Category Archives: Transitions

A Parent’s Journey through University Transition: The Day of the Send-Off and What to Expect When You Go Home

Send Off PArt two

So the dreaded day of sending-off your young adult to their dorm or other new transition has arrived and you are only days away from returning to a home minus someone you brought home to raise.  Of course, I am also excited for my son and overwhelmingly proud of him for reaching this stage in his life.  Yet, we as parents must have a safe place to acknowledge that this part of the university transition can be one of the hardest moments.  

I don’t believe that most parents or guardians, when they bring home a child from the hospital or as a foster or adoptive parent, think of this day.  Even when you prepare for it in your head, it is still not the same as experiencing it.  As I mentioned in Part One –  What I Wish Someone Warned Me About the Send Off: Perspectives from my RAFT, “Much of the difficulty of this transition is the emotional process of what you conceptually prepared for.”

This is Part Two of The Send-Off to Adulthood: A Parent’s Journey through University TransitionThe Day of the Send – Off and What to Expect When You Go Home.  As I shared in Part One, I hope my sharing of my own journey will help affirm the journey of others and encourage the processing of this transition.  By sharing my story in Part One, I found that it has helped me move through this transition.  I hope it will encourage you to share as well, below in the comments and within your circle of support.

The Day of the Send-Off

I was both dreading it and excited for my son.  Processing the emotions leading up to this day, as I did through the process of writing What I Wish Someone Warned Me about the Send-Off helped me tremendously.   Between the logistical tasks that needed to be taken care of and the fact that we as a family didn’t have privacy to huddle and cry like it would have the effect of a game plan strategy for how to win the day emotionally, I held myself together as much as a mother can. 

Here are some tips for how to get through the day of the send-off:

SendOFf KeepCalm Med

Keep calm and cry in the car.  Unless you have a expressionless-cry face that allow you to tear but without the dramatic expressions or don’t mind people seeing your cry today, I suggest to cry in the car before you step out and when you step back in. If you have anything emotional to say that you didn’t get a chance to say before you left the house, say it in the car, before the hustle and bustle of the move-in day starts.  Chances are, however, that you all will be too busy on this day to have time to be as emotional as you have been at home.  

Try to save your emotions for when you’re alone or away from your young adult so that it isn’t harder on your young adult.  They might seem emotionless today or can’t wait to break free, but know that there is much going on within them as well and might be fighting tears themselves.  Hopefully, you aren’t alone during this send-off so that when you step back in the car, you’ll have someone to speak to and ensure you are driving safely.  (And please know you’re not the only sappy parent in this world.)


Seeing more of my son’s self-determination helped me have less concerns about his adjustment.


Get out of the way helpfully.  Allow your young adult to focus on what they need to get done in the way that makes sense to them.  There is most likely a part of them, even if it is small, that is trying hard to not succumb to the overwhelming mixture of sadness, excitement, fear, and tremendous courage.  As I helped my son with little but practical things that wouldn’t get in his way of taking charge of how to handle move-in day and the move-in week schedule, I started to see more and more of his personal self-determination come out.  

Seeing more of my son’s self-determination helped me have less concerns about his adjustment.  If he made any mistakes along the way today or this week, I had faith that he would learn from it and that it wouldn’t be the end of the world.  For someone with some OCD tendencies, this was a big step for me, but observing how he has been becoming more and more mature this summer helped me let go.

Day one of being their own boss.  Today is a day your young adult will need to be the boss while receiving your age-appropriate guidance.  It’s a smoother drop from being a co-boss on the day of the send-off to being the only boss after the family leaves for your young adult than being completely dependent on parents until the last minute.  Allowing them to take ownership of their decisions and as a parent, balancing that task of guiding your student on a day they are most likely trying their best to be strong and brave will need to be flexible today.

It would be wise to still provide solid and well-timed guidance of major things like making decisions that ensure personal safety and security, and the smarter options for purchasing textbooks. However, as young adults, they will only need to be shown how to do such things so they can practice making these decisions themselves.  If they make a mistake, they will learn from it.  Just like when you were younger, the lessons you learned were also the mistakes you made.  As a parent, in reality, your guidance will not really end, but it will most likely involve more and more respect.

Find your co-supervisor in your young adult.  Certain things, like billing and matters related to your young adult’s student account, will still need to be supervised by you as a parent, of course, but you can start to share that responsiblity with your young adult.  Your guidance will be teaching them how to supervise it themselves and as a co-supervisor, follow up on anything confusing while allowing them to be part of the finding the solution.

And finally…

 

If you feel like stalking your own young adult child, it’s normal (I hope) but not advisable.  It’s funny looking back now, but after we emptied the car of the last of his belongings (the next day), I wanted so badly to stalk my own son around campus.  How do you just leave a child you raised and just drive off?  I literally visualized tiny invisible vacuum cleaners sucking the tears before they could fall from my tear ducts.  Of course, he didn’t invite us to attend all the things he needed to (mostly because we might have looked like the Addams family creeping up from spot to spot with the way my eyeliner had run around my eyes and how relatively quiet I was behind my arms intentionally composed at my waist), so if I wanted to see where he’d go next, I’d have to stalk him.  

My senses came to me however, and I didn’t.  I just stalked his bike (to make sure it hadn’t been stolen of course).  I noted that it had moved and that gave me a reason to call later and follow up with him on how it was to ride around campus for the first time.  To mothers for whom this day is a very dreaded day, please know that there is grace for you for things like this (but not forever).  Big hugs!!  

 

What to Expect When You Go Home

It was a hard process to get through the day of the send-off.  Of course, you are also excited and rejoice for your young adult’s success at coming this far.  However, the type of sadness you can feel on move-in day at the dorm or other transition is not like any other because this is a child that you raised.  Also, as I described in Part One, home will be so different now.

