Ambiguous Loss and Anticipatory Grief

I wish I had known about ambiguous loss and anticipatory grief much earlier in my life.

In yesterday’s post, I alluded to my Dad’s transition into residential aged care. 

Today, I want to share some knowledge I have gained over the past few months, because I have found it enormously helpful and therapeutic in dealing with my own experiences and feelings.  I am sure I wasn’t the only person who didn’t know these things, and my hope is that others will benefit from these insights. 

My father has become increasingly frail, and even though I knew the time was coming, making the decision to move him into residential aged care was incredibly painful. For him, it was a loss of independence, his home, his cat and my dog. His sadness was profound, and completely understandable. Still, he was very thankful — as were my siblings and I — that he could move into an excellent place where the care is consistently empathetic and kind, where the food is good, and where he can have his own things around him. 

My emotions, too, were complex. I felt guilty, even though I knew it was the right time and the right thing to do. No loving child wants to see their dad leave behind the life he has known and the things he has accumulated, and no loving child wants to see their Dad so sad. 

I experienced a very real sense of grief and loss while packing up his things, setting up his room, and helping him transition to a new phase of life, There was more to it, though, and often I didn’t know how to express what I was feeling. 

Through my research and reading, and through wonderful constructive advice from friends who have been through similar situations, I have come to understand that many of the things I am experiencing are encompassed by two terms: ambiguous grief and anticipatory grief

I had never heard of either one until recently, and I think they should both be much more commonly known.

Ambiguous Loss is a kind of grief experienced where there is no distinct end or no closure. Generally speaking, it arises from an emotionally painful or turbulent situation that one is going through, and which doesn’t have an “end date”. The reasons for grief or a profound sense of loss might be indistict, or complex, or unidentifiable at the time. Sometimes the grief masquerades as anger, frustration or overwhelm. To experience ambiguous grief is vague, exhausting and indefinite in more ways than just the timeline. 

It’s that mixed feeling of sadness at having to make big decisions that we didn’t feel ready to make, and thankfulness that things worked out perfectly when we needed them to.

It’s the sadness we felt at making decisions about what to do with his things, and asking my best friend to adopt his cat, even though he is still with us.

It’s the sadness I feel at saying goodbye and leaving Dad behind every evening, knowing he is safe and well cared for in his new home, but also that he is no longer ‘at home’. He is exactly where he needs to be, and I love it and hate it at the same time. 

Anticipatory Grief occurs when one realises or acknowledges that death is approaching, or even just a likely outcome. 

This is what I have experienced on a number of occasions when Dad had a health crisis and ended up in hospital. Most vivid in my memories was March 1st this year when I had followed the ambulance to the ER in the wee hours of the morning. When I got there, instead of being taken through to see Dad right away as I had always been before, the doctor on duty actually took me into a little room and  had “the talk” with me to made sure I understood how precarious Dad’s condition was, and that he might not make it this time. To his relief, I was fully aware of that. I suppose many people are surprised by it, or in denial, and I totally get that, too. It’s the natural reaction but, having been there more than once, it is no longer my default. There was no dozing while I sat by my father’s bed that night: instead, I spent hours composing the message I would send to my siblings, and another that I would send to other family and friends, at a decent hour of the morning. 

This is what we felt when packing up Dad’s things for his room at the home, and when sorting and cleaning out the accumulation of papers, trinkets, and household items in his house. Those are the sorts of things usually done after someone dies, not before. Still, it had to be done. 

Similarly, putting his wallet and the jewellery box containing my grandfather’s wedding ring and Dad’s much-loved pocket watches in a special spot in my own house for safekeeping felt strangely poignant and painful and incredibly sad. 

This is what I go through every time Dad has a episode of poor health, or gets an infection, or can’t express why he doesn’t feel good. It happens when he has times of vagueness or confusion, and when he can’t find his words All of those things are happening more often than they used to, so the sense of grief increases as time goes on. 

What I have learned thus far is that ambiguous grief is a very real and important part of the emotional process, and that my feelings don’t always have to be understood to make sense and be accepted as valid

In hindsight, I wish I had understood both of these realities when my mother was diagnosed with dementia, when she went into care, and when she didn’t know who I was anymore. My father, siblings and I were grieving the loss of the person she had been long before she actually passed away. When she died, it felt like it was my mother and someone entirely different at the same time. I felt so guilty about feeling that her passing was a liberation for her and a relief for us, even though my grief was as desperate and profound as ever. I was angry at myself for not knowing how to feel. 

At least this time, with experience and some knew understandings, I can accept the vagueness and complexity of my feelings, which can change from one moment or one day to the next, and just let it be whatever it is. I can cherish every moment with Dad and grieve at the same Time. I am free to laugh and cry, to tell my siblings the stories that are simultaneously sad and funny, and to live each day as it comes without having to explain to myself or anyone else why I’m a mess. 

