Archive for the ‘Mental Health’ Category

Terminal illness, caregiving, and anticipatory grief

Posted on: August 29th, 2012 by Hope And Cope No Comments

Terminal Illness

The diagnosis of a terminal illness is often quite upsetting for a family. Accepting the fact that a loved one has an illness that may drastically limit their life requires processing. Families need to understand what the likely, realistic outcomes of the illness are, and how to cope with them. It is vital to get the facts about the prognosis and symptoms from your health care provider. Your treating physician is usually the best person to provide information about your terminal illness diagnosis. Make sure that when you are speaking with your health care provider about the details of the terminal illness, you ask questions to clarify anything you do not understand. It is important that you hear, and comprehend, what the illness will mean for you and your family.

Caregiving

Family members are often called upon to provide care for those with terminal illnesses. Spouses and adult children are frequently drafted as caregivers when a loved one begins to decline in functioning. Becoming a caregiver for a family member is no small task. It takes a great deal of physical, mental, and emotional energy. Caregivers often spend countless hours caring for the needs of someone else, and may fail to take the time to care for themselves.

There are several dimensions of caregiving that have been found to significantly impact the experience of family caregivers. These dimensions are as follows:

  • Characteristics of the family caregiver
    • What is the caregiver’s attitude?
      • If their attitude is more positive, they are more likely to have a positive experience
    • Do they have religious beliefs and are these beliefs helpful?
      • Those who have spiritual and/or religious beliefs often have a more positive experience as a caregiver
    • Do they feel the patient is a burden for them?
      • If you feel the patient is a tremendous burden, the experience is likely to be more negative
  • Patient characteristics
    • What is the patient’s attitude like?
      • If the patient has a more positive attitude, the caregiver is likely to have a more positive experience
    • How does the patient relate to their own death?
      • If the patient is better able to come to terms with their impending death, the caregiver often has a more positive experience
  • Symptoms of the illness
    • Is the patient experiencing confusion?
      • High levels of confusion can be very difficult for family caregivers to deal with
    • Does the patient have behavioral symptoms, like acting out physically?
      • Behavioral symptoms like acting out can be associated with a more negative experience for a family caregiver
  • Relational context
    • How do other family members relate to the patient?
      • If other family members are supportive and helpful, caregiver is more likely to have a positive experience
  • Social and professional support
    • More social (i.e., friends) and professional (i.e., health care providers, mental health, etc.) support can help the caregiver have a more positive experience
  • Circumstances surrounding death
    • The moment of death
      • Some family caregivers have more positive experiences when they are present when the patient dies, others have more positive experiences when they are not present
    • Preparedness for death
      • When caregivers feel as if they are prepared for the death of their loved one, they have a better experience leading up to the death and after the death

Those who have notice that a loved one is terminally ill may choose to seek out palliative care and/or hospice care.

What is palliative care? Palliative care is an approach that improves the quality of life of patients and families facing problems associated with life threatening illnesses. The approach focuses on the prevention and relief of suffering by addressing pain and other problems.

What is hospice care? Hospice care is focused on providing support and care for individuals who have life-limiting illnesses. When hospice care is selected, families are no longer seeking cure-oriented treatments. It is important to recognize that hospice care is not intended to hasten death in any way, but rather make an individual comfortable as they near the end of their life. Health care providers in hospice are specially trained to consider the physical, emotional, and psychological aspects associated with end of life care.

Anticipatory Grief

As a caregiver or family member for someone who is terminally ill, you may have some notice before your loved one dies. Even if you do have notice before the death of your loved one that does not necessarily mean the death or grieving process will be easier. When you begin grieving for a loved one before they die, it is called anticipatory grief. More generally, anticipatory grief consists of the reactions to the expected death over past, present, and anticipated losses. Many family members of those with terminal illnesses consider the impact of the loss, after learning about the amount time the person is expected to live. After hearing that a loved one has days, weeks, or months to live, individuals often consider what the death will mean to them.

For a family going through anticipatory grief, it is important to acknowledge the reality of death. Denial of death, or the severity of the illness, often leads to more difficulty facilitating the process for the person dying. It is important to acknowledge that anticipatory grief is painful, and the loss within the family will require some reorganization. A family should also include the dying patient in the grieving process so each member can have their own sense of closure. The person who is dying may have unresolved issues with different family members that can be processed before their death.

