Grief is not a disorder, a disease or sign of weakness. It is an emotional, physical and spiritual necessity, the price you pay for love. The only cure for grief is to grieve.” – Earl Grollman.
Grief is difficult – but would we rather not have loved? Of course not!
When we know the end is coming for a loved one, such as in Cancer Care, we can make the most of every second that is left in their lifetime. There is time to think ahead (anticipatory grief), or say goodbye over many prolonged months or years as the patient slowly slips away (complex, delayed grief). There is time to plan and adjust our grief to every slight change and nuance.
But what happens when there is a sudden death of a loved one and no time to prepare? You may be that person who has lost a loved one quickly and dramatically, or you may be supporting someone who has.
If you are a First Responder or responding in a life and death situation, then thinks PACS: Purpose, Assess, Contain/Communicate, and Support.
1 – PURPOSE: What is our Purpose here?
If you are the support person here, then think psychological first aid. You don’t go deep. You don’t run ahead. You read the situation. You find where you are comfortable in it. You provide emotional support not advice.
You assist with material aid – a chair, some privacy, a hot/cold drink, some coolness or some warmth – depending on the situation. What is happening is not alright, but the other person is not going through it alone. Facilitate what the bereaved person needs – perhaps a phone, another relative, a comfortable chair. You are there in a helping role. And you are the silent sentinel.
If you are the bereaved person, then you will be looking, looking – for meaning, for support, for any sign of encouragement, for a sign of life. A panic may be rising that everything is about to change, and not for the better. You may find yourself incredibly stressed and upset. What is your purpose? Just to be present, just to breathe. It may appear that everything is happening around you in slow motion. Mal McKissock states that in a time of traumatic grief, you may regress to the thinking and feeling of a 7-year-old: You may blurt things out, you may get angry, little things may annoy you. You may want everyone to go away. You may feel that you want to go away.
2 – ASSESS the Situation
For the support person: check for safety of all persons in the room – do persons have a safe confidential space to talk and grieve? Check for people with urgent basic needs, check for people with serious distress reactions. Seek out health professionals to help you manage the situation. You may be able to build a short conversation on a piece of information you already have. Ask: “What has the doctor/paramedic/nurse told you so far?” Don’t run ahead of proven professional assessment of the situation.
Help those who are catastrophizing the situation and are making others very anxious. You may wish to say: “I heard the doctor say so and so – so we are waiting on further information”. This may slow down the process so that persons can take a breather, even if the outcome looks bleak.
For the bereaved, the same information applies. One piece of information at a time. Breathe. You are not alone. Seek out the best, most informed, up-to-date information and hang on to it. Surround yourself with positive people and stay close to them.
3 – CONTAIN / Communicate:
For the support person: Self-soothe – you may have had experience in how to de-stress in these situations before. Build some positive rapport with those in the room. Be aware of body language and behaviour. Seek professional support and back-up. Use psychological first aid, use it on yourself as well – be kind to yourself.
For the bereaved person, hold on tight for the ride. You have an amazing support person near to help you. Remember times in the past where you came through. Remember to breathe.
The therapist, Murray Bowen, states:
(Manageable) change occurs when anxiety is low and understanding not behaviour is the critical vehicle for change.”
The calmer we stay, the more we will be able to listen and comprehend what is happening around us. This is important.
4 – SUPPORT:
Practical and emotional support really is needed after the loved one has passed away. Assist relatives and friends of the deceased to address basic needs and access services. Relatives and friends of the deceased may act confused and dazed. Try to give accurate information with the help of professional support where available. Connect persons with other loved ones. Being accepted in the room as a helpful person will allow you to continue your role to support. Connect relatives and friends to a source that can answer the following questions:
- I want more information on death and dying – what actually happened to my relative?
- What happens to my loved one now? Where do they go?
- How long have I with the deceased?
- What are my options?
Just filling in spaces in the conversation with information given at the wrong time is not always helpful. When these questions arise will depend on the bereaved person and his/her family – they will signal when this information is needed.
So where to now?
The death of a loved one is just the start of the journey. When it happens quickly and tragically, you may need a lot of support on every level to get through the next few weeks and months. It may all seem like a dream. Grief counselling can help here. You can talk about and remember your loved one as often as you like. You can do this with a health professional, a chaplain or a trusted friend.
You can go through the discharge summary of your loved one, if they died in a hospital, with your general practitioner – they can get a copy of it for you and go through it with you. This can help.
Hearts don’t heal overnight.
Give yourself all the time you need …
Author: Vision Psychology
- Coping with Grief by Mal and Diane McKissock (Harper Collins, 2018, Sydney).
- Traumatic Stress by Bessel A van der Kolk et al. (The Guilford Press, New York, 2007.)
- Worden’s Four tasks of Mourning https://whatsyourgrief.com/wordens-four-tasks-of-mourning/