Serious illness can suddenly make families come together more closely than they may have been for years. Adult brothers and sisters may have to understand what is happening to their parents and to make decisions. In some situations, it is clear who will decide and how. In others, there are too many options, too much friction, and too little practice in making decisions together (and the patient and the family suffer for it). Think about how your family operates. Could you make a decision about a business matter without one of you being in charge? Are you still arguing about what to have for lunch when it's time for supper? Do you tolerate one another's shortcomings and habits or annoy one another endlessly?
How your family and closest friends unite is something that they and you can plan. Perhaps it will be best for you to make many decisions in advance, or to name one person who has final authority. Perhaps it will be fine to let things go, trusting them to work out. However, it is almost always best to check out ideas with each other first. Let your family learn what it is to pull together on some early issues that really don't matter too much. Rather than letting the first family decision be something really shattering, like selling a family home or stopping a ventilator, start by figuring out how to make decisions on which doctor to stay with, or whether to take a trip.
Reflect a bit on how the family is working and how it will do without you. Encourage family to think about who will fill some of your roles. If you are the one who always remembers birthdays or hosts the celebrations, encourage others to start doing these things. Offer advice, or share your address book or calendar. If they say that this is uncomfortable while you are still alive, be glad to keep the role while you can but be gently forceful about passing it along, too. Remember, these are the same children who were so eager to learn to drive, get a place of their own, or stop calling if they were going to be late. They can take on some of your responsibilities now when you are ready for them to.
Sometimes families really are too distant, either emotionally or geographically, to work together. Instead, hope for some camaraderie and contact. And, of course, some people have no family or friends at all and rely on volunteers and health care providers.
At times, families and loved ones get into fierce disagreements over the treatment of a seriously ill family member. All too often, a caregiving family member pitted against a distant family member who may feel guilty for not "being there. " If there has been a history of feeling left out, arguing, or providing an unfair share of caregiving, there can be deep resentment, too.
Often, family members need some perspective. Starting a conversation with a prayer, if that is in your tradition, may set the right tone of humility, service, and working together for something important. Turning to a professional for help is also worthwhile. A chaplain, social worker, nurse, or doctor may be able to listen and advise. It is not as important to be "right" as much as it is to be dedicated, helpful, and forgiving.
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