Miller,+Grief

Okay, I changed my topic to grief. This is the perfect topic for the GW (Grieving Widow) in the class. As I explore grief, I hope I can find some gems for you to use with your students whom I hope never have to grieve while they are in your class.

The five most important things I learned from this wiki process are: 1. The term grief is used for more than just loss of a loved one; it's used for loss of a job, health, etc. Whereas, the term bereavement is specifically for death. 2. The Five Stages of Grief (denial, anger, bargaining, depression, acceptance) are a bunch of hooey. 3. Children need honesty when dealing with death and grief - no euphemisms, lies (Buffy, the dog, ran away.) 4. People who are severely depressed from grief were depressed before they experienced death of a loved one. Or they have a family history of depression. 5. Two years is a "Wrinkle in Time."

This is my five star choice; however, this is an hour long lecture. Probably only widows would be interested in listening to it. Dr. Zisook clarified my state of mind.

Sidney Zisook, MD. Department of Psychology, UCSD


 * Grief ** – can be loss of health, job, cognitive function, or loved one


 * Bereavement ** is specific to DEATH

// Grief is the price we pay for love; the only way we never experience grief is to not have attachments. //

San Diego Widowhood Study – 350 widow and widowers studied for two years

Low sixties, white, well-educated, middle-class

2/3 expected the death of their spouse

88% STILL GRIEVING – after two years

This study did not hold the truth that grief occurs in stages, anger, depression, guilt, etc. NOT TRUE in this study

Attenuated pain by – avoiding reminders (clothes, photos), others threw themselves into reminders, others drank or took medication – no one mechanism was healthier than the other except for drugs, of course.

Examples of Emotional Responses:

Yearning Crying Loneliness are common and decrease some with time but don’t go down as much as they should if there were so called "STAGES OF GRIEF" –

Two years later:

42% still yearn 70% still cry 75% are still lonely

Two Years is a “**//Wrinkle in Time”//** for someone who’s lost their life-long partner and best friend.

MEN - 61% of widowers were remarried after two years

Disease does increase after loss of a loved one.

Most people that get depressed were depressed prior to the death or have a family history of depression

Do’s
 * Directly express sympathy
 * Don’t pretend you know what bereaved went through
 * Inquire about circumstance of death
 * 3 H’s Hush, Hug, and Hang out

Don’ts Dr. Zisook's lecture: media type="youtube" key="Qyt56m_3tNM" height="315" width="420"
 * Be passive or casual about the death “You knew this was going to happen.”
 * Never imply it was for the best

The very first snippet of information I found was this piece from Scientific American. In this one minute podcast it basically says, "Stop with the counseling; holding it in is better." The University of Buffalo studied people who witnessed the tragedy of the Twin Towers on 9/11. People who held in their grief faired better. Rating 4 out of 5

http://www.scientificamerican.com/podcast/episode.cfm?id=6AEBB9CD-CB06-B40C-233869623A68680E

This site is a .com, so consider the source. However, I really liked to information especially "pet loss" which may be the grief your students experience most often. When my P.C. (named for Production Control the building my husband found her consumed with fleas and starving to death and brought her home our first year of marriage ) died, I experienced horrible grief. This cat was on my chest every morning waking me up with sweet kisses (forget about my husband). She was with us half our marriage, so I was a GW then as well. @http://www.recover-from-grief.com/7-stages-of-grief.html

This woman put in words how I felt when my husband died. Until you experience it, you have no idea the depth of pain. 5 out of 5 rating. @http://www.pbs.org/thisemotionallife/video/price-being-human

= Grief, Bereavement, and Coping With Loss (PDQ®) = Last Update: September 23, 2011.

Overview
People cope with the loss of a loved one in different ways. Most people who experience grief will cope well. Others will have severe grief and may need treatment. There are many things that can affect the grief process of someone who has lost a loved one to cancer. They include: This summary defines grief and bereavement and describes the different types of grief reactions, treatments for grief, important issues for grieving children, and cultural responses to grief and loss. It is intended as a resource to help caregivers of cancer patients.
 * The personality of the person who is grieving.
 * The relationship with the person who died.
 * The loved one's cancer experience and the way the disease progressed.
 * The grieving person’s coping skills and mental health history.
 * The amount of support the grieving person has.
 * The grieving person’s cultural and religious background.
 * The grieving person’s social and financial position.

Bereavement is the period of sadness after losing a loved one through death.
Grief and mourning occur during the period of bereavement. Grief and mourning are closely related. Mourning is the way we show grief in public. The way people mourn is affected by beliefs, religious practices, and cultural customs. People who are grieving are sometimes described as bereaved.

Grief is the normal process of reacting to the loss.
Grief is the emotional response to the loss of a loved one. Common grief reactions include the following:
 * Feeling emotionally numb.
 * Feeling unable to believe the loss occurred.
 * Feeling anxiety from the distress of being separated from the loved one.
 * Mourning along with depression.
 * A feeling of acceptance.

Key Points for This Section

 * [|Anticipatory Grief]
 * [|Normal Grief]
 * [|Complicated Grief]

Anticipatory grief may occur when a death is expected.
Anticipatory grief occurs when a death is expected, but before it happens. It may be felt by the families of people who are dying and by the person dying. Anticipatory grief helps family members get ready emotionally for the loss. It can be a time to take care of unfinished business with the dying person, such as saying “I love you” or “I forgive you.” Like grief that occurs after the death of a loved one, anticipatory grief involves mental, emotional, cultural, and social responses. However, anticipatory grief is different from grief that occurs after the death. Symptoms of anticipatory grief include the following:
 * Depression.
 * Feeling a greater than usual concern for the dying person.
 * Imagining what the loved one's death will be like.
 * Getting ready emotionally for what will happen after the death.

Anticipatory grief may help the family but not the dying person.
Anticipatory grief helps family members cope with what is to come. For the patient who is dying, anticipatory grief may be too much to handle and may cause him or her to withdraw from others.

Anticipatory grief does not always occur.
Some researchers report that anticipatory grief is rare. Studies showed that periods of acceptance and recovery usually seen during grief are not common before the patient’s actual death. The bereaved may feel that trying to accept the loss of a loved one before death occurs may make it seem that the dying patient has been abandoned. Also, grief felt before the death will not decrease the grief felt afterwards or make it last a shorter time.

