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Dealing with terminal illness of a loved one.

My loving mother was diagnosed with stage four colon cancer, two weeks back. After undergoing an unsuccessful tumor resection, chemotherapy is the only hope left. If she responds well to the chemo, there's a chance that surgeon might decide to try the resection another time. If she doesn't, nothing can be done. The situation has been very difficult for me and my dad ever since we heard this news. It is still hard for us to digest this fact because symptomatically she has been as good as anyone of us. Now I have two issues to deal with, one -deal my own suffering, another - help my family deal with this difficult situation. 

About my own suffering - I have lost mindfulness and daily practice ever since we came to know this. I had done a couple of retreats recently where I had good progress. I used to be in Equanimity in my daily sits and was practicing 3 hours daily before this happened. But I see myself back in DN now and I'm not getting enough motivation to practice. It's only misery now. My existential suffering is back and I only see meaninglessness in the world around. My thought drifts back time and again about how I am going to miss my mom in every daily activity. I pretend to be strong when I'm around family even though there's intense suffering within. Sure, my previous meditation practice and some theoretical knowledge of the Dharma has been helping me in staying calm and strong in these circumstances. Probably something like an insight of No-self or stream entry could have helped me better. But I'll have to wait until that happens. Theoretical understanding of No-self, no-free-will and the previous memory of Equanimity stages are the only things that are keeping me sane. My only goal of life so far has been ending my suffering and nothing else. I understand there's no point in suffering like this and that  I should stay as mindful as possible, but I'm failing each time.  My mind is so full of sadness, self-pity, and misery that I'm just not able to pick myself up. I'm trying metta chanting and it is somewhat helping me calm my mind but it seems not enough. This 'self' is really so miserable. Do you have any suggestions to deal with this situation? Or should I just accept the suffering until I get used to it? Are there any Dharma books which talk about dealing with terminal illness and death? Any other good sources like links, videos, movies on this subject are also appreciated.

About my family's suffering: I can say I'm in a much better position compared to my family members when it comes to accepting this truth because, from a long long time, I knew life's a bitch. The fact that 'life's not just unfair to me but it's unfair to every single organism on this planet (in fact life's too unfair for other organisms)' has helped me take things not too personally. The theoretical knowledge of Self-illusion and knowing that Insight practice being the only way out has been helping me deal with these situations with more acceptance. But I feel these concepts doesn't really bring any solace to a non-insight practitioner. I always wonder what I should tell someone who's complaining how harsh life has been to 'them'. Because the things which bring solace to me (self-illusion, hoping to see through this illusion sometime in the future, etc), doesn't really help them. Hence my question- how does Dharma help one who doesn't understand these concepts? What does an insight practitioner have to offer someone who's facing a terminal illness?

RE: Dealing with terminal illness of a loved one.
1/9/18 6:11 PM as a reply to tamaha.
I think the lack of replies shows how hard it is to answer your question. 

RE: Dealing with terminal illness of a loved one.
1/9/18 6:56 PM as a reply to tamaha.
Sorry to hear about this. It is a loved one, your mother so of course this is difficult. I'm experiencing strong depressive states now so I feel similar misery. I may not be of great help in answering your question but one thing that came up for me reading your post is reflecting on how to use as much creativity as possible in bringing Dharma to your mother. You don't have to use Dharma jargon but your own words, or words you know your mother may connect to. Guiding a dying person in Dharma is said to be highly beneficial, for the speaker and for the dying person. 

Also, if you were in equanimity nana then you have strong seeds in you and will be able to pick it up later.

Wishing you all peace.

RE: Dealing with terminal illness of a loved one.
1/9/18 7:32 PM as a reply to tamaha.
I've not much to say but thought I would respond as I am in a simliar situation and may be my story can be of help to you. My brother has been diagnosed with a brain tumour which will likely end his life in a few years. It has brought home to me some of the issues I have myself with the Dharma. Sometimes I note a feeling of guilt that I'm not suffering to the extent that I would have before. As if it is somehow wrong. In reality, I am of much more help to my family in the more balanced state I have achieved so far. Since the diagnosis I do not discuss the Dharma with any family members. Few people react positively to that. I just intend to be as kind and compassionate as I can. I do hope you are able to practice again and keep the dark night at bay. Even if not, I am sure you can be supportive and provide the help that a person with insight is better able to do.

RE: Dealing with terminal illness of a loved one.
1/9/18 8:18 PM as a reply to tamaha.
Hallo Tamaha 

you can't tell much to someone that doesn't practice, and you really don't have to. It is very difficult to let go of a lot when you didn't practice letting go little by little, and people in these situations are not usually in such an emotional state so to be receptive of any deeper contemplations. Empathic presence with some simple words of compassion suffice: in the sense of something like.. "im here, with you, in your sorrow, to hold your hand to go through this together". 

