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July 24, 2014 / 26 Tammuz, 5774
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Some Guidelines For Visitation (Part 2)


(Names changed)


 


         Last week, I started providing feedback on how to visit the sick or chronically ill. I have based these suggestions on interviews with those who are sick and their well-spouses. The first thing I was told was that people should keep their visits short. However, it is important to remember that this suggestion and the ones that follow, are feelings of the people I interviewed and do not apply to everyone in every case. Each situation must be looked at on an individual basis.


 


         If a person has no visitors or is in a nursing home, a longer visit might be much more appropriate than a shorter one. If you have a special talent and/or are a confidant of the sick person, and he specifically wants to talk or ask your help, a short visit may not make sense. As always, these general guidelines, suggested by those I interviewed, must always be adjusted to the needs of the person we wish to help. But, we must remember, it is that person’s needs we are considering, not our own. Take your cue from whom you are visiting, whether silent or verbal, and you will know how long to keep your visit.


 


         The second guideline that was mentioned repeatedly was not to ask personal questions or questions about a trauma that has just occurred. After an operation or even a minor procedure, people can be embarrassed to discuss their condition. Beyond “How are you feeling?” you may be heading into painful waters. Asking about a prognosis, or what the disease will mean for them over time, will probably be something a person does not want to discuss with you. This is especially true if they have just gotten bad news themselves and haven’t had time to digest it. If it is something they want to talk to you about, they will bring up the topic themselves. None of us would ask straight out “So how long do you have to live?” or “Will you ever be able to have children again?” or “Are you going to be able to walk?”  Yet, that is exactly what we are doing when we start asking about what they have just gone through.


 


        Menachem had been in a terrible accident. Many of the people in the accident had died. He had been injured, but thank G-d, his injuries would heal. He had difficulty sleeping. The question of why he had survived while others had not plagued him. He could not talk about the horror of the accident without reliving the trauma. Despite this, his visitors kept asking him questions about it. Specific questions. Menachem did not know how to handle the questions. He felt awkward saying he couldn’t speak about it. Besides, just hearing the question took him to a place in his mind, to which he could not go. The question itself did the damage. And, he told me, people kept asking, even after he tried to change the subject.


 


         Those who survive when others have perished, whether from an accident, an illness or any disaster, often have difficulty coping with their survival. What did it mean that G-d had spared them? They often feel an overwhelming sense of responsibility to use their life somewhat differently, but are not sure just how. It does not help to remind them of this.


 


         The people I interviewed in this situation told me that by others asking how they were going to live their lives differently now, or what they felt their responsibility of having survived meant to them, or just reminding them they owed G-d thanks − made them feel terrible. It was not that these thoughts hadn’t occurred to them. In fact, these thoughts rarely left their consciousness. Others bringing it up just made them feel guilty for their survival.


 


         To summarize then, our first two rules of visitation as told to me by patients are: keep the visits short, and don’t ask questions about what they’ve just gone through, beyond a general “How are you doing?” Next week I’ll discuss the third rule, which is to avoid visitation in groups.


 


         You can reach me at annnovick@hotmail.com

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When one is blind one learns to use Braille to read. When one cannot walk, a wheelchair gives mobility. Sign language allows a mute person to speak and ocular implants assist in hearing when one is deaf. These are all compensatory strategies that help a person function despite his disability. But compensatory strategies are not just for physical problems. Understanding our psychological weaknesses and setting up our lives to ensure that we are not tempted to repeat our past mistakes, is as necessary as any aid to the disabled.

Well spouses have often discovered that their friends and relatives, despite their closeness to the situation, often don’t realize the tremendous emotional impact living with chronic illness has on the family. With the best intentions, suggestions, ideas and criticism are offered, based on the non-experience of those with healthy families. Even when the good intentioned get a taste of the difficulties, it is sometimes not enough for them to then identify and understand what the family of the chronically ill must face on a constant basis.

Over the past two weeks I have shared letters from a therapist and a well spouse. Both of the letters gave personal insights into the process of losing hope, how we react when that happens and some ways of coping when test scores, diagnosis and just simple repetitive behavior indicate that change for the better is impossible.

Dear Ann,

I’ve read your last few articles on psycho-neurological testing (Oct.8-22) with interest. As a therapist who has counseled couples dealing with chronic illness, I’d like to give you another perspective.

Dear Ann,

Your articles on the Neuro-Psychological Testing were right on (October 8-22). My husband underwent testing twice and your articles explained it things exactly the way they were. Besides the test, we also tried therapy.

Very often when we can’t face our big hurts or big loses we focus on the little ones. We can discuss those. We can cry over the small loses, be angry at the smaller hurts even though it may look trite and sound ridiculous to others.

Over the last two weeks we have been discussing one way in which well spouses can determine whether behavior displayed by their ill partners is caused by their illness or is a way they have chosen to act. We have focused on Psycho-Neurological testing, what it can tell us, as well as its pros and cons.

Last week I discussed a question that haunts many well spouses: not knowing if the difficult and often inappropriate behavior frequently displayed by their partners are caused by the disease and therefore not-controllable, or if the behavior is a choice the spouse makes and can therefore be changed. This doubt can be the source of much frustration and many marital disagreements. One way of alleviating this doubt is by having a psycho- neurological work up done. But that path is not so simple.

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