What Would a Humanist Do? Accommodating Immunocompromised Family
Photo by Evgeni Tcherkasski on Unsplash Today we bring you our latest installment of “What Would a Humanist Do?”—offering multiple AHA staff opinions on reader questions. Because while humanists are committed to being good without a god, sometimes they need a little advice on how to pull it off.
Q: A family member is undergoing a strenuous course of chemo and is especially immunocompromised during treatment. Their adult daughter who lives with them, “Alex,” isn’t vaccinated because of mental health issues, and so Alex moved in with my immediate family to lessen the cancer patient’s risk. This has worked out great. Since moving in, Alex has been getting help, started a full-time job she enjoys, and overall is doing better.
Here’s the dilemma: It has recently come to light that someone in my immediate family home is also immunocompromised, and contracting COVID would be dangerous for them even though they are vaccinated. On top of that, Alex’s job requires her to interact with hundreds of people every day. Half of my family wants to ask Alex to find a new place to live, even though homelessness is a real concern. The other half of the family—myself included—wants to take on the added risk and let Alex stay (because, family).
Ultimately I don’t think anyone will ask her to leave, but my concern at this point is how the tension is impacting Alex. I worry that she’ll feel burdensome and decide to leave herself, which would likely mean undoing a lot of the stability she’s built in the last year. Discussions to encourage her to get vaccinated and asking her to move home are both out of the question. But any other advice about how to navigate this tense situation would be welcome.
A’s:
This situation has tension written into every twist and turn, and I certainly understand your valid concern that it could negatively impact Alex and unravel the admirable progress that she’s made. It’s been my experience, however, that the worst kind of tension is related to things that are unsaid and unexplored.
How much of this situation is Alex currently aware of? While I understand the gut reaction to protect her, involving Alex in workshopping solutions to this situation could make her feel valued, seen, and, ultimately: less tense. Maybe Alex has ideas that you haven’t considered. Maybe she’s aware of ways she can take greater precautions at her job to protect your immunocompromised family member. Maybe, in her new period of stability, she’s been meaningfully considering this situation herself.
There’s another part of this quandary that concerns me, and it isn’t something you explicitly wrote. How much of this dilemma are you internalizing and trying to take responsibility for? Trying to fill the void as the “family decision-maker” can be profoundly taxing, and the stress it creates may ultimately exacerbate the tension that’s been worrying you. Before you can dispense any meaningful advice or guide your family, you need to decide for yourself where your boundaries lie.
It’s easy to fall into the mental trap that a group’s dilemmas can be solved only by ourselves alone, but the burden of problem-solving should be shared by all of your family members – including, to the extent it does not disturb her newfound stability, Alex herself.
—Peter Bjork, Web Content Manager and Managing Editor
It’s great to hear that Alex is getting help and doing better; that’s such a vital accomplishment and one that takes a lot of hard work.
But ultimately, the only person that should make this call is the immunocompromised person in your house, or at the very least, their feelings on the matter should hold the most weight. The rest of the family can’t decide for the immunocompromised person that they are willing to risk their health. It’s important to remember that even though the immunocompromised individual is vaccinated, experts say that COVID-19 vaccines may not provide as much protection to the immunocompromised compared to the general population. The CDC recommends that vaccinated immunocompromised people continue socially distancing and wearing a mask in all indoor settings where they have to interact with someone who may not be vaccinated. It’s difficult to ask someone to do that for the majority of the time in their own home, coupled with the added stress of living closely with an unvaccinated person that interacts with hundreds of people every day. Home is one of the only truly “safe spaces” for the immunocompromised, or it at least should be. That alone can be very isolating.
On the other hand, the loss of stability for someone living with mental illnesses can be detrimental to their physical (and of course mental) health as well. It’s hard to provide detailed advice without knowing more background. If encouraging Alex to get vaccinated is out of the question, perhaps the family could pool their money to help Alex find housing that is suitable for her. Or, depending on living arrangements, it may be possible to create ground rules and boundaries so that Alex and the immunocompromised individual can minimize risks and/or do not have to share the same spaces.
—Meredith Thompson, Development Manager
Wow, there are a lot of entangled issues in this situation and it’s difficult to find a helpful answer. Of course, the extended family wants to take care of Alex during a stressful time and help her achieve stability. It sounds like she is working hard toward improving her life, and has the support she needs to accomplish that. It makes sense that no one wants to jeopardize that progress. At the same time, the family clearly wants to keep everyone else safe and healthy during an unprecedented pandemic. It certainly would set back Alex’s progress if a loved one got sick because of her.
As I understand it, the core of the problem is that there is a real risk of homelessness for Alex if she has to move from the current living situation, but her presence in the home poses a real danger to someone else. Since vaccination is not an option for Alex, is it possible to find her a new place to live, but design a support structure for her that makes living on her own possible? For instance, maybe family members could chip in financially to pay rent and other living costs, perhaps you could set up a schedule for vaccinated people who are not immunocompromised to take turns helping her with daily tasks that give her trouble (such as remembering medications, getting up on time, giving rides to work, etc.), or bring or cook meals to share with her. People could also take turns just keeping her company and doing social things with her. That might provide some of the stability of living with family while helping Alex on the road to independence. Importantly, it would also provide a measure of safety for the immunocompromised family members who, after all, also deserves consideration for their health issues.
—Nicole Carr, Deputy Director