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Dr. B. J. Miller, specialist in palliative care

Dr. B. J. Miller, specialist in palliative care

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Dr. B. J. Miller, specialist in palliative care

When most people think about the impact of a terminal illness on a loving relationship, they imagine the tension – a heavy weight that crushes the tenderness between two people. But in fact, working for 20 years as a palliative care doctor has taught me that the opposite can be true.

A patient with advanced stomach cancer told me that he and his wife were closer to each other than ever when his cancer returned, their marriage "awakened again."

As his wife put it: "It's easier if we're dealing with the disease, because we feel like we're doing something together."

I have seen sickness marriages rescued, divorced couples at the end of their lives, and estranged partners who enjoy taking on caring tasks.

Last week I explained how it is possible to achieve a stress-free and peaceful death in the middle of the heartache, and I gave 30 practical tips to help you achieve this.

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This week I will look at how relationships in this phase of life can be both challenging and rewarding.

It can be an incredibly tender time between two people, full of forgiveness and showing people how much you love them.

Remember why you fell in love

When you get a terminal diagnosis, one of the biggest shocks is adapting to daily activities and tasks that you can no longer do.

Similarly, partners must face their new role of caregiver or nurse. This can make the relationship feel strange, putting intimacy at risk.

Here are some ideas that protect you against the feeling that too much is being given away from you.

1. DO NOT FORGET EACH OTHER

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Choose a night every week and do something that is not about illness. It must be something that both of you enjoy – perhaps as simple as playing a card game – as partners or as a whole family.

And think about why you fell apart in the first place: the old jokes that you shared, the books you read, the pictures you took, the restaurants where you ate. Even if those things are not practically accessible right now, just remembering them can be powerful enough to provoke an emotional connection.

Consider why you fell apart in the first place: the old jokes you shared, the books you read, the photos you took, the restaurants you ate (stock image)

Consider why you fell apart in the first place: the old jokes you shared, the books you read, the photos you took, the restaurants you ate (stock image)

Consider why you fell apart in the first place: the old jokes you shared, the books you read, the photos you took, the restaurants you ate (stock image)

2. CONTINUE YOUR KNOWLEDGE

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Maybe you deal with the bills and your partner cooks, or you are the calendar holder and they are the washing monitor. But what happens if a person is consumed by illness or is no longer around?

It is painful to introduce yourself, but it is kind – for both of you – to do these tasks. Perform two tasks each week from each other's roles.

3. FIND A LITTLE HAPPINESS OF HAPPINESS

The new, weird reality of hospital visits and drug reminders can feel strange at first, but you can make it yours by choosing new, enjoyable rituals.

Stop in a park or ice cream parlor after every appointment. Share a sip of sherry during medication or try a kiss per tablet.

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Dealing with illness means you can forget to remind your partner that how they feel is also important. If they feel self-evident, give them a small sign of appreciation – a squeeze in the hand or a flattering comment.

NO SEX IS NOT THE END FOR INTIMACY

If you are sick, one of the first things that can be neglected is your physical relationship.

Then there is the emotional turmoil of a changing body – surgical scars, the loss of body hair and weight gain barely act as an aphrodisiac.

It can feel extravagant or even dangerous to bring pleasure to your body. But I have patients who remained active until the end – one died in the hospital during a moment of sexual intimacy (for the sake of clarity, it was his cancer, not that act that killed him).

It can feel extravagant or even dangerous to bring pleasure to your body. But I have patients who have remained active until the end (stock image)
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It can feel extravagant or even dangerous to bring pleasure to your body. But I have patients who have remained active until the end (stock image)

It can feel extravagant or even dangerous to bring pleasure to your body. But I have patients who have remained active until the end (stock image)

1. CAN I HAVE EVEN SEX?

Sex after treatment may feel different – you may feel numb or extra sensitive. Alternatively, your self-confidence, limits and energy may have shifted. A frank conversation with a doctor or nurse is a good start. If you are concerned about safety, this should be delivered scoreless: & # 39; Is it safe for me to … & # 39;

2. DO NOT FEAR THE HOSPITAL BED

… but breaking bad news is not easy

There is no easy way to tell your loved ones about a life-limiting diagnosis. First, make sure everyone is at ease – take a dose of painkillers as needed before entering into the difficult conversation so that the pain does not interfere with your ability to think clearly.

Prepare people by saying, "I have a hard time sharing news."

Be direct with what you need from your loved ones and how you feel. It can just be a confession such as: "I don't know what I need – just sit here with me!"

Keep in mind the pecking order of children, because whoever you call first can make a big difference. Organizing a family meeting or telephone meeting can work better instead.

Come to employers with a plan – what will your illness require of you and are there strategies that can cover your work?

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If you think the news has led to discriminatory action, contact your HR department or ask for independent legal advice.

And for the people who respond, don't be afraid to keep a little silence, even for a few seconds. It offers room for deeper emotions.

Do not tell people to think "positively" and do not compare their suffering with someone else's or project your religious beliefs.

Know that just being there is the real balm.

Medical equipment can cause physical barriers that suggest that you should not touch. But don't let the tubes, needles or hospital beds stand in your way.

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It is perfectly legal to lie next to someone in your bed. After all, those side rails are retractable.

3. IT IS NOT ONLY ABOUT INTERCOURSE

I had one patient who was left impotent thanks to medication and was afraid that his wife would leave him if he told her. Her response? She was relieved.

Studies show that hugging for a few minutes helps to calm the nervous system. There is a lot of body beyond the groin, and every part can become erogenous. Find a patch that doesn't hurt and start there.

… BUT DON'T BE AFRAID OF SPLIT

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Yes, some people break up at the end of their lives. It is not necessarily as destructive as you might think.

It can feel cathartic to let go of a relationship that sucks up precious air. But before you do that, consider practical details, such as to and from appointments, and make sure you have a different way of support.

A doctor, nurse or counselor can familiarize you with local services.

And if you are dependent on a spouse for financial support, a split – provided that it is amicable – does not always mean that you have been cut off.

One of my patients asked her ex-partner if she could continue to use his insurance plan until she had finished her treatment. He said yes, and it stayed that way until she got her own plan a year later.

People always make such deals, so don't let it stop you from pursuing real happiness.

  • A Beginner & # 39; s Guide to the End: How to Life Full Life and Die A Good Death, by B.J. Miller and Shoshana Berger, is published by Quercus and costs £ 20.

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