Caregiver Grief: End-of-Life Considerations

Human-Animal Bond

As caregivers, we sometimes can get focused on our desires, needs, and expectations.  This stems from a focus on the human-animal bond between ourselves and the animal.  While loving and supportive, we can inadvertently ignore another important contemporaneous relations.  That is, the animal-animal bond.

Bella and Tara

Many of us remember the touching video pieces from 2006.  An elephant named Tara was a member of an animal sanctuary outside Nashville, TN.  Tara became fast friends with a stray dog named Bella, and the video followed a critical illness of the dog.  The loving elephant held vigil while the dog recovered.   

Sadly, the animal sanctuary reported that Bella the dog passed away this week.   It’s touching to read that Tara has sought out her sister elephants to grieve the loss of her friend.   (Read press release from elephant sanctuary)

Honoring the Animal-Animal Bond

We should always keep this extraordinary bond in mind as we care for the dying.  I believe the animals understand full well the nature and extent of end-of-life and they may want to participate or honor their fellow animal in their own way.  We should always try to respect and promote this bond, which has nothing to do with us.  This includes anticipating and honoring their own grieving process.  The value, and service, is watching the beauty unfold, completely free of human intervention.

Have a peaceful and loving day!



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October 31st, 2011 Comment

Caregiver Grief: Beware of Military and Sports Metaphors

Diagnosis of a potentially terminal illness causes of rush of activity calculated to result in a treatment plan.  I’ve noticed, especially after reading any obituary, the constant use of military terms.  For example, “Doug passed after a brave battle with ….” or “Doug passed after a heroic fight with ….”    

Looking back, I was never more upset or ill at ease when I viewed myself as a Crusader in some type of personal war.  I applied my own version of martial law.  Let me explain how the words we use create a certain emotional state that follows use like a shadow. 

Mititary Terms and Illness

Referring to cancer (or other illness) as the “enemy,” or even a “monster.”  The treatment plan might be talked about as a “campaign” or a “battle” against the disease.  Multiple drugs might be your “arsenal” and more than one veterinarian constitutes a “battery” of doctors.  Occasionally, a patient will respond favorably to treatment and the word “victorious” emerges. 

Just one problem arises.  If patient “X” emerges victorious, and my dogs died, it then follows that Beezer, Boomer and Doug were “losers.”  After all, military battles require one force wins and one force loses. 

Sports Metaphors and Illness

Having a contact sports background, I use the associated sports metaphors as a type of personal bible.  The patron saint of this line of thinking is the former pro football coach, Vince Lombardi.  Selections from Coach Lombardi include: 1) Winners never quit and quitters never win,  2) Show me a good loser, and I’ll show you a loser, and, 3) Winning isn’t everything, it’s the only thing.

Speech Creates Expectations After a Diagnosis

Perhaps my greatest problem as Beezer’s illness grew more serious and objectively uncontrolled, was my insistence on following the Martialization of Illness approach.  Added into the mix was my underlying belief that my utter failure on the battlefield and/or football field, was causing my buddy to not only suffer, but die.  Letting your buddy down is a felony guy-thing and unforgivable.  I spent many tearful nights cursing myself to sleep for my perceived shameful fault in letting my best friend grow more ill.   

I’d spent all of my life believing that harder work, never, ever surrendering, and just not accepting second place, were absolute truths.  Using these words and phrases created an expectation of success based on past results.  There was just one problem:  we weren’t on a hockey rink, football field, courtroom or any of the other places where this thinking is appropriate or helpful.  I’d created unrealistic expectations and reinforced those expectations on a daily basis by Martializing the Illness. 

Tools For the Caregiver

  1.  Beware of metaphors as they create expectations.  Your emotions will follow the words you use during treatment.
  2. Consider outsourcing the battle.  That’s what doctors are for.  I learned how to focus on each day with my dog and let my doctors “fight the fight.”  We were too busy living.
  3. Never refer to cancer as a “monster.”  Monsters live in closets and under beds.  They always win and are very scary—that’s why they are monsters!

Of course, a potentially fatal illness is a deeply personal experience for patient and caregiver.  You should always follow your heart and do what works for you.  I just found these common phrases created nothing but fear and guilt in my life and decided to just opt-out of the whole Martialization of Illness thing.  It just didn’t serve my purpose.

By the way, Vince Lombardi died of cancer at age 57.  Nobody in their right mind would refer to the coach as a loser. 