Here is what you may expect when you return home and what can help:

Minus one at home.  Visiting my son’s room, of course, felt very lonely.  Especially the first few days, I had to catch myself and retrain my brain to remember I wouldn’t be hearing sounds from his room.  Emotions always take longer to catch up.  Not having your child at home on a daily basis can truly be very emotionally dislocating.  If you are the type to need time to grieve over changes that are very emotional in nature, allow yourself to just stay home and minimize social interaction or being out in public. Unless it’s social support to help get your through this transition, you don’t need to pressure yourself to get right back in the routine of things because your daily routine, up to a few days ago, always involved your child being present when you came from your routine. 

Minus one while at work.  Being in a job where you have been in a long time will feel different becuase at the end of the day, you most likely always looked forward to coming home, and home is different now without the daily presence of your young adult you just sent-off.  You may need to develop a coping method for work (or school if you are also a student).  If you need to report back to your work or other responsibilities so soon after the send-off and cannot take time off, you may need to have a way to put your emotions on hold so you can function at work.  Try to take it day by day and if it helps to talk about it with certain people during your lunch breaks, just remember to choose who you speak to wisely.  Make sure they can help you end the lunch break with a way that will bring you back to focusing on your job responsibilities until you can go home.  

Minus one on your driving route.  If  you are like me, driving anywhere on the streets of anywhere I used to drive just feels different.  Driving the same routes I used to drive on my way to pick my son up when he was younger or drop him off felt really sad.  I know this is how it feels this first week and it gets better, but just have the tissues ready during your drive.  The first day, I almost wanted to just leave a tissue under each of my eye held by my sunglasses while driving around.  The only thing is that my windows aren’t tinted that well.

Minus one on the first grocery run.  Oh boy.  It’s time to do the groceries or eat something you only have in case of emergency that you wouldn’t eat under normal circumstances.  If I would have thought of this sooner, I would have stocked up so that I don’t have to grocery shop within a week after the send-off.  You’re in public and it’s the first time you are grocery shopping.  After almost two decades (for most parents) of grocery shopping with the individual you just dropped-off away from the home in mind, this is the first time you are grocery shopping without him or her around.  You now have to have the mindset that the food won’t be eaten across the table from you, or that  you won’t have to buy certain things or as much.  This was hard, but I made it and I know you will too.

These are just some of the things I have personally experienced.  When I think of parks, homes of family friends, churches and other places my son and I used to go to together regularly, I know that I will need to adjust my emotions to match more of what I know cognitively. I know the first times will be sad.  The behavior part of the cognitive-emotional-behavior adjustment for this transition seems simple enough, but I know it will involve a new pairing of emotions for each behavior I used to routinely do with my son as a young child especially.  


If you are a parent dealing with mixed cultural expectations about what the send-off signifies, please rest in the thought that the future does not all have to be pre-determined now.  Allow yourself time to just process the moment.


A note about cultural expectations and the send-off: a perspective from a TCK who grew up with Filipino parents.  Allow yourself to reflect on your own expectations about what this life stage means and try to communicate with your young adult child throughout the various stages of this transition.  In many Asian families, a young adult going to college does not necessarily mean a breaking away from the family.  Often, under a less individualistic and more kinship sense of identity, a young adult stays with the family until it is time for them to marry. It’s important to allow yourself space to grieve according to your own cultural expectations.  If there are differences between your expectations and your child’s expectations of what this stage in life signifies, allow each other time for adjustment and seeing what each of you want as individuals with culture as an influencing factor.  We are at the end of the day, human with certain personality traits before we identify with culture.  I expect that this expectation may be fluid and depend on several factors, such as finances, the job market, and other career-related decisions, and not just culture.  

Also, I expect that there will be seasons in life related to the decisions that have to be made about the future.  If we can rest in just experiencing the moment for how it is in the moment, it may just make it easier to process rather than being caught in “cultural expectations” as a formula to follow and create expectations with to determine the future.  There are certain things I’d prefer and there are certain things my son would prefer.  It will be up to us to figure it out together as a family with sensitivity and respect for one another, but it does not have to all be determined right now especially the week of the send-off.  If you are a parent dealing with mixed cultural expectations about what the send-off signifies, please rest in the thought that the future does not all have to be pre-determined now.  Allow yourself time to just process the moment.

I hope this has been helpful to my readers. Please share your own stories in the comments below to help encourage others to process this transition.  Giant hugs to all!

 

The Send-Off to Adulthood: A Parent’s Journey through University Transition Pt 1

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The journey of sending off your child to college, joining the military or other life transitions after graduation from high school can be one of the most emotionally excruciating transitions as well as proud moments for parents or parental figures.  Just as there is nothing that truly compares to all a person puts into raising a child as a parent or guardian, there is nothing that truly compares to all a person adjusts to at the point when their young adult embarks on the bridge to their own life.

This will be the first in a series designed to help the parent, with some insights available for the young adult, through the college transition as I go through this transition myself.  It is important to discuss here because caregivers, especially sandwich generation caregivers, can play other roles in life which should also be acknowledged.  As an adult Third Culture Kid, some of what I share will be especially helpful to adult TCKs and adult Cross Culture Kids, but this series is written for all going through this transition.  For the college-bound and college students with a global nomad background and for parents as figures of support through this transition, Tina Quick’s The Global Nomad’s Guide to Univeristy Transition is a valuable resource.  

This series will be about the transition parents go through in redefining their role as parents and their relationships with their young adult children entering college.  The voice used in this series will be genuine and from the moment of experiencing these things and not only after I have processed each stage of the journey.  I hope that by doing this, it can prepare some of you for what you may experience and give affirmation that you are not alone. 

