Destruction, Reconstruction, Release: Journeying With the Dying and Those Who Care for Them The theme of this article is captured in the theme words destruction, reconstruction, and release. We left them out as markers in the text because, while the word meanings are crucial, it is more crucial that we respect that life, death, and grief cannot be scripted. These three markers are ... Article
Article  |   October 01, 2013
Destruction, Reconstruction, Release: Journeying With the Dying and Those Who Care for Them
Author Affiliations & Notes
  • Rev. Richard B Gilbert
    D.Min., CT
  • Disclosure: Rev. Richard B Gilbert is the executive director of The World Pastoral Care Center and an ordained Anglican priest.
    Disclosure: Rev. Richard B Gilbert is the executive director of The World Pastoral Care Center and an ordained Anglican priest.×
    Nonfinancial: Rev. Richard B. Gilbert has published books in this subject area, one of which is referenced in this paper.
    Nonfinancial: Rev. Richard B. Gilbert has published books in this subject area, one of which is referenced in this paper.×
Article Information
Older Adults & Aging / Healthcare Settings / Professional Issues & Training / Speech, Voice & Prosody / Articles
Article   |   October 01, 2013
Destruction, Reconstruction, Release: Journeying With the Dying and Those Who Care for Them
SIG 15 Perspectives on Gerontology, October 2013, Vol. 18, 104-111. doi:10.1044/gero18.3.104
SIG 15 Perspectives on Gerontology, October 2013, Vol. 18, 104-111. doi:10.1044/gero18.3.104

The theme of this article is captured in the theme words destruction, reconstruction, and release. We left them out as markers in the text because, while the word meanings are crucial, it is more crucial that we respect that life, death, and grief cannot be scripted. These three markers are real, vary from person to person, and can follow any number of possible pathways or sequences.

Destruction is the preliminary diagnosis that patients and family members often present when they are first engaged by the speech-language pathologist. It often is not about restoration but lament. “Death” is often very ugly, especially when communication is stopped and work, socialization, and other values have lost their channels of communication. Don't be fooled by the enthusiastic, determined patients. Their feelings may be very genuine, but so is the fear! For a time, and maybe forever, some skills have been “taken from” you.

Reconstruction is the delicate, demanding and dizzying challenge of rebuilding. We are rebuilding after Katrina and Sandy. Some things may be much improved, but much improved is a subjective assessment and does not always mean better. What is lost is lost and one must take into account that lonely lament, “Why did this happen to me?” Reconstruction, at least for a time, may feel more like salvaging rather than creating. Your clients have experienced loss! Meet them in their grief!

Release may not be the best word here, but it will serve us. It may simply refer to being released from all of their appointments. That, of course, may mean the loss of funded benefits as well as the routine and safety of their time with the therapist, structure and new friends. It is a long jump from baby steps (sounds) to walking (words and sentences). It may mean just that we are ready to face these new challenges and the resources that we have to face these challenges.

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