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The Five Stages of Grief
Each person grieves in his or her own way at his or her own pace. However, the Swiss-American psychiatrist Elisabeth Kübler-Ross authored the groundbreaking book On Death and Dying where she outlined her theory on the five stages of grief, and how we're able to process our grief, heal and move on.
STAGE 1: Denial
When you first hear the new or diagnosis, you may deny its accuracy, or continue to expect your loved one to get better, or convince yourself that the symptoms you’re seeing aren’t the result of a chornic disease or end-of-life illness.
STAGE 2: Anger
You may be angry with the person or with the life itself. You may easily become frustrated or feel abandoned and resentful.
STAGE 3: Guilt
If you are a caregiver, you may feel guilt about taking breaks. You may regret previous actions, or harbor negative thoughts about your loved one.
STAGE 4: Depression or Sadness
Loved ones may lose hope, withold emotions or even withdraw from social activities.
STAGE 5: Acceptance
This occurs when the patient’s loved ones ultimately acknowledge the situation. During the acceptance phase, many times people can find meaning in caring for their loved one or the life they've lived and the memories they've made.
Typical Myths About Grief and Mourning
It's better not to think or talk about the pain
On the contrary, it has been proven that avoiding the pain associated with grief can have negative consequences, including physical problems, anxiety and depression. Those who are grieving need to honor the amount of time they need to grieve, and not try to live up to their own internal expectations or outside pressure.
You just need to get better
The standard bereavement leave policy at many companies is three days. Does this mean we are expected to be back to business as usual in three days? Our culture often views grief the way we view the flu: that it’s something we can completely recover from, and that if we take a few days off we should be cured in no time.
It takes about one year to "get over" a significant loss
A survivor whose loved one died after a long history of Alzheimer’s disease may have a relatively short grief response after the death. He or she may have grieved the loss of the loved one’s personality years before. A parent whose child died years ago may feel they have never gotten over the loss. Generally, it is thought that intense grieving lasts from three months to a year and that some people continue experiencing grief for two years or more.
The intensity and length of your grief reflects how much you loved the deceased
This just isn't the case. There is no grieving contest and no winner. You must feel what you feel and begin to live life when you are ready, on your own timetable. Your grief has no bearing on another’s, or on the depth of your feelings for the person who has died.
We all grieve in pretty much the same way
Not true. There is tremendous variation in style of grieving (instrumental versus expressive), cultural variations in grieving, and variations in length and intensity of grieving. There is no right or wrong way to grieve.
Grief does not demonstrate a lack of faith
Grief is a natural reaction to a loss. The idea that 'those who believe need not grieve' may be uttered with the best of intentions, but the truth is we may still feel a deep and aching pain when someone we love is no longer with us. When someone we love is gone we feel the dozens of emotions that come with grief – sadness, anger, guilt, fear, loneliness, blame. Though faith that someone is in a better place or that you will see them again can be a comfort, this does not remove the pain that the person is gone. This does not eliminate the anger, blame, guilt, regret or countless other feelings that can come up following a death.
Patients and families facing terminal illness usually begin the grieving process prior to the actual loss. This is called “anticipatory grief.” Although it may be uncomfortable, anticipatory grief is sometimes helpful and may result in fewer grief complications later. Each person will experience grief in his or her own unique way. The same is true with anticipatory grief. It is a natural process that helps individuals prepare for emotional and physical closure. It is also a time when both patient and family prepare for change.
Things to consider:
Emotional and physical symptoms associated with grief may also be associated with antcipatory grieving. You may experience some of the following:
Frequently, there may be a desire on the part of the patient to put his or her “affairs in order,” so that their wishes will be honored. This is sometimes referred to as completing “unfinished business.”
The patient may also express the need to emotionally withdraw from others. Caregivers may observe “distancing” behavior, such as the patient becoming less conversational, losing interest in activities that once held meaning, and refusing to allow close friends and family to visit.
- Loss of appetite
- Tension and irritability
- Fatigue and insomnia
- Indecision about what to do
- Guilt or anger
- Mood changes over small things, crying unexpectedly
Ideas for Ways to Heal When Dealing with a Loss
When someone we love dies, feelings of hurt, loneliness and sadness are normal. They are part of the grief process. Here are a handful of suggestions that may help with your feelings of sadness and may assist in your healing.
Think of people who bring you happiness; call one of them
Take a walk
Listen to your favorite music; sing
Think of something you would enjoy doing for someone else. Then do it
Read a good book
Give something away
Plan a surprise for someone
Make your favorite meal
Take a shower, or a long hot bath
How To Support a Friend or Loved One
Avoiding family members or friends who are terminally ill or grieving is not uncommon. Nor is the reason for doing so—fear. The thought of saying the wrong thing or doing something that exacerbates a difficult situation can be paralyzing. Fear has prevented many meaningful interactions between loving individuals that could have—and should have—taken place.
There are simple steps you can take to help someone who has suffered a loss.
If your friendship was important prior to the illness or death, know that it will be invaluable during the crisis. Don’t assume that your presence will be a burden on the family. Certainly they will have moments when privacy is necessary, but a crisis is not a time for isolation. Phone to say hello or to express sincere condolences. Write a friendly note or send a sympathy card. Your quiet and supportive attendance may be all they need while they are hurting. By being there, you let them know they are loved, and that is the message they most need to receive.
It is important to let friends know their emotions are safe with you. They need to be able to speak freely about conflicting thoughts without being interrupted or lectured. Reassure them that their feelings are normal given the situation and that you empathize with their pain. Avoid using platitudes to comfort. Saying, “I know how you feel,” or “Look on the bright side,” discounts their pain and may alienate them. Comments such as “This must be difficult” or “I’m sorry you’re going through this” are compassionate and understanding statements.
Assess the situation and think of specific ways to assist. Instead of saying, “Let me know if I can help,” say, “Let me watch the children while you make the funeral arrangements.” Offer to pick up out-of-town guests from the airport. Organize a group of neighbors or friends willing to prepare meals for different days of the week. Offer to make phone calls or run errands. By making specific suggestions, you are helping to relieve some of the common stressors associated with illness and death.
Review the accomplishments of the individual. It is fitting and honoring to reflect on how this person has touched your life. Sharing special memories offers comfort to the loved ones and compliments the value of that life.
Contact your friend after the crowd has returned to normal routines. Whether Even three and six months after the loss, call or stop by for a visit. Call your friend around holidays or special anniversaries and suggest doing an activity. It can be as simple as meeting for a cup of coffee or inviting them for dinner.
What to Say When a Child Asks about Death
Tell children the truth
When a loved one dies, children should be told what is happening as it happens. They should be told the truth, and their questions should be encouraged and answered.
It is important that those answers are specific, straightforward and brief, and that they address the child at their level. It is okay for adults to tell a child they do not know the answer to a question.
Children can usually absorb only bits of information at a time, so pay attention to their cues. They often repeat the same questions merely as a way to assimilate the answers.
Check to see if a child understands what has been said. Adults unsure of the meaning behind a child’s question should probe further by asking what the child meant or what they know about the topic. For example: why did dad die? It is important to probe further to assess whether they are asking this question because they feel sad, angry or guilty about the death. If so, it is imperative to allow the child to express those thoughts and feelings. The child should be reassured that death does not seem fair. But it may also be that they are asking about the physical process of death.