Coping with Grief and Loss

When Someone You Know Is Grieving

Child depressed and cryingMany people are unsure how to help someone who is grieving the death of a loved one. If someone you know has experienced a significant loss, you are probably seeing some changes in his or her mood and behavior. The grief may seem overwhelming. You may be looking for a better understanding about grief, normal grieving reactions, and specific strategies for helping.

Normal Grief and Grief Reactions

Grieving is the natural response to loss. It is not about “getting over” the death; it is about expressing sorrow, sharing memories, and learning how to go forward with life. Over time, the person who is grieving learns to create a new reality without their loved one in it, but this is not the same as “getting over” the death. It is important for most grieving people to continue to commemorate their relationship with the deceased in some meaningful way. Sometimes it may be important for survivors to come to terms with difficult parts of their relationship and to find a way to make peace.

Grieving takes time. The person you know who is grieving may take many months, often well over a year, to gain a sense of having a new normal life. Grief is a form of healing. You would not push a friend to hurry up and walk if his leg was broken. In the same way, understand that a part of the griever is broken and needs time to heal.

Grief is not a mental illness, but it is a time of strong physical, emotional, mental and spiritual changes. Many grieving people experience disruption in their moods, thoughts, concentration and energy. Most people have some changes in their eating and sleeping habits. Each person is unique, and so is each person’s grief. Some people will become more irritable and angry, some may cry frequently, others may become quiet and withdrawn. Most people are exhausted by grief, and may become absentminded and distracted. All of these reactions are normal, and to be expected.

You Can Help

Call. It is normal for grieving people to be somewhat inwardly focused, making it difficult to express their needs. Rather than say, “Call if you need anything,” you should make the call. Not just once, but periodically over time, call and check in. Don’t offer help you can’t actually provide, and make sure to follow through on any help they accept.

Be specific. Are you running errands? Offer to pick something up or take care of some chore. If the person is a coworker, can you help make it easier for them to function during the distractible grieving period? Can you offer to take over a task or relieve one burden? This strategy is useful for the first several months.

Listen. Just listening to the stories grieving people want to tell is enormously helpful. They may need to talk about the death itself to help them figure out how to make sense of an overwhelming experience. They may express great sadness or anger. Do not take their emotions personally. Let them express them and just listen. You do not have to try to fix the feelings or problems that the griever is sharing, just be there. Avoid clichés, as these often make the griever feel you are trying to shut them up or aren’t really listening.

Be available over time. Often after a death, people are supportive for the first few weeks. Many grieving people report that their support system rallies well at the time of the death but then vanishes two or three months later – long before their grieving is over. If you can, be there for the long haul. Judge your own capacity for helping, and make it clear what you can do. You do not have to feel guilty about the limits of your helping. Give what time you can give with an open heart, and trust that by not burning out you can give more over time.

Normalize. The grieving person may be overwhelmed by reactions to the loss. Letting the person who is grieving know that you understand these reactions are normal responses to a difficult circumstance may provide needed comfort and relief.
Encourage healthful living. Gently encourage the grieving person to try to get some rest, eat well, and exercise. Understand that the griever will probably have some changes in eating and sleeping patterns. A wonderful way to help the griever is to go for a walk together. This lets the griever get some exercise and talk about whatever is on his or her mind at the same time.

When Professional Help Is Needed

Most grief reactions will lessen over time. There are times however when grieving becomes complicated and counseling may be helpful. The following circumstances may indicate a need for professional assistance:

  • If a grieving person has a history of mental illness
  • If a grieving person is turning to drugs or alcohol, or has had problems with drugs or alcohol in the past
  • If a grieving person has a limited support network
  • If a grieving person is taking unusual and/or dangerous risks
  • If grieving is causing significant daily problems for the griever
  • If the grief is complicated by trauma (the death was difficult, sudden, or unexpected, or due to violence or suicide)
  • If a griever expresses a desire to join their loved one in death. These thoughts are common and are rarely truly suicidal. However, if the griever speaks of actual plans about when and how to take their life, immediate evaluation by a doctor or mental health professional is required.

This information was provided by The Community Hospice.