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October 16th, 2011 Comment

Caregiver Grief: How Close to the Bull’s Eye Are You?
An un-official 80cm FITA archery target

Image via Wikipedia

All About Grief

I talk alot about the term “anticipatory grief,” or the pain associated with a future loss.  Fear, guilt, anxiety, hopelessness and physical symptoms are just some of results of anticipatory grief.  It occurred to me that caregivers, especially primary caregivers, are particularly susceptible to this calamity.  So how bout’ we call a spade a spade?  What we are talking about here is “Caregiver Grief.”

Think about your primary care for your sick or aging pet and carefully consider all the people in your life around you.  I even find it useful to categorize them in groups.  The more loving and supportive people are in closer proximity to you then the less supportive people who I group farther away.

Primary Caregiving

I found I was creating concentric rings, or better yet, a target or bulls eye.  The primary caregiver occupies the center of the bulls eye.  The caregiver sees periodic, and even daily, decline, as the animal grows weaker and more dependent.    Any “delay” of dealing with grief simply isn’t feasible.

Now consider the reaction of each concentric ring moving outward from the bulls eye.  These people live in a luxury the primary caregiver can scarcely comprehend.  These people remember the pet (or even Mom) as a vibrant and healthy being.  These folks have other responsibilities and go about their daily lives free of the stress that the primary caregiver finds on the center ring.  The degree of support, empathy, and actual help provided to the caregiver, results in the actual positioning on the concentric ring target.  For these people, grief will come later, at a passing or thereafter.  Of course, these people have the freedom “not to deal with it” because they don’t have to.  You do.  It’s neither good nor bad, but just the way it is.

Beating the Grief

Creating your own Target chart (even if just in your mind) can be a useful tool.  Many times people have asked me “why doesn’t (insert name) support me more?”  One answer is that each of you are too far removed on the target.

Remember, as primary caregiver, you are the bulls eye, the center ring on the target.  The “bombadiers of life and death” have an uncanny knach for hitting this bulls eye.  This is why the primary caregiver can experience so many negative emotions during the process–while those around the caregiver seem rather immune.  Recognizing Caregiver grief is an important first step to seeking out solutions.

So how close to the Bull’s Eye are you?

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September 25th, 2011 Comment

9/11 Anniversary, Heart and Service

Yesterday, September 11, 2011, was an interesting day. I flew from San Jose back to Denver. I wasn’t real excited about flying on the 10th anniversary of 9/11, but I really wanted to attend this conference in California. The flight crew provided a special moment which drew the normally detached flying public together for a moment. I felt the power and emotion deeply within my heart. Here’s what happened.

The flight attendant came on the intercom to talk about the proverbial “elephant in the living room.” Yes, it was a special day. She asked us to simultaneously flip on our “call attendant” buttons, thus ringing each of our personal bells throughout the cabin. She then asked us to observe a moment of silence for the victims. I think we were cruising at 39,000 feet.

She then thanked us for not being afraid to fly that day. I could tell the gratitude was from somewhere deep inside her as opposed to the umpteenth direction on how to breathe from the inflatable mask. The cabin then erupted in clapping. All of us, in our own way, felt this deep emotion and pride of country as our hearts opened, however briefly. It said much about the moment and place our country now occupies.
The past decades have seen much greed and focus on self. The airline incident yesterday shows how dynamically things change when we come from heart and service. The entire flight cabin was one, well oiled, unit. This is the best part of us and we’ve forgotten how to access it.

What’s happened is the events of the past few years have lead to emotional detachment. We don’t feel good, we don’t feel bad, we feel nothing. Our perception that pain is judgmentally “bad” then requires we switch off the pain switch as a preservation device. In doing so, we switch off our humanity. You see, the best part of us only emerges from the deepest pain.

I struggled with that when my dear buddy Beezer was so ill. I felt I was letting my buddy down so layers of judgmental pain overcame me. No it wasn’t fair and no we didn’t deserve this. So I had a tremendous pity party as I lamented the depth of my suffering and the complete inability for anyone to appreciate how badly I’d been wronged.

Then something extraordinary began to take place. The animals began to open my heart. They taught me that in life “pain is mandatory, but suffering is optional.” Yes it hurt, but life was also fair and together we would survive and thrive by serving each other selflessly.

Beezer never got better from his illness, but I was miraculously cured. Heck, I didn’t even know I was sick. This brings us back to today and our opportunity.

