grief and end of life

How to Be Supportive to Friends Experiencing Loss

A "Support" crash course to guide you through difficult times

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By Ken Druck
January 5, 2018

Loss is an inescapable part of life. Whether we’ve lost someone to death, or are going through a living loss such as divorce, retirement, a life-threatening illness, a debilitating injury or a life-altering condition like dementia or addiction, support can make all the difference in helping us summon the strength, faith and courage to fight our way back into life.

Although we may want to reach out and lend a hand of support to our friends, family members and colleagues who are grieving, we’re not always sure of how. Despite our best intentions, most of us could benefit from an advanced course on “Support.” As someone who was worked with beareaved individuals, families and communities for 35 years, I believe that being there for someone in their time of need is one of the most caring, courageous and sacred things we can do.

Let this list of “Dos and Don’ts” guide you to say and do the kinds of things that have proven genuinely helpful to those who are grieving the loss of a family member, friend or colleague:

Do

  • Express your condolences. A simple, sincere “I’m so sorry for your loss,” a soft hand on a shoulder or a caring hug are usually perfect.

  • Be present. Stay in touch even when others begin to disappear.

  • Show you genuinely care through kind words and actions. It’s OK to also show that you care with your tears of sorrow.

  • Be a safe harbor for others to express their feelings. Allow them to grieve without fear of being judged, analyzed, fixed, cured, saved or healed.

  • Use your listening skills. Listen patiently, and ask open-ended questions to see how they’re doing, what they need and/or how you can be helpful.

  • Give them multiple options for what you could do to help. By doing so, they’ll know you’re serious. Listen intently, and do what they ask.

  • Give grieving individuals every opportunity to talk about those who have passed. If given the chance, you can also tell stories acknowledging the lives of the people they lost — the special qualities they possessed and their loving relationship with those they left behind.

  • When they bring up the loss, respond in a way that shows them you were listening, and that you genuinely care.

  • Ask their preferences. Ask them how they would like your support on special dates such as birthdays, “angel-versaries” (days of their passing) or holidays.

  • Show genuine concern, kindness, understanding, patience, empathy and compassion. This is a time to put your ego on the shelf and be of service to others.

  • Stay humble, flexible, relaxed and at ease when you’re with those who are grieving.

  • Assist them in getting the support they need. This may include professional help from grief counselors or coaches — or even psychiatrists, if necessary. Assure them it’s not only OK, it’s smart.

  • Encourage them to ease back in. In the case of grieving colleagues, encourage them to ease their way back into work a few hours at a time until they can handle longer stretches of sustained activity. (Also, tell them that taking a leave of absence is OK and may be necessary. Most companies have bereavement policies that allow time off, and many employers will make special arrangements when asked.) When they are back, support them to set up a “back-up” or “buddy” system in case they have a meltdown or need to step back and take a break.

  • Invite them (without the least bit of pressure) to join you for lunch coffee, or a walk.

And now, DON’T:

  • Don’t assume you know how they feel or what they want.

  • Don’t put a psychological, religious or spiritual spin on their losses.

  • Don’t use clichés — for example, “The glass is half-full.” Just be positive and supportive.

  • Refrain from anything that might be interpreted as a “Hurry up.” Don’t tell them, “You’ll get over it,” “Time heals all wounds” or “In time, you will have closure” or any similar types of advice.

  • Don’t give unsolicited advice or play “shrink” with them.

  • Don’t compare your loss to theirs.

  • Don’t suggest a quick fix to take away the pain.

  • Don’t take it personally if they’re not responding to you in the way you’d hoped. Remember, it’s not about you!

  • Don’t be insensitive. Don’t allow your own feelings of helplessness, impatience or intolerance of their continuing sorrow to cause you to say something insensitive.

  • Don’t ask how they’re doing or pose any other casual question. Tell them they (and their families) continue to be in your thoughts and prayers.

  • Don’t control the conversation. Let them take the lead on what they wish to talk about; and ask respectful, open-ended questions to draw them out.