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Symptoms of “Normal” Grief

Cognitive

 Confusion, disorientation
 Difficulty concentrating
 Memory impairment
 Thoughts of wanting to join the deceased

Physical

 Achy, stiff muscles
 Changes in appetite, weight loss or gain
 Changes in sleep patterns
 Dizziness, vertigo
 Fatigue, exhaustion
 Headaches
 Nausea, stomach aches, intestinal problems
 Pounding heartbeat, tightness in the chest
 Restlessness
 Weakened immune system

Emotional

 Anger – at the deceased, survivors, doctors, self, God
 Anxiety, fear, panic
 Deep sadness
 Denial
 Depression
 Frustration
 Guilt
 Helplessness
 Irritability
 Loneliness, isolation
 Numbness
 Relief that deceased’s suffering has ended or that a bad relationship is over
 Shame
 Shock and disbelief that the death has occurred
 Worry

Behavioral

 Accident-proneness
 Frequent crying
 Loss of interest in usual activities
 Nightmares
 Over-activity Withdrawal from friends and family
 “Paranormal” experiences – visions of the deceased, etc.

This information was provided by The Community Hospice.

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Navigating Children’s Grief: How to Help Following a Death

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How and When Should Children Attend Funerals?

Candle arrayFunerals are a time we gather to honor a person’s life and to mark his or her passing. Attending a funeral helps people experience their loss with community support, and begin the transition to living without a loved one. Even though it may be difficult and painful, this participation helps grieving people, whether adults or children.

Each child is unique, with individual worries and abilities to handle social interactions. Therefore, while encouraging a child to attend a funeral, give a genuine choice about attending. It may be appropriate to allow for some options, such as attending a private family time at the funeral home before the service begins.

Here are some things to keep in mind when talking to children about funerals:

  • Give children specific information about what they will see at the funeral. Tell them where the funeral will take place, what the room will look like, who will be coming, how long the service is likely to take, etc.
  • Let children know that people attending the funeral will show many different emotions and may express them intensely. People may be upset, and it is good for people to express these feelings. Also, let the child know that people may smile, laugh and enjoy remembering good and funny things about the loved one who died.
  • Let children know that funerals are important. They are a place for people to come together in their sadness over a loss. They also honor the life of the person who died and affirm that life goes on.
  • Funeral homes will usually accommodate allowing children to visit before the funeral with only a few close caring adults. This may allow the children to feel more comfortable and give them a chance to talk more freely and ask questions.
  • Try to provide for the child to have a close person to be available just to them at all times during the funeral process. This person needs to be a caring presence, able to focus on the child.
  • Recognize that children often experience short bursts of emotion. They are impacted by loss, but outward signs of their grief will come and go. Allow for the full range of emotions in children, including happiness, playfulness, sadness, and anger.
  • Give the children a choice about whether to view the body. Children often have no innate fear about the body, and seeing the body provides a chance to say goodbye and makes the loss more real.
  • Listen to what children say and watch what they do. It is important to let children express what losing their loved one is like for them.
  • Provide the child with life affirming messages. Even though loss is painful, life continues.

This information was provided by The Community Hospice.

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Answering Children’s Questions about Death

Many children have questions about death and dying. Caring adults can help by making it acceptable to talk about these difficult issues, and by answering children’s questions carefully and honestly. This discussion may arise naturally when the subject comes up in books, television shows, and movies, or it may be related to a loss in the child’s life.

Children’s understanding of death changes a great deal as they grow through childhood. Finding out what a child already thinks about death will make it possible to correct any misunderstandings. Simply asking what the child believes before answering any questions can make the discussion much more productive.

Many people are concerned that they will say the wrong thing. The best guide is to keep answers simple, honest, and aimed at the child’s own age and developmental level. However, here are some general ideas for answering common questions.

What is death?

Death is when a body completely stops working. It becomes broken in a way that can not be fixed. The body no longer sees, feels, hears, or thinks. The force that brings a body to life is gone, like a toy with no more batteries. Death is nothing at all like sleeping. When a body is sleeping, it is resting and preparing for another day. When a body dies, it will never be alive again.

Usually when people are sick or hurt, doctors can help them get better. People go to hospitals to get healthy if they are very sick. Sometimes, though, people are too sick for doctors to heal. Then doctors and nurses try to help the dying person by keeping him or her from hurting while he or she dies.

Why do people die?

All living things die. People can die when their bodies become too sick to be healed, when they have an accident that injures their body in a way that doctors can’t fix, or when they get very old and their body wears out. All life on earth is part of a continuing cycle. Every life begins, grows, and ends. Usually people live long and healthy lives, dying when they become very old and their body parts can no longer work correctly. Sometimes people do die young. It does not happen often. It is usually very sad for the people who loved them. But even someone who died very young could have had a very special and important life while they are alive.

People do not die because they are good or bad. Being angry at someone does not make them die. Even wishing someone would die doesn’t make it happen.

