Coping with Guilt and Regret

Anyone of us caregivers have made mistakes along the way, during our caregiving journey. You are not alone there. But we have to come to the point of knowing that we did the very best we could under the circumstances. We're all human, and to continue to beat yourself up over things that should have, could have been done at this point is really a waste of your time and isn't doing you any good. You were very young to take on such a huge responsibility to begin with. Where was your mom and dad in all of this? They should have been the main caregivers for your grandmother, so you could have lived the life as a young carefree woman. But if that's not the way it was, you have to know that you did the best you knew how to, and that's all any of us can do. And as far as you being concerned if your grandmother was in pain, if she was, you would have known, either by her grimacing facial expressions, or her hollering out. Extreme pain is hard for anyone to hide. So it's time to lay the guilt down, and move on with your life. Enough is enough.

P.S. If you say your therapist is sick of hearing about this situation, perhaps it's time to look for another, as obviously this one hasn't helped you anyway, if a year later you're still having the same feelings.

What exactly did your g'ma die of? How did your lack of her dental care contribute to that? How would keeping her warmer extend her life? She wasn't in pain. You would have noticed her grimacing or being agitated. Were you the only one interested in her well being? Where were others? Did you do anything you thought that she appreciated? YES, you did! You were there for her. She couldn't speak so she couldn't tell you.

As with many caregivers, we look back with a sense of guilt thinking we could have done more. But unless your actions could have extended her life, it's guilt misplaced. Reliving woulda, coulda, shoulda will make for a sad life. Journal the things you think you would/could/should have done. Read what you've written. If you must, tell g'ma you're sorry. Then crumple it up and throw it away. You're done. You've reconciled.

G'mas gone, you're still here, it's a new day. Cherish your days with her, think of the good times. Smile.

Your therapist is "sick of hearing about this" doesn't say a whole lot about "why" that may be the case. Any good therapist works us away from paths of habitual ruminations that do us no good. Our thoughts are habits; they form a habitual path through our brains. A good therapist will tell you we are not allowed to follow our habitual path at the fork in the road; that way is blocked. We must now speak of life as it is played forward, and must CHOOSE the different path. While your self-tormenting may hurt, it is now become your "known"; choosing to move forward into another way of thinking may be more than you can face right now.
Your recognition of some ways in which you were not the perfect caregiver are fine; they are lessons for us. Lessons to you learn to try not to repeat known mistakes, to learn another way, to recognize limitations and seek placement for our elders, to move forward differently. Right now you are not using them as tools, as a lesson in moving forward. You are a bit stuck.
Continue to work with your therapist. Try to remember that you are but one more human being upon the earth doing the best you are able at the time with the limitations of your own humanity. You aren't an evil felon.
The only path honestly is forward. The past is over. We move forward with the lessons learned. Remember grieving is a process that takes us what time it takes us; we are all different. Continue to work with your therapist to form different ways of thinking of yourself and your future. If this truly is not the right therapist for you, try another one you work with better.
Honestly, there is not a lot more that you can do. Wishing you the best moving forward. Remember, also that Covid is contributing to depression right now in that our normal lives are unable to progress as they normally would.
I did re-read your original post about how you believe that you caused your grandmother's death. You have been told, of course, by doctors and now a therapist that this is not the case, but you are choosing to believe that it IS the case. Ego becomes mixed into it when we do not believe or accept the words of those trained in these matters, but choose to believe our OWN limited understanding and bad assessments of a situations. But, for arguments, let us then assume that it is the case, that your negligence WAS a factor. What could be done about that? Hypothetically, what exactly could now be done? Nothing is the answer. so no matter you are right or the experts are right, your only choice remains to go on and be better, having learned from a tragic situation.
You do tell us that in all these situations you "knew" you were choosing the wrong path.
Could it be again that right now you are choosing the wrong path?
That there is a path forward to a good, enlightened and quality life but you are CHOOSING not to take it? It is worth considering. For no one else can change YOUR own CHOICES for your OWN LIFE.
I wish you the very best. Sorry if this sounds like a bit of "tough love". I mean no offense, but I do want to tell you that you have choices to make now that only YOU can make. They will decide the quality of the rest of your life. Millions have lived on earth before us, and many millions will be coming when we are long gone. This is your one life; only you can decide what it will be.

I am so sorry. She would not want you to be in agony.

Find a different therapist to speak with.

Wishing you peace.

You can't possibly have caused an aortic dissection. Most folks I know who have had an aortic dissection had no warning aboit them in advance, or they were discovered entirely by accident (my husband was one of those).

What you are doing is called rumination. There are specific antidepressant meds that can help with this problem.

Have you spoken to a psychiatrist about the possibility of using meds to get over this sadness and make progress in reclaiming your life?

My heart goes out to you. Caregiving is a relentless physical and mental challenge. No one who has not walked a mile in our shoes can really understand what its like. I know what it is to wake up in the morning and wonder how I will make it through yet another day. I know what its like to have to force myself through every daily routine. I know what its like to feel so totally overwhelmed every minute of every day. I've come to the point of realizing that I will struggle along doing the best that I can with what I've been dealt. I'm not perfect. Far from it. I envy the caregivers who are able to cheerfully face the day and unselfishly give of themselves. My journey started that way. Now after years of being the sole caregiver I am just worn out. Physically, mentally, emotionally. It wreaks havoc on every aspect of your life. Will I have regrets after the journey ends? Probably so. But I cannot allow it to consume me any longer. I will continue to be a caregiver but accept that I've given all that I have to give and pray that I have a normal life to return to. For anyone considering caregiving in a 24-7 capacity, please know that it will turn you into a person you no longer recognize. I don't care how much you love that person and want the best for them, it is not something that one person can cope with alone. I wish you peace and comfort as you go through the grieving process.