Anger and the Caregiver by Rea Ginsberg

Tuesday, 18 Jun 2013 00:16

About Dr. Monica Williams-Murphy (120 Posts)

Dr. Monica Williams-Murphy is a Board Certified Emergency Medicine Physician, who practices in one of the largest emergency departments in the United States at Huntsville Hospital. Through her writing and speaking, she is devoted to transforming the end of life into a time of peace, closure and healing. Media Page

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Anger is one very difficult subject for the caregiver to face – to discover and discuss.  It is a socially unacceptable emotion in general.  However, dying disrupts the routines of daily living.  It disrupts not only the desired and comfortable routines of behavior.  It disrupts emotional routines as well.  Suddenly, new routines are required in caring for the loved one who is dying.  New feelings also spring up.  There they are, unwanted, unwelcome, confusing, but present anyway.  Something must be done with these feelings.  How?  What?  Anger is a frequent answer.  It is spontaneous and impulsive and perhaps frightening to the caregiver.  Nevertheless, it is entirely human.

Anger must find a target.  The first such target is the dying loved one.  After all, he is the one who has forced the caregiver to make unpleasant and unwanted changes in otherwise preferred life routines.  The feeling of anger against the loved one is usually intolerable for the caregiver.  It is perceived to be shameful and embarrassing – certainly nothing to be proud of.  If so, then, the anger may also be displaced onto others instead of – or in addition to – the loved one.  One such secondary target is often the attending physician or another medical professional.  A perfect textbook example of anger displaced onto the doctor is offered by Dr. Murphy, herself.  It is clear, crisp, uncensored.  She receives the ultimate insult that a nurse can hurl at a doctor.  It is word murder.

“I had originally asked if there was anyone else in the family whom I needed to talk to [about the elderly dying lady] and the initial answer was, ‘No.’ But shortly after, an out-of-state daughter called identifying herself as the power of attorney and said, “I want you to take the DNR order off, because this means you won’t do anything to help her.”

I politely attempted to explain otherwise: “No, I actually had filled out a limited resuscitation order which directs doctors to do everything but place her on machines. And above all, we will help her to be as comfortable as she can be no matter what kind of treatment she is receiving.”

Her response: “Well, I’m a nurse and I don’t believe you.” [emphasis added] (click here to read original article)

In this regard, also, there is a reason why the very first order of the Ten Commandments states: “Thou shalt not kill.”   That is a moral imperative.  Anger is ubiquitous and potentially dangerous.  If thoughts and words could kill (as every young child believes), probably all of us would be dead.  Anger is often viewed not only as shameful but also immoral, especially when directed against someone who is already dying.  The caregiver frequently finds additional ways to deal with this awkward and inconvenient emotion.  Anger can be turned inward against the self, also.  This happens outside of conscious control.  It says, “You are a bad, bad person to feel angry.”  Major depression can result from this turn against the self.  It is not a healthy solution to anger.  Anger, however disguised, is moreover a common cause of guilt.  Guilt in itself can cause extreme fear, panic – as though there weren’t already enough reasons to be scared!  Better to talk about it.  Don’t wait till anger becomes a sickness.  Don’t practice self-deception.  Talk soon.  Open up.  Don’t be too afraid to do it.  Talk about it with those who are patient and compassionate and able to listen without blaming.  Choose to talk with people who see that anger is complex and painful and has emotionally logical reasons.  And yes indeed, love and anger can coexist.  Anger does not mean love is dead.  Talk to someone who knows dying and surviving.

–Rea Ginsberg is a retired hospice social worker and a blooming writer.

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12 thoughts on “Anger and the Caregiver by Rea Ginsberg

  1. Julie Nierenberg

    Rea, thank you for this thoughtful and insightful post. My father, shortly before his own passing, was able to voice his anger about the situation. He felt many emotions, and I’m so glad that he could own them and tell others when the time was optimal to do that (as you pointed out, choosing a receptive and understanding listener, his fellow therapist, in this case). For my part, the anger came to the surface weeks later, and as a result, I chose to write a book (well, it ended up being a book but started out being a journal exercise to release and affirm what I was feeling in a constructive and healing manner). Anger is a normal human emotion and one key to keeping its expression within a normal and healthy range of decibels and actions is to express it often, safely, with confidence that it too shall pass. Again, thank you for your perceptive writing and for sharing.

    In Peace,

  2. Pingback: Anger and the Caregiver by Rea Ginsberg | It’s OK to Die | Loss, Grief, Transitions and Relationship Support

  3. Robert Jones

    Thanks Rea.
    A thought. Anger is an internal friend who tells us something is wrong.

    External friends help sort out what is wrong. They are also the moving companies who carry our anger away, and replace it with their soft countenance.


  4. Charlie Farley

    I work in an environment where many people die, but seeing other people’s emotions never prepares you for your own. Fury at the unfairness of a situation, the illness that’s taking your loved one away and even family members who are apparently doing things that are counter to what you believe are the best wishes of your loved one are all likely outlets for that anger, but it can leave you feeling guilty and ashamed.

    I find that while it doesn’t always help, learning not to judge your feelings is a good start. Accepting whatever you feel on face value helps uncomfortable feelings pass more quickly than by judging them or judging yourself for having them. Anger turns into guilt for feeling angry which turns into feeling stupid for feeling guilty about feeling angry. Before you know it, you don’t know where you are!

  5. Foster

    My wife and I kept all four of our parents at home during their terminal days. it spanned ten years of time! My father and Ginger’s mother were a joy to care for–they were saints! My mother, on the other hand, had mild vascular dementia, and required immense patience. I had less trouble than Ginger, who would get furious when my mother accused me of stealing her money. Ginger’s father was as good a friend as I ever had, until he had a stroke. Then he lost any empathy or understanding of other people’s problems. It was a hard time for us all! Many is the time I wished we could throw him in a nursing home and get him out of the house, but we both knew how unhappy he would be in a nursing home–unless he could run it! ( I mean no criticism of those who choose to use a nursing home–that was just our choice).
    We “made it through,” as his doctor commented at the funeral. It was hard! it required lots of patience, lots of letting his irritable demands and unkind comments roll off like water off a duck’s back, lots of grace and forgiveness. But we feel good about how we handled it, despite the difficulty.
    Being mad at someone most certainly doesn’t mean you don’t love that person! In our case not being mad wouldn’t have been a sign of love, it would have been a sign of neglect.

    1. Rea

      How well you said that, Foster! Thank you for this perceptive comment. It’s OK to feel anger. It’s not a sign of love to deny our feelings. Additionally, the dying person probably knows already what we feel, when we feel it, so trying to hide is futile and unkind. — Thank you for the comment.

  6. Pingback: Understanding Anger Over Death of Loved One | Scotto Funeral Home

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