Wednesday, January 28, 2009

Last Words

The grief support groups I facilitate are open to all members of the community, and in the years I've been doing them, I've talked to people with a wide variety of experiences. The way a loved one died can influence how we go through the grief process. Sometimes in grief support groups we talk about last words. At times, the conversation is about the last words said to us by the people who died. More often, it's about our last words to them.

Because I work for a hospice, what I hear most often is “I did everything I could, and said everything I needed to say. I have no regrets.” This does not take away the grief, but it does make it a bit simpler. I've been told that some of the sweetest, deepest moments have been spent in the knowledge that time is limited. Often, the hardest thing we have to do is give the dying person reassurance that we will be okay, and to give that person permission to die. When we are as prepared as we can be for death, and able to say what needs to be said, there is a certain peace about the relationship.

When someone dies unexpectedly, and is already gone by the time we get the news, the comment usually is “I didn't get to say goodbye.” The sense of shock and disbelief can be overwhelming. There is no warning. If there was unresolved conflict, that can certainly complicate the grief process. Even if the relationship was a strong, supportive one, there is usually a lot of unfinished business. Many people have not told their families or friends about all the things they will need to know to notify others, plan a funeral, find a will, access bank accounts, and take care of insurance and other business. The surviving family members have to figure out how to do the tasks usually done by the one who died, and there are always questions they would like to ask.

If the person committed suicide, there are a host of other issues. Last words to a loved one before a suicide are often magnified, as if we could have prevented the act by having said or done something different. Survivors often struggle with confusion, guilt, or anger, and many questions remain unanswered. Deaths by violence have an especially intense grief process. There are often specialized support groups in a community that help people deal with the unique grief issues in losses by suicide and homicide. I've added some links to North Texas groups.

I often recommend books for particular grief issues. I Wasn't Ready to Say Goodbye: Surviving, Coping, and Healing after the Sudden Death of a Loved One, by Brook Noel and Pamela D. Blair, is a good book for understanding the challenges of a sudden loss. No Time to Say Goodbye: Surviving the Suicide of a Loved One by Carla Fine can be helpful for someone whose loved one died by suicide. A mother in one of my support groups groups whose daughter was murdered found A Grief Like No Other: Surviving the Violent Death of Someone You Love by Kathleen O'Hara to be especially helpful.

When someone has gone to the hospital or is home on hospice, still alive, but unconscious when family members arrive, the question after death is often, “Were they able to hear what I said?” Last words were said to the person, but there is little reassurance that they were heard or understood. It is often said that the hearing is the last thing to go. I usually reassure people that somehow, the dying person heard them. Part of this comes from stories of hospice staff, who have told about those who wait until someone comes home before they die. Even in a state of unresponsiveness, a person often waits until everyone has arrived. In some cases, where one family member cannot come home, we've had hospice staff put a phone up to a dying patient's ear, and hearing the voice of the person who could not be present is enough to help the dying person let go.

I experienced something similar. My stepmother was hospitalized a number of times with pneumonia her last few years. She was a fighter, and always had recovered. In 2002, I was told that she was in the hospital again, just as I was starting a new job. I was hesitant to leave for Ohio in the middle of my training, but a week later, I got a call saying Esther would not survive. The pneumonia was not getting better, and she was going into septic shock. I was the last person to arrive in Ohio. All the members of my family went to Esther's bedside. She lay in intensive care, with tubes coming out and going in to many places, perfectly still except for her breathing. We all took some time to talk to her. I told her I was sorry that she wasn't going to go home, that I'd thought she'd get better. I also told her I'd bought a bell for her so she could call for help without having to use much energy while she was recovering. This may have not been the most eloquent thing to say, but it was enough. When we had all spoken to Esther, we went back to my dad's house. A few hours later, the nurse called to say she was gone, that as soon as we left, her blood pressure dropped, and she began to die. It comforted me that this deathly ill family member waited to die until all of us had come to see her. Somehow, she knew.

Stories from those who have died and then been resuscitated also confirm that a person can be aware of what is going on even when they seem totally unresponsive. Those people sometimes recognize hospital staff that were in the room while they were dying that they did not see any other time. I read about near-death experiences a long time ago, when a member of our church was talking about his. The stories can be pretty amazing.