Part One –  What I Wish Someone Warned Me About the Send Off: Perspectives from my RAFT

Tomorrow, my son will be moving into what will be his dwelling place for the next two semesters.  Preparing for it involved preparing him as well as myself.    In the few weeks leading up to this day, I started doing what becomes instinctive for parents, preparing your child for all the practical things for college living.  As any other parent, raising my son itself was preparing him for this moment and my style of parenting always involved using big and small opportunities to equip him with various skill sets and useful knowledge both practical and for social relationships.  That was the teacher in me.  The TCK in me started to refer to the Pollock-Van Reken RAFT (detailed below*) from Third Culture Kids: Growing Up Among Worlds as a type of “checklist” and Quick’s Guide to ensure I was preparing him holistically.


Because you don’t stop being a parent to your child as a young adult and your child will not stop being your child, it is equally important for parents to also build a RAFT for themselves through this transition as well.  


Tina Quick does a very thorough job in laying out how to build a RAFT* to support the college bound student and has a useful chapter for parents about the diverse range of what can be expected in the parent-child relationship during the summer before college and the adjustment period after college starts.  I want to add that because you don’t stop being a parent to your child as a young adult and your child will not stop being your child, it is equally important for parents to also build a RAFT for themselves through this transition as well.

Not only is it important to move through this transition and avoid unresolved grief, the importance of which Pollock and Van Reken discuss in Third Culture Kids: Growing Up Among Worlds.  For the relationship between the parent and child to evolve in a fruitful way, the parent must also have a way to process the internal transition of redefining the role as a parent as well as the external relationship with the child.

The RAFT* for parents going through this transition may look different for each parent and parent-child relationship due to different parenting styles, cutural standards and ways of expressing oneself.   There are four things I wish to share about the internal process of redefining my role as a parent, which some parents may need to prepare and establish a support system for as they move through this transition on their RAFT. 

I wish someone warned me that I’d feel actual pangs of hollowness that come and go during the transition to sending off your adult child to college.  This most likely also applies when a parent sends off an adult child joining the military, or moving elsewhere to start some other life transition.  I’m here to tell you that it’s going to hurt, at least for a period while you are adjusting.  Years ago, I knew this was going to be hard. However, knowing it is going to be hard is not the same thing as the actual emotional experience of it. It’s not a constant non-invasive phase in the adjustment process that you just have to wait out. It can be an actual pang that you feel that you have to really work through.


I’ve taken for granted that the house will always have his presence, perhaps not rationally, but emotionally.


Daily regular activities, like falling asleep, waking up, walking around the house, turning on the faucet suddenly felt hollow.  I found myself in tears at the thought that the house would suddenly be lacking my son’s piano and guitar playing at various times during the day or late at night while I fall asleep, for longer periods of time while he is living elsewhere.  Not being able to walk into his room to say good night face-to-face while he hugged and kissed me back as a little child, through the later years of a more detached “good night mom,” (with a now-please-let-me-have-some-privacy” tone typical of teens forming their own identity) feels really lonely.  It’s not just a sleep over either.  I’ve taken for granted that the house will always have his presence, perhaps not rationally, but emotionally.  Much of the difficulty of this transition is the emotional process of what you conceptually prepared for.


“Home” to me always meant having my son at home physically.  The knowledge that he will be elsewhere for an extended period of time is an emotional dichotomy.


I wish someone warned me that “home” will become more fluid from now on.  Building and maintaining a home is a major aspect of the role of parenthood.  The concept of home by default involves an identification of who comes home to the home.  This is why the little things like falling asleep, turning on a faucet, and other little things I do daily at home suddenly feels sad.  The layout of the physical house is the same and realtionally, I am still my son’s mom.  However, “home” to me always meant having my son at home physically.  The knowledge that he will be elsewhere for an extended period of time is an emotional dichotomy. I’ve taken for granted that the house will always have his presence, perhaps not rationally, but emotionally.   Home now will have to be where we will be together even though some parts of the year, we’re apart.  Yet “home,” at least as the physical place where you are not a visitor, will also remain “home” for my son when he is back, even though during the school year while he has his belongings elsewhere, he is technically “visiting.”

Home now will be different for my son and for me. It will not be in the same physical location, but emotionally, being home is also when we are together, whether I visit or he visits.  A physcal home that has history of us being together under the same roof is an option but not necessarily obsolete because we will be geographically apart.  Home now involves different aspects that will require fluidity.  While it was more simplistic to have home be the same as each others physically and relationally, this redefintion of home is as genuine and significant, but it is a painful process right now.

I wish someone warned me that the change in my role as a mother is really rough emotionally.  This is another thing that is easier to have a concept of than to actually experience.  Ive taken it for granted that my grocery list will always plan to feed my son as a member of the household.  It feels lonely to think that I can still buy things for him, but I will be sending it as a care package while he is away.  The same goes for managing his education.  When he graduated from high school, I graduated from having his mandatory education under my watch.  It all should be a completely freeing feeling, but at this point right now, it is still a shock to my system and I was not asking to be liberated from it all.  This adjustment is hard emotionally even though rationally I knew this was coming up.


There doesn’t seem to be an instinct for ceasing to guide and protect and it takes an emotional effort to adjust this instinct for the college years and beyond.


While raising my son,  whenever an opportunity arose that I could use to teach him a new skill, I would, such as how do a simple repair for a toilet leak, how to change oil in a car, how to prepare a healthy meal, and how to manage and balance time between what you’d like to do vs what you have to do.  Logically and instinctively, my interaction with my son was always in preparation for him to become independent.  The guidance and protection parts of my role as a parent involved my behavior and my speech being geared towards him ultimately separating and having the skills and knowledge to care for himself independently.  I believe it’s a primal instinct to do this, as much as nurturing and loving a child is.  

