Bereavement Support

The Bereavement Program at Brigham and Women’s Hospital provides information about coping with grief and information about where to find support in your local community.

If you are dealing with the recent death of a loved one, grief can be a very lonely and isolating experience. Working out what you need to do to help yourself during this time is important.

Most people who are grieving need to be able to:

  • Tell their story
  • Seek support from family, friends or within their community
  • Pay attention to their physical and mental health
  • Give themselves permission to grieve
  • Find ways to regain a sense of control in their lives, and
  • Adapt to life without their loved one

The Nature of Grief

When someone you love dies, your life changes from the moment you first learn of their death. Grief, while extremely painful, is a normal and expected reaction to loss. It is characterized by deep sadness and an intense yearning to be with that person again. During the initial weeks and months, you're likely to experience intense emotional and physical reactions, which at times might seem intolerable. You may question whether you will ever feel "normal" again. Even though there is no "right" way to grieve or set of rules to follow, there are several things people who are grieving can do to help themselves during this difficult time. Explore some strategies and tips. Knowing what to expect can help you get through the first few months more easily.

Common Emotional and Physical Reactions of Grief

People tend to report a number of emotional and physical reactions soon after the death of their loved one. Some reactions ease in a few weeks, while others persist for several months or more. You may experience many of these reactions, or just a few – everyone is different. Early on, it's also common to feel as though you're on "automatic pilot" — just going through the motions. Organizing a funeral or memorial service and attending to financial matters can be overwhelming and exhausting. You might also feel "on edge" and not remember who stopped by to visit or called to express their condolences.

Even though these feelings can be difficult to bear, they're all normal responses as your mind and body attempt to take in the reality of your loved one's death. It's important to tell yourself that eventually these reactions will lessen as time goes on.

Physical Reactions of Grief

  • Crying/sobbing
  • Muscle tension
  • Panic
  • Fear
  • Restlessness
  • Agitation
  • Difficulty sleeping
  • Difficulty eating
  • Stomach upset

Emotional Reactions of Grief

  • Intense sadness
  • Yearning or longing
  • Disbelief
  • Despair
  • Worry
  • Anguish
  • Guilt
  • Remorse
  • Emptiness
  • Anger
  • Relief

What to Expect When You are Grieving

One of the first questions people ask is: "How long will I feel this way?" The answer to this question is that it depends given that everyone’s experience is different. How you grieve and how long it takes is influenced by your personality, the type of relationship you had with the person who died, the circumstances surrounding their death and the way you tend to deal with other challenges in your life.

Unfortunately, western society isn't very good at dealing with grief. We live in a fast-paced world with a "fix-it" mentality, and when someone dies, there's often an expectation that the bereaved should "get over it" as quickly as possible. Grief, however, is not that simple. When someone dies, not only do we lose the person themselves, but we lose the many other things they were to us: mentor, confidante, co-parent, friend, hope for the future, historian, accountant, or the person who organized the social calendar.

If your loved one was ill for some time you may also miss your "job" as caregiver and the relationship you shared with the team who were involved in their treatment.

What to Expect When Your Grief is New

  • Crying easily
  • Feeling overwhelmed
  • Feeling out of control
  • Having difficulty concentrating
  • Feeling tired
  • Feeling less tolerant of other people
  • Feeling anxious or panicky
  • Yearning for your loved one
  • Having difficulty making decisions
  • Having difficulty reading
  • Having thoughts of dying to be with them again

It's helpful to think of grief as following a wave-like pattern, where the strength and frequency of the waves lessens over time. Occasionally, larger waves or "trigger waves," which are usually accompanied by strong emotions, can catch you off guard when you least expect them. These triggers can include anything from hearing a song on the radio to noticing the change in season to acknowledging significant events, such as birthdays and anniversaries.

Knowing that your grief will follow a wave-like pattern may help you understand why you have good and bad days. If you expect your grief to follow this pattern, you won't be surprised or think that you're getting worse when you have a ‘bad’ day.

What do Grieving People Need?

