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Grief and Bereavement

Grief and Bereavement

Dying in hospital:

When your loved one dies in a hospital it can be very distressing especially if it is unexpected, you may feel very vulnerable at this time because you are in a strange environment surrounded by unfamiliar people. Be assured that you do not have to rush away or that the staff want you to immediately leave; the staff in the hospital will be compassionate and will not hurry you in any way; they will sit with you or contact friends or family who you may wish to be with at this time. The loss of a partner, friend or child can cause the most over whelming anguish and the deepest sadness, and is not a time to be hurried. There is no right or wrong way to grieve or a time scale to keep to, although culturally some people may have an official time period in which to share their grief publicly; the personal mourning time may be much longer.

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Grief:
There are two different types of grief, grief which is expected which is called anticipatory grief and sudden grief which is where there is unexpected loss.

Anticipatory grief is where you are expecting the death of a loved one and have had time to think about how you will feel and react once that person dies. You have the time to talk to the person to tell them how much you love them or to maybe to say sorry. You will also have the time to imagine how you will adjust after they have died, maybe even have thought about funeral arrangements and how life will be once they are gone.

Sudden grief is where the death of a loved one is unpredicted and sudden and you may not have been present when they died. This loss has a more impacting affect on the person concerned as they may be totally weighed down by the loss of their loved one and be unable to function within normal parameters.

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How should I feel?

Quite often people are very confused at how they feel at the death of someone close, the range of emotions and the confusing manner in which they appear then seem to go away and then return again is like an emotional rollercoaster. There are acknowledged phases of grieving but these are not the same for any two people everyone deals with their grief in different ways. It is of some comfort to know that what ever you feel is right for you and there is no “normal” often time passing will be the only healer. 

Feelings and emotions can include any combination of:-

  • Shock and disbelief
  • Numbness
  • Feeling stunned
  • Trembling
  • Helplessness
  • Feeling as if this is not happening, not real
  • Difficulty with breathing
  • Lack of concentration
  • Feeling agitated
  • Thinking that you have seen or heard the deceased
  • Feeling sick unable to eat
  • Frightened of being alone
  • Inability to sleep
  • Guilt
  • Relief
  • Anger
  • Depression
  • Loneliness
  • Despair

Stages of Bereavement:

It is acknowledged that there are stages of bereavement or mourning, but the order in which people go through them and go back and forth varies from person to person. It is also a painful experience, with emotional and physical pain evident, it is important that people mourn so they are able to rebuild their lives. This can seem like an impossible task initially, but with the support of family, friends, support groups and sometimes counsellors it can happen.

    • Shock associated with numb feelings and often denial of the death itself is the first stage

    • Loss and the yearning for the one who has died can often be associated with anger, anger at being left by the person who has died, anger at the doctors or nurses for seemingly not doing enough to save them and anger and envy at others for being happy and having their loved ones still with them.

    • Why did they have to die? The grief and pain can be incapacitating, causing both physical and mental pain. Deep depression can occur with the feelings of emptiness and loneliness at this stage.

    • Eventually there is the acceptance phase; this is where a reorganisation of your life occurs, a realisation that you are able to go about you daily life without being overcome with sadness. You do not ever forget the person who has died but have learnt to remember them.

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What can I do to help my friend who is Bereaved?

Being there as a friend or family member is of the greatest help to someone who has recently been bereaved. Holding their hand, or cuddling them or being there when they want to cry are all important and positive actions you can take. Often they will want to talk repeating the same scenarios over and over; it has been referred to as giving away the grief, it is a natural part grieving. This process helps tremendously as the person is able to share memories and life moments again with more of them in time becoming positive events, rather than sad ones.

When someone cries it can often make us feel uncomfortable, it is hard to see someone we care about in tears and often we want them to stop, so try to make them feel better. However for the person who is crying this is their relief valve and it needs to be allowed to vent, it is far better to release these emotions than to keep them repressed. You will find that it is usually just a few tears and then they will regain their composure and continue as they were, being understanding and compassionate at this time will help to reassure them.

At times people will avoid mentioning the name of the person who has died because they do not wish to cause upset, this more often than not backfires, as it can be taken that the person who has died is already forgotten which is not what is wanted. If you are unsure about mentioning the person who has died by name say so, admit that it makes you anxious and that you don’t want to upset the person concerned, they will often appreciate that you are thinking of their feelings and it gives them the opportunity to express themselves.

More practical help would involve regular visiting, encouraging meals, and maintaining a normal routine, offers of help with doing the shopping or the ironing is all ways which will make opportunities to keep in contact with the bereaved. Often after the initial shock of the trauma of a death and the funeral the friends and family begin to disappear leaving the bereaved person on their own with their thoughts and sadness. Taking your lead from the bereaved is often quite hard as you don’t want to appear that you know what is best for them, but also don’t want them to feel that you are not there for them, it is a fine balance. It can sometimes take two years for a person to return to “normal” after a significant loss and it is often much longer if their grief is not worked through.  Just being there can be an invaluable gift although it may not seem so, even if it is to sit in silence with someone who is lost in their thoughts they will appreciate you being there.

Children and Bereavement: Children react to death in different ways and have differing levels of understanding depending on their age groups. It is good for them to share how they feel and to understand how you feel too; it is a learning experience for them and can often help with breaking down the old taboos of not talking about death. Children are fortunate in that they do go through a similar  grieving process but usually more quickly, and if they can discuss their feelings with you without feeling that it will upset you and that it is ok to cry then it will give them a better chance of dealing with their grief.