It’s still a shock to my system however, to be at this point of my role of what I’ve been doing instinctively for almost 18 years coming to an end.  There doesn’t seem to be an instinct for ceasing to guide and protect and it takes an emotional effort to adjust this instinct for the college years and beyond.  I understand that he has some basic skills now to be independent but it still feels anti-instinctual to just cease what I’ve been doing.  It seems that I will need to work on making the guidance role more subdued from now on and hope that the seeds I have planted for practical, emotional, relational, spiritual, financial, physical and other purposes will just continue to grow.  


…Knowing it is going to be hard is just a surface scratch to the actual pain of experiencing it.  You may need to prepare a serious support system for or plan coping mechanisms ahead of time for to get you through the “hollow pangs.”


I wish someone warned me about the pain and sadness that come before the victories and celebration.  People always talk about the end result, “It was hard but I adjusted.” “Now, he has his bachelor’s degree and he’s about to start a paid internship that can lead to a permanent job. I’m so proud of him!”   I’m here to tell you that before all of that, you may go through a period of extreme sadness.  Years ago, I knew this was going to be hard. But knowing it is going to be hard is just a surface scratch to the actual pain of experiencing it.  You may need to prepare a serious support system for or plan coping mechanisms ahead of time for to get you through the “hollow pangs.”

Before I close, I want to also share how the RAFT may look for the internal adjustment for the parent and the parent-child relationship.

The RAFT stands for the following:  

R= Reconciliation, which “includes both the need to forgive and be forgiven” (Pollock, D. and Van Reken, R., Third Culture Kids, Growing Up Among Worlds, 2009. p. 182.).  

A= Affirmation, which involves “the acknowledgement that each person in (a) relationship matters,” (Pollock, S. and Van Reken, R. 2009. p 182) including family members, significant adult figures or role models, and friends.

F= Farewells, which includes farewells to “people, places, pets, and possessions” (Pollock, D. and Van Reken, R., 2009. p 183).

T= Think Destination, which refers to considering what you need to prepare for both “internal… and external…resources for coping with problems” that may be encountered after arriving at your next destination.  (Pollock, D. and Van Reken, R., 2009. p. 184).

The following is my application of the Pollock-Van Reken RAFT for the internal process of this transition as a parent and between the parent-child relationship:


Some of this may not need to happen before your child leaves, but if anything is unresolved, it could determine how your child will visit after leaving.


Reconciliation –  If there are unresolved matters that have weighed heavily on the relationshp between you as the parent and your child, it would be healthy to address them with the goal of coming to terms with it before your child goes to college.  Some of this may not need to happen before your child leaves, but if anything is unresolved, it could determine how often your child will want to visit after leaving.  

Internally, if there are any areas where you as a parent need to forgive yourself for mistakes you’ve made, it is also important to work through them if you have not yet.  No parent is perfect and we all have made mistakes.  If you need to seek forgiveness from your child, it may help to do this before your child leaves because again, it may determine how your child visits after leaving. 

Affirmation – Communicating about the various significant pleasant memories from the time spent with your child and what you cherish about your bond with your child can help affirm special aspects of your child’s character and personality.  This may help how he or she relates and builds relationshps with new people he or she will be encountering.  

Internally, it is important to cherish and congratulate yourself for your own accomplishment that led up to this new life stage for your child.  Before that may happen, however, it may be important to acknowledge and validate for yourself the losses you feel during this transition.  In a way, sharing what has been painful through this process is a way of grieving them so that I can move forward.  I invite you to also reflect on, allow yourself to completely feel and, if you feel comfortable, share here what are the hardest moments for you.

Farewells –   As far as the farewells my son and I face together, looking back, we have always done this throughout my son’s chldhood and adolescence as he entered each new stage of his development.  We often discuss changes in his relationships with people in his life.  We have reminisced about special places that have come and gone. My son isn’t the type to be attached to a geographical place unless there is significant memories attached to it, which may now be more associated with moments with his friends.  We are in the process of determining how I will takeover his share of care for the pets.  I will need to let go of certain souvenirs from his childhood. 

Internally, I am still working through this.  Much of what I share above is what I am working through as I bid farewell to how parenting has been for me, in sharp contrast to my role now as a parent of a college student. It was a reassuring experience for me, however, when I was present during one of the times my son hung out with close friends. My son as well as his friends seem to be very genuine about their friendships yet realistic about how often they will be seeing each other.  My son also has taken intiative to bid farewell to other special people in his life he has not seen in a while before leaving and has made efforts to make sure I will be ok. All of this is helping me with my own farewell to my previous role as a mother.

Think Destination –  Between my son and me, we have discusssed how he and I each feel about the next stage in life. I told him about the plans I have for starting a business on the side that involves something he’s known that I love doing and the possible nearby cities I plan to transition to after he leaves for college.  Yes, I’ve also expressed how much I miss him (probably more than I should have), but I hope that I have also expressed well enough about other passions and goals that I have.

Internally, the emotional impact of how my parental role will change is what I have been avoiding.  My son has resources for the next stages of his life, but internally for me, it’s completely foreign territory. I’ve been in college.  As much as my dad now will guide me through this transition, I have never been through it.  What I can say at this point is that translating the instinct I’ve had in equipping him with skills and knowledge that will help him take care of himself into  equipping him for this next life stage is what propels me forward emotionally. I just have to attach new emotions to this stage that involve more unfamiliarity and change. Each step of parenting as your child ages is new of course, but this transition is completely different.


