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Don’t let illness or death ruin your relationships.

Familial relationships can be challenging at the best of times — then add an illness or death.


Within months of getting married, my husband was diagnosed with brain cancer. Suddenly, I was responsible for making life and death decisions for my new husband and interacting with my new in-laws daily. In hindsight, I wish I had been more aware and mindful of all the assumptions I was making regarding my in-laws' actions or non-actions and all that contributes to misunderstandings. That was 18 years ago, I am so grateful for the beautiful relationship I have with my late husband's family.

 

Unless you never had a relationship with your extended family or in-laws and couldn’t stand them from day one, chances are that the illness in the family and everyone's reactions or lack thereof are at the root of the new distance. Some people in our circles are much better at coping with certain situations, but going from a cordial relationship to "you're dead to me" following a death may be linked to various forms of misunderstanding.


Misunderstandings can take place on both sides for various reasons. It's never too late to explore if any of the following may have contributed new rifts:

 

1. Ambiguous Language: Were they clear about the help they wanted? Did you offer to do specific things to help them, such as groceries, meals, carpooling kids, or medical appointments? Vague or unclear wording can lead to different interpretations. Asking for help can be difficult for many, and we don't always know what we need or want. Offering support can be just as confusing.


2. Cultural Differences: Different cultural backgrounds can result in different understandings of behavior, gestures, and language. We tend to think of cultural differences as a matter of ethnicity or country of origin, but we forget that family "culture" can differ from one another. During stressful times, these differences can become painfully obvious, but we don't always interpret it as such; we may think our in-laws are uncaring if they are not visiting/helping daily, all the while they are working hard to respect the nuclear family.

 

3. Assumptions and Expectations: Everyone is guilty of making assumptions and having expectations. Just think of when we drive down the road. We make assumptions every minute we drive, and when someone doesn't meet our expectations (e.g., putting a turn signal on—we can go from zero to irate in seconds). If you're mad at your family and friends, check if there are any underlying assumptions or unmet expectations underneath it all.

 

4. Emotional States: Stress, anger, or exhaustion can affect how messages are sent and received. It's important to breathe and take a break, try not to overreact. If it's the other party that flies-off-the-handle, try not to take it personally – remember that your emotions may also be a little raw.

 

5. Lack of Context: We can't assume that we fully understand why certain decisions are made or actions taken. Missing background information can lead to misinterpretation and bad blood. How often has it happened where we're irritated that someone hasn't called us back or visited, only to later learn they or a family member was gravely ill.

 

6. Listening Barriers: Distractions, preconceptions, or lack of attention can prevent effective listening. Again, the dying and caregivers have so much on their mind, maybe concrete help was offered but they didn't hear it as such. A colleague of mine used to say, if you speak to me and you don't see the white in my eyes, don't assume that I heard you even if I reply "uh-huh" or "yes." Listening barriers are a real and unintentional.

 

7. Nonverbal Cues: We also know that misreading body language, facial expressions, or tone can lead to misunderstandings. It can also affect our own body language in return, creating a vicious cycle. Think of the times you may have gone in for a hug and handshake and felt rebuffed; you're likely to be reticent to try it again. Meanwhile, your original cue may have simply been missed due to any number of reasons above.

 

8. Technological Interference: Issues with digital communication, such as tone misinterpretation in text messages, can cause confusion. I recently heard on CBC radio that the thumbs-up emoji response to text messages can have multiple meanings. For those of my vintage, a thumbs-up gesture is a good thing, it's that you approve of what the other person is doing or saying; however, for the younger folks, it can be construed as being passive-aggressive or sarcastic. And then we're surprised that misunderstandings can arise through technological exchanges.

 

I highly recommend involving an end-of-life doula when someone is first diagnosed with a life-limiting illness. Doulas offer support to the ill person, as well as to the entire family and extended family if needed. An independent third party who is not emotionally involved with the family can help minimize family rifts that may arise in the months of palliative care. Doulas can also support families following a death, as everyone is grieving, emotions are running high, fatigue has set in, and too much may be said or left unsaid. If there was love before the illness, chances are everyone continued to love but had different ways of showing it. We all have different love languages; our needs are great when supporting a loved one; unmet needs can lead to pain and severed relationships.

 

Addressing these sources of misunderstanding involves clear communication, active listening, and seeking clarification when needed.

 

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