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advice plz - friend has advanced AIDS - when should I tell his family?

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jayek:
My friend was in serious denial.  Found out he was HIV + after losing 1/3 of his weight and suffering from thrush for months.   First test results - 16 t cells, viral load 118,000.

He was put on combination of meds, but was already showing some signs of cognitive problems.  He wouldn't eat or drink, but said he was.  He wanted to be home (he lives alone) and resisted getting a home health attendant.  He does not have a lot of friends living around him.  He finally fell and couldn't get up and was taken to the hospital.  He is not speaking coherently.  I'm hoping he gets put into some kind of nursing facility. 

He told me not to tell his family unless something "really bad" happened.  His family lives far away, he has not kept in touch with most of them except his mother.  He never came out to any of them.  They are very conservative and religious.  His mother is old and he doesn't want to upset her.   

I don't know what to do. I feel like this is "really bad" but if he gets put into a nursing facility, I suppose he could get better?  I don't think any of them would be able to help at all so I'm not sure what would come from telling them, but I feel like they'll be more upset if he dies and they didn't know. 

Any advice??  I appreciate it!

Miss Philicia:
I feel like this rises to the level of "very bad" as well and that it's time the family knows what is going on.

jayek:
 thanks.  I'm not looking forward to this. 

emeraldize:
Hi Jayek,

I read your fresh post yesterday and was glad Miss P replied. Many things went through my mind and as much as I wanted to write -- I found this an incredibly difficult scenario -- for your friend, his family and you. And, I opted not to write. I know you want more input -- you wouldn't have posted were that not so.

Your friend's setting, not having a close relationship with family nor friends close by and a ravaged immune system, don't bode well for a good outcome.

But life is fascinating -- letting his family know, particularly his mother, might be the key to him rallying.

As with any downfall, physical, emotional or financial -- they have a tendency to feed on the downward swirling trend and it takes definitive action to reverse the trend. You are in the delicate position of being the person who might cause a reversal of some sort -- of course with an unpredictable outcome.

What if, mom learns, wishes to come see him, he is inspired to eat, drink and be medicated, she is enlightened and can, in the face of his desperate situation, set aside conservativism and bias and be what a mom usually is -- a life giver and supporter. Her reaction and action could possibly lead the way for other family members.

And, the opposite could happen.

This couldn't be a whole lot worse so I would roll the dice to initiate change. Your friend gave you permission to make the call of what "really bad" is and such things are subjective.

It helps, I believe, to imagine you are his mother and following his death you learn that he kept secret so much that it led to his death. Would you not feel left out, unloved, untrustworthy and be discovering all of this with the onset of grieving.

Terribly heavy heart I would foresee for her.

In moments of life-threatening health issues, I tend to believe that most who come up to the bedside are not thinking about nor judging someone's sexuality as they are hoping to enable the furtherance of life and share demonstrations of love.

Were I in this situation, I would pick up the phone today. However, if she is within a reasonable driving distance, I would pick up the phone to learn if I could visit and then go in person. Imagine receiving such information on the phone---stunning. No hand to hold, no hug to offer, no eye contact to gauge.

You'll figure it all out and it will be as it should be -- a brave set of actions on behalf of a friend. No template, no net, but as perfect as human interactions go.

Em

jayek:
Thanks so much Em for your thoughtful reply. :)

Of course it is more complicated than I could put in my initial post.  HIs mother is actually great - probably the most open and loving of the family, but she is very old, is not able to travel and is reeling from the deaths of 2 other family members just in the past few months.    If this was 10 years ago, your positive scenario would have been possible. 

I'm trying to figure out why I'm hesitant to make the call.   Part of me feels that there isn't anything any of them can do and it will just spread bad feelings and I'll be inundated with questions I don't want to answer.   Another part of me thinks if he is put in a hospital and gets better, maybe he wouldn't ever forgive me for telling them and that makes me sad.  I made a promise to him and I take that seriously.  I know I could say things got really bad so I felt justified, but he might not agree.   If I were to ask him right now he would say don't tell them, BUT he is definitely not in his right mind.

I think there is also a little bit of me that doesn't want to get shut out of the situation if the family gets involved.  I realize that is wrong and his health is the most important thing. 
 I think I'm being unrealistic about his getting better, but this is all so sudden and it's hard to get a doctor to give me a prognosis. 

anyway, I'm rambling.  I'm waiting to hear about his condition today and then I will contact the family.

thanks again for your thoughts

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