Grief And The End Of Life Process

Grief is one of the more interesting emotions that can affect residents of Manchester and elsewhere, whether they’re receiving end of life care or other types of care. Everyone experiences their grief a little differently, yet there are also some common feelings and actions that many people can find common ground in and learn from each other.

The team at Above and Beyond Home Health Care and Hospice remain focused on helping our clients deal with loss in their lives, whether it’s mourning a loved one who has passed away or providing useful tools for when this happens in the future.

In some cases, especially when someone is receiving hospice care, the grieving process may begin when the person they’re missing is still alive, and also may not last as long after their passing. Or grief may last for years – everyone and every situation is so different.

Because we’ve worked with families in Eastern Iowa for years, we’re generally familiar with the general grieving process, but know that it’s a new experience for some of our clients and their families. We can provide a list of services in our region and nationally that offer information about grief resources and strategies.

We also encourage people to learn more about the upcoming National Grief Awareness Day, an annual commemoration of bereavement designed to help people learn more about what they can do and what the process generally can be like. The day is set for Aug. 30 this year. Visitors to the site can learn useful strategies and also how to help support yourself and others who might be going through grief. This could be as simple as reaching out to a friend or family member who may be in pain.

It was started in 2014 by Angie Cartwright, who turned her own pain of losing loved ones to a way to help others going through similar pain.

Stages of grief

Although everyone’s grief varies, one of the common approaches is the five-stage process which has been in use since the 1960s. It was created by  Elisabeth Kubler Ross and David Kessler, researchers who identified five phases that people typically follow in their grieving process, whether it’s one person and their own life, or trying to cope with someone around them.

The first stage is denial, which is pretty much not believing any information that the loss has happened or will happen. The defensive portions of our brain are good at avoiding pain, whether physical or mental. So things like a sudden loss or a terminal diagnosis are often easy to ignore or believe to be false.

This usually leads to anger, where you feel the information, and sometimes life, isn’t fair, which leads to frustration and negative feelings. After this is bargaining, where you seek ways to change your pain around or justifications. This could be prayer, negotiations with providers even advanced research.

After this is depression, where you often feel overwhelmed, sad, and hopeless. These feelings may bleed into other parts of your life.

The final step is acceptance where you learn to live with this loss and move forward.

In families where someone is going through hospice care, everyone may be at different stages, and in some cases, the person who is on hospice may reach the acceptance stage faster than others who are still in the bargain, anger, or depression. This can sometimes create uncomfortable situations where people are on different paths and viewpoints.

Different views

Of course, people who have been through grief know that it’s not always that simple.

The American Red Cross has suggested that a new step should be added between steps 1 and 2: isolation. People going through grief often feel like they need to pull back from the people around them and focus more on whatever is taking place. They also may not want people near them because they’re not comfortable talking about this topic yet, since they’re barely comfortable about it in their own heads.

Other researchers say that the five stages are a good starting place for some of the feelings but suggest it should be thought of as less linear. For instance, people may jump backward and forwards easily, such as from denial to anger, or from depression to bargaining. Plus, once you reach “acceptance,” it doesn’t mean you’re always going to be in that spot. There may be days where you feel OK with what’s happening and days when you feel angry or sad about your current situation.

All of these are certainly appropriate emotions to have, especially toward the end of your life or the end of the life of a loved one. So under this view, grief can be more of an ongoing function rather than a step-by-step process.

Some people also use grief as a positive so “post-grief” could be considered a step in the future. Perhaps the death of a loved one encouraged you to do great things in their memory or make major life changes.