Microsoft Word Elisabeth Kubler-Ross On Death And Dying doc

full of thoughts too difficult for his age. 
 
His father took him in his arms 
and the boy asked him, 
"Where is mother?" 
 
"In heaven," answered his father, pointing to the sky. 
 
The boy raised his eyes to the sky and long gazed in silence. 
His bewildered mind sent abroad into the night the question, 
"Where is heaven?" 
 
No answer came: 
and the stars seemed 
like the burning tears of that ignorant darkness. 
 
Tagore, from The Fugitive, Part II, XXI 
 
Changes in the Household and Effects on the Family 
 
We Cannot help the terminally ill patient in a really meaningful way if we do not include his family. 
They play a significant role during the time of illness and their reactions will contribute a lot to the 
patient's response to his illness. Serious illness and hospitalization of a husband, for example, may 
bring about relevant changes in the household which the wife has to get accustomed to. She may 
feel threatened by the loss of security and the end of her dependence on her husband. She will have 
to take on many chores previously done by him and will have to adjust her own schedule to the new, 
strange, and increased demands. She may suddenly have to get involved in business matters and 
their financial affairs, which she previously avoided doing. 
 
(P140) 
 
If hospital visits are involved, arrangements may have to be made for transportation and for 
babysitters during her absence. There may be subtle or dramatic changes in the household and in 
the atmosphere at home, to which the children will also react, thus adding to the burden and 
increased responsibility of the mother. She will suddenly be faced with the fact that she is-at least 
temporarily-a lone parent. 
 
With the worries and concerns about her husband, added work and responsibility also comes 
increased loneliness and often-resentment. The expected assistance from relatives and friends may 
not be forthcoming or may take on forms which are both bewildering and unacceptable to the wife. 
Neighbourly advice may be rejected as it may add to rather than decrease the burden. On the other 
hand, an understanding neighbor who does not come to "hear the latest" but who comes to relieve 
the mother of some of her tasks cook an occasional meal, or take the children to a play, can be 
greatly appreciated. An example of this is given in the interview of Mrs. S, 
 
A husband's sense of loss may be even greater, since he may be less flexible or at least less used to 
concerning himself with matters of children, school, after-school activities, meals, and clothing. 

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This sense of loss may appear as soon as the wife is bedridden or limited in her functioning. There 
may be a reversal of roles which is more difficult to accept for a man than it is for a woman. Instead 
of being served, he may be expected to serve. Instead of getting some rest after a long day's work, 
he may watch his wife sit on his couch watching television. Consciously or unconsciously he may 
resent these changes, no matter how much he understands the rationale behind it. "Why did she 
have to get sick on me, when I just started this new project?" one man said. His reaction is a 
frequent and understandable one, when we look at it from the point of view of our unconscious. He 
reacts to his wife as the child responds to mother's desertion. We often tend to ignore how much of 
a child is still in all of us. Such husbands can be helped greatly by giving them an opportunity to 
ventilate their feelings, e.g., by finding a helping hand for one evening a week during which time 
he can go bowling perhaps, enjoying himself without feelings of guilt and by letting off some steam 
which he can hardly do in the house of a very sick person. 
 
I think it is cruel to expect the constant presence of any one family member. just as we have to 
breathe in and breathe out, people have to "recharge their batteries" outside the sickroom at times, 
live a normal life from time to time; we cannot function efficiently in the constant awareness of the 
illness. I have heard many relatives complain that members of the family went on pleasure trips 
over weekends or continued to go to a theatre or movie. They blamed them for enjoying things 
while someone at home was terminally ill. I think it is more meaningful for the patient and his 
family to see that the illness does not totally disrupt a household or completely deprive all members 
of any pleasurable activities; rather, the illness may allow for a gradual adjustment and change 
toward the kind of home it is going to be when the patient is no longer around. just as the 
terminally ill patient cannot face death all the time, the family member cannot and should not 
exclude all other interactions for the sake of being with the patient exclusively. He too has a need to 
deny or avoid the sad realities at times in order to face them better when his presence is really 
needed. 
 
The family's needs will change from the onset of the illness and continue in many forms until long 
after death has occurred. It is for this reason that family members should handle their energies 
economically and not exert themselves to a point that they collapse when they are most needed. An 
understanding helper can contribute a lot in helping them to maintain a sound balance between 
serving the patient and respecting their own needs. 
 
Problems of Communication 
 
It is often the wife or the husband who is told about the seriousness of an illness. The decision is 
often left to them whether to share it with the patient or how much to convey to him or other 
members of the family. It is often left to them when and how to inform children, which is perhaps 
the most difficult task, especially if the children are young. 
 
During these crucial days or weeks it depends a great deal on the structure and unity of a given 
family, on their ability to communicate, and on the availability of meaningful friends. A neutral 
 
(P142) 
 
outsider, who is himself not emotionally over involved, can be of great assistance in listening to the 
family's concerns, their wishes, and needs. He or she can give counsel in legal matters, help prepare 

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