  • Don’t avoid, gloss over, act cute, change the subject or pretend that nothing has happened — or if you do, that nothing was said.

  • Don’t smother them with too much caregiving attention. 

  • Don’t ignore your own triggers. Don’t hide, deny, repress, avoid, displace, dumb down or “medicate” the feelings of sorrow, anger, or guilt that may have been triggered by their losses.

  • Don’t make executive decisions about what they need without consulting them.Ask them what they would like to have happen.

To find out more about Dr. Ken Druck’s Compassionate Workplace programs, Family Council Meetings, articles on grief and bereavement coaching, please go to www.kendruck.com.

Content from here.

Understanding Grief

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By Jane E. Brody
January 15, 2018

Although many of us are able to speak frankly about death, we still have a lot to learn about dealing wisely with its aftermath: grief, the natural reaction to loss of a loved one.

Relatively few of us know what to say or do that can be truly helpful to a relative, friend or acquaintance who is grieving. In fact, relatively few who have suffered a painful loss know how to be most helpful to themselves.

Two new books by psychotherapists who have worked extensively in the field of loss and grief are replete with stories and guidance that can help both those in mourning and the people they encounter avoid many of the common pitfalls and misunderstandings associated with grief. Both books attempt to correct false assumptions about how and how long grief might be experienced.

One book, “It’s OK That You’re Not OK,” by Megan Devine of Portland, Ore., has the telling subtitle “Meeting Grief and Loss in a Culture That Doesn’t Understand.” It grew out of the tragic loss of her beloved partner, who drowned at age 39 while the couple was on vacation. The other book, especially illuminating in its coverage of how people cope with different kinds of losses, is “Grief Works: Stories of Life, Death and Surviving,” by Julia Samuel, who works with bereaved families both in private practice and at England’s National Health Service, at St. Mary’s hospital, Paddington.

The books share a most telling message: As Ms. Samuel put it, “There is no right or wrong in grief; we need to accept whatever form it takes, both in ourselves and in others.” Recognizing loss as a universal experience, Ms. Devine hopes that “if we can start to understand the true nature of grief, we can have a more helpful, loving, supportive culture.”

Both authors emphasize that grief is not a problem to be solved or resolved. Rather, it’s a process to be tended and lived through in whatever form and however long it may take.

“The process cannot be hurried by friends and family,” however well meaning their desire to relieve the griever’s anguish, Ms. Samuel wrote. “Recovery and adjustment can take much longer than most people realize. We need to accept whatever form it takes, both in ourselves and in others.”

We can all benefit from learning how to respond to grief in ways that don’t prolong, intensify or dismiss the pain. Likewise, those trying to help need to know that grief cannot be fit into a preordained time frame or form of expression. Too often people who experience a loss are disparaged because their mourning persists longer than others think reasonable or because they remain self-contained and seem not to mourn at all.

I imagine, for example, that some adults thought my stoical response to my mother’s premature death when I was 16 was “unnatural.” In truth, after tending to her for a year as she suffered through an unstoppable cancer, her death was a relief. It took a year for me to shed my armor and openly mourn the incalculable loss. But 60 years later, I still treasure her most important legacy: To live each day as if it could be my last but with an eye on the future in case it’s not.

Likewise, I was relieved when my husband’s suffering ended six weeks after diagnosis of an incurable cancer. Though I missed him terribly, I seemed to go on with my life as if little had changed. Few outside of the immediate family knew that I was honoring his dying wish that I continue to live fully for my own sake and that of our children and grandchildren.

Just as we all love others in our own unique ways, so do we mourn their loss in ways that cannot be fit into a single mold or even a dozen different molds. Last month, James G. Robinson, director of global analytics for The New York Times, described a 37-day, 6,150-mile therapeutic road trip he took with his family following the death of his 5-year-old son, collecting commemorative objects along the way and giving each member of the family a chance to express anger and sadness about the untimely loss.