Normal or common grief begins soon after a loss and symptoms go away over time.
During normal grief, the bereaved person moves toward accepting the loss and is able to continue normal day-to-day life even though it is hard to do. Common grief reactions include: In normal grief, symptoms will occur less often and will feel less severe as time passes. Recovery does not happen in a set period of time. For most bereaved people having normal grief, symptoms lessen between 6 months and 2 years after the loss.
 * Emotional numbness, shock, disbelief, or denial. These often occur right after the death, especially if the death was not expected.
 * Anxiety over being separated from the loved one. The bereaved may wish to bring the person back and become lost in thoughts of the deceased. Images of death may occur often in the person’s everyday thoughts.
 * Distress that leads to crying; sighing; having dreams, illusions, and hallucinations of the deceased; and looking for places or things that were shared with the deceased.
 * Anger.
 * Periods of sadness, loss of sleep, loss of appetite, extreme tiredness, guilt, and loss of interest in life. Day-to-day living may be affected.

Many bereaved people will have grief bursts or pangs.
Grief bursts or pangs are short periods (20-30 minutes) of very intense distress. Sometimes these bursts are caused by reminders of the deceased person. At other times they seem to happen for no reason.

Grief is sometimes described as a process that has stages.
There are several theories about how the normal grief process works. Experts have described different types and numbers of stages that people go through as they cope with loss. At this time, there is not enough information to prove that one of these theories is more correct than the others. Although many bereaved people have similar responses as they cope with their losses, there is no typical grief response. The grief process is personal.

Complicated Grief
There is no right or wrong way to grieve, but studies have shown that there are patterns of grief that are different from the most common. This has been called complicated grief.Complicated grief reactions that have been seen in studies include:
 * Minimal grief reaction: A grief pattern in which the person has no, or only a few, signs of distress or problems that occur with other types of grief.
 * Chronic grief: A grief pattern in which the symptoms of common grief last for a much longer time than usual. These symptoms are a lot like ones that occur with major depression, anxiety, or post-traumatic stress.

Key Points for This Section

 * [|Researchers study grief reactions to try to find out what might increase the chance that complicated grief will occur.]
 * [|Studies have looked at how the following factors affect the grief response:]

Whether the death is expected or unexpected.
It may seem that any sudden, unexpected loss might lead to more difficult grief. However, studies have found that bereaved people with high self-esteem and/or a feeling that they have control over life are likely to have a normal grief reaction even after an unexpected loss. Bereaved people with low self-esteem and/or a sense that life cannot be controlled are more likely to have complicated grief after an unexpected loss. This includes more depression and physical problems.

The personality of the bereaved.
Studies have found that people with certain personality traits are more likely to have long-lasting depression after a loss. These include people who are very dependent on the loved one (such as a spouse), and people who deal with distress by thinking about it all the time.

The religious beliefs of the bereaved.
Some studies have shown that religion helps people cope better with grief. Other studies have shown it does not help or causes more distress. Religion seems to help people who go to church often. The positive effect on grief may be because church-goers have more social support.

Whether the bereaved is male or female.
In general, men have more problems than women do after a spouse’s death. Men tend to have worse depression and more health problems than women do after the loss. Some researchers think this may be because men have less social support after a loss.

The age of the bereaved.
In general, younger bereaved people have more problems after a loss than older bereaved people do. They have more severe health problems, grief symptoms, and other mental and physical symptoms. Younger bereaved people, however, may recover more quickly than older bereaved people do, because they have more resources and social support.

The amount of social support the bereaved has.
Lack of social support increases the chance of having problems coping with a loss. Social support includes the person's family, friends, neighbors, and community members who can give psychological, physical, and financial help. After the death of a close family member, many people have a number of related losses. The death of a spouse, for example, may cause a loss of income and changes in lifestyle and day-to-day living. These are all related to social support.

Treatment of Grief
[|Go to:]
 * [|Top▲]

Key Points for This Section
[|Go to:]
 * [|Normal grief may not need to be treated.]
 * [|Complicated grief may be treated with different types of psychotherapy (talk therapy).]
 * [|Depression related to grief is sometimes treated with drugs.]
 * == Children and Grief ==
 * [|Top▲]

Key Points for This Section
This link is five star. It does a wonderful job of letting you know the right words to say for example "died" instead of the euphemism "passed away." If you can only read one and you're teaching in the K-12, I recommend this link.
 * [|A child's grief process is different from an adult's.]
 * [|Several factors can affect how a child will cope with grief.]
 * [|Children at different stages of development have different understandings of death and the events near death.]
 * [|Most children who have had a loss have three common worries about death.]
 * [|Talking honestly about the death and including the child in rituals may help the grieving child.]
 * [|There are books and other resources with information on helping a grieving child.]

A child's grief process is different from an adult's.
Children do not react to loss in the same ways as adults. These are some of the ways children's grief is different:
 * Children may seem to show grief only once in a while and for short times. This may be because a child is not able to feel strong emotions for long periods of time. A grieving child may be sad one minute and playful the next. Often families think the child doesn’t really understand the loss or has gotten over it quickly. Usually, neither is true. Children’s minds protect them from what is too much for them to handle emotionally.
 * Mourning is a process that continues over years in children. Feelings of loss may occur again and again as the child gets older. This is common at important times, such as going to camp, graduating from school, getting married, or having children.
 * Grieving children may not show their feelings as openly as adults. Grieving children may throw themselves into activities instead of withdrawing or showing grief.
 * Children cannot think through their thoughts and feelings like adults. Children have trouble putting their feelings about grief into words. Strong feelings of anger and fears of death or being left alone may show up in the behavior of grieving children. Children often play death games as a way of working out their feelings and worries. These games give children a safe way to express their feelings.
 * Grieving adults may withdraw and not talk to other people about the loss. Children, however, often talk to the people around them (even strangers) to see how they react and to get clues for how they should respond to the loss.
 * Children may ask confusing questions. For example, a child may ask, "I know grandpa died, but when will he come home?" This is a way of testing reality and making sure the story of the death has not changed.