Dying happens because the body can’t work any more. It is not a punishment. Death sometimes doesn’t seem fair to those people who are left grieving. It hurts not to be able to see someone we love, not to be able to be with them and share time. Remembering the special times shared with that person and what their life meant to you can help bring meaning to the loss. It can help you to find a way to keep the person in your heart and keep loving.

Does dying hurt?

Usually death itself is not painful. When people die from an illness, doctors try to help them by giving them medicine to ease their pain. When people die from old age, their dying is usually very peaceful. Often, when people die in accidents they die too quickly to feel much pain. No matter how someone dies, once he or she is dead the body can no longer feel anything at all.

Where do dead people go?

The body of the dead person must be taken care of because it will change after life has left it. Sometimes people choose to bury the body. When a body is buried it is put deep in the ground. Usually a stone or marker is put at the grave to show whose body is buried there. This gives the family and friends of the person who died a place to visit to remember the loved one. Sometimes the body is cremated. This is a special process that turns the body to ashes which are sometimes kept and sometimes released into nature. In either case, the person who died no longer needs the body or feels anything that happens to it.

The part of us that feels and thinks is no longer in the body when the body dies. Many people believe that this part of us, our spirit, continues on after the body dies. Different people believe different things about where our spirits go after we die. No one knows for sure; it is a mystery. Talking to family members and others about their beliefs can help each person decide for themselves what happens to our spirits.

What is grief?

Grief (or grieving) is a word that describes the thoughts and feelings people go through when someone they care about has died. Grief is the heart and mind’s way of getting used to the loss of that person. It includes feelings such as sadness and anger. It can also include feelings of relief or happiness. These feelings may seem stuck in our bodies, giving us stomach aches, head aches, or other pains. Grief is also the thoughts we have about the person who has died and our missing them.

What can I do with my feelings while I am grieving?

Going to a funeral brings you together with other people who are grieving your special person who died. Funerals are ceremonies that help people think about and celebrate the life of the deceased. It may also help to talk about the person who has died, to write letters full of the things you wished you had said to them, or to draw pictures about your feelings. Hitting your pillow, pounding on clay, running, or doing other physical activities may help your feelings not seem so stuck in your body. It is okay to cry! It is natural to be upset and to feel angry. It is important not to do anything that will harm yourself or anyone else. Sometimes, it may help to be with other children who have had a loss or to talk to a counselor. Most of all, remember that feelings of grief will change over time. You can not make them go away completely. They are part of loving the person who has died.

This information was provided by The Community Hospice.

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Communicating With Grieving Teens

Open communication is extremely valuable to bereaved teens. In fact, allowing grieving persons to express their thoughts and feelings is the most important assistance you can offer them:

  • Information reduces fear.
  • Information can return a sense of control.
  • Talking things out now can help prepare teens for future losses

Barriers to effective communication:

  • Our discomfort with death and grief
  • Our fear of intense feelings
  • Our desire to protect teens from the reality of death
  • Our desire to “fix” things
  • Our fear of “saying the wrong thing” or “making things worse”
  • Our own grief

Techniques for successful communication:

  • Create a safe, non-judgmental environment, free of interruptions.
  • Listen, listen, listen. Don’t interrupt, interpret their feelings, or offer advice.
  • Do provide accurate information as needed. Identify and counter misconceptions about the death itself. Be honest and factual and use age-appropriate language.
  • Use the name of the person who has died.
  • General, simple words of condolence are always appropriate:

 I am sorry for your pain.
 I really miss (name of the deceased).
 He (or she) was a special person.
 I’m here if you need to talk, or cry, or just have quiet company.
 I’ve never experienced this before, and I just don’t know what to say.

  • Ask open questions to get them talking:

 What was your relationship with (the deceased) like?
 Can you tell me what this has been like for you?
 How are you doing?
 How is your family doing?
 Is there anything you can think of that I can do to help you?

  • Accept and validate whatever feelings are expressed – do not argue with or minimize their feelings. If appropriate, suggest constructive outlets for strong feelings.
  • Normalize their feelings and thoughts. Reassure the teen that difficulty concentrating, lack of enjoyment, anger, decreased energy, and so on are all normal parts of the grief process and will abate over time.
  • Leave room for a conflicted or ambiguous relationship with the deceased – do not idealize the dead.

