I had a request from one of the facilities we serve to visit one of their residents. This man had some tremendous losses in the past year. His wife, who had dementia, had died rather suddenly some months ago. He also had a stroke which affected his speech and mobility, requiring him to move in to the facility as well. I spoke with his daughter before visiting and she spoke of how concerned she was for him, saying he had talked with his physical therapists about how depressed he was.
I met with “George” and his daughter the following day, and what I saw was actually pretty remarkable. George did have a lot of difficulty speaking, but it was not as bad as I expected. Although he was in his mid-80’s, he could have passed for someone much younger. He had a nice room filled with pictures of the travels he and his wife had taken, as well as pictures of their children and grandchildren. He proudly wore his “Penn State Football” sweater, telling me that his grandson goes there and plays football. He struggled in his wheelchair at times, and you could tell that this was not a person who was content to sit still for long.
He did not seem to be someone in deep mourning. Yes there were tears, but they were good and appropriate tears. When we talked about his losses, he acknowledged them as well as his feelings of sadness. He had lost his wife, his home, his car, his mobility, his lifestyle, his speech, and over time several of his friends. I asked how he coped with all these hard changes, and he said clearly and thoughtfully, “I gave it all away. You go with the flow.”
As we talked it was apparent that although he had many losses and challenges he also had a great deal going for him. He had a lot of support, from his family who visited daily to the staff and therapists he interacted with. His faith also was a tremendous benefit. He was Catholic and had considered joining the priesthood before deciding to marry and becoming a math teacher. He attended his wife’s Methodist church as well as his own, and continued to be involved in religious activities as well as personal devotional reading.
After spending some time talking about his losses and prior life, I asked him, “those are all things in your past, what does your future look like?” This question struck him visibly as one he hadn’t considered, and after some thought he said through tears “I want to walk again.”
This response made his daughter defensive and maybe a little embarrassed. “Dad, you know that’s not going to happen.” I encouraged him to talk about this more though. He felt that he could get stronger and maybe even live independently again. He felt that even though things would never be the same, perhaps he could somehow be who he once was.
This hope, as unrealistic as it probably was, was incredibly important for him. It gave him energy and purpose in a time where both were sorely lacking. Those who go through dramatic changes like George’s can become lost and purposeless, leading not only to depression but to despair. It’s often here when grief becomes complicated and “stuck”. Many of those I help who are going through complicated grief feel this way, that what they’ve lost in the past has deprived them of their future and they can’t picture any other possible future. It is a profound loss of any hope – not only of things being better but of even being anything other than what they are right now.
This is one reason why hope is so important to us as human beings. The loss of hope makes us feel powerless and helpless. It’s a feeling that not only are my hopes and dreams for the future lost but that in some way I am lost as well. I can hear that despair when I call to offer my help and am told, “you can’t help me.” I’ve found that whenever I’m told that, it’s often true.
Maintaining and restoring hope though can be tricky sometimes. Take the interaction between George and his daughter. She wanted him to have hope and peace, but only what she thought was a realistic way. Unrealistic hope, it’s thought, can only lead to disappointment and despair because it is doomed to fail. “Better a harsh reality than a false hope,” some might say. She sought to protect him from that potential failure and the pain it would cause. However in doing so she didn’t see that she was taking away the very thing that would help him move forward through his pain. In hospice we are challenged sometimes by the hopes of our patients and families because they may go against what we feel is best for them or even be harmful. In some cases these concerns are valid: hoping that an elderly man with late-stage dementia will be OK on his own all night is not a realistic or safe hope. It is a false hope, one that causes more harm than good. At other times though that hope is giving them a purpose and meaning that should be supported and not thwarted, even if it’s not realistic. Was George ever going to go back to his old life? No. But he could recover some of his mobility, and the journey to do so was going to give him purpose and also provided much-needed support along the way. His hope, really, was not to walk but to heal.
As Christians, our faith is founded on unrealistic – even outright ridiculous – hope. We have a hope that there is a God who knows and loves us, who sent His Son into the world to save it, who died and rose again, and who promises that we will participate in that same resurrection and eternal life. By comparison, George’s desire to walk again seems easy-peasy. Yet as incredible and ludicrous as this hope seems, it has become the current that I float on. It gives meaning, purpose, and direction where there could otherwise be despair.
In discussing the hopes of a family member or patient, don’t hinge your judgment on whether or not their hope is realistic or not. Instead consider the following: how is this hope helping them? What need is their hope fulfilling? If you think a hope is unrealistic or dangerous, talk about it with them. Their underlying hope, that their loved one will be cared for and happy for example, may be attainable by other means if a hope is really harmful. We should never give out false hope though, as that can be more harmful than the truth. Above all, never take away someone’s hope without giving some other hope in return. Hope can be a fragile thing, but tremendously strong and powerful as well.