The NCPC publishes periodic articles under the title "Planning for Eldercare". Each article is written to help families recognize the need for long term care planning and to help implement that planning. All elderly people, regardless of current health, should have a long term care plan. Learn More...
From its inception, the goal of the National Care Planning Council has been to educate the public on the importance of planning for long term care. With that goal in mind, we have created the largest and most comprehensive source of long term care planning material available anywhere. This material -- "Guide to Long Term Care Planning" -- is free to the public for downloading and printing on all of our web sites. Learn More...
Bereavement or grieving is the process and period of time during which someone suffers grief from the loss of a loved one. Mourning is a public display of grief. In our culture, mourning is not an officially prescribed ritual except perhaps for certain religious groups. In other cultures it can become a prolonged public display lasting for many days or even many weeks. This might include multi-day public wakes, the use of professional mourners, the wearing of black attire, remaining sequestered in the home or the prescribed use of religious rituals.
Grief is a condition experienced by all where someone suffers a loss of another person who is close. When we love someone and they die, the feeling of loss can often become an overpowering experience. It is almost like a part of us has been torn out and we can't cope with the feelings it brings upon us.
Grief is a normal part of our human experience. As human beings, we work together and rely on each other as a part of our existence. Human culture could not exist without this inter-cooperation. This reliance on others, especially someone we love, becomes over time intertwined into the function of our brain.
When a loss occurs, our mental process must physically readjust to a new reality and the period of grieving is the process we go through to retrain our minds.
Even though no one ever completely recovers from the loss of a loved one, most of us tend to find strategies that allow us to push it into our distant memory. It lingers there and we can retrieve it from time to time but it does not evoke the same powerful emotional response it once did. On the other hand, some people simply never deal with the emotions of grief and it remains in the forefront of their minds for a long time if not forever. This can have a powerful disabling effect on a person and may prevent that person from leading a normal life. It is extremely important to learn to deal with grief not only for personal reasons but for the sake of other loved ones who are still alive.
The intensity of the grief experienced and the subsequent ability or inability to deal with it are often a result of the nature of the loss itself. When a death is anticipated from a long illness or because of extreme old age it is often easier to deal with than an unexpected death. The time between knowing that death will come and the actual death allows for the grieving process to take place in advance. A spouse, children or other close people will rehearse in their minds many times over what will happen when a loved one is gone. This helps prepare them for the day it will happen and often shortens the grieving period. On the other hand, even with an anticipated death, sometimes two married people are so close that when one dies the other is completely lost and never fully recovers. It's not surprising when the survivor dies soon after.
The most difficult death to deal with is a sudden death involving violence, accident or a suicide. Not only is the unexpected event a shocking experience but the nature of the death also leaves the survivors feeling violated, guilty and unprepared. Normally deaths of this type require professional assistance from a counselor to help the living cope with the extreme grief such a death can cause.
There is no timetable for bereavement. Every person deals with it in his or her way. For some the process requires but a few weeks and they can go on with their life as before. For others it may take years. And for some grief becomes a chronic daily burden and if that person doesn't deal with grief then it can prevent one from living. Also chronic grief often results in depression. If the intensity of the grief does not diminish and there are problems with eating, sleeping, continuing feelings of guilt or the inability to function, professional assistance is needed.
Some authors like to break down the grieving process into stages. The reason for this is so that those grieving can recognize if they are making progress towards resolving their grief. Recognizing the various emotions associated with the process will help a person determine at what stage they are. Here is one author's dichotomy.
Almost everyone has difficulty accepting a loss. Most people simply want it to go away as if it never happened. They will tell themselves such things as "why me?", "why can't I start over?", "this seems like a bad dream" and so on. Their thinking is numb and they want to forget it, but in the back of their minds there is a deep foreboding of what happened. They can't shake the reality of their experience.
After the initial shock has worn off and there can be no more denial then there must be a reckoning. Some will express anger. Some will blame others. Some will retreat and become brooding and stoic. Each person has his own way of reacting to a loss.