Several factors can affect how a child will cope with grief.
Although grief is different for each child, several factors can affect the grief process of a child:
 * The child's age and stage of development.
 * The child's personality.
 * The child's previous experiences with death.
 * The child's relationship with the deceased.
 * The cause of death.
 * The way the child acts and communicates within the family.
 * How stable the family life is after the loss.
 * How the child continues to be cared for.
 * Whether the child is given the chance to share and express feelings and memories.
 * How the parents cope with stress.
 * Whether the child has ongoing relationships with other adults.

Children at different stages of development have different understandings of death and the events near death.
> === Grief and Developmental Stages === > === Most children who have had a loss have three common worries about death. === Children coping with a loss often have these three questions: > ==== Did I make the death happen? ==== Children often think that they have "magical powers". If a mother is irritated and says, "You’ll be the death of me" and later dies, her child may wonder if he or she actually caused the mother’s death. Also, when children argue, one may say (or think), "I wish you were dead." If that child dies, the surviving child may think that those thoughts caused the death. > ==== Is it going to happen to me? ==== The death of another child may be very hard for a child. If the child thinks that the death may have been prevented (by either a parent or a doctor) the child may fear that he or she could also die. > ==== Who is going to take care of me? ==== Since children depend on parents and other adults to take care of them, a grieving child may wonder who will care for him or her after the death of an important person. > === Talking honestly about the death and including the child in rituals may help the grieving child. ===
 * ~ Age ||~ Understanding of Death ||~ Expressions of Grief ||
 * Infancy to 2 years || Is not yet able to understand death. || Quietness, crankiness, decreased activity, poor sleep, and weight loss. ||
 * ^  || Separation from mother causes changes. ||^   ||
 * 2-6 years || Death is like sleeping. || Asks many questions (How does she go to the bathroom? How does she eat?). ||
 * ^  ||^   || Problems in eating, sleeping, and bladder and bowel control. ||
 * ^  ||^   || Fear of being abandoned. ||
 * ^  ||^   || Tantrums. ||
 * ^  || Dead person continues to live and function in some ways. || "Magical thinking" (Did I think or do something that caused the death? Like when I said I hate you and I wish you would die?). ||
 * ^  || Death is not final. ||^   ||
 * ^  || Dead person can come back to life. ||^   ||
 * 6-9 years || Death is thought of as a person or spirit (skeleton, ghost, bogeyman). || Curious about death. ||
 * ^  ||^   || Asks specific questions. ||
 * ^  ||^   || May have fears about school. ||
 * ^  || Death is final and scary. || May have aggressive behavior (especially boys). ||
 * ^  ||^   || Worries about imaginary illnesses. ||
 * ^  || Death happens to others, it won’t happen to me. || May feel abandoned. ||
 * 9 and older || Everyone will die. || Strong emotions, guilt, anger, shame. ||
 * ^  ||^   || Increased anxiety over own death. ||
 * ^  ||^   || Mood swings. ||
 * ^  || Death is final. || Fear of rejection; not wanting to be different from peers. ||
 * ^  || Even I will die. || Changes in eating habits. ||
 * ^  ||^   || Sleeping problems. ||
 * ^  ||^   || Regressive behavior (loss of interest in outside activities). ||
 * ^  ||^   || Impulsive behavior. ||
 * ^  ||^   || Feels guilty about being alive (especially related to death of a brother, sister, or peer). ||

Explain the death and answer questions.
Talking about death helps children learn to cope with loss. When talking about death with children, describe it simply. Each child should be told the truth using as much detail as he or she is able to understand. Answer questions in language the child can understand. > Children often worry that they will also die, or that their surviving parent will go away. They need to be told that they will be safe and taken care of. > ==== Use the correct language. ==== When talking with the child about death, include the correct words, such as "cancer," "died," and "death." Using other words or phrases (for example, “he passed away,” “he is sleeping,” or “we lost him”) can confuse children and cause them to misunderstand. > ==== Include the child in planning and attending memorial ceremonies. ==== When a death occurs, children may feel better if they are included in planning and attending memorial ceremonies. These events help children remember the loved one. Children should not be forced to be involved in these ceremonies, but encourage them to take part when they feel comfortable doing so. Before a child attends a funeral, wake, or memorial service, give the child a full explanation of what to expect. A familiar adult or family member may help with this if the surviving parent's grief makes him or her unable to. > === There are books and other resources with information on helping a grieving child. === The following books and videos may be helpful with grieving children:
 * 1) Worden JW: **Children and Grief: When a Parent Dies**. New York, NY: The Guilford Press, 1996.
 * 2) Doka KJ, ed.: **Children Mourning, Mourning Children**. Washington, DC: Hospice Foundation of America, 1995.
 * 3) Wass H, Corr CA: **Childhood and Death**. Washington, DC: Hemisphere Publishing Corporation, 1984.
 * 4) Corr CA, McNeil JN: **Adolescence and Death**. New York, NY: Springer Publishing Company, 1986.
 * 5) Corr CA, Nabe CM, Corr DM: **Death and Dying, Life and Living**. 2nd ed., Pacific Grove: Brooks/Cole Publishing Company, 1997.
 * 6) Grollman EA: **Talking About Death: A Dialogue Between Parent and Child**. 3rd ed., Boston, MA: Beacon Press, 1990.
 * 7) Schaefer D, Lyons C: **How Do We Tell the Children? Helping Children Understand and Cope When Someone Dies**. New York, NY: Newmarket Press, 1988.
 * 8) Wolfelt A: **Helping Children Cope with Grief**. Muncie: Accelerated Development, 1983.
 * 9) Walker A: **To Hell with Dying**. San Diego, CA: Harcourt Brace Jovanovich, 1988.
 * 10) Williams M: **Velveteen Rabbit**. Garden City: Doubleday, 1922.
 * 11) Viorst J: **The Tenth Good Thing About Barney**. New York, NY: Atheneum, 1971.
 * 12) Tiffault BW: **A Quilt for Elizabeth**. Omaha, NE: Centering Corporation, 1992.
 * 13) Levine JR: **Forever in My Heart: a Story to Help Children Participate in Life as a Parent Dies**. Burnsville, NC: Mountain Rainbow Publications, 1992.
 * 14) Knoderer K: **Memory Book: a Special Way to Remember Someone You Love**. Warminster, PA: Mar-Co Products, 1995.
 * 15) de Paola T: **Nana Upstairs and Nana Downstairs**. New York, NY: GP Putnam’s Sons, 1973.

