In a conversation with a grief counselling provider the other week we talked about the grief process not just occurring after a person has died but occurring during their final illness. The person themselves will grieve over the losses they experience as they become sicker. The parts of their self that die as worsening health takes its toll on a person and their loved ones. This may include loss of the many roles that people have in life. A big one is the loss of employment, not being able to work can affect people deeply, especially if work plays a big part in who they are or represents why they are. Not being able to contribute to society can be a huge loss and a damaging blow to a person’s sense of wholeness.

Loss of roles in a family can have a huge impact. If the main carer becomes unwell it can put a great strain on the other family members. Who can be called in to help with Grandma, now that Mum is unwell? The other members of the household might need to learn how to cook and clean amongst family tasks that seemed to be taken care of as if by magic. The clothes don’t jump into the laundry basket by themselves. They pour themselves into the washing machine with just the right amount of washing powder and water. The teleporter doesn’t work any more, the smelly socks that are thrown at the laundry basket go for a swim in the washing machine. Then they grow legs and somehow jump onto the washing line to work on their tan. Once all traces of liquid have been removed the items of clothing practice yoga, contorting themselves into origami configurations all the better to line drawers with. This whole process may become much less reliable when a family member is unable to help out with house hold chores.

The toilet stops magically cleaning itself. Dishes don’t wash themselves any more. The meals stop appearing out of wormholes originating in the kitchen and exiting onto the dining table. The members of the family, who may have taken for granted how well they had it, can no longer ignore the evidence that is mounting up. All is not right with their private family world, losses are being felt by everyone, and the only certainty of the situation is that everything will continue to become more uncertain. One person’s illness affects all the people around them. Falling tears cause ripples on the pool of water, extending outwards as the disease ravages inwards.

What has been lost? The list expands on a daily basis becoming longer and longer. What’s coming next? Can we handle it? The sanctity and privacy of the family home may need to be disrupted by helpful strangers who call in to provide home support. The family has tried to continue going on but the strain becomes unbearable and they start worrying about each other. Fatigue pulls everyone down and the sense of loss is palpable throughout the home. A house full of memories, with pictures from happier times adorning the walls. A lifetime’s collection of bric-a-brac and ornaments gathers layer upon layer of dust. Generations of dust mites grow up, meet someone special and then have families of their own. Life-limiting illness is worsened by uncontrolled hay fever. Histamine-induced tears mixing with the sadness-induced ones. The children still have to go to school but they need to be picked up for weekend sport as the adults in the family are not able to take the young sports people out to their games. Losses build upon losses, and all of them are grieved in simple and complicated fashions. An eclectic collection of grief behaviours gathers together and weaves a huge bracelet with heavy, dark charms providing solemn decoration.

The tutor tells the visiting students to look at the family photos on the walls. Notice what the people used to look like, what do they look like now? A spot the difference game embellished with the stark reminders of a changing reality. One of the people in the family portrait looks to be ageing and shrinking. One of the people will soon become transparent and will soon disappear. One of the people will be missed by the others, the ones who survive the illness event. All of them will be affected in many different ways. The grief process begins long before a person’s actual death, and carries on long after. The others’ lives will go on, but they will never be the same again.