logo
Our dog died. I'm too sad to help my husband grieve. Hax readers give advice.

Our dog died. I'm too sad to help my husband grieve. Hax readers give advice.

Washington Post2 days ago

We asked readers to channel their inner Carolyn Hax and answer this question. Some of the best responses are below.
Hi, Carolyn: My husband and I lost our beloved dog a couple of days ago. He was almost 15, and we adopted him 1.5 years into our 14-year relationship, so the dog was a huge part of our life as a couple. We are both absolutely devastated.
I'm finding that my grief is so overwhelming I can't be there for my husband. We talk about our buddy and it gives me so much comfort, but at certain points when my husband talks about his grief, I just can't handle it.
I'm trying really hard to take care of myself now. I haven't slept much lately. I'm not eating, and when I get to a place where I can relax, my husband wants to grieve with me, and I'm overwhelmed again.
It doesn't help that I have several tight groups of friends plus a therapist, while I'm his primary support system. I want so badly to be there for my husband — as he has been supporting me. I feel terrible that I can't be there for him in the way he needs.
I know, on an intellectual level, that everyone grieves differently, and that I should be kinder to myself and do what I need to do. But when the loss is shared, how much can I prioritize my feelings? What can I do to get us both through this?
— Grieving Together
Grieving Together: You can tell him the truth, kindly and with love: 'I miss Max so, so much, and I know you're sad too. This feels really big, and I don't think I can handle being your support system when I'm crushed by my own grief. Let's get some grief counseling so we can learn to get through sadness together in a healthy way.'
— Honesty
Grieving Together: I think the main problem here is that your husband doesn't have friends or a support network. Time will help with the grief, but if he doesn't join a group, make friends or go to therapy (why are you the only one doing this?), this cycle will continue. You are overwhelmed, and he adds to it. I'm so sorry you both lost a part of your family, but this doesn't sound like a one-time issue.
— Laurie J
Grieving Together: I'm so sorry you lost your dog. I have loved and lost many dogs in my life. Their absence hits you again and again throughout the day. It's so hard.
Some people feel like they have to wait until they've dealt with their grief before welcoming a new dog into their lives. I'm here to say you don't have to wait. I'm not talking about replacing your irreplaceable dog, I'm talking about welcoming a successor to fill this important role in your life. If you're willing to rescue a dog, then you have the added emotional balm of knowing you are helping a creature who needs you.
Eventually you will love a new dog as much as you loved your first dog — but differently. Nothing fills a dog-shaped hole in your heart like a dog.
— Don't wait!
Grieving Together: If he's doing something particularly intense — like his grief comes out as anger, or he wants to ruminate for hours, or he brings it up 800 times a day, etc. — then say you want to support him but you're a little overwhelmed. Ask him to try to work with you on a compromise or to find another outlet so it's not all on you to absorb. If it's not something specific he's doing and you just don't have the bandwidth to be present for his sadness at all, then you can say that, too, but with the caveat that you understand that isn't fair and you're going to work on figuring out why in therapy.
Pulling away from supporting your partner who is supporting you during a mutual loss might be necessary if you can't keep your own head above water, but it's also an alarm bell of some kind. Is there a broader pattern where you are the one doing the emoting and he is more stoic, such that his displaying vulnerability is making you uncomfortable? Is he usually in the role of responding to your needs/feelings/struggles, and you're squirming when that dynamic is reversed? Or is it the opposite, and you're feeling some resentment about the degree to which he relies on you emotionally? Figure out the why, and go from there.
— Pattern?
Every week, we ask readers to answer a question submitted to Carolyn Hax's live chat or email. Read last week's installment here. New questions are typically posted on Thursdays, with a Monday deadline for submissions. Responses are anonymous unless you choose to identify yourself and are edited for length and clarity.

Orange background

Try Our AI Features

Explore what Daily8 AI can do for you:

Comments

No comments yet...

Related Articles

What to Know About High Functioning Schizophrenia
What to Know About High Functioning Schizophrenia

