• Joan lost her dad at a time the pandemic broke and it affected her mental health

• Dealing with anticipated grief requires tact and therapy if it leads to case of PTSD

It is often the unspeakable level of grief: preparing for the death of a parent.

It is hard to imagine life without them, but it’s a phase we all have to face at some point in our lives.

For Joan Njaro, a TV producer with Royal Media Services, losing her dad at the age of 74 made her realise that nothing ever prepares you for death. It doesn’t matter how old your parents are.

Death, she says, is complicated. It is not just a physical separation but also emotional and spiritual. Not to mention the financial unpreparedness that makes the situation harder.

Joan’s late father was diagnosed with Stage 4 lung cancer in April 2019. They immediately put him on chemotherapy treatment and because of his age, surgery was not an option. The doctors used what is known as targeted therapy as part of the treatment. It is a type of drug treatment that attacks specific features of cancer cells.

Five months down the line, her dad improved. But Joan explains that during that season, so many prominent people were dying of cancer.

“We had the late Bob Collymore, then a week later Bomet Governor Joyce Laboso died of cancer at the age of 58. I won’t lie, it was taking a toll on me. At some point, you couldn’t help but think of the worst, but I remained hopeful,” she says.

Come February 2020, she received a call from her mother. Her dad was in bad shape. At the same time, the death of President Moi had just been announced.

“I recall I couldn’t leave the office that day even after learning my dad had difficulties breathing,” Joan says.

“A friend came through for me, rushed home, picked my dad from Murang’a and took him to hospital. When I was done, we met at the hospital where my dad was admitted.” 

That day, doctors conducted more tests on him and found that the cancer had spread from the lung to other vital organs of his body, including his other lung and the liver.

Joan would be at the hospital at around 4.30 am and be at work by at least 6am. She was not prepared for the inevitable emotional upheaval.

“I had used my entire savings for the treatments, which were extremely expensive. And instead of him getting well, he was deteriorating. It crushed me,” she says.

“On the other hand, my dad had begun to make peace with the fact that he would not stay any longer. He kept saying, 'Anything could happen, I could die.'”

As Joan’s dad was battling cancer, her mother was recovering from a knee replacement surgery she had undergone at the same time. She had to deal with every cropping issue supported by her younger sister, who is a medic.

Their eldest child was abroad and because it was during the heightened Covid-19 period, she could not fly in due to the strict measures put in place by the government to mitigate the crisis.

As her father's situation deteriorated, the doctors asked Joan to prepare for his death.

“You guys have to make your dad happy. He doesn’t have a long time to live,” they would say.

“But how do you prepare for death? Do you do happy prayers like my mother suggested? What is it that one is supposed to do? I had a hard time broaching the subject. I decided to hope against all hopes that my dad would recover,” Joan said.

Tina Mathai, a psychologist currently working with Maryland Global Initiative, says in such situations, use the opportunity to say the things you have never had a chance to say.

“It could be you saying that you love them, you are grateful and even seek for forgiveness in areas you know you could have wronged that person,” she said.

She recommends people take time to talk and put their books in order, especially if there are issues around succession because those are some of the things that compound grief.

Having medical or life insurance for your loved ones, she says, is critical in that it helps ease the financial burden.

“If you are particular about the way you would want to be buried, have those conversations early," Dr Tina said.

"But also bear in mind that depending on the kind of person and their belief in death, they may not be willing to have that conversation. Consider bringing in a third party if the conversations are difficult to have."

The conversations are a delicate balance but it is important to try, she says.

The health of Joan’s father improved for some time. On March 29, he was discharged. It was the wisest action to take, bearing in mind the pandemic was taking effect and it would be safer if he was not under such an environment.

The family subsequently left for their home in Murang’a. They had with them an oxygen concentrator, a cylinder and a tonne of medication stashed in a bag. They had to look for a nurse. They also had to buy a generator because they had power issues at home.

