Loss is an emotion, both common and unique. Common because everybody experiences it, unique because the person you lost is irreplaceable. When people talk about what it feels like to lose a loved one, it's surprising how they choose the same words. They say they are angry, lonely and heartsick. And another word people say just as often is guilt. It seems it takes a little longer to recognize the feeling of guilt, and it usually comes up in a sentence that begins, "I only wish I had . . .." It's natural to feel anger over losing someone or to feel lonely or brokenhearted, but the combination of guilt with grief, although prevalent, is harder to understand.
Guilt is accusing yourself of having done or said things for which you're sorry or reproaching yourself for having neglected to do or say things that now you wish you had. Some sense of guilt is inevitable, because we can always think of things to regret and things that could have gone better. We need to be careful here, lest we fall into a deep pit of self-reproach. The truth of the matter is that most people are quicker to accuse themselves than they are to forgive themselves. But if you become your own prosecutor, who then is your defender?
In our experience at Continuum Hospice, we know that the feeling of guilt at the death of a loved one is usually focused in three areas. The first is the guilt associated with memories of the one we lost and the relationship we had with him or her -- the kind of thing I mentioned above and shall discuss further ("I just wish I had . . . "). The next area of potential guilt may be that connected with anxiety over whether our loved one received the best available treatment and care. And the third area is the feeling of guilt around our being the ones to survive.
It Should or Could or Might Have Been
The finality of death makes us realize that there will not be opportunities to talk with our loved ones any more. No more chances to say, "I love you" to them and make sure they know it, or to hug and kiss them, and no more chance to say "I am sorry, please forgive me."
Difficult as it is to see a loved one decline and fail and finally succumb to death, no time has greater value than the days and hours leading up to the end. Although, it is no less sad when someone dies expectedly than suddenly or accidentally, one great aspect of hospice is that our care does afford the opportunity to take advantage of whatever time is left to talk with our loved ones. Even in cases where loved ones can no longer respond verbally, most family members and friends talk to them trusting that they probably do hear.
If you were able to speak with your loved one before death occurred, you may have found an opportunity to reaffirm your love and apologize for past mistakes and become fully reconciled. Moreover, your presence with them may have provided the occasions they needed in order to give voice to the matters on their mind and heart.
Are there now still things that you feel the need to say? Some people visit the cemetery. There, at the gravesite, they speak through silence or sighing. Other people whisper to their loved ones at night, as though their bedmates' aura still rests on the pillows. And some folks that yearn for an acknowledgement of their feelings of guilt, desiring to hear a word of forgiveness for their shortcomings, will speak to a spiritual counselor, a member of the clergy, a relative or trusted friend.
Was the Care There?
One strand of a silver lining around expected death is the focus that hospice care brings to treatment decisions. As denial is replaced with honesty, pain controlled and symptoms managed, the assurance of maximum comfort care becomes paramount, even as medical science continues the quest to discover cures.
If you find yourself asking whether you did everything possible for your loved one -- from a clinical point of view -- consider the reasons you chose hospice. Perhaps the medical treatments, pre-hospice, were becoming so burdensome that the "cure" was literally worse than the disease. Discerning the difference is never really easy, but once the decisions are made, most people find that a sense of peace supplants anxiety.
Many people come on to the hospice program because they want to be in their own home rather than a hospital. Oftentimes, the quality of life at home is so vastly preferable, particularly when relatives are nearby, that the wisdom of choosing hospice becomes immediately evident. Perhaps your loved one was treated with palliative care in the hospital. Wherever the end came, remember that you helped to assure access to excellent physicians, caring nurses and spiritual counselors, as well as, in many cases, social workers, home health aids and volunteers.
It is hard to imagine feeling guilty for providing the most appropriate and excellent care available for your loved one during the end of life. Just the opposite! You recognized the wisdom in ceasing to do what was called for once and beginning the right thing at the right time, and there is no guilt attached to that.
How Can I Go On Living?
Grieving through the guilt means that we understand it to be natural. It is something we get through by living through because it is pretty hard to escape or avoid it. An almost universal aspect of guilt is the feeling of remorse, not only over having lost a loved one, but also for being the person to survive. Often we feel that we ourselves are the ones who rightly should be gone and that they should be alive. Which is frequently the case when younger spouses or younger siblings die before elder ones - and unquestionably true when parents lose children of whatever age.
Death always reminds us how little we control life or destiny. Our best-laid plans for the future are apt to go astray. It is normal to feel some guilt for being the one who escapes death when people we love have died. But this speaks more to the randomness of disease and the uncertainty of life than to the question of who deserves to be alive.
To ask whether your own life is now justified is beside the point. The point is, feeling guilty for being alive is hardly a formula for health and happiness. One of the greatest testimonies we can give to the memory of our loved ones is to live life fully. It is almost as if we have a duty to live for them, as they would be doing now, if somehow, they were with us again.
Whatever has happened in the past, the future needs to be less about self-accusation and more about the possibility of forgiveness. In this way we will gain confidence for today and hope for tomorrow. As the burden of guilt is lifted, fresh opportunities become clear - opportunities to move through the angst, to accept that we are acceptable, and to love not only the life we miss but also the life yet to be.
This meditation was written by
the Reverend William Purdy, STM, DD
Copyright (c) 2004 All rights reserved
This publication is made possible by a gift from Roland DeL.Rinsland, Ed. D.