Emotions and Spirituality
My mother wants to die rather than remain bedridden in a long-term care facility. How can I help her spiritually?

Your mother may be struggling with defining who she has become within her increasing physical restrictions. It is very difficult to be an observer of the suffering that comes with such a struggle.

An important first step is to ask your mother and her health care team if she has any symptoms that affect her comfort. Uncontrolled symptoms such as pain or shortness of breath can be so overwhelming that they become the main focus of the person’s life, and may cause someone to say they want to die. They can change a person’s emotional and spiritual state, and affect overall quality of life. Addressing physical symptoms will not make everything suddenly better. However, it may allow your mother to focus on her emotional and spiritual struggles.

As your mother's ability to care for herself declines, she may struggle to define herself in a new way. When her health suddenly worsens or she hears that her illness is advancing, she likely will experience a range of emotions. She may say she feels numb, sad, helpless, disappointed or angry, to name just a few possible emotions. You and other family members may have similar feelings. All of these reactions are normal. There really are no specific words that will alleviate the distress of the situation, but you can bring your mother much comfort just by being physically present.

With all the changes your mother has experienced she may be distressed or overwhelmed by her situation. This may make you feel helpless. It is one of the toughest parts of witnessing someone who is struggling with thoughts of life and death. It is important to understand that there is really nothing you can do to fix the situation. If your mother cries, this is a time to show your love and support. Hug her, hold her, and let her know you are there for her. Crying and feelings of sadness are very normal response to serious illness. If her feelings become severe she may be depressed. Ask her health care team to watch for signs and symptoms of depression, so they can manage any that occur. Let her team know if you notice any changes, such as trouble eating or sleeping, or loss of interest in daily activities or the things that used to bring her pleasure. Articles in this section describe common symptoms, including depression, that may arise as illness progresses:

The most important thing you can do is to be attentive to your mother and let her know you are there to support her. Often the most helpful thing you can do is to listen to her express her thoughts and feelings; listening is an excellent way to show you are attentive to her needs and available to her. It may also help you to determine if she needs help from the health care team in solving some of the issues she faces.

It is also helpful to say out loud that you are there to support her. Sometimes people don't say this clearly because they believe their support and intentions are obvious or understood. However, it is important to put your feelings into words. You could say something like this: "I love and care about you, and do not like to see you going through this difficult time. Please know that you are not alone. I am here for you whenever you need me." Such words are reassuring, and leave the conversation open to discussing emotional and spiritual struggles. If you feel uncomfortable starting a discussion, you may want to consider some of the tips in this article:
What Do I Say?

Your mother may find it hard to have such discussions with family. Ask if she is interested in talking with someone else. If she belongs to a faith community she may want to talk to her spiritual leader. Alternatively, her care facility may have a spiritual care provider or social worker on staff, or may be able to call on such people from the community.

In general, as your mother struggles with the changes in this phase of her life, you can be her advocate. Discuss your concerns with her health care team, and ask for their help in addressing these concerns.

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