Sometimes our last words to our loved ones were said in anger. It may take a lot of work on self-forgiveness to get past the words we said that we wish we could have taken back. I experienced years of guilt after my mother died because of the last things I said to her. Long ago, I forgave that 9 year old child I used to be. The day my mother's aneurysm burst, my sister and I were supposed to go back to church for a Sunday afternoon mass, a Holy Hour for girl scouts. My mother was the leader of our troop. I don't know if I was resisting the idea of going to church twice in one day, or if I was reacting to her being sharp because of the pressure building up inside her head. I do remember being very angry, and thinking “I hate you, I wish you were dead!” I didn't say that, but I did say “You hate me! You wish I was dead!” She left angry at me, and my sister and I went to the service with another adult soon after. During that Holy Hour for girl scouts, my mother, who was sitting with the leaders, collapsed. At that time, children my age were not allowed to visit relatives in the hospital. I didn't get to see her before she died, two days later. After my dad told us my mother had died, we didn't really talk about it much. I was afraid to tell him I thought her death was my fault. Over the next few years, I grew more depressed, feeling guilty, sad, and ashamed. I was the target of bullies on the playground, and often cried at school. A staff member called home, insisting I get some help. I started coming out of depression when I went into counseling and found a safe place to talk. Much later I learned that children of 9 or 10 often experience “magical thinking”, attributing great power to words or actions. Children whose parents divorce or who have a family member die may blame themselves.

Many years later, I was trying to put a cranky child to bed. He looked up at me with anger in his eyes, and spat out “I hate you! I wish you were dead!” And truthfully, I had to keep myself from laughing out loud. I realized that this did not have the power to destroy me, that as his mother I could look at the day and figure out why he was so tired and upset. I knew he really loved me, and a moment of anger didn't change the love between us. It was an oddly liberating moment.

There are some ways to deal with endings that were not as peaceful as we would like. Some people write letters to loved ones, or journal. Some work with a therapist doing an “empty chair” exercise, where they have a conversation with their loved ones. Many people talk to the person who is gone, or talk to God about the person who is gone. If a child is having trouble, I recommend a grief support group especially for children. I've added some links to family grief centers in my area to the right of this posting.

Grief counselors talk about the work of grief. If there are last words unsaid or last words regretted, I encourage you to start journaling, find a support group, find a counselor, or read a good book about your kind of loss. It feels good to let go of the burden of painful last words. I feel so much freer than I used to. Mom loved me. I loved her. Words I said in anger before she died can't change that reality.

Saturday, January 24, 2009

Memorial Services

I went to a memorial service this afternoon for a friend, 41 years old, the father of four kids, age 11 to 17. He was one of those people who could look at a computer part and know exactly what it was and where it fit. He worked in programming, and knew computers inside and out. He also was a lover of science fiction, Star Trek, and Star Wars. This could also be a description of some of the males in my family, and he was a good friend to them. I'd sung in choir with him for some years when he was a member of my church, and my family had gone to some gatherings in his home. He had a big heart, a great laugh, a keen intelligence, and a sly sense of humor. He will surely be missed.

Since I lost my mother when I was a child, one of my first concerns was finding some grief resources for Joseph's children. Some of my friends who also work in grief and loss helped me find a family grief support group in east Texas, where Joseph's three daughters and ex-wife live. I'll be sending some information to his wife and son next week about groups in the Dallas area. Any time there is a death in a family with children and teens, I always hope they will find one of those family grief support centers that exist in many parts of the country now. They are healing places.

Another thing that is healing is a good service of remembrance. Memorial services, funerals, celebrations of life, and other rituals are so important to the people left behind. I'm old enough now to have gone to services for friends and family, and I've been thinking about those that touched my heart and those that left me a little cold.

Joseph's memorial service was one of those that got everything right. There was music, scripture, stories about Joseph from friends and family, laughter, and tears. I felt at the end of the service that I knew him a little better, and was honored to have been his friend. Since Joseph knew he had a terminal illness, he asked some friends and family to share some memories. I'm glad he was able to help in planning his service.

A few services I've gone to have been very formal in nature, where most of the funeral liturgy and music was decided long ago, with the name, dates, and a little personal information added in. These seem to focus on the promises of scripture and the life beyond this one, and often are in the form of a mass or service for the dead. If there is an opportunity in the service for the leader to talk about the person who died and tell some of their stories, these are okay, but not as uplifting as the one I attended today.

It's especially difficult to go to memorial services for young people. One I attended last year for a friend of my son included a touching service and then a time at the reception where anyone could take a microphone and share remembrances. It was wonderful to see how this young man had touched so many lives. Again, there was laughter, and there were tears, and there even were times the boy's parents learned something new about their son. You could see their pride in how he had lived, and their sadness that he was gone too soon.

