Counseling Clients near the End of Life by Werth James Jr.;

Author:Werth, James, Jr.;
Language: eng
Format: epub
Tags: Counseling Clients Near the End of Life
Publisher: Springer Publishing Company, Incorporated
Published: 2012-11-29T00:00:00+00:00

The next, and related, area is involvement of significant others. If the person does have important people in her or his life, then the next issue is whether the client is willing to try to involve them in their life and perhaps the counseling process at this point. Some people may have loved ones but may not be willing to tell them about the diagnosis or invite them into counseling. The counselor will want to explore the reasons for these decisions and evaluate the possible effects on the person’s quality of life of the lack of disclosure or involvement. If the client does want to involve other people but has hesitated doing so to this point or is uncertain about whether and how much to involve others, then the counselor can help the dying person with taking the next step to increasing involvement, while respecting the client’s concerns and limits.

If other people have been involved, then reviewing with the client what has happened and whether any additional discussions would be helpful and if the counselor’s presence could be helpful would be another area to explore. For example, the possibility of miscommunication is high in the midst of such a stressful situation, so having joint counseling sessions with the ill individual and loved ones can help clear the air of any misunderstandings that may be interfering with optimal functioning as individuals or a group or may be influencing decisions by the dying person or any members of the support system. Finally, as the “Issues to Consider” document notes (Working Group, 2000, p. 85), “Review if there has been any direct or indirect, subtle or overt, actual or perceived, pressure from significant others on the decision-making process.”

CASE 9:

There is an apocryphal story in the end-of-life arena regarding a family where Janet, as the eldest daughter, has asked her mother (Amanda) to come live with her and her husband (Steve) and high school-aged son (Robert) following the death of her father and because of Amanda’s own health-related issues. Amanda reluctantly agrees but is concerned about being a burden on the family, a point with which the entire family strongly disagrees. A few months into the new living arrangement, Amanda’s health has continued to worsen. After a series of discussions among Janet, Steve, and Robert, Janet sits down with her mother and tells her that the family has decided that they wanted to make a few changes. Janet says that they have decided that she would quit her job in order to spend more quality time with Amanda and help her around the home and take her to and from medical appointments. Because they will not have her income coming in, Steve is going to try to get some overtime at work and Robert is going to get a job instead of playing in his band and playing baseball for the high school. They have also decided that Robert will put off going to college for a while to be available to help out at home and by continuing to work and live at home.

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