The American middle class is experiencing hard times, and according to most economists, the prospects for at least the near the future offer little comfort. The middle class, of course, is the engine that drives our economy. It is made up of the millions of men and women who work every day, who raise their families, and who purchase everything from houses to paper towels. If the economy cannot support a large middle class, or if that middle class is otherwise threatened, our very prosperity as a nation is threatened.
What, you might ask, does the above economic reality have to do with what we call "the new grief," which refers to the process that families and individuals are likely to experience after a loved one is diagnosed with a terminal illness? Allow me to make the connection. It begins with the fact that in America (as well as some other developed nations) advances in medical diagnosis and treatment have resulted in technologies that can either cure, temporarily arrest, or slow the process of dying. Whereas death once came relatively swiftly following a terminal diagnosis (as it still does in most undeveloped countries) this process now can extend for months or even years. In that case we grieve not the death of our loved one, but rather their slow demise. At the same time, we find ourselves taking on added responsibilities related to care and treatment for our loved one. This is now true for literally millions of American families. In other words, the middle class is being squeezed from two directions: a weak economy that strains them financially and presses them to work harder and longer for the same (or less) pay, and an increasing need to be not only workers and parents, but caregivers as well. It is little more than wishful thinking to believe that this squeeze does not have its effects, because it does -- on our health, our productivity or both.
What is this new grief like? As Paul, the brother of a woman diagnosed with brain cancer described it, "I lost my sister, the life force of our family, piece by piece over the course of eighteen months." During that period of time -- and before his sister's actual passing -- Paul said that he'd experienced "symptoms" including unrelenting sadness, anxiety, disturbed sleep, loss of appetite (and weight) and difficulty concentrating. What Paul experienced is this new form of grief. It differs from the mourning we do after our loved one dies, but it is just as real.
One of Paul's friends, a physician, had urged him to take an antidepressant during his sister's illness. He was worried, he said, that Paul's work as an attorney would be compromised. Indeed, Paul admitted that he was not as efficient or productive during those eighteen months. "My partners expressed sympathy," he said, "but I also sensed some impatience on their part -- that I wasn't bearing my share of the load. Of course, they really had no idea of what I was going through." Despite his friend's good intentions and advice, Paul opted not to go on medication. "In my gut," he explained, "I felt that I just had to go through this, without trying to artificially alter the experience."
As normal as the new grief may be, we as a society are impatient with grief and mourning. Instead of allowing the process to run its course, we encourage grieving loved ones to take medication, or to "push through it." As one woman put it, "My colleagues and even some of my friends mostly avoided talking about my husband's cancer. I got the impression that they didn't want to see me getting bogged down. But how could I not get bogged down?"
From my perspective, the above attitude, like the attitude of Paul's law partners, reflects the fact that we have come to value productivity and efficiency above all else. The idea that something like grief might slow us down -- make us less productive -- has become increasingly unacceptable. This is particularly true today, when a majority of Americans state that they worry about being able to keep their jobs. But by choosing wishful thinking over reality, and by trying to avoid the new grief and its effects, we put all those millions of people who find themselves caught up in it at risk for its emotional and/or physical consequences, including chronic anxiety and depression, hypertension and heart disease. I believe there is a way around this.
I have no case to make against productivity. Americans are the most productive workers in the world. I regard myself as a productive individual, and I am proud of it. At the same time I think we would do well to take a lesson from Paul and face this new grief, rather than running from it. We should also recognize that as time and medical research move forward, more and more of us will find ourselves facing similar situations. We are better, I believe, facing the new grief in the workplace where most men and women spend most of their time. Yes, you read correctly: the workplace.
Research has shown that having access to a support network improves the quality of life for terminally ill patients. At the same time it reduces stress (and its effects) significantly on the family members and other involved caregivers. A support network extends beyond the family and can include friends, community members and fellow worshipers. There is no reason, I'd argue, why colleagues and co-workers cannot be part of a support network. In fact I think that everyone stands to benefit when the workplace becomes part of an available support network for those employees who find themselves caught up in the new grief. To do so, employers can do any or all of the following:
- Train supervisors in ways to approach workers who are known to be dealing with terminal illness in a loved one so as to initiate a dialogue, offer personal support and refer employees to helpful resources.
- Offer on-site support groups for those employees who find themselves in this situation. Simply providing people with an opportunity to meet and talk with others in similar situations (if they choose to) can be remarkably helpful.
- Pursue workplace innovations such as job-sharing and flexible work hours to accommodate workers who must also be caregivers.
- Facilitate an employer-based system where employees can sign up to voluntarily help out co-workers in need of support. Simple things like watching a child while one parent takes another to a chemotherapy appointment (or taking a co-worker to a medical appointment) can be a life-saver, as can volunteering to help out with weekly food shopping.
- Create an online resource that employees can use to get accurate information and advice, as well as to seek out further support.
- Educate human resources personnel to be able to function as additional sources of information and support.
While we may not be able to do away with the global wage and health care cost disparities that threaten the American middle class, we can do something to help minimize the deleterious effects that having to cope with prolonged terminal illness has on our collective health, productivity and efficiency. To do the above can be nothing but a win-win situation for employers and employees alike.