Preparing for the death of one's spouse: myth or reality?
Résumé
As hospital psychologists in oncology, we regularly accompany patients at the End-of-Life as well as their beloved ones. Numerous times the care team asks psychologists: How can one prepare for death? How to communicate that we are nearing the end? How to be sure that my loved one will not suffer? These are questions intimately related to both patients and their families.
Thanks to a larger study on the effects of deep and continuous sedation until death on the bereaved spouses of cancer patients, we met M.
M. is a 44-year-old who lost her husband 3 months ago due to metastatic renal cell carcinoma. His death occurred less than 6 months after diagnosis. They had been married for 20 years and have two children aged 11 and 16.
In her case study, analyzed through a thematic analysis, we can see how hope remains present in M. Her hope hinders this reality of imminent death despite the medical information provided and discussed previously. On a physical level, M. could not recognize her sedated husband. She felt totally helpless after the loss of verbal contact.
As for many other bereaved spouses, also for M. sedation at the end of life corresponds to killing one's beloved ones, determining the subsequent sense of guilt for failing to prevent and protect them.
Medical information about imminent death doesn’t fully prepare people. The role of defense mechanisms, of the type of attachment and of relationship with the deceased are confirmed as fundamental.
M. declares that the information provided by the team helped her in the moments following the death.
However, it is important to remember that mourning is a long-term, uncertain, and individual process. At a clinical level, it is essential to determinate the impact that some practices (as sedation) and the support relationship could have on mourning.