Tuesday, February 17, 2009
Dr. Camardi: Don't rush grief
Dr. Michael Camardi
Recent columns
About Dr. Michael Camardi
Dr. Michael Camardi is a geriatrician at Carilion's Center for Healthy Aging. Age Matters is his new Roanoke Times column, appearing the third Tuesday of every month.
Camardi has been with Carilion for about three years and was one of the experts who reporter Beth Macy spoke to for her series, “Age of Uncertainty.” He wanted to start this column to help answer questions he’s often heard as part of his job.
Camardi was founder and past medical director of the geriatric liaison program for Jacobi Medical Center (Albert Einstein College of Medicine) in Bronx, N .Y.
Camardi trained at Winthrop University Hospital (Stony Brook University Medical School), where he was chief medical resident. He has received numerous commendations for his contributions to education, patient advocacy, community relations and hospital administration.
If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014, or e-mail them to extra@roanoke.com with “Age Matters” in the subject line.
Dear Dr. Camardi -- I don't know if you remember us but you were the doctor over at Raleigh Court Nursing Home who took care of our father when he was so sick and died. I never did thank you and your nurses for all the work and the time you took with us during that terrible time, but it helped us a lot when you explained what was going on and what to expect.
The reason why I am writing to you, though, is because of Mom. Since Dad died, she has just stopped living. She barely talks at times and then she'll talk nonstop, and when she does it's like she's talking to Dad or talking of something bad that happened in the past.
All she does really is get up and go the bathroom and then goes back and sits down. She wouldn't eat if we didn't bring her food. Nothing makes her happy. It's like she's just given up ... it's like she died.
It's killing us all watching her do this to herself, and what's worse is that she picks fights with us for things we did years ago that used to upset Dad, and she blames us for giving him sorrow when he was alive. I don't know what to do with her.
-- Roanoke
A key first step is to bring Mom to her family doctor for a complete evaluation. During the visit, discuss the proper role of medication as an adjunct (not an end-point) to pastor, family, friends and counseling.
Too many times I have seen medications used to blunt the essential process of the expression of grief and loss that must be vented, and when postponed by sedatives that are too strong or used too long, grieving is prolonged and made more difficult because it was not allowed to happen along a natural course.
Yes, it must "happen" -- it can't be postponed and you can't hope it goes away or it's something that "doesn't happen in THIS family" (I've heard that far too often). It is a natural and necessary process of adaptation to a new normality, that of living without the deceased.
The only constant in life is change, but when we have spent decades with someone who filled the corners of our being with their life and then they are gone, only our emotions are left to fill that space.
In the first hours after we suffer a loss, we typically go through a process of denial where we feel almost numb, shocked and confused to the point where we may act as if no one has died. As this shocked numbness begins to wear off, we may feel abandoned and angry.
That anger could be vented toward God, religion, medical professionals, the deceased, family and even oneself. When it takes a turn to becoming self-destructive, then we must seek help.
For many of us, the process of grieving and watching our loved ones grieve is not only terribly hard, but also confusing. As we seek to "move on" we are surprised by our loss of control as we go from one emotion to the next. Try to understand that there is a struggle in the mind as it copes with the new reality that the loss of a loved one represents; what it means is the attempt of the psyche to understand the meaning of loss.
That loss makes us feel insecure, which pushes us into a kaleidoscope of feelings. Now compound this by the fact that each member of the family is going through their own grieving and we can start to understand the conflicts that may arise.
At the root of this turmoil is your natural desire for a return to a new normality that Mom may not be ready for -- that of living without her husband. This is why it is different for mom than for you. You have lost a father but she has lost a husband, a mate, a partner and more. It is a different level of loss and along with that, a different pain.
One of the most important things we can do for the remaining spouse after the death of a loved one is to stop trying to interject what we think is right and appropriate for that time and that moment for the spouse and let time and space take its course.
I have found that guilt is by far the most common destructive emotion at this time. For whatever reason, guilt is the residue of living through a loss and it must be faced head-on. This is the single emotion that prolongs the grieving process, and if not dealt with in the family setting, it goes on and on.
Guilt is born of the regret of a past perceived sense of failure that can't be undone, only accepted. That acceptance is the root of our struggle, and what makes it so hard. Because the deceased is not there to say, "it's OK," we have to do it for ourselves through our family to heal ourselves. This cannot be done alone. It is a big mistake to focus only on the bereaved and not the family as a whole.
Please understand that there is no timetable for this process. It could take years and be all-consuming. In my experience, the faster the family moves through the grieving process as a group, the faster a new balance is restored.
It's not pretty, nor is it neat and tidy, but when done well, it can heal us and allow us to live our remaining tomorrows in peace.
Dr. Michael Camardi is a geriatrician at the Carilion Center for Healthy Aging. His columns run on the third Tuesday of each month. If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014 or e-mail them to extra@roanoke.com with "Age Matters" in the subject line.
