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Emotional First Aid

Helen was considering suicide when her daughter, Gail, asked me to come to her house. Gail was shocked to discover Helen was hoarding her pain pills with the intent to accumulate enough of them to end her life.

Helen had been diagnosed with ALS, a progressively debilitating and usually fatal illness. As a long-time trauma counselor, I had frequently worked with people who had terminal illnesses and it was always a challenge. Helen surprised me though. Her suicidal thoughts were not because of her own future; her fears were for her husband, who was performing more and more caregiving tasks. Helen was afraid that her long-term illness would have a crushing effect on her husband’s health and spirits. Helen had nursed her first husband though his long and ultimately fatal illness so she knew exactly what Frank would be up against in his attempts to care for her as the disease took its toll. Helen felt so strongly about this that she preferred to be dead rather than cause her husband, Frank, such stress.

I soon discovered that the roots of Helen’s concern could be found in an event that had happened more than ten years earlier. Although Helen loved her first husband dearly, the five years she spent caring for him after his stroke left her exhausted and feeling alone. She had given up her job to nurse him, a job she loved dearly. She had wanted to care for him at home and kept him there even when he expressed a willingness to move to a nursing home. Helen remembered only too well the moments of exhaustion, frustration, and even resentment as her own life had been eaten up by the need to provide full-time care. She didn’t want Frank to endure such pain although he was insisting that he wanted to provide all her care himself.

What else could she do, Helen wanted to know. She didn’t want to face the time when he might resent the sacrifices he would have to make. Most of all, she felt her exchange with him would be out of balance and this feeling was at the core of her desire to die. Already Helen’s disease had robbed her of almost all of her mobility and she knew that at the rate it was progressing, she would be unable to talk before another year was up. When Helen expressed her regret that she hadn’t taken the overdose of pills already, I knew she needed help quickly.

My years of working with terminally ill people had taught me that we might need a two-pronged approach in handling this situation. Certainly I needed to talk to Frank about allowing Helen to move to a nursing home when the appropriate time came. We needed to help him understand that Helen did not want to see him so overburdened with her care that he was suffering, too. We also needed to find a way that Helen could exchange with Frank so that she could contribute something to his wellbeing.

Helen was a good person who had spent most of her life helping children as a teacher. Like most of us, she wanted to give as well as take in life. Her mind was still intact even while her body was being destroyed by her illness. None of us wants to be put in a position when we can only take and no longer give in life. It was very noble and loving of Frank to want to care for her at home, but he needed to acknowledge her spiritual and emotional needs as well as her physical ones. And he needed to confront his own needs as well.

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