Oy Vey!: August 23, 2019

Dear Rachel,

I really enjoy reading your columns and appreciate your incisive advice!

And now, here’s my dilemma. My great Aunt Gail lives in a nursing home, is 91 years old, and unfortunately has dementia. She moved to Atlanta to be close to her widowed older sister, brother and sister-in-law. At that point, she was still functional and coherent. Unfortunately, a year after she moved, her older sister, Shirley, came down with a bad case of the flu, which led to pneumonia. Within a week of her admission to the hospital, Great Aunt Shirley was no longer among the living. By then, Gail’s dementia had progressed, and she now flits in and out of reality and clear understanding. At times she seems fully cognizant and recognizes her loved ones, including friends. But within minutes of telling her something, it will totally disappear, and she retreats into her own world.

And so, a great debate was launched between me, Uncle Marty and Aunt Cindy (her brother and sister-in-law).

“Of course, you should NOT tell her about Shirley!” Uncle Marty insisted, his white moustache bristling.

“Let her stay in that little bubble of hers, content and happy,” Aunt Cindy agreed, drawing closer to her husband.

Aghast, I stared at Uncle Marty and Aunt Cindy. Withholding the news of Shirley’s death from Gail seemed cruel to me. I understand that their intention stems from kindheartedness. They don’t want Gail to feel pain. Why should she, they reason, if she’ll just forget it anyway? But when I put myself in Gail’s place (and I hope with all my heart to NEVER be in her shoes), I believe I would want to know the truth. Shirley was her beloved sister, and it is her right to know what happened. In addition, Gail has been asking for Shirley. To be told “she went out of town” incessantly will, on some level, cause Gail anguish. Surely Gail will wonder why Shirley never said good-bye, why she never comes to visit anymore. … At some point, the excuse will flounder, and I believe, will wind up causing Gail more pain than knowing the reality.

What’s your take, Rachel?

Signed,

Voting For Honesty

Dear V.F.H.,

Thank you so much for your kind words about my column.

Whoah! This is a heavy one! I’m so sorry to hear of Shirley’s passing, and I am equally sorry about Gail’s progressive dementia. It is so difficult to see a loved one fade before our eyes, to have her and not have her at the same time.

As a mere layman and not a qualified expert, I will share my feelings. I believe the right thing to do is to inform Gail of Shirley’s passing. As you so aptly expressed, it is her right, and if G-d forbid any of us faced similar circumstances, of course we would want the courtesy and dignity of knowing the truth.

My recommendation is to tell Gail the news in steps so as not to shock her suddenly. One day I would explain that Shirley is sick, after a day or so, that she is very ill, and perhaps by the next conversation, I would reveal the unvarnished truth. The ideal would have been to do this as it happened, but unfortunately, it’s too late for that. One other thing is to follow Gail’s lead during these conversations. Depending how she reacts, that’s how you should respond. If she is pained by your revelation, give her the support she craves. If she changes the topic and seems unaffected moments later, go with that flow. I would also make sure to encircle Gail with a great deal of love and empathy during these conversations, including hugs and hand holding.

Last, before venturing to speak to Gail, I advise consulting with a geriatric psychologist, just to make sure that we are on the right track and that this is the best way of dealing with an elderly person with her specific level of mental cognizance.

Wishing you the best in this emotionally laden circumstance,

Rachel