End of life can bring out the best in families. They can come together, tell stories, hold hands, celebrate a life, and just be present. They may have lots of questions about the dying process, about medications, about what they should be doing, and about what to do next. They may need coaching, hand-holding, education, support, and guidance, but they pull together and they pull through.
Unfortunately end of life can also bring out the worst in families. They can bicker over property and money. They can argue over care and debate treatment options. They can become mired in what they want and lose sight of what the dying person wanted.
One of the saddest things I see is when a family lets their conflicts get in the way of being there with and for their loved one. It's not just a family fighting at a bedside or in the hallway, but it's the family that doesn't communicate that gets to me. For some families it's a time for healing or letting go. I see siblings going above and beyond to contact the estranged sibling or driving the streets to find the homeless sibling. They sacrifice some of their remaining time with their loved one to try and bring repair to the relationship.
And others don't. There is so much anger in the relationship (admittedly often deserved.) The caregiver knows how to reach her siblings or his aunts and uncles or the missing grandchildren, but doesn't. As I sit with my dying patients in these circumstances, I wonder how the family members will feel when they get the call, if they get the call, that their loved one has died.
And I know I can't fix it. And I know it's not my role. And I sit with my patient and hold his hand, and play music for her, and say deathbed prayers, and try my best to be present. And I am sad for all the lost opportunities and missed chances.