There is no emotional “pre-nup” equivalent for the parent-child relationship. There isn’t supposed to be one.


Although I wished people warned me about how tough this transition can be, I think that in the end, the emotional process of this would still be difficult.  There is no emotional “pre-nup” equivalent for the parent-child relationship. There isn’t supposed to be one.  For those also going through what I am, we are supposed to risk feeling this pain because becoming a parent involved an investment of so much of ourselves.  There shouldn’t be some type of safeguard to prevent parents from feeling the pain when letting go.  If others are going through the same thing as I am about to go through tomorrow, please know I am going through this with you and yes, it hurts like crazy.  Allow yourself to experience it and as you move forward, I will be also. Grab your tissues, let it out, reach out for your support system and find all the strength you have within you to get through this.  And we will get through this.

 

 

The H Word

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I wanted nothing to do with it what-so-ever.  It was the dirtiest word anyone could ever toss in my direction.  If my mind was ever close to the door where this word was waiting on the other side, I turned around and walked away.  It was a cold arrogant intrusive slap in my face.

When a social worker told me about the option for hospice care for my mother, I immediately thought of the competition businesses for the elderly must find themselves in.  As I listened to the representative for home care services and, on a separate appointment, the representative for hospice care, I thought about what PR skills they must have to “win the bid.”  It wasn’t so much that they were pushing their product, but it was the lack of empathy I saw in their eyes.  As a social worker, I was familiar with the clinical approach they must take and it felt downright dirty to be on the other end of it.

To the social workers and case workers, it was about intake forms, contracts and signatures.  To me, this was a brush with strangers who knew nothing about my mom and how she survived  doctors’ predictions about her death more than once before.  To me, they knew nothing about their client and I did not care to learn more about their product.

I was so angry that I felt numb towards the young hipster doctor who asked me with a perplexed face why we wanted to keep my mother alive the day she was brought into emergency room services.  He assessed the complete value of her life based on her current quality of life within a matter of three, maybe five minutes in front of the persons who had been caring for her every day for several years.  Just the day before, she was telling me about a recipe she concocted that she wanted me to try.

To the emergency room doctor, my mother was a patient in bad shape compared to able bodied patients who were healthier.  He practically left her for almost dead and expressed it.  We were dealing with a young arrogant doctor in unusually short and tight black pants donned in a lab coat of stolen permission to be insensitive in a moment that only lasted several minutes for him.  To me, this was my mother whom I’ve known since the day I was born.

There was also an encounter with a hospital staff worker interrupting my mother while she was sharing some final words with my son.  When I spoke to him on the side, he informed me she was ordered for a move to a different wing of the hospital and assured me the wing they were moving her to was not for dying patients.  We asked for some warning and respect for the moment.  His supervisor insisted she told the family ahead of time but then told me she would speak to the staff after realizing what my main point was.


 Newborns in hospitals have clean and monitored dedicated wards demarcated with huge windows that serve as the greeting place for human beings that meet for the first time.  However, patients who may be facing the end their life and final goodbyes can slip through holes of management that cares little about the patient’s personhood.


 

HWordImage_1_4160PostEditNewborns in hospitals have clean and monitored dedicated wards demarcated with huge windows that serve as the greeting place for human beings that meet for the first time.  However, patients who may be facing the end their life and final goodbyes can slip through holes of management that cares little about the patient’s personhood.  The rest of the world is on pause when you witness the first hours or days of a tiny human being simply breathing, sleeping or moving in the blanket.  No one wants to face the reality of what may be the last last breath, night or movement of someone one has childhood memories with.  When management does not create a system of care for the end of life stage as adequate as that for the beginning of life, there is something drastically and ethically wrong about the picture.

As a way to make it known to the doctors that the family was not giving up the way they seemed to, I took on an advocate role for my mother.  Instinctively and in my spirit and soul, I just knew there was no way God was going to allow things to go down this way.  One day, it would happen, but no way was it going down like this, so suddenly and out of the blue.  No.  Way.

I made it known that it was cultural differences and unfamiliarity with strangers vs. a neurological or mental incapacity that caused my mother to not give the type of answers assessing staff were looking for.  I made it known her life was valuable enough to try anything that wouldn’t put her in greater risk, despite the initial assessment about her life.  I made it known we were capable of helping the nurses with her care becauses they aren’t paid enough and are too overworked to always be by her side.  I made it known the person who gave me life would not go through the end of her life in an environment without dignity.


When certain hospital staff members left the room, my mother would comment, “What? Do they think I’m crazy?! Do they think I don’t understand what they’re saying?”


There was so much spunk left in my mom.  When certain hospital staff members left the room, my mother would comment, “What? Do they think I’m crazy?!  Do they think I don’t understand what they’re saying?”  The first morning after she was admitted, she pointed to an airplane flying in the sky outside her window.  My father, my son and I took a look.  Sure enough, it was there, but only she noticed it from her hospital bed.  It was her usual way of trying to make the time go by.  Throughout the entire time she was hospitalized, she just wanted to go home.

Amidst negative news, there were hospital staff members that helped lighten the situation.   During that intrusive move from one hospital wing to another, a nurse shared her story about how her sister had passed away the year before and how she knew what we were going through.  When my mother was brought out of the emergency room, a Filipino nurse was the first to greet us and it helped my parents feel more at home to hear Tagalog her first night at the hospital.  A respiratory nurse who regularly came in would brush the hair to the side of my mother’s face while they looked into each others’ eyes during breathing treatments.  Towards the very end, the releasing doctor shared his own story about the end of life care for his own father.  During these moments, they all recognized my mother’s personhood.  These encounters helped us see the human side of the hospital staff members also.


