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Forum Name: Psychiatric Topics

Question: telling death of a child to a severe stroke patient


 beaux - Fri Jun 25, 2010 1:04 am

My wife and I are retired in our early sixties. My wife had a aortic valve replacement at the end of December 2009 but suffered a stroke and seizure coming off the heart lung machine. She started to recover within a month came home for further rehab but suffered another very severe stroke. Was hospitalized again and contracted Clostridium defferens . Hospital sent her home after a month with the infection and she then had severe diarrhea, became dehydrated and was taken to another hospital. After four days on Vancomycin they sent her home but within twenty four hours she became incoherent and unable to speak with recurring diarrhea. Was taken back to hospital dilerious and unable to move any part of her body or speak. She was sent to a nursing home but required 24 hour care being unable to swallow or move any part of her body. after a month she was taken by the fire department EMTs to the hospital suffering from severe dehydration and delerious. Her blood pressure was 67/38 and Potassium level life threatening. She recovered in two weeks and was sent to another nursing home. She is still incontinent, unable to eat solid food, has occasional bouts of dilerium, and is unable to walk or hold a phone.

In April our oldest son died unexpectantly. I asked my cardiologist if I should tell my wife that her son had died and was told under no circumstances as it would probably kill her. Her mind is becoming clearer now and she can hold a fairly good conversation. Her long term memory is returning but she still has no short term memory.

When do I tell my wife that her son is dead? Is there a certain mental state that I can measure that will tell me that she is mentally strong enough to handle this news?

I have been lying to her since April 19th about our son but she is starting to ask much more often as to where he is, why no phones calls, why no visit?, etc.

I would greatly appreciate any advice that you can give me...I hate the lying and very frightened of my responsibility to tell her about our son's death.
 Faye Lang, RN, MSW - Thu Jul 01, 2010 6:47 pm

Hello, beaux,

What a difficult time for you. When your wife was so ill, she probably wouldn't have been able to take in the fact of your son's death, so it has likely done no harm to have delayed telling her. Now that she is stronger and asking about him, it is probably time to tell her. Please discuss it again with your doctor, and let him know how often she is asking about your son and how distressing it is to her. While lying to her is difficult, perhaps the doctor would allow you to break the news to her in steps, such as your son had a serious accident and is not doing well, that he is getting worse, and that he was unable to overcome his injuries and has died. Or, perhaps your doctor will feel that she is strong enough now to just hear the truth, which is generally the best approach. In either case, discuss it with the doctor first, so that if she has need of assistive medication, the doctor is prepared for it.

I'm very sorry that you have lost your son, and that your wife is so ill. Good luck to you and to her.
 beaux - Thu Jul 01, 2010 11:39 pm

Faye,

Thank you for your thoughtful response. I thought that there maybe a certain mental state that I could recognize to help me with the timing. My wife is now so depressed that she cries day and night for her family and her condition that is preventing her from going home. She is on 1mg Ativan for the past 4-5 days because she has been so agitated. But Ativan hasn't done anything for her depression/anxiety and I'm concerned that this still is not the time for discussion regarding our son.

She is scheduled for a psychiatric evaluation in the near future(next week?) maybe your advice would work better with him/her than the physician assigned to her.

Thanks again for taking the time to help.

Regards,

Doug Hoag
 Faye Lang, RN, MSW - Sun Jul 04, 2010 4:52 pm

Hello, Doug -

One of the most common effects of having a stroke is to have emotional swings and episodes of crying. It's entirely normal for your wife to miss her family and want to go home, of course, but she probably is not able to effectively control her reactions to her feelings. It's excellent that she is going to be evaluated by a psychiatrist. Depression is also very common in stroke victims. Your point of discussing how and when to tell your wife about your son is a good one; the psychiatrist can prescribe a one-time or short-term medication to help her cope with the news, if that is indicated. If you doubt that it's the right time to tell her about your son, trust your judgement. You know her best.

I'm sorry that you both are having to cope with this situation.

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