Families struggle with anger, forgiveness when loved one dying


Watching a loved one dying tests some family members’ relationships with God or the higher being of one’s faith. And the spiritual anger and resentment grow with the level of pain and suffering their family member endures, according to researchers at Case Western Reserve University.

Psychologist Julie Exline and palliative care advanced practice nurse Maryjo Prince-Paul surveyed 147 family members with a hospice patient under home care. More than four of every 10 respondents reported at least some level of anger with God, a major source of which was watching a loved one dying or suffering great pain. Resentment was strongest among family members of cancer patients and weakest among family members of heart disease patients.

Families struggle with anger, forgiveness when loved one dyingA family member’s level of spirituality was also a factor. The less religious or spiritual family members said they were, the more anger they reported toward God. Family members also reported more anger toward God if they could not see any deeper meaning in the suffering that the patient and family were experiencing.

New studies on loved ones dying

Exline, associate professor of psychological sciences in the College of Arts and Sciences, and Maryjo Prince-Paul, assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve and research scientist at Hospice of the Western Reserve, published their findings in the current Journal of Palliative Medicine article, “The Spiritual Struggle of Anger Toward God: A Study with Family Members of Hospice Patients.”

A related study by the researchers in a recent Journal of Palliative Medicine article (volume 15, issue 10, 2012), “Forgiveness, Depressive Symptoms, and Communication at the End of Life: A Study with Family Members of Hospice Patients,” explored the importance of forgiveness-related communications between hospice patients and family members. Many family members reported that they saw seeking and granting forgiveness as very important in their relationships with loved ones who were dying.

The forgiveness study showed that if family members saw forgiveness issues as important but had not completed the process, these unresolved conflicts were linked with greater depressive symptoms. Building on these findings, the new study showed that anger toward God was also linked with higher levels of depressive symptoms among family members.

Respondents in the new study were asked about which coping strategies they would prefer if they were feeling angry toward God. The most popular strategy was prayer. Other common strategies included reading sacred texts, handling feelings on their own and discussions with friends, family, clergy or hospice team members. Self-help resources and therapies were less popular, respondents said.

Overcoming anger at god for loved one dying

Exline concludes that finding ways to overcome anger with God—and being able to seek and grant forgiveness in relationships with family members— can be important for both families and patients in the dying process.

“People have difficulties when they struggle to find meaning in their lives during stressful events,” explains Exline. “If people feel guilty about mistakes they have made, or if they feel alienated from God or a family member, these issues can make it more difficult for them to cope.” Such issues may loom especially large in end-of-life contexts, when repair of close relationships can take on great importance.

In the forgiveness study, family members wrote about the significance of expressing love and gratitude, but also felt that clearing up unresolved issues was important before the patient died.

These two articles continue Exline’s research on the many anger-related issues that people can experience when they are facing stressful life events. The research also adds to understanding of the many emotional, social and spiritual strains faced by family members of dying patients.

Staff of the Hospice of the Western Reserve in Cleveland were instrumental in conducting the study and also contributing to the article. The Fetzer Institute funded the research.


2 Responses to Families struggle with anger, forgiveness when loved one dying

  1. u13099095 April 30, 2014 at 11:31 pm #

    “And the spiritual anger and resentment grow with the level of pain and suffering their family member endures”. I find this statement to be very true. Through personal experience I have noticed that people find it more understanding if a loved one dies quickly than if a loved one suffers while dying. It is a very traumatic experience watching someone suffering that you love and not being able to do anything about it. In this time I feel a lot of people turn to God and beg Him to help and all to often it seems like He does not. It feels like He leaves us when we need Him most. I think this is why we have more difficulty letting go of anger towards God when a loved one suffers while dying. When someone has a sudden death it is difficult not being able to say goodbye or ask a few last questions. I think this makes it more difficult to move on. If you have unresolved issues you tend to struggle to forgive yourself and the people around you as well as the person who passed away. I believe you cling on to people longer who died suddenly and you have more anger towards people but generally less towards God as you feel that God saved the person from difficult circumstances s/he might have had to endure if they lived longer. I do however believe that not only the type of sickness and the length of suffering causes more or less anger towards God but also the age of the loved one and the relationship you had with the person and with God before the person passed away.

  2. Renata Smith February 19, 2013 at 9:22 am #

    ” Resentment was strongest among family members of cancer patients and weakest among family members of heart disease patients. ”

    I found the above quote interesting. My family has suffered lots of cancer and heart disease. There is a distinct difference in the emotional toll between the two, it seems to me. Cancer strikes more fear, causes more haunted hours of introspection, preys on the mind more. Someone should study the differences in emotional impact on patients and families between cancer and other life-threatening conditions.

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