“It was around the same time we were getting our salaries slashed. I was mad about the 30 per cent pay cut. I wondered how we would survive, but God came through even when the cylinder ran out of oxygen ,” Joan says.

Come April 1, Joan’s father began having struggles breathing. Joan called his doctor at around 8pm. He directed them to bring him to the hospital and straight to the ICU section.

“We set up the cylinder in the car very quickly and my cousins carried him to the car. But by the time we were getting to the car, he had passed out. We started resuscitating him and thankfully he became stable,” she says.

At the hospital, Joan's dad was put on a life support machine. But before that, Joan recalls his dad telling him, “Whoever that nurse was, I feel very good. But I’m feeling very tired. Now let me sleep.” It was a Wednesday night. Two days later, he died.

“I felt some coldness. I started feeling lonely. I felt something very precious had left me,” Joan says.

Even in death, the family was not able to give their loved ones a decent burial. The government had just announced the burying of the dead should take place within 72 hours. It was the same time the government was making announcements on intercounty lockdowns due to the high rate of Covid-19 cases.

“Remember my mother is still recovering from surgery. So I started looking for a hearse. Even before I could get through that phase, an announcement was made by the President on lockdown. He said you cannot leave Nairobi,” she said.

The family hurriedly moved the body from Nairobi to beyond Thika so that getting it to Murang’a would be swift. My friend Eunice also managed to pull some strings at the police headquarters. “We were told to get 15 names who are going to travel from Nairobi to go bury so that I get a clearance,” she says.

On the fateful day, the funeral was done in less than an hour. It was rushed. “I felt like we did not give him the respect he deserves. Remember my dad had not died of Covid-19; it's just that his death happened at such a time, which affected us enormously. Police officers were all over while we were burying my dad. It was bad!” Joan says.

The aftermath of his death affected her tremendously. She was withdrawn. She lacked sleep and even experienced memory loss. The situation was getting out of hand and because she had some knowledge on Post Traumatic Stress Disorder (PTSD), she willingly decided to seek help.

“Nobody ever prepares you for PTSD. When you lose your loved one to something, fear creeps in. I would have thoughts of my mum following suit barely a year after my dad's death. Such thoughts really affected me,” she says.

“At some point, I dreamt of my dad on the eve of last year. He told me, 'You cannot continue to live in the shadows of the past. You have to find a solution and focus on your life.'”

That is when Joan resumed her studies at the University of Nairobi and also started seeing a clinical psychologist. “She told me if I don’t make an effort to get well, she will have to put me on anti-depressants. So I had to be very conscious with my thoughts. I had to tailor my thoughts. I chose me and did six counselling sessions.”

Dr Faith Muhindi, a consultant psychiatrist with Gilgil Hospital, says PTSD may last for months or even years. It depends on the individual. There is no specific timeline.

She says PTSD is a disorder as a result of trauma. Traumatic events in this case include rape, war and the like.

“For you to experience PTSD, you have to have experienced a traumatic event or witnessed it in person. The symptoms will have to have been there for a month or more for someone to be said to have PTSD,” she says.

Patients exhibit signs of distressing dreams and exaggerated response. Others get startled quickly, they are irritable and others want to be alone.

“I have encountered patients with PTSD, most of whom have been in war. Most present fear and lack of sleep. They have a paranoid delusion, which is distressing to the patient,” she says.

The disorder is treated through the use of antidepressants or psychotherapy, relaxation therapy and support or family therapy.

Dr Faith reckons that if someone is having a life-threatening condition, it’s the doctor's role to explain the prognosis, but if the person wants to hope, they have a right to still hope. It’s their decision and it should be respected.

Joan says she is still healing because grief is something that cannot be understood. It has a life of its own. She still visits her dad’s grave. She still holds conversations with him like they used to early in the morning.

“The world does not know what you are going through, so It's up to you to know how to get to the other side,” she says.

Her parting shot is that humans should not be quick to judge because you never know what someone is going through.

She recommends that people check their mental stability. It should be prioritised the same way people do high blood pressure and temperature checks.

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