The country is in trouble, but not for the reasons you might think. It’s not lack of revenue, excess spending, entitlements or anything else feed to us. It’s a lack of heart and service. The ability to feel for others pain and sacrifice a bit of ourselves for their benefit, asking nothing for ourselves. The ability to enter a battle, not for god or country, but for the guy next to you. The immense power of saying to yourself, “this is going to hurt, but my buddy needs me.” Simply put, the ability to leave guilty decisions of yesterday behind. To never fear because the perceived event we fear must take place in the future. To doggedly remain present and in the moment because this very instant of time is the source of power and the place of peace. Then use the moment to share our love, and essence of what truly makes America great, with our fellow man.

Once we do that, things will get better. We don’t need the politicians “help,” we don’t need handouts, we don’t wildly vacillating political theory. All we need is for each of us to care as deeply about the guy next to us as we care for ourselves. Once we do that, as a country, the secrets will reveal themselves like an Indiana Jones movie. It’s an opportunity for us to show “The Greatest Generation,” (and ourselves) that we got the right stuff too.

September 12th, 2011 Comment

Pet Loss and Aftercare: The Pain of Change

The first few days after Beezer passed were particularly hard and I discovered a great deal of unexplained anxiety. I was continuing to work a job that no longer existed.

My old version of normal was running a 24/7 doggie ICU. Med schedule, twice daily sub-q treatments, home cooked diets. I was in constant motion. Suddenly, I was unemployed. My brain and body needed time to catch-up with the circumstances.

Boomer would watch in considered disbelief as I’d walk laps around the house, carefully moving one object a tad to the right, only to return a few minutes later and move the object a tad to the left. Then I’d start over.

My life had changed and I needed to process and understand this new circumstance. I tried to divide up my grief in order to process it in parts. I missed the Beez and that part of the grief process would have to work itself through at its own pace. I also missed what had become part of my daily routine. You see, I’m a creature of habit. The world had once again changed around me without Doug’s permission. I had entered a New Version of Normal.

I tried to adapt to the new version of normal after recognizing this change. I sat down to read or just chill out. I’d run experiments to see how long I could last before trying to re-enter the life now passed. At first, my efforts were rather silly. About 4-5 minutes of doing nothing were all I could take before rising for a few more sprints. I acknowledged to myself that this Pain of Change was temporary and a new version of normal was right around the corner. That version of normal would allow me to relax and enjoy my life.

Aftercare of our human state is so important when a pet passes. We need to give ourselves permission to heal. It is also normal to have feelings of guilt crop up here. So I’d have a conversation with myself. “Exactly why do you need to feel guilty Doug?,” I’d ask myself. And I’d make the little voice in my head answer the question.

I’d also remind myself that I did a great job of caring for the Beez and his loving memories and lessons would stay with me for all my days. The loving care I gave my trusty Labrador needed to be turned inward now. Beezer deserved my deep affection, but so did I. I also forgave myself for any mistakes along the way. I always did the best I could. Finally, I recognized that Beezer did such a great job of taking care of me. It was now my responsibility to keep up his good work.

With self questioning and fair minded analysis like this, I was able to move through the pain of change and accept the new version of normal. I’m a lot more caring of Doug these days. I have an 85 pound Labrador retriever to thank for setting me on this journey. A job well done by my best buddy.

August 24th, 2011 Comment

The Methodology of Treatment Decisions

I’ve found decisions over treatment options, and even a decision on whether to treat at all, are perhaps the most difficult options I’ve ever considered in my life. Potentially life or death choices resting in the palm of my hand and concerning a living being that I loved so deeply. I was desperate to make the “right” decision, and terrified about how to go about this. So I examined the problem and began to dissect the methodology of arriving at decisions.

Boomer’s bone cancer was getting worse. I would either have to amputate his hind leg or euthanize him in the near future. I was concerned about making matters worse for my alpha male, The Big Dog, and at the same time, I didn’t want to say goodbye too early. How could I resolve this dilemma?

Early on, I had choices over treatment; chemotherapy, radiation, just to name a couple. These were rather objective points where I had a specific goal in mind. I just had to choose the best option to reach that goal. I called these “Results Driven Decisions.”

I also thought about the more difficult decisions. Perhaps the issue wasn’t so objectively clear or the specific goal a bit less clear. This was the dangerous territory for me because of my habit for retrospective judgment. Stated otherwise, and if the selected treatment didn’t work, I’d look back in time and chastise myself for such a stupid decision. This called being a “Monday Morning Quarterback.”

So I pondered if, and then how, I might remove all judgment from this set of decisions. Fortunately, this proved easier than I thought.

In Boomer’s case, he was down to mere hours of life. Absent amputation, he’d have to join his brother. The steadily increasing pain of bone cancer made that fact rather clear. To me, the decision became one of promoting health and life. There wasn’t any guarantee or clear goal in mind (i.e., a results driven decision), just a result I could live with later on, no matter what the result. I called this a “Process Driven Decision.”

