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Pay Attention To Emotional Health

People with serious, progressive illness may feel very sad and down. However, these periods usually come and go. Sustained periods of feeling blue can actually be a sign of depression, which is a treatable illness. One direct way to find out if your loved one is depressed is just to ask: Evidence indicates that asking people if they are depressed is a very good predictor of their mental health. (Chochinov et al., 1997). If she is depressed, recommend bringing it up with the doctor. Do not just ignore depression. With medication and therapy, clinical depression can be treated.

One direct way to find out if your loved one is depressed is just to ask: Evidence indicates that asking people if they are depressed is a very good predictor of their mental health. (Chochinov et al., 1997; Lynn J, Schuster JL, Kabcenell A. Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians. New York: Oxford Press. 2000.) If she is depressed, recommend bringing it up with the doctor. Do not just ignore depression. With medication and therapy, clinical depression can be treated.

Common symptoms of depression are:

• Changes in appetite
• Changes in sleep - either sleeplessness or waking too early
• Feelings of guilt, hopelessness, and despair
• Fatigue
• Withdrawal from others
• Lack of pleasure in once pleasurable activities
• Thoughts of death and suicide

Family caregivers are subject to exhaustion and stress, and may also feel depressed. Be sure to ask for help from other family members and friends. If you are not able to cope, and if you are depressed, talk to your own doctor about ways to help yourself feel better.

Grief

Grief is a country we all must visit, and it helps to know what it's like there, how others have made the journey, the maps they followed, the setbacks, and what they learned along the way. Grief occurs many times in the course of an illness, both before and after the death of someone you love. Here are a few suggestions on how to live through grief, ways to grieve with and for the dying person, and how to cope during difficult times, such as holidays, birthdays, and other anniversary dates.

In taking care of a dying loved one, you may experience grief at many points throughout the illness. For instance, there is the grief of first learning about the person's illness, the grief as plans you shared are lost, or as you realize you may be spending your final days together. Throughout the course of a life-ending illness, you will encounter many milestones, and with each, experience some degree of loss. With loss, in general, comes grief and sadness.

A few notes about what has helped others:

• Solitude helps. You may need time to think about your loved one, to remember times you shared, to consider how your life will be now. You may be overwhelmed by your sorrow. You may want to stay in bed and cry or sleep, go for a walk, or sit in a chapel.
• Other people help. Friends and family members are likely to empathize with you. Even if they do not know what to say, just being with other people and talking can be supportive. Accept others' invitations to participate in activities - but leave if you feel you need to. Reach out to family or friends when the next hour or day seems unbearable.
• Accepting support helps. Others may want to help by doing things for you. They may want to bring you food or talk on the phone or run errands. Accept these acts of kindness whenever you can.
• Rest and sleep help. Caring for a dying person is exhausting. You may need time alone simply to regain your physical energy, as well as your emotional and spiritual strength.
• Routines help. Even though your life may feel turned upside down, try to keep up a routine of healthy eating, occasional physical activity (even a 10-minute walk), and regular sleep.
• Time helps. Your life may never be the same again. Whatever your experience with death and dying, you will find that you see the world and your place in it differently. Time lessens some of grief's pain, but it does not diminish your loss or sadness.