Ms. Devine maintains that most grief support offered by professionals and others takes the wrong approach by encouraging mourners to move through the pain. While family and friends naturally want you to feel better, “pain that is not allowed to be spoken or expressed turns in on itself, and creates more problems,” she wrote. “Unacknowledged and unheard pain doesn’t go away. The way to survive grief is by allowing pain to exist, not in trying to cover it up or rush through it.”

As a bereaved mother told Ms. Samuel, “You never ‘get over it,’ you ‘get on with it,’ and you never ‘move on,’ but you ‘move forward.’”

Ms. Devine agrees that being “encouraged to ‘get over it’ is one of the biggest causes of suffering inside grief.” Rather than trying to “cure” pain, the goal should be to minimize suffering, which she said “comes when we feel dismissed or unsupported in our pain, with being told there is something wrong with what you feel.”

She explains that pain cannot be “fixed,” that companionship, not correction, is the best way to deal with grief. She encourages those who want to be helpful to “bear witness,” to offer friendship without probing questions or unsolicited advice, help if it is needed and wanted, and a listening ear no matter how often mourners wish to tell their story.

To those who grieve, she suggests finding a nondestructive way to express it. “If you can’t tell your story to another human, find another way: journal, paint, make your grief into a graphic novel with a very dark story line. Or go out to the woods and tell the trees. It is an immense relief to be able to tell your story without someone trying to fix it.”

She also suggests keeping a journal that records situations that either intensify or relieve suffering. “Are there times you feel more stable, more grounded, more able to breathe inside your loss? Does anything — a person, a place, an activity — add to your energy bank account? Conversely, are there activities or environments that absolutely make things worse?”

Whenever possible, to decrease suffering choose to engage in things that help and avoid those that don’t.
 

Content from here.

Top 5 Regrets of the Dying

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Bronnie Ware posted an extraordinary piece on Regrets of Dying on her blog. I share it below in the hopes we will all take it to heart.


For many years, I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last 3 to 12 weeks of their lives.

People grow a lot when they are faced with their own mortality. I learnt never to underestimate someone’s capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.

When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.

This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honored even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.

2. I wish I didn’t work so hard.

This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.

3. I wish I’d had the courage to express my feelings.

Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.

We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.

4. I wish I had stayed in touch with my friends.

Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.

It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier.

This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.

When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.

Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

This post was originally published on Inspiration and Chai.


Bronnie Ware is a writer and songwriter from Australia who spent several years caring for dying people in their homes. She has recently released a full-length book titled ‘The Top Five Regrets of the Dying – A Life Transformed by the Dearly Departing’. It is a memoir of her own life and how it was transformed through the regrets of the dying people she cared for. For more information, please visit Bronnie’s official website at www.bronnieware.comor her blog at www.inspirationandchai.com.

Thoughts at the Bedside: Creating Sacred Space

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Saying goodbye is tricky business. Sometimes our own emotional needs overwhelm us and make it harder to keep our focus on the dying person.

A prior post, Last Words, explores what to say when saying goodbye. Megory Anderson explores a different dimension of saying goodbye, creating sacred space by attending to some very practical needs. You can also download Megory Anderson’s practical suggestions at http://www.SacredDying.org/

Reclaim Grace and Dignity for Your Dying Loved One

Thoughts at bedside: 10 ideas to engage family and friends in “Spiritual Presence” for your loved-one.

De-clutter the bedside area.

Set the space apart using candles, music, etc., to create a calm, peaceful atmosphere. This will be the “sacred space” around your dying loved-one.

Within this physical sacred space keep the focus of any conversation on the dying person.

Allow intentional conversation with or about the person, but no idle chatter among visitors: keep that outside.

Take cues from your loved-one regarding practical matters.

If there is no indication that s/he would like to discuss or handle practical things, keep these things well away from the sacred space. If you know the person’s wishes regarding privacy, make sure they are respected.

Take turns or assign someone as “doorkeeper” to shepherd the transition from the outside hubbub to the sacred space.

It can often be helpful to establish a daily or weekly schedule with family members.

