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End of life care and family disputes

Discussion in 'Personal' started by littlejackhorner, May 21, 2019.

  1. littlejackhorner

    littlejackhorner New commenter

    I have posted on here before and received some thoughtful advice and am now seeking further insight. My mother in law's health has deteriorated rapidly and the nursing home are implementing end of life care. We were asked last weekend by the gp what we wanted for her and said it was best for her to remain in the home not go to hospital. My sister in law had travelled from another part of the UK to visit and was with us when this was discussed. She cried a d said to me that her mum was dying then promptly left to go back home the next day. Both my husband and I were so shocked at this that we haven't spoken to her since. Each day my mother in law is getting weaker and weaker. She barely has the energy to speak. Should I just leave my sister in law to it or should I make it clear to her how weak she is so she could come back and be with her Mum when she goes? She doesn't work and says she's worried about her dog but she could bring the dog with her as she has done in the past. I think it's so sad that she may die with her son and daughter in law with her but not her daughter.
     
  2. Lara mfl 05

    Lara mfl 05 Star commenter

    It is difficult to understand when people's reactions are so different to one's own in such circumstances.

    It may well be that your sister-in-law is in violent shock and still processing the news. Hence the 'excuse' of the dog, which is just that an excuse so she doesn't have to explain perhaps her fear and worries about how to deal with this. Some people are incredibly private and just seem to pull into themselves when receiving difficult news.

    Plus 'end-of-life' care needn't necessarily mean 'imminent'. As many people on Alzheimer's Talking Point could tell you. Or even Marshall's thread about her husband with heart failure. In fact the Health Service refused to agree to Continuing Care costs, because my mother had been taking so long and they couldn't agree that she would die within 6 months because it had already been more than a year since her deterioration and even longer before that.

    Some people also can't cope with that 'final goodbye and don't actually want to be there. Though they can change their mind.

    All yo can do is be there for your mother-in-law and keep in contact with your sister-in-law allowing her to come to terms with the situation in her own way.
     
  3. HelenREMfan

    HelenREMfan Star commenter

    Not everybody copes well with death. We hardly ever say the real word. This might well be the case with your sister in law. If it's possible she didn't get the correct gist of what was going on then maybe a phone call to her. It is though her decision. I was with my mum when she died, the rest of the family, as in my daughters, I delayed. The experience of my mum passing will always be with me. For them ...well their last moments of her still alive weren't as bad.
    As long as she knows what is going on..it is her shout. It might sound harsh but it is your sis in law who has to keep on living and if this makes it easier....well so be it.
     
  4. Lara mfl 05

    Lara mfl 05 Star commenter

    This happened to us when my husband's uncle was dying. We weren't aware things had got so bad, until she popped in to ask if we had some of those children's bendy straws to help get some liquids down him. When we asked when we could visit, he only lived at the top of the garden, she said, "No don't visit, keep your memories of him as he was." So we never saw those devastating last days and have very happy memories of earlier days with him.
     
  5. littlejackhorner

    littlejackhorner New commenter

    Thanks for your prompt response @Lara mfl 05 . I did wonder about whether she just can't face it but I keep thinking if it was my Mum her needs would be paramount not mine.
    I do understand what you are saying about end of life care. Her morphine has been increased and the nurse told me to prepare myself. My response was we've been like this for the past 2 years. In all of that time though I've never seen her like this. It's like she's shutting down and extremely tired. I know from your useful thread you started a while back you have experienced this. Its just such a heartbreaking time and my sister in laws response saddens me even more.
     
    gingerhobo48 and cissy3 like this.
  6. Lara mfl 05

    Lara mfl 05 Star commenter

    Ah, now if they're talking morphine, that does suggest something very different. You may like to pass this information on to your sister-in-law and say that if she does want to be with her mother at the end there may not be long. Then leave her to decide whether she comes or not.

    I'll say what I always say and you do know the 5 things to say to a dying person conversation? It just helps one feel there's nothing left unsaid should the end come when you're out of the room for example. This can so often be the case.
     
  7. littlejackhorner

    littlejackhorner New commenter

    @Lara mfl 05 . I dont know the 5 things to say to a dying person conversation. Should I Google it?
    She held my hand today and said I love you both. My response was a d we both love you. I'm glad that I have the time to be with her to say things like this.
     