What Not to Do:

  • Don’t avoid the issue. Avoidance causes the issues to go “underground,” resurfacing later in potentially harmful ways
  • Don’t try to “rescue” the teen from his or her feelings. Grief involves feelings that make us uncomfortable, but successfully resolving grief requires that we work through these feelings in our own way and at our own pace. Witness their pain without trying to change it, hurry it, make it better, or minimize it.
  • Don’t use euphemisms. It suggests to the teen that you can’t handle the reality of death, and may cause them to worry that they have to protect you. Use the “d” words instead: dying, death, dead.
  • Avoid clichés. Try to imagine what they would sound like to you if you were the one grieving.
  • Don’t lie to protect the family or community image. When the teen finds out the truth, they will have another loss to grieve for – their trust in you.
  • Don’t impose your own religious beliefs. Teens often go through spiritual crisis or existential questioning after a death. Be supportive, but let them find their own way.

Other Things Adults Can Do To Help Grieving Teens

  • Respect the teen’s privacy.
  • Model positive coping behaviors.
  • Maintain regular routines and structure as much as possible – minimize disruptions.
  • Maintain normal expectations of behavior and appropriate consequences for negative behavior – this helps teens maintain or regain a sense of consistency.
  • Encourage the teen to eat healthy foods, to drink plenty of water, and to sleep – physical health affects emotional well-being.
  • Encourage and facilitate age-appropriate activities:

 Memory book
 Journaling, letter writing
 Artistic or musical expression
 Physical outlets such as sports or other active recreation
 Memorial rituals

  • Give teens choices and options to help counter feelings of helplessness.
  • Introduce grieving teens to others who have also been through difficult losses – peer support can be a powerful resource for adolescents.
  • Reassure the teen that love for the deceased can be expressed through other emotions than sadness. Feeling joy and happiness about life events is often experienced by the teen as being somehow disloyal to the person who has died. Reassure the teen that it is okay for them to continue to enjoy their lives.
  • Explore if school assignments can be modified to allow grieving teens to channel their emotions and energy into writing, drawing, or other expressive outlets – this may allow students to keep up with school while they work through their grief. Have a buddy who will help the teen with homework, or assign a tutor who can help the student. Step in if needed to advocate for the teen at school.
  • Teens often benefit from having a safe way to physically express anger. You can give grieving teens appropriate things for them to unleash their anger on, such as telephone books or magazines to rip up, pillowcases full of clean cloths to wrestle with and hit, paper cups to smash, paper bags to blow up and pop, golf tees to hammer into thick Styrofoam, or clay to manipulate, pound, and smash.
  • Be available over time. Many grieving people report that their support system rallies well at the time of the death but then vanishes two or three months later – long before their grieving is over.
  • Be aware of “anniversary dates” which can reactivate grief; acknowledge these special days and assist the teen in making the connection between approaching “anniversary dates” and their renewed feelings of grief.
  • Be patient. Grief takes time.

This information was provided by The Community Hospice.

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Grief support for teens and their families

Cycles of Grief

Teens talking and being with one another during a grieving period

Grief is a natural and normal response to loss. Grief has been compared to a roller coaster ride because of its many ups and downs. It may help to know that others have traveled before you and have found their way back to safe ground. Here are some of the cycles of grief:

  • Shock, numbness and disbelief.
  • Avoidance and retreat.
  • Resistance, blame and anger.
  • Constant thoughts of the loss.
  • Jealousy aimed at those who have what you do not.
  • Anger.
  • Self-blame.
  • Confusion and feeling disoriented.
  • Physical disturbances including exhaustion and changes in appetite/sleep.
  • Nervousness.
  • Sadness.
  • Reorganizing life, gaining new insights, learning new skills.
  • Feeling at peace with the past.
  • Wanting to be alone and quiet.
  • Increased sense of inner strength and competency.
  • Increased compassion and ability to listen to others.
  • Reconnection, resiliency and hope for the future.

Self-Care

Here are some things that may help you along your grief journey:

  • Eat healthy foods and snacks.
  • Get enough rest and take naps… remember grief is hard work!
  • Don’t keep your feelings inside, find someone you trust to share them with.
  • Get some form of physical exercise daily.
  • Laugh often.
  • Keep a diary.
  • Talk to a trusted adult.
  • Spend time with friends and people who care about you.
  • Visit the cemetery if it makes you feel better.
  • Start and keep a “Book of Memories”.
  • Listen to music.
  • Remember that grief takes time, the questions and concerns you have now may take some time to get answered.
  • Do a good deed that would make your loved one proud of you.
  • Let yourself off the hook; it’s common to feel responsible for a loss, if you feel guilty, talk to a counselor about it.
  • Join a support group to be with other teens who have experienced a loss.