As awkward and painful and weird as that may be, but I think it’s a healthy way to be. Still, I know I need to manage all those pesky feelings so I stay healthy, too. 

So, I try to make sure I talk honestly with my husband, siblings and closest friends about my thoughts and feelings. My sisters and brother are feeling the same things, and they all live interstate, so keeping them in the loop and encouraging them to express their feelings are hugely important, too. 
I allow myself to cry. ‘Being strong’ is rubbish. 
I refuse to beat up on myself when things are tough, or if I don’t achieve everything on my ‘to-do’  list. 
I remind myself to take each day as it comes.
I remind myself that we are doing the best thing for our dad, and that he is being expertly and compassionately cared for.

And every single day, I hold Dad’s hand and I tell him I love him. Because, throughout this whole process, Dad being sure of that is the most important thing of all.  

Different Kinds of Grief‪
#EmotionalIntelligence #emotions #grief #feelings #MentalHealthMatters  #MentalHealthAwareness‬ #personal #blogpost 

Helpful Reading: 

What Is Ambiguous Loss? 

Ambiguous Grief: Grieving Simone Who Is Still Alive 

How To Deal With Ambiguous Loss

Grief Before Death: Understanding Anticipatory Grief

Grieving Before A Death: Understanding Anticipatory Grief

87, Not Out.

Happy 87th Birthday to my Father.

My father was born on November 17, 1931.

Just for context, the world was still in the grip of the Great Depression, Hitler had not yet risen to power in Germany, Thomas Edison had just passed away, and Al Capone had just been sent to prison for tax evasion. Don Bradman was playing cricket for Australia and Phar Lap had won

My father grew up in Rotterdam in The Netherlands before moving to Australia with his parents and sisters. Life was certainly different after WWII, and even more different on the other side of the world where the seasons were back to front, everyone spoke English, and water swirled down the drain in the opposite direction.

If someone had told Dad in 1951 that those were not the biggest changes he would encounter in his life, he probably wouldn’t have believed them. There was, however, so much more to come, such as:

Marriage. Dad and Mum married in 1953 and enjoyed almost 58 years together.

December 19, 1953.

Four amazing and incredibly talented kids.

Yep, that’s me giving the photographer the stink eye. Cute, eh?

Colour TV.
Electric typewriters.
A change of career from industrial chemistry to bookstore owner.
Computers.
The CD.
Mobile phones.
The Internet.
Smart phones.
Digital books and music.
Studying online.

Dad has taken it all in his stride. He hasn’t let new things scare him off or make him feel obsolete. Time after time, he has shown his willingness and aptitude to give something new a red hot shot.

He hasn’t always found new technology easy, but once he’s got the hang of it, he’s proven that he can send a text or an email, make a call, and waste time on Facebook and Instagram as effectively as anyone can. He has been studying Biblical Hebrew online. He has the Kindle app on his iPad, on which he reads the books his daughter has written, which he has purchased online from Amazon. He also uses the iPad to listen to his son’s sermons and keep in touch with his relatives around the world. His grandchildren send him pictures of their kids via instant message, and he saves them on his phone to look at them again later.

I’m proud of my dad. Things aren’t always easy for him now, especially health-wise, but he’s still going and he’s still doing his best to enjoy all those things that make his life interesting and entertaining.

At the age of 87, he is not only the father of four but also grandfather of seven and great-grandfather to six.

He’s had a quiet day today, but he has been spoilt with a few special treats and received some phone calls from friends and family that he has really enjoyed. We’ve enjoyed some time together, too, and I treasure the moments where we can still just hang out and enjoy each other’s company.

I know it won’t last forever. Nothing does.
But my dad is still on the wicket with a score of 87, not out. Howzat?

My Favourite Escape.

When life takes an unexpected turn, there is no better place to escape than into a book.

What a week!

It was the first full week back at school with students after the summer break. New students, new classes, new schedules, new demands.  Not only was I ready, I was keen! I was determined to get through the week without falling in a heap.

The first day was great.

Then, just after recess on Wednesday, I got a call from my local medical clinic. My elderly father was unwell – again – and was on his way to hospital in an ambulance. Everything stopped except my mind: Is this it? Is this the beginning of the end? Must let the others know. Must tell the boss that I have to leave work. Must keep breathing. Can’t breathe. Okay. One thing at a time. Call the boss. Explain. No – don’t fall apart now. You don’t have time. 

I got to the hospital half an hour ahead of Dad because I work in town and the ambulance had a 45 minute trip, plus some road works to negotiate. I completed the necessary paperwork for him, and sat down to wait.

