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Posted: March 02, 2005

Professional Caregiving

The Sea Inside: Calm or Turbulent When Facing Death?

Last night I saw the beautiful film, The Sea Inside, about a 50-year-old man who had been a quadriplegic for 28 years after a diving accident in his 20?s. It is a painful but powerful and inspiring look at the issues related to the quality of life and different ways we view life and death.

The film shed light on his loving family members and friends, who because of their love for him, either could or couldn?t accept his request for help to die. It showed very intimately the deep and powerful differences between his brother and sister-in-law.

The focus on death and his loved ones? varied responses to it made me think about our work with the elderly, and their keen awareness of how finite life is. What struck me when watching this film was the range of responses those closest to him had during his life and right before his death. Those of us working in the field of aging have learned to expect that our clients and patients will inevitably die. Some approach death as part of life, and others resist, refusing to go quietly into the night. How do we as professionals help them? Have we done our own self assessment of the meaning of death? Have we processed the deaths of our family and friends? Many of us have dealt with illness, dying and death of so many of our clients that one might say we have grown accustomed to it, even hardened to it, as the inevitable outcome of one?s aging.

How do you feel about dying? Have you experienced a loved one?s death? Do you prefer to use euphemisms about death ? passing away, gone to his maker? How do we help our clients face their mortality and how does this affect us, in our hearts, about our own mortality? These are important questions to ask, as our responses will surely color the messages we send to our clients about our own comfort with the topic of death and dying. If we have allowed ourselves to do the self work in our own lives, with our own families, we can bring to the workplace a deeper understanding with which to facilitate the older adult?s journey toward acceptance of loss and ultimately, death.

I ?googled? the phrase ?professionals + dealing with loss? and more than 100 links came up, but NONE of them addressed how professionals are affected by the pain, loss and ultimate death of their aging clients. Interesting, isn?t it?

We have talked about legacy coaching, oral histories, and journals as ways to elicit life reviews that are a developmental need of the elderly, so as to come to peace with their lives, their successes, their tragedies. This is an instance where professionals do their best work if they follow their clients? cues, and encourage the older adult to talk about or express those things that are of most significance to them. The goal is for the client to become comfortable with these conversations, enabling them to extend it to their families -- for these are the insights into the aging person?s soul.

Our work demands that we facilitate our clients? expressions of their dreams, wishes, fears and worries. We provide avenues of support to help them accept the illness and death of loved ones and friends. While wearing our ?professional hat,? we know that encouraging expression and helping clients process is critical in helping them ready themselves for the inevitable. On our way home each night, do we explore these issues for ourselves? Or do we shut it out and avoid going down this path?

Care environments are healthiest if the staff has open communication to help acknowledge the losses -- the illness, hospitalization, and death of the community residents. This offers ways for friends and neighbors to share in the announcements through group support. There is the knowledge that when and if they were to succumb to an illness or hospitalization, they, too, would be remembered and acknowledged.

Remember: professionals also need an outlet in which they can express their feelings about lost friends, clients, patients. To this end, all sophisticated medical centers should at minimum provide a sanctuary for their staff as well as for their patients.


Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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