Anticipatory grief can be a scary thing to confront. Many people feel panic, anger, a loss of emotional control, fear, and anxiety when they think of their own death or the death of a loved one. Due to the anxiety that may arise in anticipatory grief, it is vital to seek support from others, just as in the post death grieving process. Depending on the type of terminal illness, it can be common to begin grieving specific aspects of your relationship before your loved one dies. You may grieve the loss of intimacy and emotional bond if your loved one has cognitive and/or communication impairments. You might also grieve physical aspects of your relationship (like hugging, for example) if your loved one has physical limitations.

Anticipatory grief can also be helpful in that it can help you prepare for your loss. You can start to develop coping skills that will help you face the changes that will inevitably arise after the death of your loved one. You may also have the chance to express things that you are thinking and feeling to your loved one, before they die. One of the most important aspects to effectively getting through anticipatory grief is communication. Maintaining open communication with health care providers, family members, and the patient can help deal with uncertainty. Communication can also help you feel more prepared for the death of your loved one, which will help you grieve with fewer complications after their death.

Individuals who see themselves as prepared for the death of their loved one cope better after the death. Some elements of preparedness are as follows:

  • Knowing the signs and symptoms to expect in the terminal phase of life
  • Discussing one’s own feelings of grief and emotions
  • Maintaining relationships with friends and family members
  • Prayer (if religious) and talking about the spiritual meaning of death
  • Preparing funeral arrangements

Remember, seeing a mental health professional for group and/or individual therapy can be a helpful and healthy way to help you and your family process your loss.

Here are some links that may be helpful:

http://hospicecareonline.org/images/pdfs/education/adult_loss_of_a_parent.pdf

http://lifebeyonddeath.org/terminal-illness.html

Some books that may be helpful:

http://www.amazon.com/Final-Gifts-Understanding-Awareness-Communications/dp/0553378767/

http://www.amazon.com/Survive-Caregiving-Daughters-Experience-Doctors/dp/0741437252/

 

References

Cheng, J.O., Lo, R.S., Chan, F.M., Kwan, B.H. & Woo, J. (2010). An exploration of anticipatory grief in advanced cancer patients. Psycho-Oncology, 19, 693-700.

 

Dumont, I, Dumont, S. & Mongeau, S. (2008). End-of-life care and the grieving process: family caregivers who have experienced the loss of a terminal-phase cancer patient. Qualitative Health Research, 18 (8), 1049-1061.

 

Gillilard, G. & Fleming, S.V. (1998). A comparison of spousal anticipatory grief and conventional grief. Death Studies, 22 (6), 541-569.

 

Hebert, R.S., Prigerson, H.G., Schulz, R. & Arnold, R.M. (2006). Preparing caregivers for the death of a loved one: a theoretical framework and suggestions for future research. Journal of Palliative Medicine, 9 (5), 1164-1171.

 

Hebert, R.S., Schulz, R., Copeland, V.C. & Arnold, R.M. (2009). Preparing family caregivers for death and bereavement insights from caregivers of terminally ill patients. Journal of Pain and Symptom Management, 37 (1), 3-12.

 

Johansson, A.K. & Grimby, A. (2012). Anticipatory grief among close relatives of patients in hospice and palliative wards.  American Journal of Hospice and Palliative Medicine, 29 (2), 134-138.

 

Death of a parent

Posted on: August 14th, 2012 by Hope And Cope No Comments

The death of a parent can be an upsetting, though not entirely unexpected, event in life. While most of us expect our parents to die before us, that does not erase the difficulty of the experience. Both young children and adult children are greatly impacted by the death of a parent. The impact may differ depending on the age of the child when the loss occurs, and there are varying issues to consider when a parent dies.

Death of a parent can be especially difficult for children that are minors. The loss of a parent can cause severe grief and stress reactions in young children, and the support of adults is extremely important. Children that rely on their parents as caretakers, and primary attachment figures, suffer immediately following the loss of a parent. Bereaved young children are at greater risk of physical, psychological, and social problems. Those that are under five years old, and in early adolescence, are especially vulnerable to adjustment difficulties following the death of a parent. This risk is largely due to the fact that they are at ages where parental involvement is extremely vital in development. Parents really nurture the physical, psychological, and social formation of children at these ages. It can take time to restructure life without the deceased parent, and find someone to fill in the gaps.