During these moments, they all recognized my mother’s personhood.  These encounters helped us see the human side of the hospital staff members also.


When it was time for my mother to be released, it seemed the wisest option was for my mother to be released into home hospice care.  I felt lost and I did not know how to even think about funeral arrangements, but out of concern for my mother’s comfort if she was really about to pass away, home hospice was the best option.  Her physical condition was such that the day of the actual release, my mother’s blood pressure dipped so low that it seemed she might pass before she could even go home.  Hospital staff workers remedied it, perhaps with the goal of prolonging her life just long enough that if it were to happen soon, it would happen within the comforts of her own home.

My mother did not know it at that time, but there was a terrible storm of events happening.  I had to be strong enough to choose the right time to tell my father that her eldest sister had just passed away.  The day my mother was admitted to the hospital, my dear aunt had a stroke and was rushed to the hospital herself.  The day my mother was released from the hospital, my aunt passed away from the stroke, while she was in a coma.  Our larger extended family was going through a terrible time, and my father had to temporarily leave my mother’s bedside in this condition to attend his sister’s funeral.  We experienced multiple losses only a year after one of my father’s younger brothers passed away with cancer.

What served as a blessing was that my mother’s siblings had schedule their visit to see her and it happened to be around the time my father needed to leave for my aunt’s funeral.  It helped my mother cope with my father being gone, who had only explained that he needed to visit his sister.  We told my mother the news of my aunt’s passing when she was physically more stable.  Just being home made a big difference to my mother while my father was away.


 The hospice nurse my mother was assigned to worked and adjusted with us so well that she became an important part of our lives.  It become so clear that home hospice care was one of the best decisions we made for my mother’s life.


 The weekly visits from different hospice staff members throughout the week greatly helped my mother as well as my father.  The hospice nurse my mother was assigned to worked with and adjusted to us so well that she became an important part of our lives.  My father looked forward to their visits.  It become so clear that home hospice care was one of the best decisions we made for my mother’s life.  My mother actually healed from the two main conditions that placed her into hospice care.  There was a third condition that we continued to monitor and there were a few other health issues that popped up, but the nurse helped us through them all in ways we simply were not trained for.  What I also cherish is how my mother developed relationships with the hospice staff members who came regularly. They got to know her as someone who made them all laugh so hard and someone who genuinely cared about them and their loved ones.

My mother’s time in home hospice was most likely the best way she could have left us.  Ultimately, my mother ended up being on hospice care for a little over one year and one month.   For a while I even thought she would disqualify for hospice care.  She was able to witness another full year of birthdays, watch her grandson meet more milestones as a young teenager, and spend more quality time with all of us.  The cause of her death was not ruled to be related the health conditions that originally placed her into hospice care.    It seemed that it was just time for her to go.

My mother knew it was her time and she demonstrated she had peace about it before the rest of us in the family did.  My mother was able to say her goodbyes and final requests in the comforts of her own home.  She expressed concern to the hospice chaplain about my father as the one who was most adamant against her passing, but was ready herself.   When it came close to her time, she lost her ability to speak.  Yet, my mother still managed to communicate her goodbyes and final thank-yous to the hospice staff workers.  One hospice worker bid her regular farewell, “Dios te bendiga.  See you next week.”  My mother shook her head, but seemed to want to say thank you among a few other things.  I found myself translating to hospice workers during their final visits what she wanted to say, as if I had a different set of ears to hear what she would otherwise be speaking out loud.   She gave a thank-you-and-goodbye pat on the hand of the hospice nurse as her condition progressed and the nurse knew what it meant.  My mother had help with pain management, oxygen and other tools that made the final days bearable for her.

As a family, we let my mother know she was never alone the days leading up to the last moment.  We did not want to say goodbye, but we eventually came to accept it was better for her to pass away in peace than be concerned about our lack of peace and our unpreparedness. My father began to come around to speaking to her about letting go if it was truly God’s will it was her time.  I also assured her that I would take care of the family and make sure her husband whom she knew as a child and whom she was married to for 47 years would be alright.  As a daugher I also shared my farewells.  Within a couple hours after my  son spent time with her and bid his final farewells, she passed away.  My father, my son and I surrounded my mother, holding her hands, praying for her and telling her we love her during her last breaths and final movements.   It was as if she was waiting for all of us to have peace.

Things would have been different without home hospice care.  I learned so much about something that used to be such an object of aversion for me.  What I thought was synonymous with giving up was actually just a different context to keep trying everything that would not put her in greater risk or otherwise end in a bleaker situation.

The H word stands for hospice, but also for hope and for home.  

 About the Author

Expat Youth In Aging and Disability: Why It’s Not Just about the Elderly

"Hold On To Your Children" Photo Credit - Spiesteleviv Used with Creative Commons license

“Hold On To Your Children” Photo Credit – Spiesteleviv Used with Creative Commons license

We see families at the airports, at times perhaps with more than two generations represented, briskly walking through the terminals in long single file or as a wide marching band at a parade with various carry-on luggage as musical instruments.

While middle aged adults that pass through the airport corridors seem to begin to resemble one another in attire, the younger passengers tend to show more individuality:

…the teen girl with a partly shaved head with purple tips wearing a Ramones t-shirt, the tween boy with one eye covered by his long hair dressed in black or grey clothes, the cosmopolitan little lady wearing her kid sized tweed travel jacket with suede elbow patches, the toddler with a bowl haircut in the stroller calmly snacking on soft cookies while the mom is dashing for the connecting flight, and the baby in the infant carrier kicking the air and giggling at strangers behind his father who enlarge their eyes as part of their big open-mouthed, head nodding smile.