    gingerhobo48 and HelenREMfan like this.
  8. Lara mfl 05

    Lara mfl 05 Star commenter

    You could certainly google it, but it's basically
    1. Please forgive me. Forgiveness can be daunting. It’s natural to hesitate if you seek it, but once you ask for it, you’ll feel better. If you believe your loved one holds any grievances towards you, it will be of great relief to the both of you to let those go. You can continue your life and they can conclude theirs knowing a past issue has been resolved.
    2. I forgive you. Offering forgiveness can be even more daunting than seeking it, but it will deliver great relief and renewal in the end. When you offer your forgiveness to a loved one, you give them a final gift of passing in peace.
    3. I love you. These three little words are so special. Everyone deserves to hear them, but so often we may go on without sharing them. Ask yourself when was the last time was that you said “I love you” to this person? No matter when it was, say it again. If ever there was a time to share these words, it’s now.
    4. Thank you. There’s a story told that an author once tried to copyright a book that would have the word “thanks printed a million times, but couldn’t by law because “thank you” is a common use phrase. Let that serve as a reminder to use use these words freely and often — they don’t cost anything! Sometimes it may be “Thank you for all that you taught me,” or “Thanks for taking care of me when I was in need,” or “Thank you for all that you are to me.” Whatever it may be, don’t wait.
    5. Say goodbye. Saying goodbye brings closure to a relationship. But sometimes it’s just too hard to say. In that case, consider saying, “Until we meet again.” It makes a huge difference. Saying this is a reminder that a loved one is never gone, but that they always remain in your heart. This will help you in your time of grief.

    6. And this website has some useful info.
    7. Grr, can get rid of those extra numbers. They're not 6 and 7 but separate.
     
  9. magic surf bus

    magic surf bus Star commenter

    When I received a call from my sister to say our Mum was into the final approach path, I was 100 miles from the nursing home on a dark rainy autumn night and I'd said my goodbyes to her a couple of days previously when it had been my turn to care for her over the weekend. My Mum had been under heavy sedation and hadn't reacted to any previous visits I'd made for some time. I could have leapt into the car and driven in the dark for over two hours in poor conditions with my mind on everything but driving, only to miss her departure by a couple of minutes. Consequently I opted not to go.

    My sister, who lived about 15 minutes from the nursing home, was with her when she passed away. My sister said that despite all the sedation in her final few seconds Mum had opened her eyes very briefly, then went. I understand that might be an effect of the final endorphin surge so I'm not going to mystify it.

    It would be easy to beat myself up for the rest of my life about not being there for a couple of seconds of apparent awareness at the end, but I'm not going to. I probably wouldn't have arrived in time for it anyway, I was not in a good frame of mind for a long night drive in poor weather, and my sister had plenty of support when she returned to the comfort of her own home. I'd have had to spend yet another solitary night in my Mum's half-empty house, with all its childhood memories attached. If some judge me as callous or uncaring, that's their business - I know I'd done what I could for her at other times.

    When our Dad passed away in a hospital some years previously, nobody from his family got there in time, but a member of nursing staff was with him. Sometimes that's how it happens. It had been sudden but not unexpected, and none of us felt we'd failed him.

    I suppose what I'm trying to say is there are no rules - you make your own decisions and you live with them, because it's nobody else's place to pass judgment on you.
     
  10. Lara mfl 05

    Lara mfl 05 Star commenter

    This has always been my standpoint. There are no rights or wrongs to do with how we deal with death and later grief. We are all individuals and should be allowed to deal/ grieve in a way which suits us.
     
  11. cissy3

    cissy3 Star commenter

    When my mother was dying, I have to confess that I felt angry about the lack of help I'd had from my two brothers.
    Irrational, though, because one of them lived half-way across the world, and couldn't have helped anyway!

    But I felt that I'd had it all on my shoulders, and felt resentful that no-one else seemed to know how difficult it all was.
    When my other brother did occasionally, and briefly, visit, he just seemed to faff around, when the best thing he could've done, was just sit and hold her hand.

    I now think he was just trying to help, but didn't really know how, and he had other commitments which I didn't have. But I really could have done with more support!

    I wonder if you've had to ''bear the brunt'' of your MIL's care, @littlejackhorner ? And if so, whether you feel that your
    SIL is somehow leaving it all on you to deal with?

    Sorry, not much help, but I don't know what to suggest, apart from what everyone else has said, as we're all different, and who knows what is going through her mind.

    But please accept my sympathy. It's a horrible time, and I feel for you.
     
  12. minnie me

    minnie me Star commenter

    So helpful to read this .My Dad’s anniversary will be June 1st .11 years now He died at home of pancreatic cancer on a Sunday - 6 days after being discharged from hospital. The day before I had sat on the floor by his bed ( fine/not in pain/ relaxed) and we had joked about how my Mum drove us both mad ! (I was just about to take her shopping) . When we had left he told my husband to get the whisky out - his way of ‘normalising’ the situation.

    The following morning he was in dreadful pain and the doctor called. He said my Dad had only hours to live .Someone though had to go to get more morphine but the on call doctor made a mistake on the prescription and I had to make two journeys to the walk in centre for a signature / Boots ( on a big retail park ) which bit significantly into time. Imagine.