Waiting rooms suck on a major level. You sit there, surrounded by other people’s pain and misery, feeling alone and fearful, and trying to keep everything under control in your own overactive imagination – it’s quite some challenge.

reading-wonder.jpegSo while I sat and waited, I took refuge in a book. It didn’t stop me from looking up every time an ambulance rolled in, wondering if that was Dad being wheeled in. It didn’t stop me checking my phone and answering messages and questions from my siblings. But it did give me somewhere to go.

For the six and a half hours that I sat by Dad’s bedside in the Emergency Department, with medical questions answered and initial treatment under way, I escaped back into the book whenever I could. Dad knew I was there, but he wasn’t up to conversation. Reading someone else’s story kept me from focusing on my own, and it kept me from being overwhelmed by the flood of emotions that threatened to sweep me away while witnessing the pain and distress of my increasingly frail father.

After a somewhat tearful journey home, I thought I might be exhausted enough to fall asleep as soon as I got to bed. Nope. No such luck. Yet again, it was a book that came to the rescue. It didn’t put me to sleep, but it did relax me enough to be able to rest.

Taking refuge in a book is something I have often done in the troubled times of my life. Over the past couple of years, that has taken the form of both reading them and writing them. There are times, though, when I can’t write because the pain and fear is actually too close to think about at that level of depth. Wednesday was one such day.

Thursday was a blur of medical consultations, visits with various physical therapists, and further tests for Dad. Thankfully, at the end of all of that, I was able to bring him home again. It will take time for him, and for me, to recover. There will, undoubtedly, be further moments when I feel the need to make the world around me stop by escaping into a book.

Today, I’ve tried to catch up on the things I’ve let slide over the last few days. I haven’t quite managed yet to pick up all the threads again. I use Buffer, so my Twitter feed has kept on rolling, but many other things, including my writing, are at a standstill. Social media has only had the occasional cursory glance. I’ll get there – but not today.

For now, I’m thankful that Dad and I both survived the week, and that things are starting to return to normal.

And to the authors who continually craft such brilliant stories for me to escape into: thank you, from the bottom of my heart.  Your gifts mean more to people than you realise.

 

 

 

My Father’s Childhood Memories of Christmas

Today, I took the opportunity to ask Dad what Christmas was like for him when he was young.

I spent some time in the car with my father today, and as we travelled the presenter on the radio was asking people to call in and talk about family memories and traditions at Christmas time. This was a great opportunity to ask Dad what Christmas was like for him when he was young, so that’s exactly what I did! 

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My father grew up in Holland during the Depression and World War II. His family were not really poor, but neither were they rich. My grandfather worked very hard to provide for his family, and both he and my grandmother managed their resources carefully. 

The house was usually not decorated much for Christmas, but they did have a Christmas tree lit with candles. Dad also remembers the large fir trees that were put up in the churches, almost as tall as the roof.  Some were lit with electric lights, but most were lit with candles. As many churches were built of wood, this was a cause of many fires. I can understand how the sight of such a big tree, lit and decorated, in a church would imprint itself on the memory of a young lad. 

Christmas was a time when family would visit and often put on Christmas plays for one another. It was usually the children, but sometimes grownups too, who  would act out  the story of the first Christmas or plays about Sinterklaas and his companion, Swarte Piet.  A play like this was usually the only observance of the St Nicholas tradition in my father’s family, although for some Dutch families, Sinterklaas is almost as big a celebration as Christmas itself. By the time Dad was a teenager, it was more common for people to listen to stories or plays on the radio than to perform them at home for their relatives.

 

Gifts were generally not exchanged by adults, but the children received a book as a gift.  Dad also remembers that this was the time of year when children of a certain age – probably 11 or 12 years old – were presented  with a Bible of their own by the Sunday School of their church. 

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I can’t imagine how strange their first Christmas in Australia must have seemed to them in 1951. Even then, it would have been such a world away from how we celebrate Christmas now. Commercialism and materialism have seen to that.

2013-12-24-19-07-20.jpgHaving just turned 86, Dad celebrates Christmas on the other side of the world in the heat of summer, with trees illuminated by LED lights, a plethora of Christmas movies and ‘Carols by Candlelight’ concerts on TV . Family is still a focal point for all of us – my grandparents’ values have been firmly imprinted on us in that way, even if we do indulge in giving and receiving gifts that are generally luxuries. Dad, his sisters, and their families are spread across this enormous continent, so visiting happens via Skype and phone calls, while photos and news are shared on social media. 

I do like to think, though, that there is still a sense of wonder at a pretty Christmas tree being lit up at night, and I hope that people stop to hear and reflect on the story of Christmas that goes beyond reindeer, presents and “being good”.