people who weren’t very spiritual or religious throughout most of their lives, it’s natural to experience spiritual anxiety during a serious illness. And it’s also natural for this anxiety to lead to questions that caregivers might find difficult or even overwhelming. If your loved one asks, for instance, ‘What’s next? Will prayer help? Why did God let this happen to me?’ it’s best to call in a qualified cleric.
Encourage the patient to meditate or pray. Again, each patient is unique, and each will have a different set of spiritual beliefs and preferences. If you feel that your loved one might be open to prayer or meditation, it’s okay to encourage him to engage in that practice. And if you feel comfortable, you can even offer to pray (silently or aloud) with him. Prayer and meditation can be immensely comforting to some patients, and may also have a positive influence on their mental and physical health.
Never argue with the patient on spiritual matters or try to strong-arm her into your way of thinking. Even if the person you are caring for doesn’t share your own spiritual beliefs, she still has beliefs—and you must respect that. As a caregiver, your role is to offer comfort and support, and to create a sense of togetherness that will allow the ill person to make her own honest investigation of matters that are of great spiritual concern to her.
Let the tears flow (the patient’s and yours, too). Just as most of us are not comfortable with chronic illness, we are also not comfortable with crying. When tears appear, we tend to whip out a tissue and murmur something along the lines of, “It’s okay. Don’t cry.” From now on, continue to pass the tissue when your ill loved one starts to tear up, but don’t pressure him to stop sobbing. Tears are a natural emotional release for emotions ranging from anger to sadness to fear, and can be very therapeutic.
Resist the urge to spout platitudes. When your loved one is uncomfortable, upset, or worried, you might be tempted to utter platitudes like, “Everything will be okay,” “I know how you feel,” “God has given you a long life,” or “It’s God’s will.” While we hope that these phrases will be a quick fix to problems we’d rather not deal with, the truth is that they’re trite and meaningless. What’s more, sugarcoating reality doesn’t fool most people, and it certainly doesn’t spark positive change.
Don’t offer false hope. Similarly to using platitudes, “looking on the bright side” is often done with good intentions. We’ve all heard about the transformative and healing power of positive thinking, and more to the point, we just don’t want to acknowledge that someone we love might be chronically ill with no hope for recovery. Regardless, don’t say things like, “I’m sure you will get well soon,” “You’re going to be just fine,” or “Think positively—it may go away.”
Respond constructively to anger. Anger is a natural human emotion, and it’s important to recognize that chronically ill people have a lot to potentially feel upset about. Understandably, many patients are angry that they are so sick. Plus, their pain and energy levels might make them less patient or less able to handle stressful situations. Therefore, it’s not unusual for caregivers to be on the receiving end when their loved one’s fuse blows for any reason.
Above all, seek to connect heart to heart. Understanding how and why an illness is getting worse and more painful is intellectual. But experiencing it is a very visceral and emotional thing. The patient needs for you to connect with him on a heart-to-heart, gut-to-gut level, not just a mental one.
Chronically ill people are facing an incredibly uncertain, anxious time, and most feel compelled to come to terms with their own mortality. And it’s natural for patients to reach out to caregivers, whether they’re family members or professionals, for answers and comfort. Learning how to respond and react properly can give the patient the sense of peace he or she is seeking.
About the Author:
Dr. Walter St. John is a retired college professor and administrator who lives with his wife in Old Town, Maine. He taught interpersonal communications courses for more than twenty years and has presented communications workshops throughout the United States and Canada. He has hands-on experience with disabled veterans, multihandicapped youth, and Special Olympics participants, and he has written widely in the field of communications.