We're Always Saying Goodbye - Kansas City Hospice & Palliative Care

Every change of a home address, every loss of relationship, loss of a pet, every change in beliefs or life transitions —marriage, divorce, illness or retirement— means saying goodbye to something. Dr. Elisabeth Kubler-Ross calls these goodbyes “little deaths of life.” However, the death of someone who gave life meaning, purpose, safety or stability is one of the most challenging goodbyes of all. So let’s explore some important questions:

What is grief?

Grief is a natural and healing response to loss, not a disease to be cured. All people experience grief, so in most cases the absence of grief is abnormal. Grief can be painful, long and unpredictable and may cause you to feel anxious, confused, sad, overwhelmed and uncertain. No wonder so many people try to avoid grief. Often people may urge you just to get on with your life. But grief is a necessity, not a luxury. As English poet William Cowper said, “Grief itself is a medicine.”

What are the phases of grief?

Shock and Numbness: You don’t want the death to be real and may disbelieve it. Even if you expected the death and felt prepared you may feel a sense of unreality. All these feelings help protect us from the pain of the loss until we can better tolerate it. This phase may last for hours, days, weeks or even months.

Suffering and Disorganization: This phase can last months, and may be the most difficult because now you begin to accept death’s reality. It happens each time you reach across the bed to touch your spouse but find an empty space or when you start to call your mother about her grandson’s antics but remember that she won’t answer. Your restlessness, anxiety, fear, guilt, sadness and emptiness may make you think you are going crazy. Rest assured, you are not. You are grieving, and the grief comes and goes in waves.

Reorganization: After several months, your needs and the pace of your life begin to change. The sense of loss diminishes from intense sorrow to milder sadness. Appetite, sleep and energy patterns move toward normal. You become more interested in the world and your future. You don’t forget your loved one, but you know you will survive, even though life will never be the same. You regain a sense of control. This phase does not begin suddenly. Often it coexists with earlier phases and can produce aftershocks of unexpected old feelings of loss and grief. This phase, with its apparent relapses, can last well into the second year after a death.

Is there a timetable for grief?

If your loved one was ill, you’ve already grieved, sensing that your time together was limited. This is anticipatory grief. But even if you have grieved a great deal before the death, you still have some grieving ahead. How long grief lasts varies widely from person to person, so the following timetable is general:

The First Months: You may be so busy with funeral arrangements, visitors, paperwork and other tasks that you have little time to grieve. Also, your shock can last beyond the first month, especially if the death was sudden, violent or particularly untimely.

Months Three to Five: This period is particularly challenging for many. Visitors have gone home, cards and calls have slowed or stopped and most of the numbness has worn off. Family and friends who don’t understand grief may pressure you to “get back to normal,” but you are just starting to understand what this loss means. You are trying to create “a new normal.”

Months Six through Twelve: You continue learning to live with loss, and you begin to have more good days. But even now difficult times can occur with no obvious trigger. This is normal, not a lack of progress.

Throughout Your Grief: Significant anniversaries, birthdays and holidays present additional challenges. Even such anniversaries as the dates of diagnosis and death can hurt, and you may need additional support.

What is the work of grief?

Although the passage of time can be helpful, it’s not enough for most grieving people. The following tasks describe the steps most people complete as they move through the grief process. This model is based on the research of Dr. J. William Worden and his work with grieving people.

The First Task: Acknowledging the Reality of the Death.

Often, when a death occurs, we can’t or don’t want to believe it. It feels like a bad dream. We may have trouble believing the deceased will not walk through the door at any moment. Funerals can help by providing a chance to talk freely about the deceased and the circumstances of death. With each retelling, some of the intense emotions associated with our memories are released.

The Second Task: Openly Expressing Feelings — even guilt and anger. Having mixed emotions about the person who has died is common and important as you begin to see that person more realistically. You may find you have unfinished business, a word unsaid or an act undone, that you must acknowledge before moving forward.

The Third Task: Learning to Live Without Your Loved One.

You may have lost your best friend, housekeeper, handyman, source of family income or confidante. The absence of this person may change your world completely. You may have to learn new responsibilities and change daily routines. Your own sense of identity could change. You may need to create a new social network.

The Fourth Task: Finding a Way to Remember Your Loved One Without Pain.