Self-Support System

Create a grief support system for yourself:

  • Think of 3 people you feel comfortable to talk to.
  • Name a place you can go that feels comfortable and safe.
  • Name 3 things you can do, or 3 people to be with, to let out anger without hurting yourself or others.
  • Name 3 things you can do, or 3 people you can be with, to let out sad feelings.
  • Name 3 non-harmful things you can do to relieve anger and tension
  • Name 3 things you can do when life feels meaningless.
  • Name 3 activities you can do that will help you express your feelings. Examples: writing, drawing, hitting pillows, singing or playing music, dancing, walking, sports.
  • Name some things that help you get your mind off your loss.
  • Surround yourself with positive people.
  • Be good to yourself.

This information was provided by the Healing Place website.

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Suggestions for Coping with Grief

Adult holding hands over faceUnderstand Your Grief

  • Grieving is the natural response to loss, a gradual process of healing. Each person’s grief is unique.
  • Grieving is not about “getting over” the death. It is about expressing your sorrow, sharing your memories, and learning how to go forward with your life.
  • Grieving is not a mental illness, but it can be a crazy feeling. Changes in your mood, thoughts, concentration, and energy are to be expected.
  • Grieving takes time. Each person grieves in their own way and at their own pace. However, grieving is about healing, and most of the intense feelings of grief do become less frequent and less intense over time. Eventually, you will find that your memories bring more pleasure than pain.

Take Care of Your Heart

  • Many grievers feel as if they have lost control of their emotions, never knowing how they will feel from one moment to the next. Painful as these feelings can be, they are all part of the natural response to the death of someone loved. Expect ups and downs, and be patient with yourself.
  • Share your thoughts, feelings, and memories with others. It may feel more painful to talk about it at first, but opening the door allows for healing. Find those who are comfortable listening to you talk about it, whether old friends or other grieving people, and let them know how it helps you.

Take Care of Your Body

  • Get regular physical exercise. Whether you are starting from scratch or continuing an old routine, exercise is a good way of keeping your body and mind in balance. It can help you sleep better, lowers your risk of depression, and can boost your immune system.
  • Eat well. Appetite changes and changes in eating habits are common, but try to eat regular nutritious meals as much as possible. Grief stresses your body as well as your heart and mind, so your body needs nourishment more than ever.
  • As best you can, try to get enough sleep – take naps during the day if you find you can’t sleep at night, and rest as much as you need to. Lighten your schedule as much as possible, and don’t be too hard on yourself when you can’t get as much done as you’re used to.
  • Consider other ways to nurture yourself, such as massage therapy, yoga or meditation, long baths, or walks in nature.

Take Care of Your Mind

  • It is normal to have a hard time concentrating, remembering things, or making decisions. As much as possible, postpone making major decisions. If circumstances allow, do not move, change jobs, or make any large changes to your life until the intensity of your grieving subsides.
  • Some people find doing purposeful work helpful. As you begin to have more ability to concentrate, use your mind. Be patient with yourself if tasks feel more difficult.
  • Once some time has passed, taking opportunities to give to others is sometimes helpful. This may be as simple as sharing in a support group or may involve giving volunteer time to others.

Take Care of Your Spirit

  • Grieving people often feel guilt over real or imagined wrongs. Consider writing a letter to your loved one expressing any sorrow or regrets. Find ways to forgive yourself; remember, we are all human.
  • Writing in a journal is often very helpful. It can be a safe, private place to express and explore your thoughts and feelings. Looking back over earlier writings also helps us see the changes we’ve managed.
  • Creative energies can help us heal. Some people prefer creative outlets for their grief, exploring and healing through drawing, music, or other artistic expression. Creating your own grieving rituals, prayers, or poems can also be very healing.
  • Find peace in your own spiritual process. For some people, religion is exceptionally helpful in the grieving process. For some, doubts are raised. Remember that personal faith does not make one immune to grief, or to the spiritual doubts grief can raise. Find safe avenues to explore your feelings, thoughts and questions. Take spiritual comfort where you can.

Accept Help

  • Many friends and family members do not know what to do to help. As much as possible, let them know what you need and what you find helpful.
  • Find those who are comfortable listening to you, who encourage you to be yourself, and who can accept all of your feelings.
  • Some people find a support group or grief counseling helpful; often just a few sessions can help you feel less alone. Your local Community Hospice Grief Center provides support groups, counseling, and referrals.

This information was provided by The Community Hospice.

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Teen Suicide

Facts about suicide in New YorkSuicide is the second leading cause of death for young people between 10 to 24. Here are some resources to help families and friends coping with a teen suicide:

Suicide Prevention Hotline phone number

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