When a family member becomes ill, whether for a week, for a few months, or with a long-term or terminal illness, each individual has a reaction and the entire family unit has a reaction.

Frequently I am asked by family members and by those who are ill, how to talk to others in the family. Illness deeply affects everyone in the family in many ways.

"Role reorganization" is a healthy process that a family undergoes in response to the illness or death of one of its members. If we think about the family being a system for a moment, the entire system is thrown into disequilibrium.

Roles and responsibilities must now be reassigned to re-establish the equilibrium, that is, to bring back balance and harmony to the family system and each individual.

Using each family's values, beliefs, and ways of coping, they must re-evaluate and re-establish the rules, communication patterns, family expectations, and behavior patterns that will keep the family operating in a stable manner.

It is very useful for each person to talk about how the person's illness is affecting him or her and discuss the idea and necessity of role reorganization for their entire family. Everyone in the family must be included in all the conversations. No side or private conversations should occur until each person in the family is talking about the issues and working together to find mutually acceptable solutions.

There is a good chance for success if communications between all the family members are open and honest. Each person's needs must be recognized as being legitimate and important. Each individual must, with mindfulness and intention, make a commitment to the survival of the family.

It is vital to include all siblings, no matter what their ages, because they deserve an opportunity to talk about how they have been affected and they have a right and a responsibility to assume some new roles.

It is also essential to include the person who is ill so he or she can feel reassured that they are still an important family member and can know how the family is adjusting itself to accommodate the illness. This will help the ill person be reassured that his or her needs can and will be met and that no one will be over-burdened because of him/her.

In the event one of the family members is unable or unwilling to participate, I encourage the other members to set firm boundaries and communicate directly what they are willing and able to do. Often people are in a reacting mode and not thinking very clearly. When approached with some information and a plan, people often welcome discussions and easily consider alternatives to this painful dilemma.

Please remember, one person's illness affects everyone in that person's life; friends, family members, co-workers, and even neighbors and business associates. If you are the ill person and have the presence of mind and the physical strength, provide the space for everyone to talk to you and each other about their thoughts, feelings, and reactions to your illness.

If you are a friend or a family member, please create the time and space for everyone to talk about what has happened. Be sure to include the ill person.

Nobody ever wants to 'bring it up' and upset anybody else; everyone is thinking about what is happening and everyone is already upset.

Have the courage to tell the truth in the presence of those who are special to you and face the pain and sadness that is making its home in your heart.

Remember, only YOU can make it happen!

Copyright Dr. Jackie Black 1999-2005

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