I just read an article on how a caregiver can respond to a senior who is saying, “I just want to die.” I appreciate the advice given by Margaret Sherlock, M.A., Clinical Director of the Behavioral Health Program & Assessment Program Services at the Visiting Nurse Service of New York, which includes not ignoring the statements and being realistic about a senior’s need to talk about death and dying, while still setting limits on such heavy discussions and monitoring for signs of clinical depression in both the senior and in yourself. You can read all of her advice here.
This is sound advice, but I do think there is one important piece missing: you must think about how to deal with all of the emotions you and your loved one are both feeling. In fact, this kind of conversation can be so emotional for both the senior and the caregiver that it can be difficult to tell who is feeling what. You might think, is this person feeling depressed? Or is he just ready to die? Or is this person saying she wants to die because she wants to make me upset or get more attention from me? Or am I interpreting all of this wrong because I am the one who is feeling sad, or tired, or frustrated? Or maybe it’s a mixture of all of the above feelings, and I’m not really sure how to put words to it?
Even just trying to identify these feelings is difficult. No wonder these emotional conversations can wear you out! As Ms. Sherlock advised, though, you can’t just sweep the difficult feelings under the rug: they’ll just build up and create bigger problems for you and the senior later on. That’s why I’m usually not a fan of just changing the topic or putting on happy music to avoid the conversation.
When someone says, “I just want to die,” you need to acknowledge their emotional expression and honor your own.
A great way to do this is by allowing a song to be the container for that emotion. Musicians for generations have been putting these kinds of feelings into music, and you can let their songs hold your feelings, too. There are hundreds of songs that could work well as containers for difficult emotions. Here are some examples, with significant lyrics:
Fire And Rain – James Taylor (Folk/Rock)
“I’ve seen fire and I’ve seen rain
I’ve seen sunny days that I thought would never end
I’ve seen lonely times when I could not find a friend
But I always thought that I’d see you again”
Help Me Make It Through The Night – Kris Kristofferson (Country Ballad)
“Yesterday is dead and gone
And tomorrow’s out of sight.
Lord, it’s bad to be alone.
Help me make it through the night.”
Peace In The Valley – Thomas Dorsey (Gospel)
“There will be peace in the valley for me, some day
There will be peace in the valley for me, oh Lord I pray
There’ll be no sadness, no sorrow
No trouble, trouble I see
There will be peace in the valley for me, for me”
I’ll Be Seeing You – Sammy Fain/Irving Kahal (Jazz Standard)
“I’ll be seeing you
In all the old familiar places
That this heart of mine embraces
All day through”
Each of these songs addresses loss and end of life in a different way, with a focus on a different emotional aspect, but each one can be a container for the difficult emotions that might otherwise be suppressed or allowed to overflow in a way that is unhealthy for you and for your relationship with the senior.
If you want a song to be part of the conversation about death and dying, consider these ideas:
- Choose a song that expresses how you feel, how you imagine your loved one might feel, or both.
- Introduce the song, maybe by saying why you chose it. For example, say, “Grandma, I heard this song and I wondered if you feel the same way that this singer does.” Or just, “Dad, I want to listen to this song with you.”
- Listen actively, paying attention to the senior’s reactions as well as your own. If something feels off or totally uncomfortable, it’s okay to stop the music.
- Talk about the song afterwards. Identify how you thought certain feelings or ideas in the song matched your own.
- Or, don’t talk about the song afterwards. Sometimes, the song can hold all of the feelings and ideas, and when it’s over, you can move on.
It’s important to have conversations about death, but when words aren’t working, you just might be able to meet your loved one in a song.
This is a musical experience that you can use on your own with your favorite senior, but there are times when music therapists or other mental health professionals might be needed. Here are my words of caution:
- Music can bring up very strong emotions, sometimes in ways that surprise you. Please know that you can contact a music therapist or another health care professional to help you work through these feelings in a way that will bring about better health for you and your favorite senior.
- Use caution with seniors who have dementia. Sharing songs can be a great way to validate the underlying emotions for a person who has dementia, but attempting to talk about the song and death and dying issues may be confusing and agitating to the person with dementia. A music therapist can help you navigate this in a way that is emotionally-validating but not confusing.
- Talking about the end of life as an approaching reality is different than contemplating suicide. If your loved one is suicidal or you’re just not sure what they are thinking, contact a mental health professional.