En español | “The second year is harder,” I heard myself saying to the still-grieving 55-year-old woman whose father had died the year before. It was one of those psychotherapist aphorisms I’ve been offering to bereaved clients for three decades. I point out frequently that, during the first year after a loved one’s death, most people brace themselves for fresh waves of pain and loss with each impending holiday and major event —Thanksgiving, Easter and their loved one’s birthday and death anniversary. But then Year Two finally rolls around and they do it again. And then again the following year. For this woman, the finality of her father’s death would likely fully set in during the coming months with the aching realization there will always be an empty seat —figuratively or literally — at her family dinner table.
As the end of the second year of my own bereavement approaches, I’ve been thinking about my typical advice. Is the second year following the end of family caregiving truly harder? It has been for me, though for reasons I wasn’t anticipating.
From 2010 to 2017, I was the primary caregiver for my mother as she declined from kidney disease and vascular dementia. While she and I had never been particularly close, I had approached caring for her as a way for us to get to know each other as adults. If anything, however, our tense relationship became more fraught. The more she resisted my overeager assistance, the sterner and more insistent I became. We argued a lot about her habit of spending money she didn’t have. When I recently reread the AARP.org column I wrote upon the first anniversary of her death, I was struck by my tone of lingering resentment.
Today feels different. The anger has faded. (After two years, perhaps it’s time.) Its absence has revealed to me an underlying emotional layer of mostly sadness — about her terrible decline, her death, and our lost chance to understand one another.
I feel guiltier, too. Her suffering is more evident to me in hindsight. My many grievances about her seem beside the point. I’m sorry for specific instances when I lost my temper at her. Why did I begrudge her the magnanimous gesture of taking her home health aides out to lunch every day? My disapproving reaction seems petty.
I know I'm not the first or last family caregiver to be angry and then regretful. This is not an emotional aftermath that any of us wants. How can caregivers avoid it? Here are some ideas.
With death, caregiving may end but the caregiving relationship doesn’t: My mother’s fair face, Bronx-inflected voice, and love of vanilla ice cream are still clear in my mind. So are our sometimes-snippy, sometimes-heated exchanges. None of that has died for me. That proves the import of another aphorism: Take the long view — always. Caregivers should practice a kind of “prehindsight,” considering how they may look back upon and judge their caregiving performance from some vantage point yet years away. By doing so, they’ll hold themselves to greater accountability every day by their own future reckoning. That was a piece of my advice I failed to take to heart as I got caught up in the daily tiffs and challenges.
Anger comes too easily; sadness too hard: The frequent debating between me and my mother served important psychological functions for us both: It kept us intensely engaged with one another, gave us an outlet to vent our respective frustrations, and prevented us from focusing too much on the overwhelming medical crisis. For my mother — incensed at her loss of cognitive and physical abilities and control over her life — it was easier to direct blame at me than squarely face what was happening to her. For me — shocked and appalled by the spectacle of my mother’s slow disappearance — arguing with her was my unconscious means of reassuring myself she still was capable of fiery presence. The problem, though, is that we badly hurt one another’s feelings at times. Talking frankly together about her condition and the mounting losses might have brought us closer together in sad communion.
Try a little tenderness: That was the title of one of my favorite Otis Redding soul ballads from the 1960s. There were small loving moments for us — a light touch on the shoulder, sharing a turkey special sandwich that we both loved, and sitting quietly together in a spring garden — but they came too infrequently. Fortunately, those times are also there in my mind. I don’t regret them. I cherish them. I only wish she’d seen more of them.
Barry J. Jacobs, a clinical psychologist, family therapist and healthcare consultant, is the co-author of Love and Meaning After 50: The 10 Challenges to Great Relationships — and How to Overcome Them and AARP Meditations for Caregivers (Da Capo, 2016). Follow him on Twitter and Facebook.