    We then decided to bring my son over who was not yet driving to say good bye but we arrived too late ...,I am not even sure I may willed this to happen subconsciously? My husband was with him ( lounge )when he died and a nurse but my Mum was in their bedroom - not sure if she could handle it ?? My guilt was overwhelming - still is .... I wanted the funeral to be over quickly. I think he deserved better but this was my way of coping.

    My Dad was v private person - did not want anyone to know he was so ill .... months later my Mum was being asked about him as in ‘not seen him around ‘ ... he was popular, witty and knowledgeable.

    I suppose I am saying that at a time we react / behave / conduct ourselves in a certain way . No rhyme or reason. When I discovered that my Dad had cancer and it was terminal I cried of course and my husband tried to comfort me . I recall rejecting him and his attempts to make things better ...,
     
    gingerhobo48 and Lara mfl 05 like this.
  13. Lalad

    Lalad Star commenter

    I was about to post but others have beaten me to it. Please, please don't ostracise your sister-in-law for reacting to her mother's deterioration in a way that is different to what you would expect.
     
  14. lindenlea

    lindenlea Star commenter

    @littlejackhorner As others have said, you don't know why your sister-in-law has reacted like this but it only seems fair to swallow your own reaction and get back in touch to give her an update on the situation. Then she can decide what she wants to do. It would be sad to leave her in the dark and after your mum-in -law has gone you don't want her blaming you for her not being with her mum close to the end.
     
  15. Doitforfree

    Doitforfree Star commenter

    I'm very glad I didn't have this saccharine conversation with my mum when she wag dying. Are you supposed to sit there with a tick sheet? I said goodbye one day and she died the next day. This type of prescriptive thing that you're 'supposed' to do just makes people feel guilty. In the same way people feel they've done something wrong if they don't follow the invented stages of grief. There's no right way to say goodbye and there's certainly no list of things you should feel you'd said.
     
  16. ROSIEGIRL

    ROSIEGIRL Senior commenter

    I think it's meant more as something to consider, rather than a prescriptive list. Some people might find it helpful, particularly I think in those circumstances when there is time for conversations - a preparation if you like, rather than a list of things to say quickly before someone dies? If I remember rightly, it was based on what people wished they'd been able to say, looking back.

    But everyone's circumstances are different, as are ways of dealing with it. @littlejackhorner all you can do is keep your sister-in-law updated and let her make her own choices. As everyone has already said, there is no right or wrong.

    A horrible time for your family - much sympathy.
     
    gingerhobo48 and harsh-but-fair like this.
  17. Lara mfl 05

    Lara mfl 05 Star commenter

    As ROSIEGIRL says
    it's more some areas to consider so you don't have any regrets later about anything you may have wished to say.
    The 'advice' on the website does stress you may think a certain area is more important for you and another not at all relevant.
    It's just a 'jumping-off place' of things to say and not all at one time but over a period of time, using one's own words to make it more personal.
     
    gingerhobo48 likes this.
  18. mothorchid

    mothorchid Star commenter

    The different reactions to the list @Lara mfl 05 posted indicate the very different reactions people have to death.
    For what it's worth, I'd suggest you contact your sister-in-law, by text if you cannot face speaking, and tell her the latest update. Then leave it up to her what she wants to do. If the whole process goes on for a while, perhaps contact her more than once. But don't pressure her to come or not. That is her decision and she needs to live with what she decides.
    In my post-teaching life I come across many, many families with issues of non-contact and frequently this has been a result of losing a parent, and/or inheritence issues. It is often very distressing to all concerned. Please don't go down this route.
    Take care of yourselves at this difficult time.
     
    littlejackhorner likes this.
  19. Lara mfl 05

    Lara mfl 05 Star commenter

    Indeed it's so often death, and the way people deal differently with it and then wills/ inheritance, which are the cause for many a family dispute. :(
    Which is sad as it ought to actually make people realise how important it is to support each other, despite differences, as the family shrinks.

    And deed of variations do allow opportunity to ensure that any 'oversights' on the part of the deceased can be rectified, As in the case of my husband's step-gran who had only mentioned grandchildren alive at the time of writing and not indicated 'any future blood-relatives', which meant more grandchildren were left out than included.:(
     
  20. mothorchid

    mothorchid Star commenter

    Yes, sometimes the will is badly drawn up and a little more thought would prevent problems, such as the one you describe, @Lara mfl 05. And while it is quite possible to circumvent some of them by the use of common sense, that isn't always much in evidence at times of stress.
    I should add that sometimes a split becomes visible after the death, but the crack has been there before. I have a friend who broke contact with a family member after the mother's death. She had wanted to do so for years - it was a toxic situation - but had held off for fear of causing her Mum distress. She is much happier without the contact. Sometimes it's a good thing.;)
    But I fear I am hijacking this thread. Sorry, OP.
     
    Lara mfl 05 likes this.

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