More information 4 out of 5
 * ||  || [[image:http://helpguide.org/images/global/header.jpg width="870" height="79" caption="Helpguide"]] ||

=Coping with Grief and Loss=

Understanding the Grieving Process
|||| ||

What is grief?
Grief is a natural response to loss. It’s the emotional suffering you feel when something or someone you love is taken away. You may associate grief with the death of a loved one – and this type of loss does often cause the most intense grief. But any loss can cause grief, including: The more significant the loss, the more intense the grief. However, even subtle losses can lead to grief. For example, you might experience grief after moving away from home, graduating from college, changing jobs, selling your family home, or retiring from a career you loved.
 * * A relationship breakup
 * Loss of health
 * Losing a job
 * Loss of financial stability
 * A miscarriage || * Death of a pet
 * Loss of a cherished dream
 * A loved one’s serious illness
 * Loss of a friendship
 * Loss of safety after a trauma ||

Everyone grieves differently
Grieving is a personal and highly individual experience. How you grieve depends on many factors, including your personality and coping style, your life experience, your faith, and the nature of the loss. The grieving process takes time. Healing happens gradually; it can’t be forced or hurried – and **there is no “normal” timetable for grieving.** Some people start to feel better in weeks or months. For others, the grieving process is measured in years. Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.

Myths and Facts About Grief
Source: //Center for Grief and Healing//
 * MYTH: The pain will go away faster if you ignore it.**
 * Fact:** Trying to ignore your pain or keep it from surfacing will only make it worse in the long run. For real healing it is necessary to face your grief and actively deal with it.
 * MYTH: It’s important to be “be strong” in the face of loss.**
 * Fact:** Feeling sad, frightened, or lonely is a normal reaction to loss. Crying doesn’t mean you are weak. You don’t need to “protect” your family or friends by putting on a brave front. Showing your true feelings can help them and you.
 * MYTH: If you don’t cry, it means you aren’t sorry about the loss.**
 * Fact:** Crying is a normal response to sadness, but it’s not the only one. Those who don’t cry may feel the pain just as deeply as others. They may simply have other ways of showing it.
 * MYTH: Grief should last about a year.**
 * Fact:** There is no right or wrong time frame for grieving. How long it takes can differ from person to person.

Are there stages of grief?
In 1969, psychiatrist Elisabeth Kübler-Ross introduced what became known as the “five stages of grief.” These stages of grief were based on her studies of the feelings of patients facing terminal illness, but many people have generalized them to other types of negative life changes and losses, such as the death of a loved one or a break-up.

The five stages of grief:
If you are experiencing any of these emotions following a loss, it may help to know that your reaction is natural and that you’ll heal in time. However, not everyone who is grieving goes through all of these stages – and that’s okay. Contrary to popular belief, **you do not have to go through each stage in order to heal.** In fact, some people resolve their grief without going through //any// of these stages. And if you do go through these stages of grief, you probably won’t experience them in a neat, sequential order, so don’t worry about what you “should” be feeling or which stage you’re supposed to be in. Kübler-Ross herself never intended for these stages to be a rigid framework that applies to everyone who mourns. In her last book before her death in 2004, she said of the five stages of grief, “They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but **there is not a typical response to loss, as there is no typical loss.** Our grieving is as individual as our lives.”
 * **Denial:** “This can’t be happening to me.”
 * **Anger:** “//Why// is this happening? Who is to blame?”
 * **Bargaining:** “Make this not happen, and in return I will .”
 * **Depression:** “I’m too sad to do anything.”
 * **Acceptance:** “I’m at peace with what happened.”

Grief can be a roller coaster
Instead of a series of stages, we might also think of the grieving process as a roller coaster, full of ups and downs, highs and lows. Like many roller coasters, the ride tends to be rougher in the beginning, the lows may be deeper and longer. The difficult periods should become less intense and shorter as time goes by, but it takes time to work through a loss. Even years after a loss, especially at special events such as a family wedding or the birth of a child, we may still experience a strong sense of grief. Source: //Hospice Foundation of America//

Common symptoms of grief
While loss affects people in different ways, many people experience the following symptoms when they’re grieving. Just remember that almost anything that you experience in the early stages of grief is normal – including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious beliefs.
 * **Shock and disbelief** – Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened, or even deny the truth. If someone you love has died, you may keep expecting them to show up, even though you know they’re gone.
 * **Sadness** – Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning, or deep loneliness. You may also cry a lot or feel emotionally unstable.
 * **Guilt** – You may regret or feel guilty about things you did or didn’t say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.
 * **Anger** – Even if the loss was nobody’s fault, you may feel angry and resentful. If you lost a loved one, you may be angry at yourself, God, the doctors, or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you.
 * **Fear** – A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks. The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.
 * **Physical symptoms** – We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

Coping with grief and loss tip 1: Get support
The single most important factor in healing from loss is having the support of other people. Even if you aren’t comfortable talking about your feelings under normal circumstances, it’s important to express them when you’re grieving. Sharing your loss makes the burden of grief easier to carry. Wherever the support comes from, accept it and **do not grieve alone.** Connecting to others will help you heal.

Finding support after a loss

 * **Turn to friends and family members** – Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient. Draw loved ones close, rather than avoiding them, and accept the assistance that’s offered. Oftentimes, people want to help but don’t know how, so tell them what you need – whether it’s a shoulder to cry on or help with funeral arrangements.
 * **Draw comfort from your faith** – If you follow a religious tradition, embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you – such as praying, meditating, or going to church – can offer solace. If you’re questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community.
 * **Join a support group** – Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help. To find a bereavement support group in your area, contact local hospitals, hospices, funeral homes, and counseling centers.
 * **Talk to a therapist or grief counselor** – If your grief feels like too much to bear, call a mental health professional with experience in grief counseling. An experienced therapist can help you work through intense emotions and overcome obstacles to your grieving.