Take cues from your loved-one regarding not only physical needs but emotional and spiritual as well.

Don’t take center stage with your own emotions. While your own needs are certainly valid, if all eyes are on you and the comfort you need, consider stepping outside the sacred space to allow the focus to re-shift to the loved-one.

When s/he begins actively dying, the most important element of vigiling is your calm presence. It is a solemn gift.

To hold this quiet space so your loved-one can transition as easily as possible, use tools that you have already gathered in a “vigiling toolkit.” Items to include: special objects to hold that have personal or religious meaning (a prayer shawl, a favorite scarf, a rosary), reflective readings or books or prayers, music, candles (flame or battery). Traditional prayers are often used, but other favorite readings can be appropriate, too. The idea is to personalize these items for your loved-one.

If you are at home, don’t be surprised if family pets want to participate.

If possible, let them behave naturally: on the bed or on your lap, etc.

Friends/family who can’t physically be there during this time can still be involved from afar.

For example, someone long-distance could be in charge of mass communications, informational emails, etc. There are many online choices such as candle-lighting websites, creating a Facebook page with updates, and other internet options.

Ask absent friends/family to vigil with you at a designated time once or twice daily.

They could do this from anywhere in the world, simply taking a few minutes in shared thought/prayer, listening to music, lighting a candle, etc.

Don’t worry about making practical calls immediately after s/he passes.

Spending some time in silence can be profound and meaningful. Then, consider designating one person to go do practical things while one continues to sit quietly for as long as possible.

This post was originally published by Megory Anderson at http://www.sacreddying.org/

 

Last Words

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You may have heard the statistic:  More people are afraid of public speaking than dying. But how about when we combine the two, speaking about dying to those near death? From my experience, the idea of speaking to those near death conjures dread. We don’t know what to say, and knowing these may be our last words to someone we love weighs heavily.

Poet Dylan Thomas writes, “After the first death, there is no other.”

Too bad. We’d probably be better navigating a second death if we got a crack at it.

Greek mythology’s tour guide for the journey to death was Charon the ferryman. He accompanied people across the River Styx on a one way trip to the underworld.

Years ago, someone shared with me six simple things to say when someone is dying. I consider this the wisdom of a modern Charon. Simply put, they are:  I love you. Thank you. I forgive you. Forgive me. I (We) will be okay. Goodbye.

I love you.

Three simple words. Three powerful words. My crusty, WWII veteran dad was 88 before he uttered those words to me. For years, I’d say “I love you” as I hung up the phone. My dad would fumble around and say something like “same here” or “I feel the same,” but the actual words eluded him until he was on his deathbed. Then, remarkably, he said, ‘I love you.”

Thank you.

I have a thank you card that reads, “When eating the apple, remember who planted the tree.” We don’t always remember to thank, and surely we don’t often thank the ones who brought us the momentous stuff in our lives:  our parents’ sacrifice and dedication to make sure we had a chance at a good education; their presence at our band concerts and soccer games; their cheering us on, and seeing the best in us when others saw a different reality. Thank you.

I forgive you.

Face it. We’ve all held on to offenses and grudges way too long. Likely, we even remember slights that were not intentional. We hang on to the hurt even though the pain does not serve us well.  We allow the pain to be a barrier in our future relationships. Forgiveness does not mean forgetting. It does not mean we are willing to be taken advantage of again. It does mean we are letting go of our option for revenge as we hand our hurts and anger over to God.

Forgive me

The church uses the words, “for my sins of omission and commission”. Forgive me for what I have done and what I have failed to do. Sometimes we are more culpable for our inaction that for our actions.

I will be okay.

I am convinced our loved ones sometimes hang on for us, cling to life because they know we are not yet ready for them to die. Saying the words, “I will be okay” gives your loved one permission to go. When young children are in the picture, I suggest people let the dying person know the child will be loved and cared for.

Goodbye.

Simply letting the dying person know they can go to God when it is their time frees them.

