Grief and Bereavement

1. Grief and Bereavement Circle of Life Community Coalition End of Life Toolkit Ministry Home Care Hospice and Wood County Aging and Disability Resource Center

2. Agenda • Definition • The tasks of the bereaved • Support for the grieving person Circle of Life Community Coalition End of Life Toolkit

3. Grief… • Grief is a natural and normal response to a loss • The loss may have already occurred or may be anticipated • Responses are emotional, physical, social and spiritual • Intense feelings and emotions are normal and purposeful Circle of Life Community Coalition End of Life Toolkit

4. The goal of the grieving person is to find the delicate balance between the past that should be remembered and a future that must be created. Circle of Life Community Coalition End of Life Toolkit

5. Grief Responses.. • May be physical, emotional, social, and spiritual Circle of Life Community Coalition End of Life Toolkit

6. Physical Reactions… • Appetite change (up or down) • Sleep disruptions • Upset stomach, headaches • Restlessness • Crying • Sighing • Lethargy Circle of Life Community Coalition End of Life Toolkit

7. Emotional Responses… • Anger • Blaming • Hopelessness • Panic • Anxiety • Guilt • Sadness and depression • Relief Circle of Life Community Coalition End of Life Toolkit

8. Social Responses… • Withdrawal • Aggressiveness • Over protectiveness • Separation anxiety, fearfulness • Disinterest in others • Change in school performance Circle of Life Community Coalition End of Life Toolkit

9. Mental Responses… • Concentration problems • Memory problems • Continuously thinking about the loss • Difficulty accepting the reality of the loss • Feeling nothing is real Circle of Life Community Coalition End of Life Toolkit

10. Spiritual Responses… • Awareness of fragility of life • Searching for meaning in the loss • Appreciation of lessons from the person who died • Challenge to one’s faith • Experiencing the presence of the deceased Circle of Life Community Coalition End of Life Toolkit

11. Instrumental vs. Intuitive Grieving Circle of Life Community Coalition End of Life Toolkit

12. Myths About Grief… • Grief is orderly and predictable. • Everyone grieves the same. • Grief is over after the funeral service/the first year/after three days/etc. • If you ignore grief, it will go away. • Staying busy is a good way to cope. • If someone is not showing emotion, they are handling their grief well. • The goal of grief is to get over it. Circle of Life Community Coalition End of Life Toolkit

13. Tasks Of The Bereaved… • Acknowledge the reality of the death • Experience the pain of the loss • Adjust to an environment in which the deceased is missing • Go on living without that person, keeping them present in heart and mind Circle of Life Community Coalition End of Life Toolkit

14. Grief Vs. Clinical Depression Grief • Labile mood • Able to experience some pleasure • Can express anger appropriately Clinical depression • Consistently low mood • Unable to experience pleasure/ withdrawn • Anger is turned inward Circle of Life Community Coalition End of Life Toolkit

15. Grief Preoccupied with the loss Is hopeful Responds to support Self-esteem intact Clinical Depression Preoccupied with self-blame Feels hopeless, helpless No response to support Lack of self-esteem Circle of Life Community Coalition End of Life Toolkit

16. Grief Trajectory… • Shock – suffering – recovery • Shock – protest – disorganization – reorganization • Disbelief – anger and guilt – restlessness – acceptance • Shock – searching and yearning – disorientation - reorganization Circle of Life Community Coalition End of Life Toolkit

17. Factors Affecting Grief… • How the person died • Relationship with the person who died • Cultural or family traditions and expectations • Experiences with death and grief • Ones own strengths and resources Circle of Life Community Coalition End of Life Toolkit

18. Euphemisms… “Grandma is sleeping.” “Grandpa went on a trip” “We lost Daddy” “Joe passed away” “passed on” “expired” “…went to meet his heavenly maker” “… pushing up daisies” “…kicked the bucket, croaked” “…taking a dirt nap, bit the dust” Circle of Life Community Coalition End of Life Toolkit

19. Offering Support… • Listen, listen, listen!!! • Try to understand the grief process • Encourage expression of feelings whatever they are • Be patient • Keep what is shared confidential Circle of Life Community Coalition End of Life Toolkit

20. Not Helpful… • “It was God’s will” • “Only the good die young” • “God needed her” • “God will not give you more than you can handle” • “At least she didn’t suffer.” • “At least he is out of his suffering” Circle of Life Community Coalition End of Life Toolkit

21. Not Helpful… • “At least you have another sister.” • “Now you have to be the man of the house.” • “Iknow how you feel.” • “Time heals all wounds.” • “You’ll get over it.” • “Everything happens for a reason.” • “Aren’t you over it yet?” Circle of Life Community Coalition End of Life Toolkit

22. Helpful… • “I’m sorry.” • “I care about you and what you are going through.” • Talk about the loved one • Share stories • Celebrate the loved one’s life • Sincerely ask “How are you doing?” and “How can I help?” …then, follow their lead. Circle of Life Community Coalition End of Life Toolkit

23. Some Things You Can Do… • Help them name their feelings (sad, hurt, angry). • Encourage them to be patient with themselves. • Share the knowledge that it is okay to laugh, to play, and to have a good time. It does not mean that they did not love the person who died. Circle of Life Community Coalition End of Life Toolkit

24. Supportive… • Help identify and find needed resources • Support groups • Attend with the grieving person if needed • Actions may offer more support than words –offer concrete help • Offer to have family coming for the funeral stay at your house; pick people up at the airport • Organize meals Circle of Life Community Coalition End of Life Toolkit

25. Supportive… • Offer to go with the grieving friend to make funeral arrangements • Make necessary phone calls to notify other friends of the family • Help with thank-you notes • Stay in touch with the grieving person. • Greatest need for support is in the weeks and months that follow Circle of Life Community Coalition End of Life Toolkit

26. Extended support is particularly important when the death involved tragic circumstances such as suicide, homicide or an accident. • Let survivors know they don’t need to hide the cause of death • Let survivors know it is not their fault • Help find professional support, if appropriate Circle of Life Community Coalition End of Life Toolkit

27. Encourage Self-care… • Need to accept their intense feelings as rational, normal and necessary • Need to normalize their feelings of grief • It’s OK to cry and OK to laugh • Encourage the person to accept support • Support and help with tasks of daily living • Food, water, exercise – go for a walk, or out to eat together Circle of Life Community Coalition End of Life Toolkit

28. Encourage Self-care… • Encourage • Sharing of feelings and concerns • Talking about the loved one • Being patient with themselves • Maintaining good nutrition and sleep habits • Encourage the person to maintain contact with others and not isolate • Encourage the person to embrace their spirituality • Talk with clergy; Pray or meditate Circle of Life Community Coalition End of Life Toolkit

29. “Grief is the other side of love.” As painful as mourning is, it would not happen if there were no love in the first place. The mourning process is a normal part of the life process. It is through death that we ultimately learn the meaning of life. Chaplain Hank Dunn… Circle of Life Community Coalition End of Life Toolkit