Those who lose parents as young children may continue to feel the negative effects into adulthood. Due to the loss of such an important figure, they may lose self-esteem. This loss of self-esteem has been shown to result in lower self-confidence as an adult (when compared to children with parents who remained alive and living together). Children whose parents die when they are young are also at greater risk for depression as adults. Again, this is likely due to the loss of social and emotional support. It is significant to keep in mind that the death of a parent in childhood does not mean one is doomed to poor outcomes as an adult. However, it is imperative to increase support following a loss to prevent negative future consequences.

Even if the death of a parent is more expected in adulthood, it frequently impacts one’s functioning. Though parents typically are no longer primary sources of daily, physical and emotional support in adult children, they remain important sources of social support. Many adult children continue to have a strong bond with their parents. If an adult child has a particularly close relationship with their parent before their death, the death will likely be more difficult to process and grieve. The child must grieve the loss of a parent and a confidante.

When adult children are coping with the loss of a parent, they gain strength by sharing their loss experience with family. Other family members will grieve the death as well, and can provide support. Families often reorganize their structure after the death of a parent to accommodate for roles the parent may have held. These roles can include story teller, family connector (one who keeps everyone in the family connected and communicating), advisor, and sounding board. Other family members may step up to assume these roles, and help maintain equilibrium within the family.

Many adult children also consider what they would like to pass on to future generations of the family once a parent dies. They may reassess their values and goals for their children. Once they look at their values, they may make behavioral changes to better reflect these values.

Partners can help adult children grieve in a more healthy and productive way. Partners can help the adult child take care of logistical issues immediately following the death. Many adult children feel a sense of duty and obligation, and need to make funeral and burial arrangements. Partners can help make phone calls and run errands. Partners may also recognize if the grief being experienced by an adult child is hindering their daily functioning. They may take the role of sustaining the daily routine the family requires (for example, cooking for children, doing chores, paying bills, etc.). Though they may pick up the slack for a while, eventually they help bring the grieving child out of their preoccupied state. If the adult child is having particular difficulty moving past the loss of their parent, a partner may help remind the person of life, their current obligations, and living in the moment.

Research has shown that women are better equipped than men at coping with stressful unforeseen events. This means that they often deal with the loss of a parent in more effective ways than men. This is not to say that men cannot cope with the loss of a parent, but women are more likely to use positive coping (i.e., seeking social support, talking about the loss, processing their emotions) than men. Men are more likely to engage in risky behaviors (like drinking more alcohol, using drugs, and becoming more isolated) in their grief, as a means of escaping emotional pain. For this reason it is vital to look for signs of poor coping in adults after the loss of a parent.

Grieving the loss of a parent can be a difficult, but not impossible task. When helping children who are grieving a parent, it is vital to share information and openly express feelings around them. This openness helps children adapt to the loss in a healthy way. Encourage children to communicate their thoughts and feelings about the death so they do not feel as if they have to avoid talking about their parent, but can keep realistic memories alive. Most children who are bereaved by the death of a parent experience the resolution of their grief within one year of the death. This shows that they can adapt and move on in their lives in spite of tremendous loss. Adults who grieve the loss of their parents often report they feel a sense of strength after coping with the loss. They also frequently strengthen the connections they have with their own nuclear family members.

Remember, seeing a mental health professional for group and/or individual therapy can be a helpful and healthy way to help you and your family process your loss.

Here are some other links that may be helpful:

http://www.cancercare.org/publications/68-helping_yourself_as_you_cope_with_the_loss_of_a_parent

http://hospicecareonline.org/images/pdfs/education/adult_loss_of_a_parent.pdf

Some books that may be helpful:

http://www.amazon.com/Miss-You-First-Look-Death/dp/0764117645/

http://www.amazon.com/Orphaned-Adult-Understanding-Coping-Parents/dp/0738203610/

 

 

 

References

Costa, L. & Holliday, D. (1994) Helping children cope with the death of a parent. Elementary School Guidance and Counseling, 28 (3), 245-262.

 

Gray, L.B., Weller, R.A., Fristad, M. & Weller, E.B. (2011). Depression in children and adolescents two months after the death of a parent. Journal of Affective Disorders, 135, 277-283.

 

Mack, K.Y. (2001) Childhood family disruptions and adult well-being: the differential effects of divorce and parental death. Death Studies, 25,419-443.

 

Melhem, N.M, Porta, G., Shamseddeen, W., Payne, M.W. & Brent, D.A. (2011) Grief in children and adolescents bereaved by sudden parental death. Archives of General Psychiatry, 68 (9), 911-919.