Dealing with the death of someone you love can be a very lonely and isolating experience.

Working out what you need to do to help yourself at this time is crucial. People who are grieving need to be able to:

  • Tell their story
  • Give themselves permission to grieve
  • Find ways to regain a sense of control and balance in their life
  • Build a different path without their loved one

Tell Your Story

Everyone has a different story to tell about how their loved one died and the impact that their death has had on their life. Being able to tell your story — whether verbally or through writing — can help you make sense of what has happened and how your life has changed.

Permission to Grieve

One of the hardest things about grieving is that no one else can do it for you. There's no "off" switch or easy way around grief; it's something only you can do for yourself. How much your life changes relates to the degree of adjustment that you have to make. You may have to move or return to work, or you may have to find ways to fill your days that had been consumed by caregiving and medical appointments. Regardless of the types of changes you have to make, the more changes you face, the longer it is likely to take.

Even though grieving can be particularly painful, it is in fact good, as it gives you the time and space to adjust to life without your loved one and the many changes that follow. Giving yourself permission to grieve doesn't mean "getting over" the death of your loved one, but rather involves acknowledging to yourself that it's normal to feel sad and to express your concerns about your future.

In the beginning, the best advice is to takes things slowly. Set aside some regular time to grieve. Healthy grieving involves getting through all the firsts: holidays, significant dates, birthdays and the first anniversary of your loved one's death.

If at any time your grief feels as though it is getting harder and you feel increasingly depressed or have thoughts of harming yourself, seek help immediately from your doctor or mental health professional.

Strategies and Tips for Grieving

Staying Healthy While Grieving

The death of a loved one is a very stressful life event that affects not only your emotional well-being but also your physical health. Keeping yourself healthy during this time is vital. If you are physically healthy, you will have more resources to deal with your grief.

We recommend that you:

  • Establish a simple routine
    • Try to wake up at a similar time each day and go to bed about the same time each night
    • Eat at regular meal times, even if you don't feel like it
    • Plan a simple activity each day, including weekends
    • Develop a to-do list and aim to check off one or two things each day
  • Keep active and focus on your health
    • Try to do something outdoors each day
    • Walk wherever you can
    • Limit your alcohol intake
    • Eat fresh food- avoid processed food where possible
    • Do something for yourself — self-care is really important
  • Visit your doctor
    • Because grief can be very stressful, let your doctor know what has happened
    • Follow up on appointments such as the dentist, your PCP or optometrist, that you may have put off if you were care-giving
  • Connect with people
    • Seek opportunities to be with your friends and family, especially those who are good listeners
    • Accept invitations: Try to do something socially even if you don't feel like it
    • Seek counseling if you have little support or feel overwhelmed

Setting Aside "Grief Time"

In the weeks and months ahead, try to carve out time to grieve on a regular basis, otherwise your busy schedule can push grief into the background. Even though you may be reluctant to do this, scheduling grief time can help you feel more in control of your grief and less overwhelmed. One suggestion is to begin by setting aside 20 to 30 minutes every few days when you won't be disturbed.

The following tips may give you some ideas about what to do in your "grief time":

  • Sit quietly and think about your loved one
  • Talk to them as though they were sitting right next to you
  • Play music that reminds you of them
  • Allow yourself to cry
  • Write them a letter
  • Start a journal, a memory book or a photo book
  • Write about the events leading up to their death
  • List any questions you have
  • Make a 'to-do' list about what needs to be done

Making Difficult Decisions

There will likely be many decisions to make after the death of your loved one. Some decisions will concern finalizing their affairs and sorting through belongings whereas others will concern your grief and building a new life for yourself.

Decisions that often cause people distress include:

  • When to sort through their loved one's belongings
  • Whether or not to take off their wedding ring
  • When to return to work
  • How often to visit the cemetery
  • Whether or not to sell or move

When grief is new, it's harder to think clearly about things because there is so much emotion involved. A general rule of thumb is to avoid making major decisions in the first year, especially if those decisions are irreversible, because you are more likely to make a decision that you might regret.

