GRIEF

1
GRIEF

• Ruth Mireau
• Mental Health and Addiction Services
• Saskatoon Health Region

2
Grief

• We grieve when we are faced with the loss of
  something or someone that is important to us,
  something or someone that gives meaning to our
  lives.

3
Grief is normal

• Normal grief is the opposite of what many people
  call normal.
• We lose our ability to problem solve, to be
  optimistic, to cope with every day life.
• We may not feel adequate, strong or competent.

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Complicated Griefa normal reaction to a
complicated situation

• Experiencing many losses at one time
• Losses that are unexpected or untimely
• Feeling responsible for the loss
• Loss that affects financial security
• Loss of support from those we are used to
  depending on
• Pre-existing relationship problems
• Loss that is not evident to others (ie chronic
  illness)
• Loss that is ambiguous (we dont know if people
  will recover / dont know what to expect)

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• In medical circles, normal grief reactions last
  up to 2 months.
• In reality, normal grief may last several
  months or several years.

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When we grieve, we may appear to be ill to
others.

• Because we appear ill to others, grief can be
  treated like a curable illness.

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Symptoms of depression

• Persistent sad mood
• Loss of interest and pleasure
• Changes in appetite and weight
• Sleep disturbance
• Restlessness and agitation
• Fatigue and loss of energy
• Feeling guilty or worthless
• Poor concentration
• Unable to make decisions
• Thoughts and fear of death / suicide

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Symptoms of anxiety

• Pounding heart, chest pain
• Trembling
• Shortness of breath
• Nausea and stomach discomfort
• Feeling dizzy
• Feelings of unreality
• Fear of going crazy
• Fear of dying
• Feeling restless
• Being easily tired
• Muscle discomfort
• Sleep disturbance
• Difficulty concentrating

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Bridges model of loss and change (1980)
When chaos overwhelms us, it feels good to go
back.
Additional losses
NEW BEGIN- NING Acceptance

• ENDING
• Recogniton of the loss

CHAOS Adjustment to the loss
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Impact of grief on families and caregivers
(Terkelson)

• Family members experience loss differently
• The primary caregiver is very affected by the
  needs of the care receiver often becoming very
  limited by the progress of the illness and the
  demands of the ill person

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Impact of grief on families and caregivers
(Terkelson)

• Relatives not involved in physical care will be
  emotionally affected by the illness
• However their lives are unaffected in a practical
  sense.

12
Impact of grief on families and caregivers
(Terkelson)

• Different experiences of the loss may create
  conflict in families.
• For example, some members may minimize the impact
  of the illness on the caregiver.
• Or, some family members may be unsupportive and
  critical in terms of the needs of the caregiver,
  and the decisions that the caregiver needs to
  make.

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Caring for oneself when grieving

• Taking care of self
• When we are grieving, we lose interest in taking
  care of ourselves eating, sleeping, bathing.
• What do I need to do to keep myself physically
  well?

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Caring for oneself when grieving

• Adjusting to and accepting loss
• We will be sad. Our world has changed because of
  what we have lost. Loss has many meanings. We
  will have regrets as a result of loss.
• What do I need to do for myself in order to feel
  and express sadness?

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Caring for oneself when grieving

• Finding support
• The loss has an impact on our relationships. Who
  can we talk to about what we have lost? What
  kind of support do we want? Some people are good
  to cry with, some to laugh or to go to a movie.
  Do we get the support we need from people
  currently involved in our lives?
• What do I need to do to be connected to others
  who will provide support?

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Caring for oneself when grieving

• Quality of life
• We need to have fun, or at least quality in our
  lives art, gardening, meditation, reading, talk
  therapy, dancing, hobbies, movies, sports,
  walking, exercise, music, talk to friends,
  writing, relaxing, using respite services, going
  to the lake
• What will I do that adds quality to my life?

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Caring for oneself when grieving

• In order to continue to manage and cope, what do
  I need to do next?
• How will I know when I am coping better?
• How will others know when I am coping better?

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Receiving professional care when grieving

• Professional counselling services may not lead
  you to feeling less sad.
• Counselling services open the door to express and
  experience sadness.
• People who are successful in counselling will
  learn that they have the strength to feel sad as
  long as they need to, in order to finish grieving.

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If you know someone who is a caregiver

• Offer to spend time with the person who needs
  care provide respite.
• Dont judge. Dont criticize the way that care
  is given or the choice to continue to give care.
• Dont give advice
• Listen
• Ask