 

Petersen, S. & Rafuls, S.E. (1998). Receiving the scepter: the generational transition and impact of parent death on adults. Death Studies, 22 (6), 493-524.

 

Raveis, V., Siegel, K. & Karus, D. (1999). Children’s psychological distress following the death of a parent. Journal of Youth and Adolescents, 28 (2), 165-180.

 

Rostila, M. & Saarela, J.M. (2011). Time does not heal all wounds: mortality following the death of a parent. Journal of Marriage and Family, 73 (1), 236-249.

 

Umberson, D. & Chen, M.D. (1994). Effects of a parent’s death on adult children: relationship salience and reaction to loss. American Sociological Review, 59 (1), 152-168.

 

Explaining death to children and helping them cope with loss

Posted on: August 9th, 2012 by Hope And Cope No Comments

Losing a loved one is difficult, but explaining the loss to a child can present an additional challenge. Children cope with death better when they hear about the loss from a family member rather than a stranger. For this reason it is vital that family members understand how to give children news about the death of a loved one. It is important to be open and honest, at an age appropriate level, when explaining death to children. Though it may be tough, adults should use the words “death” and “dying” when talking to children. The use of these words shows that death is something that can be talked about. When children feel as if they can talk about death with their families, communication can be more open. Open communication and expression of emotions will help the child process and understand the loss more effectively.

Some of the normal grief responses that may be seen in children can include:

  • Anxiety
  • Sleep problems (including nightmares, not wanting to sleep in their own beds, and difficulty sleeping)
  • Sadness
  • Longing for the deceased
  • Anger
  • Acting out
  • Physical complaints (like headaches or stomachaches)

It is important to remember that the loss of a loved one, and the grieving process, often occurs within the larger context of the family unit. If a family member dies, everyone in the family must grieve in their own way. When adults are grieving, children may not understand all of the emotions they see expressed. Children are often confused by their own feelings as well. When children are confused about their feelings, they may express this confusion by acting out. The acting out behaviors may be new for the child, or might be prior behaviors that escalate. If your child begins the act out it is best to provide a space for them to express their feelings (verbally or using art). It is also helpful to make sure the child has a consistent schedule and routine that they can count on. The predictability of a schedule (i.e., waking up, eating breakfast, going to school, coming home on the bus, doing homework, etc.) can help a child feel more grounded and safe after a loss. Children must feel comfortable and secure as adults grieve to allow them to go through their own process.

Remember, children learn most by the behaviors of adults around them. This means that they will respond to expressed emotions of adults, regardless of their age. Even toddlers can pick up when their parents are abnormally sad. Children may see their parents crying and ask what is wrong. Again, it is important to be honest about what is going on. It is ok to say that you are sad because you’re thinking of your loved one or something reminded you of the deceased (for example). Your children will learn by your example and will see that grief is a natural part of life.

There are many ways parents can help their children get through the grieving process. Children should be encouraged to express their feelings. When facing grief children need stability and they also need to be curious. Parents can provide this space for their children at home. Children can use play, art, music, and nature to express their emotions. Many children use these different outlets to communicate things they are not able to convey verbally. Parents can also help or encourage children to write a goodbye letter to their deceased loved one. This letter can help the child feel a sense of closure.

Remember, seeing a mental health professional for group and/or individual therapy can be a helpful and healthy way for children to process loss. Also, if you suspect your child is experiencing complicated grief, it is important to take them to see a mental health professional. Complicated grief is a psychological disorder that can greatly impair their life functioning.

Amazon.com offers a wide selection of books that may be helpful depending on the age of your child.

Here are some links that may be helpful:

http://kidshealth.org/parent/emotions/feelings/death.html

http://www.hospicenet.org/html/talking.html

As an additional reference, please see the chart that shows comprehension of death by age. This chart provides information about developmentally appropriate ways to help your child cope with death. It also shows some normal and abnormal reactions children have to death and grieving.