Health Line

time17 minutes ago

  • Health Line

What to Know About High Functioning Schizophrenia

When a person's schizophrenia symptoms do not appear to interfere with their daily life, their condition may be referred to as high functioning schizophrenia. But this is not an official diagnosis. Schizophrenia is a complex and varied psychiatric disorder that affects each person differently. Some people have relatively mild symptoms that come and go. Others experience more severe, persistent symptoms that interfere with their daily lives. When a person with schizophrenia is able to live a mostly independent life, hold a job, and maintain relationships, their condition is often referred to as 'high functioning.' Language matters The term 'high functioning' doesn't have a clear medical definition. Some clinicians use it to refer to people who require a lower level of assistance for daily activities. But terms like 'high functioning' and 'low functioning' don't account for people's unique life circumstances, abilities, and strengths. It's best to avoid using this kind of language outside of a conversation with your healthcare professional. What is high functioning schizophrenia? High functioning schizophrenia is a term used when people with schizophrenia are able to function well in daily life despite their diagnosis. They may have milder symptoms, or they may have developed good coping mechanisms despite having more severe symptoms. It's important to note that 'high functioning' is a subjective term and not a clinical diagnosis. And the label doesn't necessarily reflect the severity of a person's symptoms. People with high functioning schizophrenia may still experience significant challenges and need continuous treatment and support. A person's level of functioning can be influenced by a range of factors, including: Symptom severity: People with fewer or less severe symptoms may be able to function better in daily life than those with more severe symptoms. Treatment response: Those who get timely, appropriate treatment are more likely to maintain good functioning. Research from 2020 suggests that early intervention may be linked to better long-term outcomes. Personal coping strategies: Some people develop strong coping strategies that allow them to effectively manage their symptoms and prevent those symptoms from having a major effect on their daily life. Strong support network: Those with very supportive family and friends may be able to function better in daily life than those who don't have this support. Lack of other mental or physical health conditions: Many people with schizophrenia have other mental or physical health conditions that make it more difficult to function in daily life. People who don't have another condition may appear higher functioning. Symptoms of high functioning schizophrenia Any person with schizophrenia, whether it's considered 'high' or low' functioning, can experience the same types of symptoms. Schizophrenia symptoms are divided into positive, negative, and cognitive symptoms. Positive symptoms are those that 'add' to your personality (in other words, they weren't there before the condition). These symptoms include those of psychosis, such as: hallucinations delusions disorganized thoughts and speech atypical motor behavior (e.g., catatonia) Negative symptoms 'take away' from your personality and involve five key areas: alogia (reduction in the number of words spoken) anhedonia (reduced experience of pleasure) asociality (reduced social activity) avolition (reduced goal-directed activity, due to decreased motivation) blunted affect (difficulty expressing emotions, such as diminished facial expressions) Cognitive symptoms may include issues with: focus and attention span working memory executive functioning The negative symptoms of schizophrenia are often more challenging to treat than the positive symptoms. For some people with schizophrenia, these negative symptoms persist, even when positive symptoms are well managed. Research from 2020 suggests that negative symptoms are associated with poorer outlook and long-term disability. While many people with high functioning schizophrenia do have negative symptoms, these symptoms may be less severe. Diagnosing high functioning schizophrenia In the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. text revision (DSM-5-TR), schizophrenia is now listed as a spectrum disorder. This more accurately represents the condition's wide range of symptoms that can change over time. It's important to note that high functioning schizophrenia is not a clinical diagnosis. So, whether a person exhibits a higher or lower level of functioning, they still have to meet the same diagnostic criteria. A diagnosis of schizophrenia must include at least two of the following symptoms, with one of these symptoms being among the first three: delusions hallucinations disorganized speech severely disorganized or catatonic behavior negative symptoms The symptoms must occur frequently for at least 1 month, with some symptoms lasting for more than 6 months. In addition, you'll need to have experienced reduced functioning in one or more important areas of life, such as personal relationships, work, or self-care. Treating schizophrenia Schizophrenia is typically treated with antipsychotic medication as well as various types of therapies and skills training. Schizophrenia may be treated with the following: Atypical antipsychotics: Atypical, or second-generation, antipsychotics are the first-line treatment for schizophrenia. These medications lower dopamine levels in the brain, which helps target symptoms of psychosis. Cognitive behavioral therapy (CBT): CBT helps people with schizophrenia identify and fix unhelpful thought processes and behaviors. Social skills training: Social skills interventions help people with schizophrenia learn social and independent living skills. These may include classes covering interpersonal skills and medication management. Cognitive remediation: This intervention focuses on skills such as attention, memory, and flexible thinking. Social cognition training: This intervention targets skills such as social perception (understanding social cues or body language), emotion perception (identifying others' emotions), and theory of mind (identifying and understanding another person's mental state). Some people with high functioning schizophrenia may have achieved symptom remission after responding well to treatment. Symptom remission means that your symptoms are mild enough to not significantly interfere with your life. Research from 2018 suggests that symptom remission is possible in 20% to 60% of people with schizophrenia, but this depends on many complex factors.

