This guide is written by clinical psychologists from Northumberland, Tyne & Wear NHS Trust. Used here with permission.
Coping with bereavement and grief
These are the experiences of three people who have suffered a bereavement.
“My
father died six weeks ago after an 18 month struggle with cancer. Now,
I can’t get the picture of him at his worst, pale, very thin and not
able to sit up, out of my mind. I wish I could remember him as he was
when he was well two years ago, but I can’t. I feel so guilty, I wish I
could have done more ...”
“After 45 years of marriage I lost my
wife six months ago, thankfully she only had a short period of illness
during which she never regained consciousness. I don’t seem to be able
to cope with it, I still keep expecting her to walk through the door. I
sometimes feel she is present during the night but always wake up
disappointed ...”
“My husband was killed in a car crash earlier
this year, and I am left on my own to bring up my two small children. I
feel so lonely and isolated, sleeping is a problem. At times I feel
angry with my husband for leaving me to cope on my own - even though I
know this is the last thing he would have wanted for us...”
As you can see people can have quite different experiences when they lose someone close to them. This guide aims to help you to understand some of the emotions which may be faced during a bereavement or loss, to make some practical suggestions which may help you to get through this difficult time and to offer some basic details of what needs to be done when
there is a death. At the end of the guide there are some addresses and
telephone numbers of organisations which may be helpful to you.
How do people feel when they have experienced bereavement?
Serious
loss is something which we will all face at some time in our lives.
This may be because of the death of someone close to us or it may be
because of other circumstances such as the loss of our health or our
home. Many of us will not experience bereavement or loss until later in
life and may have little opportunity to learn about death and about how
people are affectedby grief. It can seem difficult to know what is
“normal” and to understand how we or our families may respond when we
face a loss.
You may think you are the only person who has felt
the way you do. Whilst everyone’s response to a loss is a very
individual experience, there are some common experiences that many
people will share.
How do people feel in the early hours and days after the death of a close relative or friend?
People often describe shock soon after the death of such a person. They may feel numb, panicky, very weepy or unable to cry at all. Some people find it difficult to sleep, others may have many physical symptoms such
as heart palpitations. Some people find they calmly go through the
practical tasks surrounding the death, and worry that they may be seen
as uncaring. This is just one of the signs of shock and it is most
likely that they will feel the impact of the death at a later point.
Some people find themselves completely unable to cope and need a lot of
practical and emotional support from those around them at this point.
What sorts of feelings do people have weeks and months after a bereavement?
Some
people feel a sense of agitation for quite a long time after the death.
People may become very active at this time, doing things like cleaning
out the whole house. This agitation can sometimes amount to panic and
symptoms of anxiety such as breathlessness, palpitations, dry mouth,
tingling and dizziness can be present.
People may feel they are
“going mad” because they have such odd experiences. People often report
that they thought they saw, heard or felt the dead person near them or
in the distance. These experiences are not unusual following a death.
These feelings may alternate with depression, weepiness, tiredness and low mood.
People may think or wonder “what’s the point in going on?” They may feel guilt,
and review the circumstances of the death, and their relationship with
the person that has died. They may wonder what they could have done
differently which might have helped the situation. This is also common
when there has been relief at someone's death following a painful and
prolonged illness. It is worth remembering that many people feel relief
when suffering ends.
People also often do feel angry
after a death. This can be directed at the dead person “why has he left
me”? or at those around. Family members or people involved in caring
for the dying person, may be the target for the bereaved person's
anger. They might think or ask, “why didn't you do more?”
Other people’s reaction
may be difficult for the bereaved person. Sometimes people will be
clumsy in what they say or do. Occasionally, people will avoid contact
with the bereaved person. These reactions are usually because people do
not know what to do or say in the face of someone’s grief. Sometimes
other people do not realise that it can take a long time to begin to
recover from a death.
When do people begin to recover from a bereavement?
Coming to terms with a death is a very gradual process which
can take a considerable time. People usually find that gradually they
are able to get on with their lives and think a little less about the
person they have lost. Most people begin to feel like this within one
or two years of the death of someone close to them. It may be difficult
to accept the death of a loved one but possible to move on with life in
spite of this.
It is important not to feel guilty if you
are beginning to build a life for yourself following a death. It is
quite normal to begin to recover and start to rebuild your life, and is
not in any way disloyal to the memory of the person who has died.
Can tablets help?
Your doctor may offer you
tranquillisers to help you through the early phase following the death.
They can make you feel calmer and may help you in the short term but
are not helpful for longer term use. Some people find that the numbing
effect of tranquillisers does not allow them to experience grief during
this time.
Antidepressants can be helpful if the depression following bereavement becomes severe or prolonged.
What can a bereaved person do to help themselves?
Bereavement is always a difficult time but there are things you can do to help yourself through it. If you have the opportunity.
-
Prepare for the death of someone you are close to.
It is important emotionally and practically to talk things over. If you
are preparing for the death of your partner, discuss with them the jobs
your partner used to do, sort out finances. Say all the things you
would want to say.
- Carefully consider whether you want
to see the body of the dead person. Some people may feel this is too
distressing but can regret it later on if they have not done this.
Follow your own feelings. There is no right or wrong thing to do, but
do think it out.
- Funeral arrangements should be
considered carefully. Try to have someone with you. Don’t feel
pressured into a funeral that is too expensive for your budget. Try and
think about what you really want.
- Don’t make major changes in your life, such as selling your house, moving areas, jobs, etc, until you have had time to adjust to the death. This is a time when people may make changes they can regret.
- Do make sure you look after your own health.
This is a time when you may become prone to illness. Eat well, rest
properly, take extra care. You may want to take vitamin supplements if
your appetite is very poor.
