Dennis Kane
Article #4
September 27, 2007

Dealing with Grief During Hospice Care

Grief can appear as the result of any major change from losing a job or divorce to receiving a terminal medical diagnosis. Having keys for dealing with grief can make the hospice experience less stressful for all involved.

Making It Through Grief
There are a number of keys to supporting yourself and those who are grieving to move as quickly as possible (or as quickly as they want to) through the stages of grief.

Make sure emotional needs are met. Possibly the most important thing in dealing with grief is making sure emotional needs are recognized and addressed. To be recognized, they must be expressed. Create for yourself and/or provide for others an emotional environment in which it is clear that expressing feelings is not only acceptable, but encouraged.

Make sure there are people who can act as a support group; people who are willing to listen and hold when grief is challenging you. If there are none among family or friends, consider contacting bereavement groups. These may be found through churches, mosques, and synagogues, community centers, hospitals, and some hospices.
Accept help. In most cases there will be friends and relatives who are offering help. Let them help. If there aren't people offering, then ask for help, even professional help if the grief is particularly painful.

Be kind to yourself and let those grieving know it’s important to be kind to themselves. Some days are going to be more difficult than others. Whether it's more difficult or not, do things you enjoy doing, just to take care of yourself.
Stay Healthy. This includes getting plenty of rest, for example. Especially when caring for someone in hospice it is important to make a conscientious effort to making sure physical needs are met.

On the other side of that coin, be aware of potential health problems. If energy stays low or other symptoms persist, it could be related to grief, or you may need some sort of help. Poor sleep, weight loss, low energy, can be signs of depression, which is a treatable condition. Contact your doctor and get advice if you experience prolonged grief or severe depression.

Getting Back On Track
At some point grieving will ease and you will begin to look at creating a normal life, either around the person in hospice or after the person has passed on. Start with short-term goals, reachable goals that allow a sense of accomplishment.

Sometimes making lists helps. Acknowledge yourself for the progress that you make. Though it may sound trite, the fact is it really works to take things one day at a time.

As you become more successful with your short-term goals, create longer-term goals. Look at ways to compensate or fill in the holes in your life the person you have lost had occupied as far as your daily routine. There is no way to replace them in your heart, and you wouldn’t want to do that anyway. However, your life will continue and it needs to have a balance of fun and fulfilling activities.

Take up a new hobby, go out with friends. Try new activities. Take a class, do some volunteer work, keep busy, keep active, keep your mind active.

There are sources of help if you need it including bereavement programs, counselors, and support groups. They're easy enough to find on the Internet and through your hospice.

Grieving to Completion
Some people feel that the end of the grief means it's an end to caring about the loved one who has passed. Of course that's not the case. People never stop caring and never stop missing someone they loved. You're just no longer dwelling on the loss, and that's healthy.

Summary
All of our past losses come up when we start to lose someone. Losing, or knowing we will soon lose someone evokes all of that. If you haven't worked through your losses in the past, then they become very immediate and compound your feelings of loss in the present. That's why it's important to work through feelings of loss, to grieve and to work through the grieving process, because if we do not, when loss comes again, as it inevitably will, it is compounded by what happened in the past.

The bottom line is that, for most people, whatever they—or you—are feeling is for the most part appropriate. And for dealing with your own grief or dealing with someone who is grieving, there is no definitive right or wrong way to do it as long as you're coming from your heart.

The best approach is to have a foundation of information like this, and then follow whatever your heart is telling you.

Dennis Kane has been a hospice nurse since the late 1908’s. In addition to his private duty hospice practice, he consults with hospice patients and their families and is a frequent speaker on hospice to health care professionals. This article was adapted from his report, How to Work through the Stages of Grief, which is available at www.hospiceathome.com.