Birth-2 years of age

  • At this age children have no cognitive understanding of death
  • Grief reactions are possible and separation anxiety is a concern
  • Infants and toddlers may regress developmentally and behaviorally
  • Important to maintain routine and avoid separation from significant others in their life
  • Be aware of the fact that the primary caregiver may not be as emotionally available to the child as normal. Others should try to provide extra nurturing and support to the child

Ages 2-6

  • Children this age see death as temporary and reversible
  • Remember that they interpret their world in a concrete, and often literal, manner
  • May have magical thoughts about death
  • Children at this age may think death is caused by thoughts, and that they could somehow be responsible
  • Important to provide straightforward explanations and avoid euphemisms
  • May need to remind them that their loved one will not return
  • Children may ask a lot of questions, and may even repeat the same questions
  • Children this age who lose a parent may seek attention from anyone, including strangers

Ages 6-8

  • By this age they realize death is final/irreversible
  • Children do not think death is universal or will happen to them
  • Children might think of death as a character or person
  • Children may express anger toward the deceased and/or those who they believe were unable to save the deceased
  • Child often has fears about death
  • May express concerns over safety of loved ones
  • Make sure to give clear, realistic information
  • At this age it is appropriate to invite child to funeral services (if they wish to attend)

Ages 8-12

  • Children at this age have a more adult understanding about death – it is final, irreversible, and universal
  • Can understand biological aspects as well as cause/effect relationships
  • May have the tendency to intellectualize death as they are not as used to identifying and dealing with feelings
  • Their ability to identify causal relationships may lead them to experience guilt
  • To help identify emotions may want to introduce some typical emotional responses others have (i.e., some people feel sad, angry, or guilty)
  • Child should be allowed to see dying patient (if applicable) and participate in activities surrounding death
  • Child may develop a morbid curiosity about the dying process

Ages 12-18

  • Adolescents have an adult understanding of death
  • Developing abstract thinking so may engage in some existential thinking about death
  • May reject adult rituals and support
  • May think that no one understands them
  • Some engage in high risk activities to test their own mortality
  • Often have strong emotional reactions, but still can have difficulty identifying and expressing their feelings
  • Important that adults allow their independence and access to peers
  • Offer emotional support as needed

Normal

  • Anxiety
  • Sleep problems (including nightmares, not wanting to sleep in their own beds, and difficulty sleeping)
  • Sadness
  • Longing for the deceased
  • Anger
  • Acting out
  • Physical complaints (like headaches or stomachaches)

Abnormal

  • Longing and searching for deceased
  • Preoccupation with thoughts of the deceased
  • Purposelessness and feeling like their future does not matter
  • Numbness and detachment from others
  • Difficulty accepting death
  • Lost sense of security and control
  • Extreme anger or bitterness over death
  • Behaviorally the child may
    • Appear depressed
    • Have difficulty carrying out normal activities/routines
    • Withdraw from social activities
    • Become irritable or agitated

 

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision ).Washington, D.C, American Psychiatric Association.

 

Davis, C.B. (1989). The use of art therapy and group process with grieving children. Issues in Comprehensive Pediatric Nursing, 12, 269-280.

 

Himebauch, A., Arnold, R.M., & May, C. (2008). Grief in children and developmental concepts of death #138. Journal of Palliative Medicine, 11 (2), 242-243.

 

Melhem, N.M., Moritz, G., Walker, M., Shear, M.K., & Brent, D. (2007). Phenomenology and correlates of complicated grief in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 26 (4), 493-499.

 

Salladay, S.A. & Royal, M.E. (1981). Children and death: guidelines for grief work. Child Psychiatry and Human Development, 11 (4), 203-212.

 

Willis, C.A. (2002). The grieving process in children: strategies for understanding, educating, and reconciling children’s perceptions of death. Early Childhood Education Journal, 29 (4), 221-226.

 

Disclosure and disclaimer

Posted on: August 9th, 2012 by Hope And Cope No Comments

The information and articles provided in the mental health section of this site are for informational and educational purposes only. The information is not intended to substitute any professional medical, psychiatric, or psychological treatment or diagnosis.

Always seek the advice of a qualified mental health professional to obtain specific advice and treatment. Do not disregard any treatment advice you have received based on information you read on this site. Do not delay mental health treatment based on information you obtain from this site.

If you have a medical or psychiatric emergency please call 911 or to go a hospital immediately.

If you utilize information found on Hope and Cope it is strictly at your own risk. Hope and Cope.com and Dr. Carr-Lee are not liable for any advice or information provided on the site. No warranties, either express or implied, are made on the information provided.

Opinions and other statements expressed by authors are theirs alone, not those of Hope and Cope.