-
Talk to people about
how you feel. Don’t bottle things up. Go to your doctor if you feel you
have no one you can talk to. He or she may suggest speaking to a
counsellor.
- If your health is not good, consult your doctor.
- Keep up contacts and relationships. Accept invitations, invite people to visit keep in touch with family and friends. Find out about local events/clubs/classes.
-
Ask for help if you feel you are not coping. Talk to family, friends or your doctor.
- Do not enter into new financial arrangements without proper advice. Talk to a friend or family member.
- Do not turn to drinking to get you over this difficult time.
- Plan
what you will do on anniversaries such as birthdays, Christmas,
anniversary of death. It will help if you decide in advance how you
want to spend these occasions which are likely to be emotional times.
- If you feel you are stuck or not coping at all well with your grief then contact your doctor to discuss this.
Other organisations which may help are listed at the end of this guide.
What can family and friends do to help?
Family and friends can help at this difficult time.
- Spend time with the bereaved person if that is what they want.
-
Talk and listen
to the bereaved person. Don’t be afraid of saying the wrong thing -
this is a situation many of us feel awkward about. It may help to admit
that you don’t know what to say if that is how you feel.
- Don’t be surprised if the bereaved person wants to talk and go over the same ground again and again, this is quite usual.
- Don’t take anger or irritability personally, it's part of the bereavement reaction.
- Talking
about the dead person can be helpful for the grieving person and don’t
try and avoid mentioning them in everyday conversation.
- Offer practical help if
the bereaved person wants this. Caring for children, help with shopping
etc may be useful, especially in the early days following a death.
-
Don’t expect too much of the bereaved person initially even if they look as if they are coping.
-
Include your relative in social events.
- Support your relative in building new links, social contact and interests.
- Try to discourage the bereaved person from making any major decisions, such as moving home, soon after the death. Support them in thinking through the options and implications of this.
- If your friend or relative seems ‘stuck‘ and not coping at all well, encourage them to seek help. The family doctor is a good place to start.
Other organisations that may help are listed at the end of this guide.
What practical things need to be done if there is a death?
- When
someone dies at home a doctor must be called to sign a medical
certificate. If the death has been sudden the doctor will have to talk
to the police who will report it to the coroner. A post mortem
examination may be arranged.
- When someone dies in hospital the doctor there will give you a medical certificate.
- Once you have the medical certificate you must take it to the register office and register the death
within five days. The registrar will issue a death certificate and
notification of disposal which should be given to the funeral director.
Make a few copies of the death certificate. You may need these for
pension and insurance purposes.
- A funeral director can
be chosen before or after you have registered the death. Most people
obtain a name from the telephone directory or by word of mouth. He or
she will advise on the procedures for the funeral.
- Contact your social security office
(local Benefits Agency) to arrange pension and other entitlements. You
may be eligible for funeral payment or widow's payment. (There are
guides to your entitlements available in the benefits agency.)
- Inform the tax office about your change in circumstances.
- You may want to put a death notice in the local or national papers.
- If there is a will the
executors will make sure it is carried out. Contact the solicitor. If
there is no will contact the Probate Registry for an application to
administer the ‘estate‘. Your local Citizens' Advice Bureau can help
you if you are not sure.
Useful organisations
Carers UK
32-36 Loman Street, Southwark, London, SE1 0EH
Tel (CarersLine): 0808 808 7777
Compassionate Friends (Support for parents following the death of a child at
any age)
53 North Street, Bristol, BS3 1EN
Tel. 0845 123 2304
CRUSE Breavement Care
PO Box 800, Richmond, Surrey, TW9 1RG
Tel (Helpline): 0844 477 9400
Foundation for the Study of Infant Deaths
Artillery House, 11-19 Artillery Row, London, SW1P 1RT
Tel. 0207 233 2090
Lesbian and Gay Bereavement Project
Tel: 0207 403 5969
(from 7pm Mon, Tue, Thurs)
Miscarriage Association
c/o Clayton Hospital, Northgate, Wakefield WF1 3JS
Tel: 01924 200 795 (24 hour answer phone)
Mind – Mental Health Charity
Tel: 0845 7660 163
Victim Support
VICTIM SUPPORT – is an
organization which offers support and practical help for people who
have experienced trauma. Details of their local offices can be obtained
from 0207 735 9166.
National Debt Line
Help for anyone in debt or concerned they may fall into debt.
Tel: 0808 808 4000 (freephone).
NHS Direct - Telephone Help line/Health Information Service.
Talk confidentially to a nurse or information officer.
Calls charged at local rate: Tel: 0845 4647
Samaritans
Linkline local rate Tel: 08457 90 90 90
Confidential support for anyone in a crisis
Terence Higgins Trust (Aids Charity)
52-54 Gray’s Inn Road, London WC1X 8JU
Tel: 0845 1221 200
Stillbirth and Neonatal Death Society
23 Portland Place, London, W1N 3DE.
Tel: 0207 436 5881
Suggested reading
What to do After a Death in England and Wales
A
guide to what you must do and the help you can get. Leaflet D49 April
2006, available from the Benefits Agency Department of Social Security.
What to do When Someone Dies
From Which? Castlemead, Gascoyne Way, Hertford SG14 1LH
Telephone: 01992 822800
Through Grief by Elizabeth Collick.
Published by Darton, Longman and Todd.
From Cruse Bereavement Care and from bookshops.
Also available on cassette (from Cruse only)
All in the End is Harvest edited by Agnes Whitaker.
Published by Cruse Bereavement Care.
Dying
By John Hinton. (Pelican)
Facing Grief - Bereavement and the Young Adult
by Susan Wallbank from Cruse
The Early Days of Grieving
By Derek Nuttall (Beaconsfield)
A Grief Observed
By C S Lewis (Faber)
© EMIS and PiP 2008 Updated: 23 May 2008
