Grief and Bereavement

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Northwestern Brain TumorSupport Group
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• Grief the normal, dynamic process that occurs in
  response to any type of loss 1
• Mourning often used interchangeably with grief,
  but more specifically refers to the public
  expression of grief 2
• Bereavement the state of having suffereda loss
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• Complicated mourning arises from an interrupted
  or obstructed grief process2

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• Changing assumptions
• Adapting to role changes
• Finding a balance
• Experiencing feelings of sadness, depression, and
  anxiety6

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Benefits

• Opportunity tocomplete unfinishedbusiness

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Complications

• Premature EmotionalWithdrawal
• Affects NaturalBereavement Process

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• Identify and legitimize feelings of sadness,
  anger, guilt and anxiety
• Encourage expressions of feelings in a private,
  comfortable setting
• Redefine terms related to expressing grief
• Enable people to complete unfinished business
• Encourage them to live fully and enjoy life
  whenever and wherever they can 10

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• Life review and memory work
• Religious rituals
• Meditation
• Photography/video
• Journeys

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• The Nature of the Relationship Between the
  Deceased and the Bereaved
• The Manner of Death
• The Length of the Illness
• Symptoms and Side Effects
• The Time of Death Experience
• Social Variables

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• Importance of a GoodSupport System

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• Cultural andReligious Beliefs

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• Personality Traits and Coping Style

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• Defining Griefis Complicated

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• Old
• Stages Resolution
• New
• Accommodation Process of Adapting to Fit New
  Circumstances

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• Task I
• Accept the Realityof the Loss
• Traditional RitualsHelp

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• Task II
• Experience the Pain of Grief
• Physical
• Emotional

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• I thought everything was fine but now I feel
  like things are worse.

I may seem normal on the outside, but I am
screaming on the inside.
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• Task III
• Adjust to the Loss
• Difficult Firsts
• We always used to

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• Task IV
• Reinvesting Energy from the Deceased into a New
  Life
• Saying good-bye to grief, without saying good-bye
  to the loved one

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Signs that a person is learning to accommodate
their grief

• A return to good health
• Acknowledgement of the reality of the loss
• Redefined activity
• Emergence of new skills or roles
• Establishment of or a reconnection with asocial
  support system
• Ability to cope effectively with
  temporaryupsurges of grief
• Comfort with the quest to find meaning
• Personal growth and transformation

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• You cant make the pain go away,but you can make
  it easier

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• DetailsMay Help

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• The Roller-Coaster Ride

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• Reassure them that upsurges are normal
• Anticipation is worse than the actual event
• Make plans
• Grief is a journey
• Self-care is essential

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• Explore spiritual responses
• Encourage creativity
• Strengthen their support system

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• Encourage the use of ritual

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• What do you want to bring from your old life into
  the new?
• What do you need to leave behind?
• What do you need to add?

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Summary

• Reach Out
• Give permission to grieve in waysthat work for
  them
• Normalize responses
• Educate about what to expect
• Encourage good self-care
• Refer for appropriate medicalevaluation

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Summary

• Encourage creativity
• Encourage ritual
• Explore spiritual responses
• Strengthen and encouragethe use of a support
  system
• Affirm efforts to re-engage in life
• Help the bereaved recognizeopportunities for
  growth and transformation

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Summary

• No one can take awaythe pain
• Dont let a sense of helplessnessprevent
  outreach
• Recognize the value ofbeing present
• Develop empatheticlistening skills

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• Can it be in a world so full and busy that the
  loss of one creature makes a void in any heart so
  wide and deep that nothingbut the width and
  depthof vast eternity can fill it up?
  Charles
  Dickens

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