Rethink Closure

There is no such thing as closure!

It drives me crazy when pop culture cliche invades mental health. It creates unrealistic expectations and pushes people further away from the help they need. Do you know when you get closure? When you die. Until then, the door can swing open any time.

Let’s say someone significant in your life dies. For the first few months, you cry easily and a lot. You struggle to focus on day-to-day life. That’s normal.

As time goes by, the tears subside. You resume daily activity. You find reasons to feel good without feeling guilty. You cry a little on birthdays and anniversaries. All normal. You think you have closure.

Then one random day 10 years down the road, you have a meal that tastes just like Mom used to make...see a guy wearing a jersey of your husband’s favorite team...hear the shared song that you haven’t heard in years...and you break down and cry like you just heard the news for the first time. Closure just opened up.

In real life, the door swings open and shut all the time. You can’t predict it. When you think you have closure, an unexpected wind blows it open. Maybe just a crack. Maybe rips the doors off the hinges. That’s life and that’s normal.

Closure is not life and closure is not normal.

When you see a therapist, it’s for big reasons. Life changing reasons. Emotional hurricane reasons. It’s not realistic or healthy to think you can close the door and never look back. If it’s big enough to seek help, it’s too big to forget.   

If you are currently in therapy or considering it, it is important  to have realistic expectations. If you don’t, no therapist will be good enough to help you.

You can cope...manage...strive to find a balance...make lemonade...dance in the rain...whatever suits your needs. Remember the past, move forward with the lesson and leave the pain behind. But know that sometimes the pain gets a second wind and catches up to you...if only for a moment.  

Don’t look for closure. You’ll never find it.

Do you have questions about a specific situation in your life? Topics you want addressed in future essays? Let me know about it in the comment section.

For information on individual counseling, please contact me at bradleyjabel@gmail.com.

I’m an LPC and a writer. If you are a mental health professional and need creative consultation for your professional literature, contact me.

A nursing home primer

Consider these 2 fact:

1. Every day, thousands of Baby Boomers are retiring.

2. Development and construction of nursing homes and senior living facilities is booming.

Put these together and that means in the next 10 to 15 years, a lot of you will face the reality of putting your parents in a facility. When that day comes, here are some tips to help make the transition less stressful.

1. ASK QUESTIONS. I worked in a nursing home for 5 years. I listened to nurses rattle off terminology as if they were speaking in code while family members nodded along, clueless. As you age, you are essentially learning a new language dominated by acronyms. COPD. CHF. UTI. CNA. LPN. Acting smart is dumb. Educate yourself.  

2. GET TO KNOW THE STAFF. Nursing homes are divided into units. Each unit has a social worker/case manager. They generally handle all non-medical stuff but you can go to them for anything. You have nursing assistants (CNAs or PCAs) and head/charge nurses. Then there’s a unit manager who oversees everything on the unit. There is a director of nursing (DON), possibly even an assistant director of nursing (ADON). Then you have various administrators. If you have a problem, find the right person who can help. And don’t stop. Keep going until you get the results you want.

One of the most popular people on my unit was the housekeeper. He knew the residents and visited with families. He kept track of special requests. It’s helpful to be on the good side of the people actually doing the work, not just the important bigwigs.

3. KNOW YOUR MEDICAL CONDITION. What you have dictates your level of care and what services you will need. Can you expect to get better, manage the pain or simply slow down your decline? Also, diseases progress in stages, so it’s important to know where you are.

4. KNOW YOUR EXPECTATIONS. Some people walk into a nursing home hoping to be there for years. Others roll in knowing they won’t last the month. This ties directly into knowing the stage of your illness. Do you expect aggressive treatment, maintenance or comfort measures/hospice? If you don’t know what you want or need, you won’t know what to ask for.

5. BE SPECIFIC. The more information you can give staff, the better they can meet your needs. “Dad likes to eat” is not as valuable as “Dad has a big breakfast and skips lunch, but he does enjoy a snack around 2pm, usually fruit or yogurt, something light.”

6. KNOW WHAT THE FACILITY PROVIDES. It always frustrated me when residents assumed we provided everything. Facilities aren’t obligated to buy you new socks, pay for cable tv upgrades, electric razors and anything else you don’t want to purchase. If you have unrealistic expectations, you will be disappointed. This is a good rule of thumb for life in general.

7. BE PART OF THE CARE. It also bothered me when families would drop their parents at our door with the unstated message they are now our problem. Stay involved. If staff sees you’re a regular, they’re more likely to respond to you in a positive manner when you ask for help. If you roll in on the big 5 (Christmas, Thanksgiving, birthday, Mothers/Father’s Day, Fourth of July) then staff will see you as the jerk who only comes in on holidays.

9. I have saved the best for last, something I told every new resident upon admission: ADVOCATE FOR YOURSELF! It is YOUR OBLIGATION to make sure staff provides the level of care you expect. If something doesn’t look right, ask questions and speak up. DO NOT EVER feel like you are “bothering” staff. And don’t ever tolerate staff that makes you feel like a pest or a burden. Staff is there to do a job, to take care of human beings in a dignified fashion. If they don’t want to do that, then they can hit the road. I have a low tolerance for people who underperform in this field...and you should too.

Ultimately, growing old is like any other endeavor in your life: the more you know the better off you'll be.  

Do you have questions about a specific situation in your life? Topics you want addressed in future essays? Let me know about it in the comment section.

For information on individual counseling, please contact me at bradleyjabel@gmail.com.

I’m an LPC and a writer. If you are a mental health professional and need creative consultation for your professional literature, contact me.