A Decalogue: Ten Commandments
for the Concerned Caregiver
by Rabbi Earl A. Grollman
Living With Grief:
When Illness is Prolonged
edited by Kenneth J. Doka
with Joyce Davidson
Hospice Foundation of America
Grieving is hard work-- work that tears at you in so many ways. Grief
taxes every part of you-- body, soul and spirit. And when loss comes after
a prolonged illness you may feel that you have twice as much work. And in
many ways, you do-- for you are grieving both during and after the
There really are no commandments in grief. But I offer this
decalogue, a list of ten recommendations, to help sustain your spirit as
you grieve. For those of you who are not family members or friends, but
caregivers-- nurses, doctors, clergy, counselor-- this decalogue is for
you, too. Your calling is not only to minister in whatever way to the
spirit of others-- you also grieve, and you must sustain your spirit. Only
by struggling with your own healing can you help others heal.
DURING THE PROLONGED ILLNESS
I. Be Realistic
"I believe God creates miracles. No matter what the doctor says, he'll
get better. You'll see."
A Jewish expression states: "Believe in miracles but be prepared for
alternatives." William James said it differently: "Acceptance of what is
truly happening is the first step to overcoming the consequences of
Of course, you don't want to accept the diagnosis. You can't imagine that
your loved one is so sick and will die. Feelings of vulnerability mount.
Suddenly you realize that you are not in control. The truth is that no one
is as powerful as he or she would like to think. And some miracles may not
happen. When you cling to false expectations, you distort the present and
postpone the future. Truth challenges you to understand what the human
being is capable of enduring.
Think in terms of possibility-- not impossibility. There will be
moments when you want to believe that all is back to normal and that your
prayers are being answered. Then an event takes place where actuality
forces you into a downward plunge. Though reality is harsh and unfeeling,
it is the compass which keeps you on track, a directional guide to aid you
through your painful journey.
If there is a sin against life, it consists not so much as
despairing of life rather than in hoping for another. --Albert
II. Be Informed
"I'm so confused, I know my loved one is seriously ill but I honestly
don't completely understand what is really wrong with her and what I can
do to help."
The natural coping mechanism of defense is to shut out potentially
agonizing news. Yet to cope with adversity, you must speak with the health
professionals to understand the impact of the illness and how you can be
of the most assistance.
Before speaking to the doctors, organize your thoughts. Concentrate on
the real concerns: diagnosis, prognosis, tests, treatments, procedures,
research findings. Ask specific questions. Stay on track. Delve into
important matters. Don't be embarrassed to share your real fears and
anxieties. What really needs further clarification?
Concentrate. Actively focus your attention on what is being expressed.
React to ideas, not to the person. Don't interrupt. And remember to
listen. Your listening rate is faster than your speaking rate (Speech rate
is about 100 to 150 words per minute; thinking and listening is eight
times that fast.) It is you who must hear, understand and learn in order
to help your loved one and yourself.
God in Hebrew is called Rofé, meaning healer. But says Ecclesiasticus:
"Honor the physician whom the Lord hath appointed."
III. Be Caring of Your Physical Health
"How can I help my loved one when I'm so tired all the time?"
For of the soul, the body form doth take
For soul is form, and doth the body make.
Just as your heart aches, so does your body complain of severe loss of
appetite, insomnia, fatigue. It is so draining to care for your loved one
Walking can be an energizer. Adrenaline pumps through the body as you
are revitalized, which can lead to feeling, eating, and sleeping better.
As you move your feet, your mind begins to clear and the sinking feeling
in the pit of the stomach may gradually begin to disappear.
You might benefit from extended activity, such as jogging, tennis,
swimming, aerobics. Exercise produces powerful stress-reducing effects,
fending off anxiety and depression, reducing risks of coronary mortality.
Be sure to check first with your physician. Then build your endurance
gradually but surely. At this time of apprehension and stress, respect
your body more than ever. You must maintain your health if you are to
effectively take care of yourself and others.