Sometimes last conversations bring healing to a relationship that had become defined by wounds and history.  As John Philip Newell writes, “It is about bringing into relationship again the many parts of our lives, including our brokenness, in order to experience transformation.  It is not about forgetting the wound or pretending that it did not happen.  It is about seeking a new beginning that grows inseparably from the suffering.”

Birthing and dying are oddly similar bedfellows in the circle of life. We had no ideas on how to be born, but we allowed others around us to coax us into the world. The same can be said of dying.  In death, I’ve noticed that the most peaceful person in the room is often the one dying.  As Carl Jung reminds us, “Wholeness is about integration . . .  but not perfection.”  What we say doesn’t need to be perfect.  Just say it with love.

Originally published in the Eden Prairie News ©Beryl Schewe  www.berylschewe.com

The Power of Presence

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I am responsible. Although I may not be able to prevent the worst from happening, I am responsible for my attitude toward the inevitable misfortunes that darken life. Bad things happen; how I respond to them defines my character and the quality of my life. I can choose to sit in perpetual sadness, immobilized by the gravity of my loss, or I can choose to rise from the pain and treasure the most precious gift I have—life itself.
— Walter Anderson
Love is stronger than death even though it cannot stop death from happening. No matter how hard death tries, it cannot separate people from love. It cannot take away memories either. In the end, life is stronger than death.
— Anonymous

The Power of Presence

All Things Considered, December 26, 2005 by Debbie Hall

"Presence is a noun, not a verb; it is a state of being, not doing."

I believe in the power of presence.

I was recently reminded of this belief when I and several other Red Cross volunteers met a group of evacuees from Hurricane Katrina. We were there, as mental health professionals, to offer "psychological first aid." Despite all the training in how to "debrief," to educate about stress reactions and to screen for those needing therapy, I was struck again by the simple healing power of presence. Even as we walked in the gate to the shelter, we were greeted with an ardent burst of gratitude from the first person we encountered. I felt appreciated, but vaguely guilty, because I hadn’t really done anything yet.

Presence is a noun, not a verb; it is a state of being, not doing. States of being are not highly valued in a culture which places a high priority on doing. Yet, true presence or "being with" another person carries with it a silent power -- to bear witness to a passage, to help carry an emotional burden or to begin a healing process. In it, there is an intimate connection with another that is perhaps too seldom felt in a society that strives for ever-faster "connectivity."

I was first hurled into an ambivalent presence many years ago, when a friend's mother died unexpectedly. I had received a phone call from the hospital where she had just passed away. Part of me wanted to rush down there, but another part of me didn't want to intrude on this acute and very personal phase of grief. I was torn about what to do. Another friend with me at the time said, "Just go. Just be there." I did, and I will never regret it.

Since that formative moment, I have not hesitated to be in the presence of others for whom I could "do" nothing. I sat at the bedside, with other friends, of a young man in a morphine coma to blunt the pain of his AIDS-related dying. We spoke to him about his inevitable journey out of this life. He later told his parents -- in a brief moment of lucidity -- that he had felt us with him. Another time I visited a former colleague dying of cancer in a local hospice. She too was not awake, and presumably unaware of others' presence with her. The atmosphere was by no means solemn. Her family had come to terms with her passing and were playing guitars and singing. They allowed her to be present with them as though she were still fully alive. With therapy clients, I am still pulled by the need to do more than be, yet repeatedly struck by the healing power of connection created by being fully there in the quiet understanding of another. In it, none of us are truly alone.

The power of presence is not a one-way street, not only something we give to others. It always changes me, and always for the better.


Debbie Hall has been a psychologist in San Diego's Naval Medical Center Pediatrics Department for 12 years. She volunteers for the Disaster Mental Health Team of her local Red Cross and lives in Escondido with five cats and a 15-year-old golden retriever.


The world is more magical,
less predictable,
more autonomous,
less controllable,
more varied,
less simple,
more infinite,
less knowable,
more wonderfully troubling
than we could have imagined
being able to tolerate
when we were young.
— James Hollis, Meaning in the Second Half of Life