As for you , there is a transition and an emotional resolution and alleviation of suffering in redirecting fear and confusion to sadness and compassion: compassion is an antidote to fear. Compassion to yourself and to others. See how it goes if you treat your same fear with kindness and compassion and then turn from its contracted state to a more open attitude of compassion towards the suffering of loosing our beloved ones that we all share. And see also if the situation allows it and you don't really have to pretend among the relatives and conceal your emotions (at least to the same degree). Emotions can be a great means of self healing and conecting with others

Wish you peace through these difficult times 

RE: Dealing with terminal illness of a loved one.
1/9/18 8:15 PM as a reply to tamaha.
Losing one’s mother is one of life’s most traumatic experiences. My mother died at the age of 97 last April. For the final 4 years of her life she suffered from dementia, spending most of that time in a secure memory care unit. When the dementia first hit, I had just attained fourth path. In those first few months my mother became irrationally angry at me over the loss of her freedom, hitting me with the kind of strategically-aimed insults and accusations that only a parent could make, because she knew all my vulnerabilities. I went into a grief spiral, until one of my more seasoned dharma friends told me to step back from the stories that were triggering the crying jags. I could see how the words would trigger tears, which in turn would set more stories in motion, and so on. I was wallowing in it. Once I saw through it, I was able to temper my reaction, at least for awhile.

Once we got her properly settled in a nearby facility, which was just about the best place someone with dementia could possibly be, and on a program of meds that took care of the hallucinations, paranoia, and anxiety, things fell into a rhythm. I told myself that I would probably bear up well once she died because I had mourned her loss so deeply when the person I’d known all my life was no longer herself. This turned out not to be the case. If anything, her death hit me even harder than the dementia. I stayed with her for several days as she went through the dying process, and what I felt was unbearable grief. At one point I tried to do some noting practice, but the feelings were so strong that I could not stand getting even more intimate with them. Nothing consoled me at all. I tried thinking about each life being a wave in the ocean and it was absolutely useless. I thought about letting go, and absolutely could not do it. I remember wishing I could believe she and I would be reunited some day. 

The dharma is a wonderful thing and precious beyond describing, but it does not protect you from life and death. It gives you the strength to endure the pain of it at times like your own suffering now. It also has taught me a profound respect for all living things, for all of us endure pain, loss, sickness, and death. What I would suggest in your case is to stay in the present as much as possible. You are tempted to go into the future and imagine life without your mother, and you will go there, but at present you can’t know what it will be like. You can’t know what you yourself will be like. So stay where you are and let the process unfold within yourself, your mother, and your family as it inevitably will. Be there. Don’t hold up some unrealistic image of what a good meditator ought to be able to feel and do. My heart goes out to you, and I honor you and your grief as a fellow being in this world. 

RE: Dealing with terminal illness of a loved one.
1/9/18 8:17 PM as a reply to tamaha.
In terms of book, try this one

She's a Buddhist author speciallizing in care for the dying. Most of her advice have no Buddhist jargon to it.

RE: Dealing with terminal illness of a loved one.
1/9/18 10:00 PM as a reply to tamaha.
I've more experience than I wish for this. Am still dealing with a brother who OD'ed on a cocktail of drugs and is in a vegetative state. I will be concise so please do not construe it as being harsh:

What else is there to do in terms of dhamma other than qualitative investigation? So there is grief, it is suffering, you know the name. What is it? What does it feel like? What causes it? Is the suffering bad because it is personal as in your loss? Is it from lack of control? What do you lose? Is that which you lose, part of you? What are its causes and what are all its effects (feelings)? Feed your own qualititive questions. Understand it all, completely. Swim to the deep end, know the currents. Is there a difference when you are totally engrossed in it vs when you possess a subtle level of trying to understand it with wisdom, collecting useful data? Try lowering fear, resistance and wishing for it to stop. What happens when your mind is tasked with investigation and when you achieve greater levels of non-resistance?

Feel free to ping me...

RE: Dealing with terminal illness of a loved one.
1/9/18 10:18 PM as a reply to tamaha.
After undergoing an unsuccessful tumor resection, chemotherapy is the only hope left. If she responds well to the chemo, there's a chance that surgeon might decide to try the resection another time. If she doesn't, nothing can be done.
there may be nothing doctors can do, this does not mean it is hopeless - Please read up on these protocols

I like the Cesium Chloride therapy but you would have to figure out what, if anything, you are drawn to.
Good luck,

RE: Dealing with terminal illness of a loved one.
1/9/18 10:46 PM as a reply to Dream Walker.
Great advice given above. My heart also goes out to you and your family and those others above who mentioned their own trials and losses.

I might add the book It's Ok to Die, by my friend and co-worker Dr Monica Williams-Murphy (actually now just Dr Monica Williams, but that's another story). There is also good information on the website of the same name.

There are multiple excellent and various meditative strategies for dealing with suffering and pain mentioned above. I might add that, in addition to all the strategies that involve allowing and going into the grief, sadness, anger, bargaining, tears, and all of those, that at times sometimes just doing some basic body-meditation and sometimes even something concentrative/samatha-esque to just calm down and ground down until one can go back into the hard stuff can be very helpful and skillful. We don't have to do it all at once or face everything all at once, and, as coping strategies go, concentration-based practices are pretty darn skillful. Sometimes just picking a nice guided meditation on YouTube can give us a much-needed break from it all. The Brahmaviharas are skillful in these situations.