Coping with grief and loss tip 2: Take care of yourself
Helpguide's //Bring Your Life into Balance// mindfulness toolkit can help. When you’re grieving, it’s more important than ever to take care of yourself. The stress of a major loss can quickly deplete your energy and emotional reserves. Looking after your physical and emotional needs will help you get through this difficult time.
 * **Face your feelings.** You can try to suppress your grief, but you can’t avoid it forever. In order to heal, you have to acknowledge the pain. Trying to avoid feelings of sadness and loss only prolongs the grieving process. Unresolved grief can also lead to complications such as depression, anxiety, substance abuse, and health problems.
 * **Express your feelings in a tangible or creative way.** Write about your loss in a journal. If you’ve lost a loved one, write a letter saying the things you never got to say; make a scrapbook or photo album celebrating the person’s life; or get involved in a cause or organization that was important to him or her.
 * **Look after your physical health**. The mind and body are connected. When you feel good physically, you’ll also feel better emotionally. Combat stress and fatigue by getting enough sleep, eating right, and exercising. Don’t use alcohol or drugs to numb the pain of grief or lift your mood artificially.
 * **Don’t let anyone tell you how to feel, and don’t tell yourself how to feel either.** Your grief is your own, and no one else can tell you when it’s time to “move on” or “get over it.” Let yourself feel whatever you feel without embarrassment or judgment. It’s okay to be angry, to yell at the heavens, to cry or not to cry. It’s also okay to laugh, to find moments of joy, and to let go when you’re ready.
 * **Plan ahead for grief “triggers.”** Anniversaries, holidays, and milestones can reawaken memories and feelings. Be prepared for an emotional wallop, and know that it’s completely normal. If you’re sharing a holiday or lifecycle event with other relatives, talk to them ahead of time about their expectations and agree on strategies to honor the person you loved.

When grief doesn’t go away
It’s normal to feel sad, numb, or angry following a loss. But as time passes, these emotions should become less intense as you accept the loss and start to move forward. If you aren’t feeling better over time, or your grief is getting worse, it may be a sign that your grief has developed into a more serious problem, such as complicated grief or major depression.

Complicated grief
The sadness of losing someone you love never goes away completely, but it shouldn’t remain center stage. If the pain of the loss is so constant and severe that it keeps you from resuming your life, you may be suffering from a condition known as //complicated grief//. Complicated grief is like being stuck in an intense state of mourning. You may have trouble accepting the death long after it has occurred or be so preoccupied with the person who died that it disrupts your daily routine and undermines your other relationships. Symptoms of complicated grief include:
 * * Intense longing and yearning for the deceased
 * Intrusive thoughts or images of your loved one
 * Denial of the death or sense of disbelief
 * Imagining that your loved one is alive || * Searching for the person in familiar places
 * Avoiding things that remind you of your loved one
 * Extreme anger or bitterness over the loss
 * Feeling that life is empty or meaningless ||

The difference between grief and depression
Distinguishing between grief and clinical depression isn’t always easy, since they share many symptoms. However, there are ways to tell the difference. Remember, grief can be a roller coaster. It involves a wide variety of emotions and a mix of good and bad days. Even when you’re in the middle of the grieving process, you will have moments of pleasure or happiness. With depression, on the other hand, the feelings of emptiness and despair are constant. Other symptoms that suggest depression, not just grief:
 * * Intense, pervasive sense of guilt.
 * Thoughts of suicide or a preoccupation with dying.
 * Feelings of hopelessness or worthlessness. || * Slow speech and body movements
 * Inability to function at work, home, and/or school.
 * Seeing or hearing things that aren’t there. ||

Can antidepressants help grief?
As a general rule, normal grief does not warrant the use of antidepressants. While medication may relieve some of the symptoms of grief, it cannot treat the cause, which is the loss itself. Furthermore, by numbing the pain that must be worked through eventually, antidepressants delay the mourning process.

When to seek professional help for grief
If you recognize any of the above symptoms of complicated grief or clinical depression, talk to a mental health professional right away. Left untreated, complicated grief and depression can lead to significant emotional damage, life-threatening health problems, and even suicide. But treatment can help you get better. Contact a grief counselor or professional therapist if you:
 * Feel like life isn’t worth living
 * Wish you had died with your loved one
 * Blame yourself for the loss or for failing to prevent it
 * Feel numb and disconnected from others for more than a few weeks
 * Are having difficulty trusting others since your loss
 * Are unable to perform your normal daily activities

=Coping with Pet Loss=

Grieving the Death of a Dog or Cat
Pets enrich our lives and provide us with companionship, emotional support, and unconditional love. Given the intense bond most of us share with our animals, it’s natural to feel devastated by feelings of grief and sadness when a pet dies. You may also feel shocked, confused, angry, or have trouble sleeping or difficulty focusing. While there is no right or wrong way to grieve, there are healthy ways to cope with the pain. Some people may not understand the depth of feeling you had for your pet, but you should never feel guilty or ashamed about grieving for an animal friend. The key to coping is to accept your feelings and embrace the emotions you feel.

In This Article:
[|Authors] Text Size
 * [|Grief after pet loss]
 * [|Tips for coping with pet loss]
 * [|Helping a child cope with pet loss]
 * [|Putting a pet to sleep]
 * [|Getting another dog or cat]
 * [|Related articles & references]

Understanding grief after the loss of a pet
For many people a pet is not “just a dog” or “just a cat.” He or she is a beloved member of the family and, when they die, you feel a significant, even traumatic loss. The level of grief depends on factors such as your age and personality, the age of your pet, and the circumstances of their death. Generally, the more significant the loss, the more intense the grief you’ll feel. Grief can be complicated by the role the animal played in your life. For example, if your pet was a working dog or a helper animal such as a guide dog, then you’ll not only be grieving the loss of a companion but also the loss of a coworker or the loss of your independence. If you cared for your pet through a protracted illness, you likely grew to love him even more. If you lived alone and the pet was your only companion, coming to terms with his loss can be even harder. If you were unable to afford expensive veterinary treatment to prolong the life of your pet, you may even feel a profound sense of guilt.