When striking back at a loss no longer seems an acceptable strategy, then sorrow sets in. A person might feel sorry for himself or for others or both. A great deal of tears are normally shed and it is at this stage that one seeks comfort from others. The person in mourning may also find it difficult to do anything or to talk to anyone. Family or friends should recognize that comfort is being sought, regardless of the attitude of the person in mourning, and offer their support. But sympathy may not always be the best strategy. Encouraging activity and involvement in other things might be a better way to support someone in grieving.
At some point most people who have lost a loved one have worked through their emotions and no longer have the need to be angry or to feel sorrow. Those emotions may still be there but they are placed in the back of the mind and a concerted effort must be made to relive them. Otherwise they seem as a wisp of smoke, something seen but not recognized.
Some People can work through bereavement very quickly and resolution comes within a matter of days or weeks. They readily accept the loss, work through their anger and sorrow and are ready to move on. Unfortunately some people get stuck in one phase of the process. They may spend considerable time in denial. They may spend months or even years being angry. Or they may have gotten past the anger and they are preoccupied continually with feeling sorry for themselves.
In fact this is the test that one uses to determine if the grieving process is spent. If a great deal of one's waking moments are spent on rehashing what could have been (disbelief),working on strategies of "getting even" (reaction) or allowing thoughts of the loss to interfere with daily life (sorrow), then a person is not through the grieving process. By stepping back and looking at oneself as if from someone else's eyes and then recognizing the problems we have just discussed, a person in grieving can then make a decision about what to do next. This may involve seeking help from family or friends or it may involve the services of a professional counselor.
Grieving and depression are not the same thing. Prolonged grieving, however, can often lead to depression. And as we have discussed previously, depression is a major contributor to suicide in older Americans. The suicide rate of the elderly is about four times that of the rest of the population. It is therefore very important to avoid depression with the loss of loved ones. Grief may manifest symptoms similar to depression such as sleeplessness, loss of appetite or a feeling of gloom but unlike depression, grief can be set aside. One way to recognize the difference is if engaging in physical or mind stimulating activities results in the gloom going away, at least for that period of time, it is unlikely to be depression. Depression does not go away regardless of what one does.
Generally, the grieving process is a mental process that can be overcome by retraining one's thinking. Depression on the other hand may have resulted from improper thinking but it has become a physiological problem with an imbalance of chemicals in the brain. The brain itself is not working correctly. Depression is much harder to treat. It may require medications, or it may respond to cognitive therapies but the intensity of those therapies is much deeper than what one would need to work through a grieving issue.
When a person feels he or she cannot cope by themselves with grief or the potential of depression it is time to seek help. It is important for family or friends to realize that many people can't recognize by themselves they have a problem. Especially those who have become depressed. Depression creeps up over a period of time and results in mood changes and changes in thinking patterns that the afflicted person may not recognize have happened. A person with depression often feels he is "normal" and will even resist someone telling him that there might be a problem.
For those needing professional help there are two types of therapy. The first is called grief support. Grief support may simply consist of talking through issues with a counselor and recognizing the faulty thinking and implementing corrective strategies. Or it may involve group sessions with people in a like situation, again with the idea of coming away with strategies to deal with the grief problem. Grief support can be found by contacting a local hospice agency as these people specialize in helping their clients through the bereavement process.
The other therapy is called grief therapy or grief counseling. This usually involves sessions with a trained therapist to resolve underlying issues. Grief therapy is often needed when a person is dealing with very intense grieving issues. This may be a loss of a loved one in an accident or a murder or through suicide. Such losses can be so traumatic that people can't get through them themselves and require professional help to deal with it. For example, grief therapy is an automatic response for students who might experience a fellow student dying in a tragic accident, taking his or her life or using firearms in the school to take the lives of others. Grief therapists are going to be licensed therapists, psychologists or psychiatrists specializing in this practice.