Do they need to know when shit happens?
Delivering Bad News
Aunt Lizzie fell last week.
“Who the hell is Aunt Lizzie?” you ask? Why, she’s the coolest, most fun Deep South aunt who came from Newark, NJ in the entire world! She is also Mom’s only older sister, clocking in at 96 years old at the time of the fall.
She broke her hip in a very difficult way right inside the ball joint, and required surgery. Her Mayor didn’t have a choice—without the surgery Aunt Lizzie would have been bedridden forever. We’ve talked many, many times on this blog about the difficult choices that fall to The Mayor in times of emergency, and the tremendous difficulty with which we make these decisions. Alone.
So Aunt Lizzie had general anesthesia and the surgery she required. And her dementia went crazy. Just like Mom’s did when she had her hip surgery. I wasn’t there—this all happened in Georgia (Deep South, remember?), but I heard it was B.A.D.
Aunt Lizzie entered hospice several days later, and this morning she died. I grieve with her two daughters.
Do They NEED To Know?
So, what do I tell Mom? If anything? This is yet another of those decisions that you get to make as Mayor in your own time and in your own way.
You need to start—and end—with what is best for your loved one. This isn’t about you, Boo Boo.
Mom doesn’t NEED to know much. There isn’t anything she can really do—she has trouble signing a birthday card nowadays and she has no access to her phone or financials without my assistance. With Aunt Lizzie deep in her own dementia nightmare, they haven’t had much communication, with her Mayor and I communicating sporadically through social media.
She doesn’t NEED to know, but she has a RIGHT to as much information as she can handle, in my Mayoral opinion.
Choose Your Time Carefully
I held the news of the fall for several days, since we’ve been having a lot of trouble with Mom being off-center and not quite herself lately. It hasn’t been a good summer at the facility, with visits being punctuated by random thoughts and requests for dead people to come and visit. She’s been sundowning before the sun comes up, frankly.
But, the other day, Mom was having a great day. The first really great day in months, honestly, so I thought I should let her know about her older sister. In “real life”, she would absolutely want to know, so I decided she should be aware of what happened.
Choose Your Words Carefully
Get a hold of yourself
This isn’t the first bad news I’ve had to deliver to my parents in my lifetime. Mostly clearly, I remember when Nanny died, and my parents were at sea on a Panama Canal cruise. Back then, I couldn’t even speak to them immediately, but just had to relay the message through the cruise line. Nowadays, I’m actually the ‘parent’ in the situation, so I need to be calm when I speak to Mom. It wouldn’t help her process her own feelings or emotions if I sat there bawling like a baby, so it is important that you be calm, relaxed and focused when you decide to share the important news.
Share information clearly
I started the conversation asking Mom if she remembered her own fall and broken hip. I reminded her of how scared she was, and how frustrated with the recovery process she had to endure. Then I explained to her that a similar fall happened to her older sister, and shared with her the care plan. By relating it back to her own fall several years ago, it was easier for her to envision both the fall and the recovery, remembering that no matter how hard it was, she had, in fact, recovered.
Prepare for their reaction
My parents are pretty solid, stoic type people—children of the Great Depression—so I expected a relatively calm response, even through severe dementia. Nothing, and I mean nothing, could have prepared me for Mom’s reaction to this news. She stared for a few seconds, processing. Then, she rolled her eyes, shrugged her shoulders and said…”Shit happens”.
Explaining What Happened
Talk about examples
When you are explaining whatever the news is, the more you can relate it back to your loved one, the more likely they will be able to process the news. Whether you are delivering difficult news or family gossip, the more connections you can make, the easier it will be for your elderly loved one to understand the information you are sharing. That’s why I started the conversation with memories of her own broken hip and hospital stay. You can do the same with almost any news you are sharing with your person.
Talk about the person
We don’t talk about Mom’s sisters every day. It’s not that we avoid talking about them, it’s just not a daily topic. So, we spent a good amount of time talking about Aunt Lizzie, and how her life has been in recent years. We talked about when she moved out of her home and into the facility, and how much she enjoyed the social aspects of her nursing home. We talked about the last time they spoke, and how happy they both were to chat.
Share distant memories
Remember that a facet of dementia is that decades-old memories are very clear, whereas recent happenings are a blur. Capitalizing on that, we spent a good half hour talking about Aunt Lizzie when she was just a girl. We discussed all of their different living situations when they were young and poor, and about Aunt Lizzie moving to Georgia as a young bride. These are the types of stories that put the glimmer in Mom’s eyes, so we focused on those olden times as much as we could.
Talk about what’s next
I used Mom’s own experience to talk about what my dear Aunt Lizzie would be facing—the rehab and the physical therapy and trying to walk again on her own. It is a daunting process, but talking Mom through it made her feel better about Aunt Lizzie’s recovery.
Revisit The Subject
These conversations definitely aren’t “one and done”, as we will continue talking about Aunt Lizzie as she goes through recovery and hopefully ends up back in her own facility in Georgia.
By bringing the subject up two days later, I gave Mom the opportunity to talk about anything she had been thinking about. She was actually more upset by the news this second time we spoke, probably because she had some quiet time to reflect as best she could on the long recovery road facing her beloved sister.
Remember, when you revisit the subject, due to the dementia it just might be like you are telling them for the first time, so be careful to keep your facial expressions neutral until you determine where they are in processing the news. I’ve had many topics that I thought we were revisiting turn into a total reconstruction of the “first time” Mom was hearing something.
Prepare For Different Reactions
With severe dementia, you just don’t know what you’re going to get, so be ready. Really, with the elderly, news of a sibling’s illness could provoke any number of different reactions, which is why it is so important that your own feelings and emotions are in check.
Nothing, and I mean nothing, could have prepared me for Mom’s reaction to this news about her sister, Lee. She stared for a few seconds, processing. Then, she rolled her eyes, shrugged her shoulders and said…”Shit happens”.
Sweet Husband and I were completely stunned. While we tried desperately not to laugh at Mom channeling her own mother, Nanny, in her reaction, I responded. “It sure does, Ma”.
Sometimes GOOD Shit Happens, Too!
As a Mayor, you know just how difficult The Job can be, and at no time is it worse than having to face the pain and misery of your elderly loved one. Being the bearer of all of the bad news in the entire family is a difficult and sometimes soul-sucking endeavor.
But it’s The Job. And I do it with love and compassion.
Mom continues to live an amazing life filled with joy and love. That life, however, comes at a cost, and sometimes the bad news comes.
I also get to deliver the fantastic news. Just not today.
Follow-Up
Last week, Aunt Lizzie passed away. We grieve with her two daughters in Georgia, and wish her well on her travels to see her beloved husband and parents.
THANK YOU FOR READING THIS FAR
Wow! You made it! Thank you for reading about if they need to know!
Hey, since you’re here! You may as well check out therapeutic lying, here, or if you’ve read that, check out more dementia problems, here! Or maybe you want to hear more about Pop, here. Or, check out our other topics here! Either way, I appreciate you!
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