HOW MUCH IS ENOUGH?

This is not an essay about having too many possessions, knowing when to stop acquiring things and deriving happiness from a “less is more” philosophy. That topic has been covered by Arthur Simon in his thought-provoking book, “How Much is Enough? Hungering for God in an Affluent Culture” and is worth reading. Rather, this article poses some questions having to do with aging, medical and end-of-life issues. How much of one’s time and resources should be given to aid a family member, even if that means making sacrifices and adjustments to one’s own life? How much treatment should be pursued when serious and/or life-threatening illness is present?

Sometimes the answer is straight-forward, if not easy, such as when trying to help a person in the throes of addiction. Resisting the urge to give money, offer excuses or otherwise enable, forces the person to face the consequences of his chemical dependency. This is often an effective way to help and one that experts in the recovery field would recommend.

Other situations are more complicated. For example, how much of one’s life should be given over to help a loved one, when that entails sacrificing parts of one’s own life? Most people don’t think twice about giving up plans to take a relative to a medical appointment, but this can become burdensome as the needs increase. Sometimes a sibling feels that he is shouldering the majority of caregiving, which can lead to resentment. Ideally, all the adult children will discuss the needs and equally share the duties. This doesn’t always happen, or there may be only one family member who can and will help. And eventually most families face the decision of where the elder should live. Financial factors almost inevitably arise as well, unless the family is lucky enough to have unlimited resources. Should a person put their own life on hold to help an elderly or ill relative? The immediate, obvious answer to most people would be “of course,” but the issue is not always that simple. Everyone involved needs to talk about their feelings and wishes honestly and often so that the best decision can be made (i.e., one that everyone can live with).

I have known many adult children who have given up a lot to care for ailing parents. Sometimes this is easy, as the caregiver has the time and resources to devote to the elder/parent. But I have also witnessed examples where the child has put their own life on hold, so to speak, for example by moving to another state to assist their relative, even if that means giving up a job. Many people would say the decision is easy, though others agonize over the cost – emotional and financial – of making such sacrifices. Pre-illness relationships among family members factor into the decision, but even when they have been positive, resentment can build as one realizes what has been given up. I have also known cases where not helping results in self-doubt and guilt.

A further complicating factor is the issue of agency. When the older person who needs care wants or doesn’t want an intervention that her caretakers do, problems ensue. Where and with whom should the person live? How much medical treatment should a person have when there is a terminal illness? Who gets to make the decision? If a person is in the hospital, it can be difficult to take a stand since the mandate of the medical profession seems to be treat at all costs. Thankfully, it appears that now more emphasis is being made on life and care plans so that the personnel will know when it is time to move from curative to palliative care. Hospice care is enormously helpful at this time. But of course, the patient and family need to be in agreement with terminating treatment and moving toward a good death in order for patient and family to receive all the benefits. Studies have shown that often patients themselves desire the cessation of treatment and are more comfortable with end of life plans than their family members. All this is to say that, again, everyone involved needs to communicate their feelings and wishes openly and often.

Unfortunately, there are no easy answers to these questions. When deciding “how much is enough,” there are some things that will help. As emphasized above, one of the most important things to do is communicate, involving an aging specialist or hospital social worker when needed. Also, doing research so that you are informed about the available options, as with any important decision, is helpful. And of course, pray. After all, God is and has always been a very present help in time of trouble.

Finally, on a personal note, I am retiring from the Center for Pastoral Counseling at the end of this month. I started working with CPC in February of 2000. I have seen many changes over those twenty-one years, both in our organization and in the larger world. What has been constant is that I have been blessed with coworkers whose compassion, spirituality and therapeutic skills have been an inspiration. And I have also been blessed to work with and learn from clients who have trusted me to be a part of their life’s journey. I am grateful to them all.

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The views and opinions expressed in this article are those solely of the author and do not necessarily reflect the views and opinions of the Center for Pastoral Counseling of Virginia.

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