Often we feel the need to protect our children when someone dies, saying things like “they have gone to sleep” or “have gone away”. This can cause children great fear and worry as they then think that they may never wake up if they go to sleep, or that they should go and look for the person who has gone away. Being honest with children and explaining to them that a member of the family has died is far easier for them to understand as they will more than likely have come into contact with death even if it is only the death of an animal or insect they have seen. Giving children the opportunity to ask questions and to understand why someone has died gives them a clear understanding of the nature of the death; otherwise children can start to make up reasons why someone died and that it was somehow their fault.

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Hospice Care:

Hospice care has grown from the needs of dying people to be cared for in specialist environments with a specialist team of carers and professionals looking after their and their families needs. The multidisciplinary team aim to care for and not cure, and to promote the quality of life incorporating, spiritual, social, physical and emotional needs.

The hospice team work with the patient and family enhancing their lives, providing pain relief and dignity. According to statistics provided by hospice information 25,000 people a year receive treatment from hospices all over the country 95% of people admitted to these units are suffering from cancer with nearly half of all people admitted to a hospice returning home again, and the average length of stay is just 13 days.

In many hospices you can find a wide variety of services ranging from complimentary therapies and beauty treatments to pain control and counselling. All the care is bespoke, focused around the individual needs of the patient and family. Treatment and care are all free; the majority are run by charities and are maintained through generous donations.

If you would like help in finding a hospice or palliative care service, please email the hospice information team at: info@hospiceinformation.info

Or call: 0870 903 3 903

Or find their web site at. http://www.hospiceinformation.info

 Association of Children's Hospices (ACH)
Kings House,
14 Orchard Street,
Bristol,
BS1 5EH
Tel: 0117 905 5082
Fax: 0117 905 5340
Email: info@childhospice.org.uk
Website: www.childhospice.org.uk

Help the Hospices - is the national charity for the hospice movement. It supports hospices throughout the UK through grant-aid, training, education, information, national fundraising and advice.

Hospice House,
34-44 Britannia St,
London
WC1X 9JG
Tel: 020 7520 8200
Fax: 020 7278 1021
Email: info@helpthehospices.org.uk
Website: www.helpthehospices.org.uk

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Carers:

There are over 5.7 million carers in the UK and with over half a million deaths each year, many of these carers will have been caring for someone who is terminally ill. Often the needs of the family out way the needs of the patient as the amount of psychological pressure that is placed on the shoulders of the carers is often excessive.

Information for carers and healthcare professionals working with carers can be found on the website: www.timetocare.org.uk

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Organ Donation:

If your loved one carried a donor card or had expressed a wish that their body organs could be used to save many others please make this important information known to the hospital staff. The UK organ transplant organisation is in need of your help, many very sick people are on long waiting lists hoping for the “gift of life”. As of January 2007 over 7,000 people in UK alone are on the waiting lists for transplants.

It is an important decision to make and one that can change lives in the most wonderful ways. Almost a million more people pledged to help others after their death by registering their wishes on the NHS Organ Donor Register, bringing the total at 31 March 2006 to 13,122,056

If you would like to become a donor yourself or find out more about organ donation please follow this link. 

http://www.uktransplant.org.uk/ukt/

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What do I do now?

If your loved one has died in the hospital you do not need to do anything or arrange anything immediately as the hospital will place them in the hospital mortuary. If you, family or friends wish to visit to say goodbye this can be arranged as most hospitals have rooms where you will be left with your loved one for as long as you wish. From there the funeral home will be able to collect them in preparation for the funeral arrangements.  If your loved one dies at home they are able to remain there until the funeral alternatively the funeral directors will collect them and keep them where you and your family will be able to visit until the day of the funeral.

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Who do I need to tell?

If you have specific religious requirements please do discuss this with the nursing staff who will do all they can to help you with your arrangements.

There are legal procedures which need to be seen to when someone has died if your loved one dies in hospital then you will be given a death certificate from the Doctor who was looking after them. You will also be given a medical certificate for the Registrar at the registry office which needs to be delivered within the first five days following their death. If your loved one is to be cremated then two doctors will need to have examined them and signed the necessary documentation. Funeral arrangements will need to be commenced; family and friends may be able to help you at this time with these. It may be necessary to check if the deceased had any special wishes which they would like at the funeral which may be in their will.

Other people who will need to be informed will range from the bank and credit card holders to policy holders of mortgage, rental companies, DVLA, and clubs or associations where fees may be due. You will also need to tell their GP and if your loved one was receiving any benefits these will need to be cancelled.

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Why is there a Coroner’s enquiry?

If the person has died due to:

  • An accident or injury

  • An industrial disease i.e. chemical or asbestos

  • During a surgical operating procedure

  • Before recovering from an anaesthetic

  • If the cause of death is unknown

  • If the death was sudden or unexplained, for instance a sudden infant death (cot death)

  • If the person had not seen a doctor in the last fourteen days or did not have a GP

You will not be able to register their death or have a funeral if any of the above circumstances are relevant and you will need to wait until the Coroners office are satisfied with the cause of death; this can mean that an inquest may be held into their death and or a post mortem (an examination of the deceased body). The Coroners office do not need too seek your permission to do this although they will contact you. When the Coroner’s enquiries are over they will issue the death certificate which you may then take to the registry office in your area, and proceed with arrangements.

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