The process driven decision then insulated me from guilt later on. Since I acknowledged the lack of a clearly defined goal, prior to the decision, I couldn’t beat myself up later on. What I did need to do was sit down with my dog and have a long talk about our life together. The decision became one more of personal philosophy than veterinary medicine. I was simply making a decision that I could live with many years down the road.

I decided that Boomer’s offending leg would have to be amputated. I’ll always be a bit uncertain as to whether I honored Boomer or disobeyed a direct order. However, I am certain I made the best possible decision under the circumstances and remain comfortable in this choice several years afterwards.

August 14th, 2011 Comment

Pennys From Heaven

My Mom once sarcastically remarked, “when I get sick, I hope you treat me as well as you treated those dogs.”  I’ve been doing exactly that for the past three months.  Our earthly Journey together ended at 5:25 pm yesterday evening.  Mom passed very peaceably at hospice.

My intention had been to write about her final illness as I applied the lessons from Beezer and Boomer to an impending human loss.  Alas, the speed of the illness was too great and I’ll do a recap at a later date.  Sometimes, you just have to tell the end of the story first, and this is one of those days.

The funeral people arrived about 8:00 pm.  I helped wrap Mom’s body in blankets and then loaded her onto a gurney.  I dismissed one of the attendants and helped wheel the gurney out of the facility and into the van for transportation.  Upon arrival, I helped unload Mom at the facility.  I followed my checklists for the B Brothers exactly and said so to nobody in particular.

Once home, I collapsed into a large easy chair in the living room.  The room has a high vaulted ceiling, the same ceiling where I hung IV bags in my desperate attempt to save Beezer so many years ago.

At the crown of the vault is a smoke detector.  Years and years ago the battery beeped a few times before it died.  Not having a folding ladder, I constructed a type of homemade hillbilly ladder with bar stools and got high enough to remove the deceased battery.  I then realized I didn’t have a replacement.  I left the battery door open as an optical reminder to borrow a ladder and get a battery.  That was at least five years ago and the little door remains open and battery compartment empty.

I closed my eyes and noticed my Lab Dory sound asleep at my feet.  I was startled a few minutes later by a series of three short beeps.  I looked around and Dory was now at alert.  “You heard it too?” I asked my dog.  Then it happened again, “BEEP, BEEP, BEEP” and the sound was coming from the inoperative, powerless, smoke detector.

I was now fully alert and focused all attention on this small device above me.  A few minutes later a sound emanated directly from the smoke detector, “BEEP, BEEP, BEEP.”  No mistake, no error, no imagination.

Then the phone rang.  It was my friend Terri who had just read that my Mom died.  As we were talking, the smoke detector went off again, “BEEP, BEEP, BEEP,” always in sets of three.

“What was that noise?” Terri asked.  “Oh, it’s just my mother beeping at me,” I said as matter of factly as I could.  Terri, a dear friend and the animal communicator that helped me with the Boys, absolutely loved this little event.

In all, the event lasted about thirty minutes and had perhaps five or six sets of beeps, each set comprised of three beeps.  It was classic mom.

Only a loving mother would stop by on her way to the Bridge to remind her son to just put a battery in the friggin smoke detector.

And my dear mother, bless her heart, was seldom understated.  If a situation called for one reminder then fifteen to eighteen reminders was just about par for the course.  I’m so glad she stopped by since she was in the neighborhood.

The coming days will involve getting used to a new version of normal.  I’ll have to get weather and traffic reports on my own.  I’ll also have to sit down and make a list of whose birthdays are coming up—all stuff that mom was so good at.

For now, I’ll save more comment for a later date.  I think I’ll run out and buy a battery and borrow a ladder.  I’d hate to have a fire next week and have my mom mutter “that damn kid never listened to me when I was alive either.”

February 19th, 2011 Comment

Christmas, Appreciation and Our Animals

Today is December 23rd.  A date with much significance for me.  It was December 23, 2004, when Beezer was given 90 days to live.  I’ll always remember that day.  A cold concrete floor, a bit of white noise in my ears, no windows.  The doctor delivered the news with some brutal blood tests.  I came home, canceled Christmas, canceled New Years, shut the blinds, and closed off the world.  It was the beginning of my downward spiral as I battled the universe over my perceived control.  It didn’t go well.