If you're facing a decision, write a list of the positives and negatives for the different options you are considering. Focus on the consequences of whatever decision you are entertaining, and ask yourself: Can I live with the consequences?

Facing the First Anniversary

By the time the first anniversary of your loved one's death comes around, you most likely will have dealt with many other 'firsts,' such as birthdays, holidays and other significant dates. For many people, anticipating the first anniversary is particularly difficult as it not only highlights their loved one's absence, but marks the passage of time.

It is helpful to remember the wave-like pattern of grief, where the waves are likely to increase in size as the first anniversary approaches. Many people find that they replay over and over the events of the year before that lead up to the day their loved one died. It's not unusual to think, "This time last year we were doing…" or "This time last year we had just found out this news." Often it feels as though you're getting worse again, but this is a normal part of grief.

The best advice for dealing with the first anniversary is to make a plan. This helps you prepare for the day before it arrives, which increases your sense of control. If the first anniversary is approaching, think about the following questions:

  • How do you want to acknowledge the day?
  • Who do you want to share it with?
  • What arrangements do you need to make ahead of time?
  • Are you plans realistic?

If you are having trouble deciding what to do, think about the favorite places you shared and ask yourself, what would my loved one suggest if they were here now?

Maintaining A Connection

When someone special in your life dies, it's important to work out how to maintain a connection with them. Often people worry that they will forget the sound of their voice, their face or their smell. These are all normal fears and working out how to maintain a connection with that special person based on memory and legacy is the key.

The aim of working through your grief isn't to forget your loved one but to learn how to continue living without them physically present in your life. The following questions can help you think about how to develop a new connection with them.

Ask yourself:

  • What did you learn from them?
  • What were their values that are important to you today?
  • What history did you share?
  • What advice would they give you now about how they would like to be remembered?
  • Who can you share stories with? - Find opportunities to reminisce with others.

Use Technology to Maintain A Connection

Technology is a wonderful way to maintain a connection especially for those families with young children. Creating picture and story books are great ways for children to learn more about their parents, grandparents or other friends and relatives who have died. Update any home movies to DVDs and if you have saved voicemails, find someone who can transfer these recordings to a safe storage device.

You could also:

  • Start an online journal
  • Make a coffee-table photo book with all your favorite photos
  • Contact friends, family and colleagues of your loved one and ask them to send their special memories or insights that you can collate into a book

Coping with the Holidays

The holidays can be very difficult because what were once happy times may now fill you with sadness and dread. How soon after the death of your loved one they fall will most likely influence your decision about how much you want to participate in them. There might also be differing opinions in the family as to how to spend them, which can complicate things.

The same guidelines about facing the first anniversary apply here. The best strategy to deal with the holidays is to make a holiday plan:

  • Speak to your family ahead of time about the holidays
  • Consider making changes to your usual plans
  • Lower your expectations about holiday preparations
  • Tell yourself (and others) that it is perfectly normal to feel sad and to cry
  • Give yourself permission to enjoy yourself without feeling guilty
  • Honor your loved one: What did they like about this holiday?
  • Find ways to reminisce as a group or on your own

Caring for the Bereaved

If someone you care about is grieving, there are simple things you can do to help them at this difficult time.

  • Encourage them to talk about their loved one
  • Let them tell their story, even if you have heard it before
  • Listen without interrupting
  • Accept their feelings, have empathy
  • Let them cry, even if you feel uncomfortable
  • Invite them to do things with you that they normally would enjoy
  • If you say you will call, make sure you do
  • Remember significant dates such as their loved one's birthday or the date they died
  • Use their loved one's name
  • Reminisce with them
  • Offer to accompany them to first-time appointments,such as visiting the bank
  • Offer to help write thank-you notes
  • Offer to help them plan for significant "firsts" such as holidays and the first anniversary of their loved ones' death
  • Suggest they see a counselor if they appear to be struggling.

Contact Information for Bereavement Support

For more information about finding bereavement support in your community, please contact us at Patient Family Relations on 617-732-6646.

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