Everyone grieves differently
Grieving is a personal and highly individual experience. Some people find grief comes in stages, where they experience different feelings such as denial, anger, guilt, depression, and eventually acceptance and resolution. Others find that grief is more cyclical, coming in waves, or a series of highs and lows. The lows are likely to be deeper and longer at the beginning and then gradually become shorter and less intense as time goes by. Still, even years after a loss, a sight, a sound, or a special anniversary can spark memories that trigger a strong sense of grief.
 * **The grieving process happens only gradually**. It can’t be forced or hurried—and there is no “normal” timetable for grieving. Some people start to feel better in weeks or months. For others, the grieving process is measured in years. Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.
 * **Feeling sad, frightened, or lonely is a normal reaction to the loss of a beloved pet**. Exhibiting these feelings doesn’t mean you are weak, so you shouldn’t feel ashamed.
 * **Trying to ignore your pain or keep it from surfacing will only make it worse in the long run**. For real healing, it is necessary to face your grief and actively deal with it. By expressing your grief, you’ll likely need less time to heal than if you withhold or “bottle up” your feelings. Write about your feelings and talk with others about them.

Dealing with the loss of a pet when others devalue your loss
One aspect that can make grieving for the loss of a pet so difficult is that pet loss is not appreciated by everyone. Friends and family may ask “What’s the big deal? It’s just a pet!” Some people assume that pet loss shouldn’t hurt as much as human loss, or that it is somehow inappropriate to grieve for an animal. They may not understand because they don’t have a pet of their own, or because they are unable to appreciate the companionship and love that a pet can provide.
 * Don’t argue with others about whether your grief is appropriate or not.
 * Accept the fact that the best support for your grief may come from outside your usual circle of friends and family members.
 * Seek out others who have lost pets; those who can appreciate the magnitude of your loss, and may be able to suggest ways of getting through the grieving process.

Tips for coping with the grief of pet loss
Sorrow and grief are normal and natural responses to death. Like grief for humans, grief for animal companions can only be dealt with over time, but there are healthy ways to cope with the pain. Here are some suggestions:
 * **Don’t let anyone tell you how to feel**, and don’t tell yourself how to feel either. Your grief is your own, and no one else can tell you when it’s time to “move on” or “get over it.” Let yourself feel whatever you feel without embarrassment or judgment. It’s okay to be angry, to cry or not to cry. It’s also okay to laugh, to find moments of joy, and to let go when you’re ready.
 * **Reach out to others who have lost pets**. Check out online message boards, pet loss hotlines, and pet loss support groups. If your own friends, family members, therapist, or clergy do not work well with the grief of pet loss, find someone who does.
 * **Rituals can help healing**. A funeral can help you and your family members openly express your feelings. Ignore people who think it’s inappropriate to hold a funeral for a pet, and do what feels right for you.
 * **Create a legacy**. Preparing a memorial, planting a tree in memory of your pet, compiling a photo album or scrapbook, or otherwise sharing the memories you enjoyed with your pet, can create a legacy to celebrate the life of your animal companion.
 * **Look after yourself**. The stress of losing a pet can quickly deplete your energy and emotional reserves. Looking after your physical and emotional needs will help you get through this difficult time. Eat a healthy diet, get plenty of sleep, and exercise regularly to release endorphins and help boost your mood.
 * **If you have other pets, try to maintain your normal routine**. Surviving pets can also experience loss when a pet dies, or they may become distressed by your sorrow. Maintaining their daily routines, or even increasing exercise and play times, will not only benefit the surviving pets but may also help to elevate your outlook too.

Tips for seniors to cope with pet loss
As we age, we experience an increasing number of major life changes, including the loss of beloved friends, family members, and pets. The death of a pet can hit retired seniors even harder than younger adults who may be able to draw on the comfort of a close family, or distract themselves with the routine of work. For older adults who live alone, the pet was probably your sole companion, and taking care of the animal provided you with a sense of purpose and self-worth.
 * **Try to find new meaning and joy in life**. Caring for a pet previously occupied your time and boosted your morale and optimism. Try to fill that time by volunteering, picking up a long-neglected hobby, taking a class, helping friends care for their pets, or even by getting another pet when the time feels right.
 * **Stay connected with friends**. Pets, dogs especially, can help seniors meet new people or regularly connect with friends and neighbors while out on a walk or in the dog park, for example. Having lost your pet, it’s important that you don’t now spend day after day alone. Try to spend time with at least one person every day. Regular face-to-face contact can help you ward off depression and stay positive. Call up an old friend or neighbor for a lunch date or join a club.
 * **Boost your vitality with exercise**. Pets help many older adults stay active and playful, which can boost your immune system and increase your energy. It’s important to keep up your activity levels after the loss of your pet. Check with your doctor before starting an exercise program and then find an activity that you enjoy. Exercising in a group—by playing a sport such as tennis or golf, or taking an exercise or swimming class—can also help you connect with others.

Helping a child cope with pet loss
The loss of a pet may be your child’s first experience of death—and your first opportunity to teach them about coping with the grief and pain that inevitably accompanies the joy of loving another living creature. Losing a pet can be a traumatic experience for any child. Many kids love their pets very deeply and some may not even remember a time in their life when the pet wasn’t around. A child may feel angry and blame themselves—or you—for the pet’s death. A child may feel scared that other people or animals they love may also leave them. How you handle the grieving process can determine whether the experience has a positive or negative effect on your child’s personal development. Some parents feel they should try to shield their children from the sadness of losing a pet by either not talking about the pet’s death, or by not being honest about what’s happened. Pretending the animal ran away, or “went to sleep,” for example, can leave a child feeling even more confused, frightened, and betrayed when they finally learn the truth. It’s far better to be honest with children and allow them the opportunity to grieve in their own way.

