05/23/2008 05:12 am ET Updated Nov 17, 2011

How To Support A Sick Parent

Q: My father just had a stroke. He is 62 years old, and has always been active and healthy. His speech is fine, but his motor skills are impaired. The family is in shock. My mother and sister and I only want to take care of him and to return all the love and care that he has given to us. We are afraid of losing him and we are afraid that he may hurt himself. Let me just quickly mention that I had a younger brother who died by a hit-and-run as he was riding his bike. This tragic event occurred fifteen years ago. My brother was 12 years old.

My father doesn't want any of our loving embrace and protection. He gets quite angry when we discuss what his regimen will be once he leaves the hospital. We want him to have full-time nursing care and physical rehabilitation at home. We don't want him to return to his job as an accountant. He says he can do the work from home until he is ready to actually return to work. He believes he will soon be walking again and that all of this will end up fine.

We don't understand why he doesn't just want to retire and finally have the time to smell the roses. He can have visits from all of us and enjoy a full and rich life, time to be with his grandchildren and time to do whatever he wants. We are also afraid that if he doesn't accept his new limitations, he will become deeply depressed later on if, as we all know, he never makes the recovery he expects. I think he is in denial and doesn't want to face reality. We even seem to have differing views of what the doctors are saying. I think they sound tentative when they are asked if a full recovery is possible. He hears something else entirely: anything is possible. Who here is dealing with reality?

A: I don't think either of you are. But of the two, I much prefer your father's version of reality to yours. If he thinks, as you and the rest of the family seem to be feeling, that he cannot get better, then just like any other self-fulfilling prophecy he won't. If he doesn't believe he can get better, then the doctor will probably tell you with certainty that he won't get better. However, if he does believe he will get better, then at least there is a chance it will happen. He will certainly try hard to make it happen.

Your father's story reminds me of Franklin Delano Roosevelt. I just recently saw a documentary on his life and of course, any history of FDR has to include his paralysis from polio. We all know that following the polio attack that left him unable to walk, he went on to be elected governor of New York State and a four times president of the United States. We also know, or think we do, that FDR accomplished all this because he was a buoyant personality who came to terms with his infirmity and decided to work around it.

Not so. In the first place, Roosevelt went into a prolonged depression. For some time, he did nothing to advance his political career. But when he did resume it, he did so with the aid of good old fashioned denial. Until the day he died, Roosevelt believed that some day he would walk again. This is why he poured his family fortune into establishing a rehabilitation center at Warm Springs, Ga. Starting in 1924, he was a frequent visitor, believing that the area's celebrated waters had great curative powers. Roosevelt believed. Roosevelt was in denial.

Let me state quite emphatically that even though I am a psychologist who believes in coming to grips with reality, denial can sometimes be a wonderful defense mechanism. I am in fact jealous of others who seem to be able deny a variety of distressing situations or events. I, on the other hand, seem to always be burdened by reality. Sometimes it is better to just move on or let go - deny the anxiety or fear that can be so crippling. Your father has his own reality. It may in fact help him get better.

You did mention the death of your brother, so I have to believe that you are aware of how this event has affected your entire family. A traumatic event can come back to haunt us at unpredictable times, but it's much more likely to happen when something in the present dredges up emotions from the past. In your case, a button has been pushed -- the painful reality of what it feels like to lose a loved one.

You all seem to want to protect your father, keep him from the sort of danger that killed your brother. If he is embraced by all of you, he will be safe. If your brother had been home and not out and about on a bicycle, he wouldn't have been hit.

But the situations are dissimilar. You know that intellectually. You don't know it emotionally. One of the ways we treat post-trauma-stress-disorder is to separate the two events. This is what you need to do now. Your father is stricken; your brother was struck and killed. Both are close relatives, desperately loved. You feel one died because he faced danger, unprotected. The other now seems in desperate need of protection -you, your siblings, your mother, nurses. But who, really, are you protecting - your father or your own fears that history will, in a purely emotional sense, repeat itself? It all feels so familiar. But the situations are different. Treat them differently.

In this situation, your family needs to understand why it is not accepting your father's lack of reality. Solve your problem before you even begin to solve his. Why not let your dad remain in denial? He'll be happier that way and -- who knows? -- it may actually help him to walk again.