I went to one service some years ago for two elementary age children that I will never forget. The pastor of the church was young, and perhaps had very little experience with death in his congregation. Two children from the same family died of an infection, days apart. The music was touching, the slide show about each child very nice, but the sermon left me cold. The pastor didn't talk about the tragedy of one family losing two children in the same week. Instead, he chose to build his sermon around the phrase “These deaths are a victory for God!” He went on to say that these children loved God and more than anything wanted to be in heaven with him. He ended with an exhortation for people to come to Jesus so they could go to heaven like these two. Now, I am a Christan, and I am not afraid of death, and feel like I will have great joy after I die, entering into God's presence, and seeing people who have gone before me. But I do hope my family is allowed to grieve as much as they wish, without people adding some sort of guilt trip to them for doing so. I especially object to telling people that they should praise God's goodness and victory when children die. I went up to the mother after the service and told her she needed to grieve and mourn, because “blessed are those who mourn, for they will find comfort.” I hope she remembered what I said, if the thought came to her that she was somehow wrong for feeling mad at God and desolate at her children's deaths. Someone once told me “God doesn't take people, he receives people”. I believe He was in heaven mourning the death of these children, just like the rest of us should have been.

A few memorial services I've gone to have had “pass the microphone” times. I have enjoyed hearing the stories people tell about the person who is gone. One service for a young man who'd been an outstanding singer played a recording he made of the song “Silent Night”. It gave me goosebumps. I've also gone to a memorial service of person who had taken her own life. I was so glad the minister acknowledged the circumstances and addressed the spiritual questions in a way that was very healing to the family and attendees.

Each time I go to a service, I think a little more about what I would plan for myself, if I am able to have a say when my time comes. I do want music, and scriptures, and storytelling. I'd like people to pass the microphone either at the service or at a reception afterwards. I hope for a long life, but I do hope I don't live so long that I have no friends left to attend my service when I die! And there is a song I wrote some years ago that I want to put on a CD some time between now and then. I would like this song played at my memorial service, and hope other people will get goosebumps. It could happen.

My life’s a constant journey. I make stops along the way.
I find some places fit me, and some where I can’t stay.
Some farewells are bittersweet, but I still walk the road
Looking for that welcome, when I’m finally home.

Lights like beacons calling when the night is falling
Open hearts and open arms, I’m home
I’m anticipating you will be there waiting
I won’t stop until I’m finally home.

From "Finally Home" © 2006 Sue Rafferty

Wednesday, January 21, 2009

Grown-Up Motherless Child

Sometimes I feel like a motherless child
A long way from home
A long way from home...

Like someone who belongs to a twelve-step organization, with a few words I can say an awful lot about myself. For me, it's not

"Hi, I'm Sue, and I'm an alcoholic..."


"Hi, I'm Sue. My mother died when I was nine years old."

Motherless children understand right away that this is just the beginning of a story about loss, about a world turned upside down, and how we survive to become who we finally are.

Sometimes I like to put my loss in a historical context. I'm part of the generation known as Baby Boomers. Most of us in this demographic remember how old we were and what we were doing on November 22, 1963. Young president Kennedy, father of two, was waving at crowds in the early afternoon, and was dead by the end of the day. I was nine years old, in fourth grade at St. Jude's Catholic School in Elyria, Ohio. This was the first time someone I cared about had died. It was shocking and incomprehensible. I lost some of my innocence that day, along with the rest of America.

Almost four months later, on March 15, 1964, my mother collapsed in a church service, was taken to the hospital, and never came home. She died two days later. That was a lifetime ago. Memories of that time are dim, and yet that time affected who I became more than any other event.

Some people view life through rose-colored glasses. Loss has become a subtly colored lens through which I see the world. I don't even realize it most of the time. I've been tested and found strength while navigating a difficult road, and somehow, I've become useful.

I spend a lot of my workday talking with people about the grief process. I walk in a well-known part of my landscape, helping people who are in territory that is unfamiliar to them. I've written articles for a bereavement newsletter we publish at work, and sometimes have a column in a local paper. Posting my thoughts online seems like a natural progression.

I also journal, and from there learned to write music. When I post here, I will tell my own stories, talk about things I've learned from years of talking to bereaved people, and may add lyrics from some of my songs. This will not be just about loss, but about living. I am a survivor. I'm not the person I would have been, but I think I'm the person I was meant to be.

Here is where I plan to share my thoughts. Please feel free to add your comments.