If we could see a floating bubble attached to each family member narrating a summary of each person’s story or reason for the trip, we’d probably be amazed by the depth of what we don’t know about strangers.  Out of these stories are trips adults make to tend to a family member experiencing a sudden health crisis, and their children, whether they travel with their parent(s), stay behind or end up following after, are affected.

Photo Credits: Yogendra Joshi Used with Creative Commons license

“Granny… I Am Coming!” Photo Credits: Yogendra Joshi, used with Creative Commons license

My son and I lived one of these stories.  I received the call that my mother had a stroke the night after my son attended his first day at kindergarten.  We were in Los Angeles, California.  My parents were in Manama, Bahrain.  I was preparing to start my second year for my Masters in Social Welfare at UCLA.  I had just met my supervisors for my second year internship placement.  I was about to serve as one of two co-presidents who tied in elections for the Social Welfare Asian Caucus that upcoming year.  That would have been my final year for a graduate program that accepted only 20% of its applicants.  My son had to take leave of absence after just one day in kindergarten and I had to file for leave of absence before my second year orientation even started.

Since that phone call, our lives as a collective family as well as each of our lives individually, were never to be the same or “normal” again.

I had no idea that the photos I took of my son’s first day of kindergarten were not going to be the first in a series of photos representing the traditional path of education most children living in one country take.  I had no idea it would take me several years to finish my masters degree for a program that usually lasts for two years.

When my son and I left to go to Manama, I only knew a portion of what I was about to find out as soon as I landed.  It turned out that what I thought was a mild stroke for a 57-year-old woman was actually a severe stroke, involving the cerebellum and a coma. My mother’s doctors did not hold back from preparing my dad for funeral arrangements.

It was a long journey itself to watch my mother in her coma.  People did not dare to raise our hopes about her situation and I could see in some of the eyes of my parents’ friends at the hospital that they themselves were scared to hope.   Most of my mother’s siblings were there visiting, but it is a world of a difference when a health crisis like this happens continents away from the larger family.  My father described the days before my mother’s siblings, my son and I arrived in Bahrain as the loneliest and longest days in his life.

My family went through a rough, dark, faith-testing journey while visiting my mother daily in her comatose state.  However, after three weeks, she came out of that coma that was supposed to take her mental alertness, memory, speech, and overall capacity to interact with us again if she even survived.  Never in a million years did I have a clue I could ever find strength though an experience like that, but I found it through prayer.

When she woke up, our small family, consisting of my father, my son and myself, were about to live the rest of our lives with a family member who would be disabled without the ability to walk, sit on her own, go to the bathroom by herself and  swallow food and liquid completely.  Yet my mother was so filled with life and a desire to be around us that she mustered up enough strength, faith and passion that she survived that stroke for almost 12 years.   It may sound like torture to some of my readers, but it is a gift when the survivor is your  loved one.  It is a gift when you see your loved one’s eagerness to keep waking up to see another morning with and say another “good night” to her husband, only daughter and only grandson, and enjoy everything that can happen in between.

This drastic life change came much earlier than I had anticipated.  I had imagined that if I were to experience a sudden onset of disabling illness of one of my parents, that my son would perhaps be in high school or college.  My son was four years old,  about to turn five.

Photo Credit: Rajesh Pamnani, Used with Creative Commons LicenseUp to that point, what my son knew about his grandmother after the time she stayed with us when he was born and during the few months after, were our visits to the Middle East, my parents’ visits with us in the US, letters with photos, and gift packages filled with books, snacks, clothes and toys.  After this point, the one he used to know as his active grandmother excited and delighted to meet him at airports and who threw big celebrations for his birthdays became someone  who spent the majority of her days lying down in a hospital bed if not in a wheelchair.

One of the areas a middle aged or  elderly person’s health crisis can affect grandchildren is their education.  In our situation, my son’s education involved various twists and turns because of the series of relocations necessary to accommodate for my mother’s caregiving needs as well as the transitory nature of my father’s career.  The temporary leaves of absence we had in our perspective schools became permanent withdrawals.

By the time my son turned five, when it became clear that we were going to live in Bahrain for some time, he started attending the Philippine School in Manama.  He was nicknamed “Little Ambassador” after my father, who helped secure a much larger property for the campus together with the Prime Minister of Bahrain.  By the time my son turned six in the Midwest, where my mother temporarily stayed with a sister while my father’s assignment was in transition, I was homeschooling my son.  The timing of my parents’ relocation and the availability of caregiving resources did not align with school semesters.  After living in Bahrain, my son and I lived back and forth between the Midwest and California until my father’s next assignment to Mexico.

The rest of my son’s education involved a quilt of educational settings that involved difficult decisions, paying for private school, attending a school on a scholarship that taught three foreign languages, trial and error, more homeschooling, and adjusting to the transitions between the US public school system divisions of elementary, junior high and high school.  Looking back as a parent, I may have been able to make different decisions and stick to one, but each school transfer decision was made for a good reason. A few of the experiences could only be discovered with trial and error and some decisions had to be made to fit our family’s unique needs and circumstances.

Not only was my son’s education affected, but my mother’s stroke also affected his own personal growth.  The children of caregiving parents can also be affected when their parents’ caregiving role plays a large part of their daily environment.  This may apply to a daily environment of one parent’s absence.

When my father retired,  I started supporting  my parents due to the various needs that come with physical disability and post-stroke health management.  This impacted my son’s life dramatically.  My son left a school that he grew to love so that we all could move to a city where it was economically feasible for me to support everyone.  We all moved in together so it would be practical for me to help with my mother’s caregiving as a single parent without someone to tag team with and to make sure my father, as my mom’s main caregiver, also stays healthy.