Tips for a helping a child cope with the loss of a pet

 * **Let your child see you express your own grief at the loss of the pet**. If you don’t experience the same sense of loss as your child, respect their grief and let them express their feelings openly, without making them feel ashamed or guilty. Children should feel proud that they have so much compassion and care deeply about their animal companions.
 * **Reassure your child** that they weren’t responsible for the pet’s death. The death of a pet can raise a lot of questions and fears in a child. You may need to reassure your child that you, their parents, are not also likely to die. It’s important to talk about all their feelings and concerns.
 * **Involve your child in the dying process**. If you’ve chosen euthanasia for your pet, be honest with your child. Explain why the choice is necessary and give the child chance to spend some special time with the pet and say goodbye in his or her own way.
 * **If possible, give the child an opportunity to create a memento of the pet**. This could be a special photograph, or a plaster cast of the animal’s paw print, for example.
 * **Allow the child to be involved in any memorial service**, if they desire. Holding a funeral or creating a memorial for the pet can help your child express their feelings openly and help process the loss.
 * **Do not rush out to get the child a “replacement pet”** before they have had chance to grieve the loss they feel. Your child may feel disloyal, or you could send the message that the grief and sadness felt when something dies can simply be overcome by buying a replacement.

Making the decision to put a pet to sleep
A decision concerning euthanasia may be one of the most difficult decisions you will ever have to make for your pet. As a loving pet owner, though, the time may come when you need to help your pet make the transition from life to death, with the help of your veterinarian, in as painless and peaceful a way as possible.

Knowing when it’s time to put a pet to sleep
Euthanasia for a beloved pet is highly personal decision and usually comes after a diagnosis of a terminal illness and with the knowledge that the animal is suffering seriously. Your choices for your pet should be informed by the care and love you feel for the animal. Important things to consider include: If you do decide that ending the suffering is in your pet’s best interest, take your time to create a process that is as peaceful as possible for you, your pet, and your family. You may want to have a last day at home with the pet in order to say goodbye, or to visit the pet at the animal hospital. You can also choose to be present during your pet’s euthanasia, or to say goodbye beforehand and remain in the veterinary waiting room or at home. This is an individual decision for each member of the family.
 * **Activity level.** Does your pet still enjoy previously loved activities or is he/she able to be active at all?
 * **Response to care and affection.** Does your pet still interact and respond to love and care in the usual ways?
 * **Amount of pain and suffering.** Is your pet experiencing pain and suffering which outweigh any pleasure and enjoyment in life?
 * **Terminal illness or critical injury.** Have illness or injury prohibited your pet from enjoying life? Is your pet facing certain death from the injury or illness?
 * **Your family’s feelings**. Is your family unanimous in the decision? If not, and you still feel it is the best thing for your pet, can you live with the decision that you have to make?

What to expect when putting your dog or cat to sleep
According to the American Veterinary Medical Association, euthanasia for a pet is most often achieved by injection of a death-inducing drug. The veterinarian may administer a tranquilizer first to relax your pet. Following the injection of the euthanasia drug, your pet will immediately become unconscious. Death is quick and painless. Your pet may move its legs or breathe deeply several times after the drug is given, but these are reflexes and don’t mean that your pet is in pain or is suffering.

How to explain pet euthanasia to a child
Explain that the pet is ill, often suffering, and that you have the ability to end that suffering in a very humane and gentle way. It is a simple injection, very peaceful and painless, and if you really love a pet you have to make these kinds of difficult decisions. Source: //Dr. Larry//
 * Children tend to feed off of how their parents react. If a parent is hysterical, the children will be the same. If the parents are truly sad, and deal with the sadness in a healthy and thoughtful manner, the children will follow their example.
 * If you are putting your beloved pet to sleep for the right reasons, tell your children that it is OK to feel sad, but don't feel guilty. These are two very different emotions. You should feel sad, and your children can feel the sadness, but don't mix guilt in with the sadness. One emotion is healthy, the other terribly burdensome.

Getting another dog or cat: Moving on after pet loss
There are many wonderful reasons to once again share your life with a companion animal, but the decision of when to do so is a very personal one. It may be tempting to rush out and fill the void left by your pet’s death by immediately getting another pet. In most cases, it’s best to mourn the old pet first, and wait until you’re emotionally ready to open your heart and your home to a new animal. Some retired seniors living alone, however, may find it hardest to adjust to life without a pet. If taking care of an animal provided you with a sense of purpose and self-worth as well as companionship, you may want to consider getting another pet at an earlier stage. Of course, seniors also need to consider their own health and life expectancy when deciding on a new pet. Each animal is different, so trying to exactly duplicate your old pet will likely result only in frustration and disappointment. A new pet should be appreciated fully for its own sake, not as a direct replacement. That may mean choosing another type of pet or a different breed. Whatever you decide, give yourself time to grieve the loss of your old friend and follow your instincts. You will know when it is right to bring a new animal companion into your life.



Death and Mourning
//[|The Gale Encyclopedia of Children's Health: Infancy through Adolescence]//

Definition
Mourning is a person's understanding and adjusting to death and loss at various stages of life.

**Students gather around a memorial on a college campus in remembrance of classmates killed in a school shooting.** Scott Olson/Getty Images News/Getty Images.

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Description
Almost every child or adolescent faces the death of someone close—a relative, friend, or even a pet—at some point in his or her life. In fact, it is estimated that about five percent of children under age 15, or about 1 in Page 674 | [|Top of Article] 20, will lose one or both parents. The loss of a parent before age 18 has been shown to have lasting effects on the child's later development, including his or her sense of identity. With regard to the loss of a pet, parents should keep in mind that for many children, the death of a beloved cat, dog, or other pet is usually their first encounter with death. They should let the child know that pets are also members of the **family** and that it is normal and natural to grieve for them when they die; they should never say things like, “Well, it was just an animal, it's no big deal.” Many doctors think that it is helpful to allow the child to care for the pet in its last illness and to say good-bye to it before it dies.