Hope and Cope provides independent mental health information and resources. We accept advertising from many different companies. No advertiser or organization has direct influence on editorial decisions, or what we publish on this site.

Coping with the death of a child

Posted on: August 9th, 2012 by Hope And Cope No Comments

The loss of a child is something no parent wants to even consider. When you have a child, you never expect your child to die before you do. If you have the unfortunate experience of outliving your child, you are faced with the loss of one of the closest relationships humans have. Many parents have endless hopes, dreams, and aspirations for their children, and these wishes are dashed with the death of a child. Those who lose a child often say that they feel as if there is no reason to continue living without their child. Yet somehow, you must muster the strength to continue to engage in daily activities. Going to work may provide a mental break from grief for some, but become increasingly difficult and meaningless for others. No matter what your experience is have patience with yourself, and respect your reactions.

Some of the normal experiences (in addition to typical grief responses) of someone who has lost a child can include:

  • Feeling numb
  • Feeling intense despair
  • Loneliness and isolation
  • Anger
  • Guilt

While the loss of any family member is extremely difficult, the loss of a child poses some unique challenges. Parents often experience a more intense grieving process because of the strong bond they had with their child. The attachment between parent and child that begins before the child is even born, and strengthens over time, makes the loss deeply painful. Not only do parents feel the loss of a family member, but they also feel the loss of part of themselves. The bond that a parent and child share is a special part of the relationship that remains within a parent. Parents continue to feel bonded to the child as they were when they were alive, and as to the “immortal” child that continues to live in their memories. There is also a perception that a child’s death, regardless of age or method of death, is unnatural. It seems unnatural in the sense that most expect grandparents and parents to die before their children. While they may anticipate the loss and subsequent grieving for other family members, they expect their children and grandchildren to continue to thrive past their own lifetime.

One experience that is particularly helpful for parents who are grieving the loss of a child is attending a support group. Parents frequently feel very lonely in the grieving process but resist attempts from others who offer support. A support group for grieving parents allows space to discuss shared difficulties, and offer support to those who are going through a similar process. Parents may feel like their friends and family members cannot truly relate to what they are going through, but strangers in a support group can come together to provide support and feedback coming from their own experiences. Many grieving parent support groups even offer space to share and celebrate the memory of their child. The sharing of memories can help parents to feel as if they are keeping their bond with their child though they are gone.

The following phases have been identified as those parents move through following their loss. There is no specific amount of time expected for each phase, and many move back and forth between phases:

  • Numbing
    • You feel shocked that you lost your child and this shock makes you feel emotionally numb
    • You may feel as if the loss isn’t real, or cannot be real
    • Yearning
      • You feel a deep emotional longing for your child
      • You may look for your lost child in dreams, strangers, or their belongings
      • You search for anything that was part of your child as a way to remain connected
      • Disorganization and despair
        • You recognize that it is hopeless to recover your lost child
        • Your attention shifts and you become less focused on the deceased
        • Reorganization
          • You accept the loss as permanent
          • You make shifts in your life to continue without the living presence of your child

 

After the loss of a child, parents are at greater risk of psychological suffering, and declines in physical and mental functioning. It is important to monitor your mental, physical, and emotional health as you go through the grieving process. Couples who lose a child also face a potential strain on their relationship as they address their own grief, and that of their partner. Not only do parents have to work through their own grieving difficulties, but they must consider the feelings of their partner, and the support they both need. This is where support from other family members and friends can help each individual and the couple. Supportive loved ones can provide extra understanding and help with logistical needs to help with the grieving and mourning process.

The goal when going through the grieving process following the loss of a child is not to sever the bond with the child. In fact, successful grieving ends when parents are able to integrate the child into their life and social networks. This integration takes time and effort to achieve, and the child will be integrated in a different way than when they were alive. For some this integration looks like creating memorials and giving back to other parents who lose children. For others specific rituals are set up around birthdays and holidays to include the deceased in celebrations. Parents often keep symbols to provide positive reminders about the energy and love the child embodied throughout their lives. This is a healthy and affirming way to keep the child with you. Parents often search to make meaning of the loss of their child and this meaning may never be resolved. However, parents can empower themselves to help others who go through similar losses, and assist them through the grieving process. Parents who have lost a child say you don’t get over your grief, but it doesn’t stay the same. This is to say that the loss is painful, but the pain lessens over time.

Remember, seeing a mental health professional for group and/or individual therapy can be a helpful and healthy way to process your loss.

