Life, death, and family dynamics

By Joan

Briefly explain how you might use process consultation in your personal life

It is an excruciating time for my family. This week we are waiting to hear if my sister will be eligible for a heart transplant. Becky has been in cardiac ICU since October 24 and since then doctors have tried everything to improve her end-stage congestive heart failure. Now a balloon pump is keeping her alive and a heart transplant is the only option left. If she is found to be ineligible (for health, financial, social or other reasons), she will go into hospice care right there on the third floor of University of Maryland Hospital and will pass away within minutes/hours of being removed from the machines. This would certainly be a tragedy for Becky and for our family.

But the option of Becky receiving a heart transplant also creates an enormous challenge for the family. She will need round-the-clock care for months, specialized equipment, expensive medications, and will never be able to work again. Because she is the bread-winner for her household (two of her six children are not yet launched) and divorced, the family at large will need to step in and provide her care and keeping and to a lesser extent, support to her two adult children still dependent on her. This is probably a good time to mention that there is more than a little dysfunction in my family and that my sister has some mental health issues that will complicate care and recovery.

As someone who is intimately involved in Becky’s care now and possibly in the future, I would not attempt to use process consultation myself but would look to hire an external process consultant to facilitate this group of potential caretakers. The first intervention, and probably the most valuable, would be to set up a calendar of events split between opportunities for dialogue and task- or process-focused meetings. At the dialogue-focused convenings, we would use dialogue techniques to shed our outer shells of perceptions, assumptions, and opinions and start building a common understanding of ourselves, our family dynamics, and our work to support Becky.

The next stage of interventions, task- and process-focused meetings, we’d prepare calendars of care, work out budgets, and assign areas of responsibilities to group members. During the process-focused conversations, we’d discuss the maturity of our group, assess our interactions, brainstorm ways we can improve our communication and processes. Eventually Becky’s caregivers would develop relationships of trust and cooperation that could support us over the long haul.

Let’s hope we have the chance.

Postscript: My sister Becky died November 26, 2019, after being determined to be ineligible for a heart transplant.

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