I agree that using dharma terms around non-dharmic folks in these situations is generally counter-productive, but the standard books, such as the work of Elizabeth Kubler Ross and the like, are accessible and helpful to many from many backgrounds.

Very best wishes,


RE: Dealing with terminal illness of a loved one.
1/11/18 5:42 AM as a reply to tamaha.
When I started working with MCTB, mindfulness awareness and all of this my parents were in their 90’s. Mom declined first, hospitalizations, rallies, set backs and then death that first year. Dad took a slightly slower course but still lots of ups and downs along the way and died last year.

The one strategy that seemed to work for me was when I was with them to be there as much as I could and to let go of any of my demands for how it should be. I could be an advocate with the doctors, nurses, therapists and medical staff but I also had to let go of the desire to control what would happen. We could make plans about what we would do today or even in the next hour or minutes but I had to be willing to let them go and change to something else as their energy, ability, interest or desires changed. I had to be willing to go deeply into my emotions and reactions feel them and let them work their way through. It was a magnificent lesson both seeing and letting go of craving and aversion. The memories of being present with them especially for some of the small moments still bring tears to my eyes as well as a sense of peace.

Instead of words about the dharma - you have your presence to offer your Mom, your family and all of those that care for her. Being present in a difficult time is what the dharma is all about.

I second Daniel's recommendations about Monica Williams, Kubler Ross etc. Not sure if you are dealing with hospice services yet, even if not, they might provide good referrals for counselors or clergy that you and your family might talk with.

RE: Dealing with terminal illness of a loved one.
1/11/18 10:22 AM as a reply to tamaha.
Hi, tamaha,

I'm sorry to hear about the difficulties you and your family are experiencing. I have sent you by Private Message a link to an article that may help.

RE: Dealing with terminal illness of a loved one.
1/11/18 7:21 PM as a reply to tamaha.
I am sorry that you and your family are experiencing such pain. As difficult as this is for you, your family is fortunate to have you there.

I just started reading Bikkhu Analayo's Mindfully Facing Disease and Death: Compassionate Advice from Early Buddhist Texts and think you might find it very helpful. It contains much on dealing with grief and how to care for the dying, among other things that may be useful for you. I am currently going through something similar with a friend who was dying quickly, then rallied, and now is in a sort of limbo. 

I will second the recommendation for the brahma viharas. They are wonderful practices anytime, but especially appropriate in times like these and so it's no surprise they are a running theme in the book above with an entire chapter dedicated to them. I have personally found that when confronting sickness and death, it is particularly important to not overlook opportunities for joy. That may sound counterintuitive or even a little callous, but actually it is not. The four brahma viharas are a set for a reason: these are the dimensions of love, notes in a chord. This may be a good time to get out the old photo albums and reminisce over happy memories, read aloud old favorite books or re-watch loved movies, put the extra effort into preparing favorite meals, etc. Write your mother a heartfelt letter about how grateful you are that she raised you and why. These moments may lighten the load for everyone, even if only for a brief time, and help make the pain easier to bear.

Best wishes.

RE: Dealing with terminal illness of a loved one.
1/12/18 8:15 AM as a reply to tamaha.
Thank you, one and all for taking time to respond with your kind words and helpful suggestions. Sorry for all those of you who are/were in a similar situation as mine. I will take each one of your advices on handling this difficult situation. I will try reading all of those books mentioned above. 
I had dreamed big. I introduced my parents to Vipassana last year and my Mom had picked it up nicely. She had more dedication than me in that she had a constant daily practice for an hour or two. For the kind of interest she was showing, it was hard for me not to dream of my mom seeing Nibbana sometime in the future. These words of Goenka keep coming to my mind-

She just turned 60 last month and I am in my mid-twenties. Considering the age and the interest we both have, I saw a definite possibility doing and achieving it together. But as how life works, things come up so suddenly and unexpectedly, that it is extremely hard to accept. I love my mom, the kindest lady I know, so much that it is so hard for me to imagine my life without her. There is a lot of acceptance to be learned now. Hopefully, I will gain enough strength and come out of this grief spiral and constant wallowing soon. I lack a bit of motivation at times to 'see' my suffering objectively as I'm too carried away by it. But like a dear friend of mine told me a few days back, "your mom doesn't want you to suffer like this, hence it is important to gather enough motivation to work through this pain". 
Not sure if you are dealing with hospice services yet, even if not, they might provide good referrals for counselors or clergy that you and your family might talk with.
Yes, she is in the hospital now, recovering from the surgery she underwent last week. I wish such things existed in Indian hospitals, but they don't. In fact, there isn't any protocol to inform these kinds of difficult news to the patients themselves. Now, since I am the only one who knows the complete story of the slim chances of her survival, there is an extra burden on me to carefully inform my family about this.  

RE: Dealing with terminal illness of a loved one.
1/12/18 9:34 AM as a reply to tamaha.
Hi Tamaha,
I was moved by your story and created an account just to add to the list of above ressources Ajahn Brahm's talks, which can be incredibly powerfull, depending on the circumstances
you could start here :
The guided meditations and samatha instructions are also great if you are not familiar already..

Wishing you well..