 

http://www.4to40.com/greetings/cards.asp?festivals=Love_You_Grandma-Grandparents_Day-442

Image of the Filipino “Mano,” a gesture of respect to the elderly. (Artist: Jasmin O.)

My son grew up in an environment where my mother’s caregiving needs were always a backdrop to his childhood and adolescence. However, it also deepened his understanding about the capacity of supportive relationships, humanity, the value of life and time with loved ones.  He grew up knowing medical terms and concepts, understanding it can be an everyday routine for one person to depend entirely on others to survive and that it’s actually okay, not being able to go on family outings with the whole family, and not being able to expect a rigid schedule for things that require flexibility.   My son’s childhood and adolescence involved sacrifice and nothing looked picture perfect because his grandmother was physically disabled, but he learned to go to where a person is and be okay with it.

At a young age, my son learned to deepen his love language, or how to express love to and receive love from a person who is limited by physical disability.  He learned little things, like conversation at home with grandmother, is enough to build a relationship on and enough to continue valuing that bond.  He didn’t require kiddie rides, trips to theme parks, movies at the cinema or lunches at a favorite restaurant to maintain that bond.   My mother would of course have loved to continue doing all those things with him through the rest of his childhood, but she was content with letting him enjoy his outings and hearing stories about them when he got home.  I am so proud of my son for this.  I don’t think he even realizes this is something not everyone learns in youth, but my son demonstrated it through the remainder of his grandmother’s life.

Towards the end before my mother passed away, my son began to share some of the caregiving tasks.  When my father and I needed a break, he would feed her her nutritional formula through the feeding tube in her stomach.  About sixteen years prior, my mother used to feed him infant food.  My mother lived to see things come full circle and witness many milestones in her grandson’s life.  My son matured to watch his grandmother look into his eyes without him having to stand on a footstool to see above the bed rails of her hospital bed.  My son continues to cherish her as someone who is irreplaceable.  Both lives, along with my son’s relationship with his grandfather, forever imprinted by love language that evolves through drastic life changes.

The next time you see the families at the airports, stop and take time to consider the journey they may be on.   The next time you get to know a caregiver with children, consider what their children are going through and the unique perspectives they have to offer.  They may teach you something.

“Children Looking at Taxiing Airplane” Photo Credit – Thaths, used with Creative Commons license ***Special thoughts and prayers for all the families affected by the lives lost on the recent Malaysia airlines flights of 2014. With Kuala Lumpur as my childhood home, I will always remember you, Malaysia and its expat/ foreigner community. – Myra Dumapias***

The Unspoken Parting Words

Sometimes goodbyes are far from what we wanted them to be.

Towards the end before my mom passed away, she lost her ability to speak and communicate.  Yet I seemed to develop a language of understanding what she wanted to say or ask or was concerned about.  I believe it was because my life circumstances allowed me to spend years with her, helping my father with the care giving, but I know not everyone had or can have this opportunity.

As I was able to have my parents live with me and my son for almost nine years before she passed away, I was able to get to know her much more.  I was able to get to know her usual patterns throughout the day and over a month, understand the relationships she built with the hospice workers who worked with us at home, and observe the intricate ways her relationship with her husband grew through this life stage.

I was there daily for the most part,  but I know this isn’t a story everyone can tell.  Perhaps you were able to visit regularly, or had a chance to be there for just a brief moment.  Maybe you did not arrive in time.  

Perhaps there was a neurological or mental condition that affected your loved one’s ability to communicate or seem like themselves anymore.  Perhaps your relationship with your loved one had been strained before the moment of passing.

I just want to speak from the heart of a mother myself and a daughter observing how my mom tried to communicate after she lost her speech, and relay the words: 

“Thank you.”

and 

“I love you.”

…to all the loved ones and caregivers out there who may not have heard these words.   I did not hear these words myself at the time of parting, but there is a level of communication that remains after speech ends or gets distorted.  

Deep beneath the loss of speech, changed personality due to a neurological condition, or total mental breakdown, is or was still the person you once knew and loved, and who once loved you and was enthusiastic to be around you.  

Sometimes love has to involve giving the benefit of the doubt that if conditions were different,  the words you would have wanted to say and hear would have been exchanged.   That is what we must focus on to honor our loved ones, who they once were and what they once were capable of.  Allow their healthier selves to dictate the long term impact of their lives on yours and allow yourself to see the less than ideal goodbye (or lack thereof) in perspective of that. 

I hope that these words can release more memories of your loved ones from a time when they were healthy, laughing through the hallways, splashing water with you, eating under the sun, chasing you, sitting on a bench with you, running to a gate to catch a plane with you or other memories that may be shadowed by a less than ideal goodbye.  May it release you from any heaviness because this is not what your loved one, in their right frame of mind or healthy condition, would have wanted to part you with.  And may you know that the words, “Thank you,” and “I love you” are probably not even enough to fully communicate what they felt at the time they parted.

I would bet that every loved one would try to communicate in whatever way they could if they were able to, like the story of the dying grandmother who wrote in code before she passed away.

For those who are going through journeys where perhaps it is difficult to find good memories because the nature of your relationship with someone who passed away, I hope to also hear from you and what has helped you.  Your journey involves much more strength and unconditional love.

Until our next hello,

Myra

Related story – “Dying Grandmother’s Mystsery Code Cracked by the Internet After 20 Years”

Original source of the story – “Decoded Cancer-Addled Ramblings” 

Photo credits: “A Year in Boarding Passes” Kim Davies with Creative Commons License (photo cropped)

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© Myra Dumapias and The Last Boarding Call, 2014-2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Myra Dumapias and The Last Boarding Call with appropriate and specific direction to the original content.