Two years later, Boomer was diagnosed with bone cancer at the same time of the year.  My Big Dog was given 120 days to live.  This would be the last Christmas we’d spend together, but my attitude was 100% different.  With Beezer, my emotions were running rampant.  My thoughts followed along dutifully after my emotions.  Little wonder that my thoughts were so self destructive and negative.

By 2006, I had learned that by changing my thoughts, my emotions followed.  I was sad that Boomer was critically ill, but I stopped the emotions in their tracks right there.  My dogs had taught me that guilt resides in the past, fear resides in the future, and my safety zone was today–the here and now.  So I channeled all my thoughts into remaining present on today.  It worked!  My emotions followed suit and I felt gratitude and appreciation.

In fact, as we celebrate the holidays in 2010, my emotions remain full of gratitude, love and appreciation.  It’s sad that the fellas are gone, but I’m so darn appreciative of their contribution in my life.  Every facet of my life is improved because of their teachings.  Two lives well lived.

The blow is a book excerpt that applies especially today.  Cherish one more Christmas with you old or sick animal.  Think about the lessons, meaning of events, and your ability to shape and frame your thoughts if your dear animal has departed.  It’s never too late to look back and give new meaning to these events!

Most of all, I wish each of you a Merry Christmas.

A Christmas Letter to Boomer

Dear Boomer,

It’s Christmas morning. My gift to myself is to write a letter to you. We are so lucky to have each other today. The winter morning in Colorado is cold, crisp and a trackless expanse of white. Everyone else is busy inside with presents, so we will have the whole neighborhood to ourselves. I like that. I will read this letter to you as we walk.

I’m not going to wish for a Christmas present of cancer remission, a cure or even a miracle. Those would be future events and you know how I try to stay out of there. I’ve learned that these things are out of my hands, and, in fact, never were in my hands. I’ll try my absolute best to give you quality care but will release the outcome. It’s not for me to decide or control.

In this way, I can live with balance. I will embrace your illness in order to fight it on my terms, not the disease’s terms. I will invite it into my heart and soul. Only there can I defeat its progeny: fear. All outcomes are good when I walk without fear.

I will wish for one special moment each and every day, a moment so seemingly innocuous that only you and I recognize that brief second. A moment where we both look at each other and say, “This is why I love you today; this moment makes today special.” You see, my dear friend, I know that I might easily miss these treasures if I’m not looking for each one. The snapshots simply pass too quickly in the movie we call life.

I also wish for a Christmas present of continuing to place your best interests first. It’s not about the quantity of life, it’s about the quality. You are so much about fun and lightheartedness, my Big Dog. You are about the silly things that make me laugh and enjoy your company. I wish for a few more of those moments and the objective eye to see when they slow down and cease altogether.

I wish for you to have control and participation in the daily events in your life. It’s not about me, it’s about you. I will speak to you in frank terms about your condition and request your counsel and instruction. I pledge to respect your Christmas wishes as well.

Also on the list is a guilt-free journey. I know this is your wish for me as well. I remind myself that I don’t have a crystal ball and there isn’t going to be any way to pick the exact 100 percent correct solution to take care of you. What I can do is weigh each option that is available, discuss it with you, and make the best combined election. What matters is that the decision comes from a place of love and compassion. Under these circumstances, the outcome is irrelevant.

Most of all, my dear brother, I wish for a happy day. We are intertwined in each other’s lives today and nothing else matters. I am grateful for the gift of today and all the magnificent times we have had and the adventures to come, both here and beyond. You and your brother and now Coral are the best things ever to come into my life and I’m so very, very lucky to have you in my life this day.

Thank you, my best friend, and Merry Christmas!

With much love, your brother, Doug

December 23rd, 2010 Comment

Tampa Book Signing

Tuesday, November 30, 2010, from 6:30 to 8:00 pm

Downtown Dogs

Hyde Park Village
1631 W. Snow Circle
Tampa, Fl 33606

This event will benefit TampaPets.Org.  This wonderful coalition of over 50 rescue groups is making a difference by dropping the rate of unnecessary euthanasia of animals.  Perhaps that says it all.  I’d be very honored if you could dedicate an evening to helping out those whose only sin was not being born into a loving family.  These little guys and gals really need our help.

I hope to see you there!


November 21st, 2010 Comment

Clearwater Book Signing

Monday, November 29, 2010, from 6:30 pm to 8:00 pm

Fluffy Puppies

1447 S Fort Harrison Ave.,
Clearwater, FL 33756

This event will benefit Labrador Retriever Rescue of Florida .  The B Brothers want to hit the ball out of the park for this event and help out the Labs.  I hope to see you at Fluffy Puppies.



November 21st, 2010 Comment