Fear of forgetting or losing a connection with your loved one may cause you to hold onto pain. A part of you may desperately wish that your loved one could continue to respond to you and fulfill your needs as he or she did when alive.

Ask yourself these questions:

What special memories do you have of your loved one?
What did his or her life teach you?
What aspects of his or her life do you wish to carry on?
How will you keep his or her memory alive?
What baggage from the past should you discard?
What new skills should you develop?

When can you let go?

At some point in your grieving you realize you must move on to life beyond loss. This does not mean forgetting. You aren’t being disloyal. Resuming your life doesn’t mean you can’t stay in touch with your sadness or that tears will cease. It means you have decided to accept two realities — that your loved one has died and that your life goes on.

Author and theologian Dr. Ronald H. Sutherland points to three important lessons about letting go of grief:

Reaching this decision is painful.
No other person can make the decision for you.
Nobody else knows when you are ready to make the decision.

Is grief only an emotional experience?

No, it’s also physical, intellectual, social and spiritual. Although the following symptoms of grief are normal, if you have any questions about what you are experiencing, especially physical symptoms, please contact your physician.

Can you help yourself as you grieve?

Yes. In addition to the love and support of relatives and friends we also must try to help ourselves. But working through grief takes much energy, so treat yourself with the same care and affection you would offer a grieving friend.

Think About Your Loss. As you do, allow the details and emotions that come with them to be fully expressed. Explore memories as they arise. It’s part of healing. The repetition of painful memories helps flush out strong emotions.

Talk About Your Loss. This provides much release. You may need to retell the same stories as part of your healing. You may wonder if anyone wants to hear them anymore. A support group can give you the opportunity to be heard.

Ask for Help. Don’t fear to seek professional counselors. Family and friends may not always know what you need and may find it difficult to help. Seek someone who cares, with whom you can talk freely. Accept help when it is offered, remembering that other people want to be told when you want to talk and when they can do something for you.

Write About Your Loss. Keeping a journal can be a powerful healing tool. Writing can help focus and identify emotions, channeling fear and pain constructively and helping you measure progress.

Cry About Your Loss. Tears can relieve pressure. Trust your body’s need to cry or not to cry. People use tears differently, so respect your own relationship to tears. Just don’t tell yourself that tears mean you are weak, out of control or regressing.

Make Space For Your Loss. Sometimes people lose their routines after a death, giving them too much time for grieving. Others are so busy that they need to create time to grieve. Respect your need for healing time and create opportunities to grieve.

Take Care of Your Health. Get adequate food and rest. If you are due for a physical or have postponed health screenings or follow-ups, make an appointment. Exercise can release a surprising amount of tension, anger and frustration.

Be Good to Yourself. Plan things you can look forward to. Create pleasant times with family and friends. Don’t feel guilty if you have a good time.

Be Patient with Yourself. Throw away notions of a fixed period for mourning. Grief takes time. Just remember that you will get better.

Will grief change family dynamics?

Death touches the very heart of a family. Routines change and family members take on different roles. Each member grieves differently, meaning some may temporarily withdraw into themselves, some may seek the comfort of others and some may appear unaffected. Anger, resentment, guilt and misunderstanding can create tension. So:

Try to be sensitive to feelings. Emotions can be difficult to verbalize.
Schedule time just for family.
Discuss your loved one’s former role in the family.
Recognize that anniversaries, birthdays and holidays can be difficult.
Consult family members on the disposition of the deceased person’s possessions.
Continue to give attention and time to your family members as you grieve for your deceased loved one.

How can you tell if you’re making progress?

This can be difficult to evaluate. Emotions, even intense ones, are not a sign of lack of progress. It may be helpful to use this list below to think about where you’ve been and where you have yet to go in your grief journey:

You have experienced a decline in physical symptoms or they occur less often.
You have times when you don’t think about your loss.
You can speak with less emotion about the person who died.
You don’t feel a need to be busy all the time.
You don’t feel as anxious or overwhelmed by new roles and responsibilities.
You are able to enjoy activities without feeling guilty or disloyal.
You are able to return to normal routines and set new goals.

It helps to have appropriate expectations and to remember that progress can be slow.

We hope you have found this information to be helpful in your journey through grief. If you need more information or have a question, please contact Grief Support Services at 816-363-2600.

We’re Always Saying Goodbye