How to Improve Dermatologic Care of Older Adults
How to Improve Dermatologic Care of Older Adults

Medscape

time32 minutes ago

  • Medscape

How to Improve Dermatologic Care of Older Adults

WASHINGTON, DC — Whole-person, age-friendly dermatological care for older adults considers the 5Ms of geriatrics — medications, mobility, what matters, mentation, and multi-complexity — and can be optimized through 'simple steps you can take in your practice this month,' geriatrician Christina Prather, MD, told dermatologists at the ElderDerm 2025 conference on dermatology in the older patient. For medication adherence and safety, for instance, possible steps include changing your practice's pre-visit call center script to prompt patients to bring in 'everything they take — the supplements, the eye drops, the ointments, the pills,' Prather said, and then doing 'a plastic bag biopsy' before the visit ideally, or afterward if necessary. 'The MAs [medical assistants] in my clinic know what to do with these plastic bags of medications, and yours can too,' said Prather, director of the Division of Geriatrics and Palliative Medicine, and associate professor of medicine at the George Washington School of Medicine and Health Sciences, Washington, DC, which hosted the conference. Other steps include using the real-time 'teach-back' method that asks patients to tell you in their own words what they need to do for their care, and having an MA or nurse call the patient 4-7 days after the visit to check for questions and ensure understanding of the care plan. 'Or maybe you're scheduling a follow-up visit 2 weeks later to make sure patients are implementing the plan,' said Prather, also clinical director of the GW Institute for Brain Health and Dementia, Washington, DC. 'With treatment plans, you always have to pause and ask [yourself] what makes sense for this patient?' she said. If it appears that the patient is not fully understanding the care plan, 'just [appreciate] that it won't happen without significant support and follow-up,' she said. When necessary, she noted, 'you can order home health to have a nurse go out and implement the medication care plan that you've enacted,' she said, noting that his is available through Medicare. Printed copies of care plans — done in large print for readability and with specificity — can be helpful in reducing barriers to medication adherence, as can specific suggestions for compound pharmacies. 'A lot of our older adults may not be as savvy with the internet in finding a pharmacy,' Prather said. 'Another handout you can have on your wall ready to give people is information about bubble packing and online packaging pharmacies that will package your medications based on what you need to take and when,' she said, citing PillPack as an example. Considering Possible Cognitive Impairment These actions apply to the 'mentation' component of geriatric care as well, Prather said, noting that pre-visit call center scripts can also prompt/remind patients to bring a family member or companion — in addition to their medications. By 2030, 20% of the population will be older than 65 years, noted dermatologist Freba Z. Farhat, MD, in another presentation at the meeting. People older than 85 years are the fastest growing segment of the US population and are expected to number 9.6 million by 2030 and 20 million by 2060. Of consequence for dermatologists is the significant number of people who have cognitive impairment, Farhat said. According to a cross-sectional nationally representative study led by researchers at Columbia University Irving Medical Center, New York City, published in 2022, almost 10% of US adults aged 65 years or older have dementia, and another 22% have mild cognitive impairment. Consideration of cognition and other factors such as functional mobility, social support, and polypharmacy are guiding principles in geriatric medicine and can all 'factor into what treatment plan we recommend,' said Farhat, assistant professor of dermatology at Georgetown University School of Medicine and director of the Inpatient Dermatology Consultation Service at Georgetown University Hospital/Washington Hospital Center, Washington, DC. Prather suggests that practices with a large senior population consider training their MAs to administer a Mini-Cog, a fast and simple screening test to detect possible cognitive impairment. 'You don't have to take ownership of it, but it might really help you think about how you communicate your care plans,' she said, noting that patients whose results suggest possible cognitive impairment can be referred back to the primary care physician. Mobility, Multi-Complexity, What Matters Other considerations for older patients include whether chairs in the clinics have arm rests, Prather said, noting that 'some older patients need those armrests to push up.' For older patients who need more time to move from place to place and more support overall, 'consider not double-booking these patients, or maybe schedule them at the end of the clinic block,' or, if possible, schedule them for a longer visit, she advised. Telemedicine visits for medication checks — to check on possible side effects, for instance — may be especially valuable for these patients, she noted. Regarding the multi-complexity often involved in the health of older adults, Prather encouraged dermatologists to 'embrace nutrition' by telling patients, for instance, 'your nutrition is really important to your skin health…and I'm not going to judge but I just want to get a general sense of your dietary intake.' She then asks patients what they ate for breakfast that morning, how many glasses of water they had that day, and what they ate for dinner the prior night. By asking such questions, 'you'll know if nutrition is contributing to your patient's skin health,' she said. (During her presentation, Prather said that she saw cases of scurvy in three patients in 2021 'related to the lack of nutritional access during COVID in individuals who were homebound.') Nutritional/meal support and other services are sometimes available through local offices on aging — and handouts that list these offices and other local community-based services can be valuable in the dermatology practice. 'In DC, we have the Department of Aging and Community Living,' which can facilitate free meal delivery for seniors who are dually eligible for Medicare and Medicaid, she said, 'and there are similar programs elsewhere.' To understand what matters most to patients, Prather suggested asking questions like these: 'What concerns you most about your health? What is the most important thing I need to know about how this [condition] impacts your quality of life? What are the things that bring you joy or make you happy most days, and are you able to do those things now? And what is going to make this treatment challenging for you?'

DOWNLOAD THE APP

Get Started Now: Download the App

Ready to dive into the world of global news and events? Download our app today from your preferred app store and start exploring.
app-storeplay-store