Additional sites that may be helpful:

http://www.athealth.com/consumer/disorders/parentalgrief.html

http://www.recover-from-grief.com/parents-grief.html

Some books that may be helpful:

http://www.amazon.com/When-Bough-Breaks-Forever-Daughter/dp/0836252829/ref=sr_1_2?s=books&ie=UTF8&qid=1342994734&sr=1-2&

http://www.amazon.com/Beyond-Tears-Living-Losing-Revised/dp/0312545193/ref=sr_1_4?s=books&ie=UTF8&qid=1342994657&sr=1-4

 

 

References

Alexy, W.D. (1982). Dimensions of psychological counseling that facilitate the grieving process of bereaved parents. Journal of Counseling Psychology, 29 (5), 498-507.

 

Keesee, N.J., Currier, J.M., & Neimeyer, R.A. (2008). Predictors of grief following the death of one’s child: the contribution of finding meaning. Journal of Clinical Psychology, 64 (10), 1145-1163.

 

Klass, D. (1997). The deceased child in the psychic and social worlds of bereaved parents during the resolution of grief. Death Studies, 21 (2), 147-175.

 

Wijngards-de Meij, L., Stroebe, M., Schut, H., Stroebe, W., van den Bout, J., van der Heijden, P., & Dijkstra, I. (2005). Couples at risk following the death of their child: predictors of grief versus depression. Journal of Consulting and Clinical Psychology, 73 (4), 617-623.

 

 

Coping with the loss of a loved one to suicide

Posted on: August 9th, 2012 by Hope And Cope No Comments

We know that death is a universal occurrence that can be openly discussed and shared by others. Unfortunately, suicide is a very common way of dying that is much less talked about in our society. The lack of discussion about suicide is not a reflection of the actual number of people who commit suicide every year, but rather a discomfort in addressing a widespread issue.

Suicide is one of the top causes of death in the United States. It is in the top 10 causes of death for adults, and the top 5 causes for adolescents. While many have focused on the elderly and adolescents as those most likely to commit suicide, the demographics of suicide appear to be changing in recent years. According to data recently analyzed by the Centers for Disease Control and Prevention (CDC) those who are 40-49 years old experienced an increase in suicide rates over the past decade (see link http://www.cdc.gov/mmwr/preview/mmwrhtml/su6001a11.htm). This is noteworthy because many individuals who commit suicide in this age group leave behind large numbers of grieving parents, children, siblings, friends, and co-workers. Those in their 40s often have contact with many individuals in different domains in their lives. This is not to say their suicide is any more or less significant than those in other age groups, but provides an important reminder that suicide can occur across the lifespan, and have a tremendous impact on loved ones.

Those who are left behind by people who have committed suicide are often referred to as survivors of suicide, or simply survivors. Survivors can include spouses, children, siblings, peers, parents, extended family members, friends, co-workers, and acquaintances. The impact of suicide is often felt by at least 6 to 10 people who knew, and had a relationship with, the person (according to conservative estimates).

Survivors often have a more complex grieving and bereavement process than those who lose their loved ones due to natural causes or accidents. One of the primary reasons that the bereavement is difficult is because of the shock of the death. Those who commit suicide often do not have a period of illness leading up to their deaths, which would allow loved ones time to prepare for the loss. Getting over the initial shock of suicide can take weeks to months for many. Another reason that grieving can be complex in survivors is because our society attaches some stigma to suicide. This stigma may cause survivors to feel additional guilt, shame, embarrassment, and isolation. These emotions may take more processing over the course of grieving.  Stigma associated with suicide also leads to less support from others. People who are close to the survivors may want to provide support, but feel uncomfortable around them because they do not know what to say or do. Our society does not have a protocol for how to comfort or support someone who has lost a loved one to suicide. Lack of support from others can cause the survivor to feel more alone and depressed in their grief. When social support is available, it can help the survivor access services that will help them adjust to their lives without their loved one.

Some of the normal experiences (in addition to typical grief responses) of someone who has lost a loved one to suicide can include:

  • Feeling rejected by the deceased
  • Feeling betrayed by the deceased
  • Feelings of guilt
  • Questioning why the person committed suicide
  • Wondering if they are to blame for the person’s suicide
  • Feeling wounded by the loss
  • A sense of personal violation (i.e., the deceased did something directly against you)

When grieving a loved one who committed suicide, there are several factors to consider. Think about your relationship to the deceased. If you felt very close to that person it will likely take you additional time and resources to grieve and mourn the loss. Remember that others may want to help you and provide support, but may not know the appropriate words or actions that would be comforting. Other survivors can be helpful resources to you. Those who have lost loved ones to suicide often can relate to your experience, and may provide helpful ways of coping and managing grief. Finally, even though it may be painful, talking about your loss has been shown to help you process your emotions and grieve in a healthy way.