Causes and symptoms
Parents, caregivers, and teachers can provide support and minimize **fear** by answering a child's questions about death, whether of humans or animals, honestly. Encouraging communication will help the child through the essential grieving period. At one time, well-meaning adults felt that it was in the child's best interests to avoid discussing death. Research has shown, however, that children cope more successfully with a loss or death if they feel included in the group that has experienced the loss, and share in grieving and mourning. When listening to a child's observations about death, adults must keep an open mind. A child may respond to the death of a grandmother who used to make cupcakes for her by observing that there will be no more cupcakes for dessert. This response could be interpreted as selfish, but it is in fact an expression of the child's loss in her own very personal terms. When a child learns of the accidental death of a playmate, he may ask to go out to play. This too may be an expression of the loss, as the child might want to remember his friend by engaging in the activity the two of them shared. The child's response to loss can be misunderstood by adults, especially by those who are also grieving. By passing judgment on the child's reactions (“I can't believe you said that! Don't you feel sad that Grandma died?”), adults undermine the child's feelings and make the loss even more difficult for the child to handle. In the days, weeks, and months that follow a death or loss, adults should refrain from criticizing or reacting negatively to the child's feelings. When the child seems to repeat the same questions over and over, the same answers, as open and honest as possible, must be repeated patiently. Young children may express concern, either directly or through behavior, about being abandoned or neglected, or fears that they may have in some way caused the death. Changes in appetite, complaints of feeling sick, and changes in activity patterns can be indications that the child is worried or anxious. Adults can help a child deal with these fears by acknowledging them and by reassuring the child that he will still be cared for, and that no one can cause a death by thoughts and feelings. When the death or loss is unanticipated, as in the case of accidents, violence, or sudden heart attack or **stroke**, children may grieve longer and more intensely. Sad feelings may resurface over the years when the child experiences the loss anew, such as on holidays or other occasions. In addition, every death that the child experiences in later life will tend to reopen memories of the first loss. When a parent is deeply affected by the death of a loved person, the child may need the steady support of another adult. Books about illness and death can also be helpful. Adults should review the books in advance or ask a librarian, teacher, spiritual leader, or counselor for advice. Issues of concern include age-appropriateness, situation-appropriateness, and religious point of view.

Preschool and school-age years
By the time a child is about two and a half or three, he will be able to acknowledge that a death has occurred, but he will not really understand the reality of death. Research indicates that by ages five to seven, children begin to understand that death is permanent. They also begin to acknowledge the universality of death—that it happens to everyone. Around this age, children are often ready to be part of rituals of death, such as visits with the deceased's family, wakes, funerals, or memorial services. Prior to participating in a visit or funeral, it is helpful to prepare the child for the experience, and to explain the purpose of the visit—to grieve and help the family. If a child expresses reluctance to participate in any aspect of the rituals of death, adults should accept his feelings and not exert pressure. School-aged children can understand what death means, but they may be so overwhelmed that they act as if nothing has happened. Unexpressed feelings may surface in the form of such physical symptoms as **stomachache, headache**, and feeling unusually tired. Behavior may also change, demonstrated by reluctance to go to school, daydreaming in class, or a decline in academic performance. On the other hand, children do not have long and sustained periods of sadness like adults. They will sometimes want to play or have fun even while they are working through their grief. Parents should not shame them or accuse them of disrespect or of not loving the person who died. Children will both grieve alone and share their grief with others. Families can take a number of actions to support emotional healing, such as openly acknowledging the death, letting children participate in the rituals, and maintaining such familiar routines as school and bedtime Page 675 | [|Top of Article] activities. Parents should also let children see them grieve. Rather than avoid any mention of the deceased, it may help to display a photograph in a prominent place as a way of letting family members maintain memories. The visual reminder provides a way to help the child understand that it is okay to talk about the person who died. In many cases children benefit from attending a support group of other recently bereaved children.

Adolescence
Teenagers have an adult understanding of death, but may find it even more difficult than younger children to deal with their sorrow. Behavior problems, dropping out of school, physical complaints such as headache or chest **pain**, sexual promiscuity, and even **suicide** attempts may result from their feelings of pain and loss. Oftentimes, teenagers are reluctant to talk to adults who may help them through their grief. The death of a peer—even someone they hardly knew—affects adolescents differently than the death of an older person. They must cope not only with the shock of life's unpredictability but also their own mortality. Adolescents may also have a similar reaction to the death of a celebrity or entertainer with whom they identified, particularly if the famous person committed suicide. It is not unusual for a celebrity's suicide to trigger a wave of copycat suicides among vulnerable adolescents.

Special circumstances
There are some situations in which children's grief will resolve more slowly because of the circumstances of the loved one's death:
 * When the death occurs in the emergency department (ED) of a hospital. In most cases these are sudden and unexpected deaths, in many cases they are traumatic, and in many EDs, staff have not been trained to offer grief support even though they are usually the persons who must notify the family.
 * When the death is a suicide. If it is difficult to explain death to young children, it is doubly difficult to explain why the loved one took his or her own life. While parents should not hesitate to ask a spiritual leader or grief counselor to help them explain suicide to the child, they should never lie to the child about the fact of suicide. The American Association of Suicidology maintains that “secrecy about the suicide in the hopes of protecting children may cause further complications.”
 * When the death results from a natural or transportation disaster. Children very often develop a form of posttraumatic stress disorder when a loved one is killed in a plane crash, avalanche, tsunami, or similar disaster. If the child was also involved in the disaster but survived, he or she may develop a form of survivor's guilt for living when the loved one died. In addition, grieving families often have their privacy violated by news media after major disasters. It is a good idea to have a trustworthy friend of the family or a grief counselor available to deal with the media and answer questions for reporters to minimize stress on the family.
 * When a parent dies in military service. In addition to suffering a sudden loss, the child may not have seen the deployed parent for some time. In this situation also, there is the problem of media attention, sometimes compounded by outsiders who want to exploit military funerals as occasions for political protest.

Parental concerns
Most bereaved people begin to feel at least somewhat better within a few months after the loved one's death and to slowly return to normal activities and interests. In some cases, however, the person does not seem to be adjusting to the loss and beginning to look to the future, but is preoccupied with thoughts of the dead person, seeks him or her constantly, and is excessively lonely. Children who are having problems with complicated grief may show one or more of the following: If these signs persist, the parents may want to consult a therapist who can help the child with the grieving process.
 * a long period of depression marked by lack of interest in daily activities
 * sleep disorders and/or loss of appetite
 * excessive fear of being alone
 * frequently dressing like or imitating the dead person
 * talking repeatedly about wanting to join the dead person
 * avoiding friends
 * school refusal or sharp drop in academic performance

Hospice nurses are angels, and I mean they are TRULY angels. For this reason I have included this link; it may add a little variation on the same theme - 4 out of 5 stars. http://www.hospicenet.org/html/parent.htm