Savvy Minds: Ask Dr. V, Death and Dying

Venus Nicolino holds a Doctorate in Clinical Psychology. Her column addresses Love, Life and Relationships.

Dear Dr V,

I moved to LA from out of state about seven years ago. Since then things have gone great for me here. I met and moved in with a great guy, my career’s taken off, and I just really love living out here. I feel like I’ve really found my place. The problem is, when I went home for a visit recently, my Grandma, who’s in her 90’s, was not doing too well. Physically she seems OK, but her mind is going, fast.

She still recognized me, but it’s obvious dementia, or maybe even Alzheimers is kicking in. I’ve always been very close with her; she’s been my only living Grandparent since I was eight, and I’m terrified of losing her. I’m also feeling very guilty for moving away, like I could have spent these last few years with her. Moving back seems silly, but I feel like I need to do something. What should I do?


Dear Monica,

I can truly empathize with the confusion, pain and sadness you must be dealing with. I think one of the biggest changes to the way family dynamics work over the last few years has been the phenomena of people moving away from where they grew up (or at least where their parents live) to strike out in the world on their own. This makes the way a family works much different then when everyone is in the same town or roughly the same general area for generations. Know that you are not alone in this dilemma, nor should you feel guilty for the choices you have made.

It’s all too easy to start beating yourself up for what you might perceive as “abandoning” your grandmother by moving away from home. I urge you to resist taking that path, as it will be not only painful, but futile and meaningless for you to follow.

From how you describe it, it really does sound like you were meant to move out to Los Angeles and find your way here. Had you stayed back home, you may have had more time with your family, but how would that time have been spent? What kind of a person would you have been had you been living an unfulfilling life when it’s clear you needed more than what that place could provide you to thrive? You might have ended up carrying resentment and even anger towards your family, perhaps seeing them as holding you back from achieving your full potential (though to be fair, even in the context of a hypothetical, the only person holding you back in that case would have been you).

The point is your relationship with your family and your Grandmother might have suffered if you had stayed back. It sounds to me like you followed your heart in the life choices you’ve made, and have been rewarded accordingly. I think people often misunderstand the advice to “follow your bliss” and expect that as long as they honor their true selves in what they do, the road of life will “rise to greet them,” as the old song goes.

While it is true that if you honor your heart in the way you live your life you need never question if the decisions you made were the right ones, it does not mean they will be easy choices to make, or that your life won’t have its share of bumps in the road. It just means you can take comfort and strength in knowing you are following the right path. If you think about it, it’s a heroic thing to live your life in such a way. And while we often admire the deeds of heroes, we rarely think of them as easy.

You also mentioned that your grandmother is your only living grandparent, and has been since you were eight. From the tone of your letter it sounds like this may also be your first confrontation with death in quite some time, let alone as an adult (talk about heroic ordeals!). While both agonizing and inevitable, facing the death of a loved one and the grief that follows in a healthy, holistic way can be one of the most enriching and growth-inducing experiences you have. Of course, I don’t mean this as if to say, “Look on the bright side.” Nor will I tell you “She’s in her 90’s, she’s lived a good life.” While, of course, living to 90 is certainly a long life, it doesn’t change the fact that you are losing someone you love, and to be plain about it, it just sucks and hurts terribly. I think it’s symptomatic of our culture’s fear and lack of understanding of negative emotions that people so often rush to deny someone a right to grieve.

Which brings me to what I think is the most important aspect of this situation for you; what you need to be doing now to take care of your own emotional and spiritual well-being. Though your grandmother is still here, and may indeed be around for possibly even a few more years, your letter is proof enough that you are anticipating her loss and how you will deal with it. So for you, the grieving process has begun. This is perfectly normal. In her amazing book, “On Grief and Grieving,Elisabeth Kubler-Ross discusses how people often experience what she calls “anticipatory grief” before the actual loss occurs (I strongly suggest reading this book when you feel it’s appropriate. Though it won’t make the pain better, it can help you make sense of the pain).

This being said, what I recommend you do now is be sure you’ve said all you need to to your grandmother, but perhaps even more important for you is simply to listen to her. Whenever you see her next, just pay attention to what she has to say. When people realize their death is nearing, they are often finally ready to share whatever things they may have carried their whole lives, and as one who is going on with life, it is your responsibility to be aware and alert enough to receive these messages.

The odd thing about dementia and even sometimes Alzheimers is that while they can ravage both body and mind, moments of clarity do come and go, sometimes even shortly before death. So long as she’s here, she can still share with you. Be open and ready for it.

Facing death is one of the most difficult things we have to do as people. Because not only must we deal with the pain of loss, we are also confronted with the reality and fear of our own mortality. I think it is this fear that can often drive us away from both our loved ones at the time of their passing and facing our grief itself, a tragedy when both have so much to teach us about just being human. You sound like someone with a warm, strong and loving heart. I hope you can continue to honor both it and your grandmother, and that this love is a source of strength and courage for you in the challenging times ahead.

With Empathy,

Dr. V

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