While moving through grief, mourning, and healing these tips may be helpful:

  • Grief groups are wonderful resources for talking about your loss with those who have had similar experiences. You also may be able to find groups specifically for survivors of suicide. Use the internet to search for grief groups in your area.
    • Groups can help survivors break their silence about the loss. They provide a space to grieve openly, and be accepted in your current state of grief.
    • Groups can also help build confidence when speaking with others about the loss. Group members can provide tips about interacting with others that may not be as sensitive to your loss.
    • Support from others is one of the most crucial elements in recovering from a loss. Allow family members, friends, and loved ones to provide support for you at this time.
    • Don’t feel pressure to explain the reasons for your loved one’s death.
    • The entire family unit may become stressed by the loss of a family member. While everyone is suffering it may be difficult to provide support for one another.
    • It may be helpful to pay tribute and continue to love the deceased.
      • Some people choose to write poetry, create a photo album, listen to and create music, create art, meditate, light candles, and write journal entries. These forms of expression allow you to stay connected to your loved one, and engage with your emotional experiences.
      • Create a quiet and comfortable environment to process your loss. This environment could be in your home, at a park, or somewhere else.
      • Exploring and connecting with spirituality can provide comfort and support.

 

Survivors of suicide say that it is important to let go of the negative impact of the suicide to achieve health and continue to live their lives. This process looks different in different people, and takes time to achieve. In the healing process, one should strive to validate their own reality as separate from the deceased. Work to let go of your sense of responsibility for the suicide. And at some point you must decide to move toward healing.

Many survivors of suicide report that they learned about themselves, and their experiences, when going through the grief and healing process. After healing from their loss, survivors often feel stronger, more independent, and gain a greater sense of their priorities and values. You can learn to integrate the memory of your loved one into your life while adjusting to life changes and moving forward.

Remember, seeing a mental health professional for group and/or individual therapy can be a helpful and healthy way to process your loss.

Some websites that may be helpful:

http://www.buddhanet.net/r_suicid.htm

http://www.afsp.org/index.cfm?page_id=fed822a2-d88d-4dbd-6e1b55d56c229a75

http://www.mayoclinic.com/health/suicide/MH00048/

Some books that may be helpful:

http://www.amazon.com/Dying-Be-Free-Healing-Families/dp/1592853293/ref=sr_1_2?s=books&ie=UTF8&qid=1342124248&sr=1-2&

http://www.amazon.com/No-Time-Say-Goodbye-Surviving/dp/0385485514/ref=sr_1_1?s=books&ie=UTF8&qid=1342124248&sr=1-1&

 

 

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision ).Washington, D.C, American Psychiatric Association.

 

Freeman, S.J. (1991). Group Facilitation of the grieving process with those bereaved by suicide. Journal of Counseling and Development, 69, 328-331.

 

Kalischuk, R.G. & Hayes, V.E. (2004). Grieving, mourning, and healing following youth suicide: a focus on health and well being in families. Omega, 48 (1), 45-67.

 

Knieper, A.J. (1999). The suicide survivor’s grief and recovery. Suicide and life-threatening behavior, 29 (4), 353-364.

 

Mauk, G.W. & Weber, C. (1991). Peer survivors of adolescent suicide: perspectives on grieving and postvention. Journal of Adolescent Research, 6 (1), 113-131.

 

Mitchell, A.M., Kim, Y., Prigerson, H.G., & Mortimer-Stephens, M. (2004). Complicated grief in survivors of suicide. Crisis, 21 (1), 12-18.

 

 

Welcome To Hope And Cope!

Hope And Cope is your web portal to easily create a page for the funeral of a fallen loved one or friend.  You can create your own funeral page with an obituary. Easily create your page and share it with all your friends that plan on attending so everyone is on the same page. Donations can be made through your page for the family or to help pay for the funeral home. Let people know what to bring to the funeral as well as directions to the funeral home.  You can add any content you want to your page so go ahead and try it today!