Grieving Is Hard.

Grieving During A Pandemic Is Even Harder.

Without rituals, or a communal gathering, the the loss of a loved one can be felt even more keenly

by Julia Paskin

I recently lost someone who, in a lot of ways, was like a second mother. She didn’t die from COVID-19 but pandemic regulations still stand. It’s not safe to have a memorial for her.

Grief is never easy. I’m having trouble processing her loss for a few reasons but a big one is that Mama Sue was a mother to a whole lot of people, and being unable to gather with all of them in her honor has me feeling kind of stuck in my grief.

Dr. Katherine Shear says rituals surrounding death are an important part of the health process. “Without those rituals we struggle a lot more with coming to terms with the loss, which is of course what we have to do,” said Shear. Ultimately healing requires us to “regroup and find our way forward.”

PROLONGED GRIEF

Shear teaches psychiatry at Columbia University and specializes in prolonged grief, something she’s seeing a lot more of these days. Grief is considered prolonged when the feelings disrupt everyday life beyond what’s considered a healthy degree and amount of time. Symptoms of prolonged grief, also known as complicated grief can include extreme sorrow, isolation, and an inability to feel joy long after suffering a loss.

For many, it’s not only about missing out on the ritual and sense of community. It’s also about not being with someone when they die. Shear says separation from loved ones during the dying process can also make healing more difficult.

“Those things contribute to the processing of the reality of the death,” said Shear. “That’s a part of what we have to do – accept the reality. And then we have to find a way to restore our capacity to feel well-being.”

ENORMOUS NUMBERS

Demographer Emily Smith-Greenaway teaches sociology and spatial sciences at USC and has quantified the impact of COVID-19 fatalities on its survivors. She says “each death results in about nine Americans grieving the death of a close relative.”

Based on that projection, 225,000 people in California were personally affected by the death of someone from COVID-19 in 2020 alone. “The size of the population grieving, and grieving very intimate losses, is just enormous,” said Smith-Greenaway.

Fellow USC professor Diane Blaine specializes in thanatology which is the study of death and its impact. She says there are ways to find solace in creating our own rituals to help the healing process…

“Write a letter, light a candle too, you know, I have a little altar, and to just sit and weep,” said Blaine. “We can still do those things.”

FUTURE GATHERINGS

Many are finding ways to connect with other mourners. Zoom memorial services and online religious ceremonies are being frequently held. If you’re still struggling though, Blaine recommends talking to a grief counselor or support group.

The challenge is that there are a lot of communities where mental health services are hard to access and they’re often the same communities with high COVID-19 mortality rates. An emerging idea is to train people already trusted in the community like barbers and church members to give support.

Most importantly, Blaine says to remember that grief doesn’t have a timeline.

“Even though right now there might have to be a forestalling of whatever form of grief process, it can continue and it can continue on even for years.”

Blaine says we will be able to gather in the memory of those we’ve lost again at some point. And that can be healing whenever it happens.

For what it’s worth, I think I’ll light another candle for Mama Sue tonight.

Complete Article HERE!

There Is No Vaccine for Grief

But there are ways to prepare to face it.

By A.C. Shilton

For months, I’ve felt like the emotional equivalent of a car with a cracked windshield. I’m still rolling through daily life, but one good knock is bound to shatter me. Although the number of coronavirus cases has been declining, the number of deaths has soared well above 500,000, and now we have the new variants to worry about. I know that if I have not yet lost a loved one, I’m one of the lucky ones — and no one’s luck lasts forever.

I love being proactive — I’m all about having a go bag with extra batteries, duct tape and granola bars ready for any emergency. But what, if anything, could I do to prepare myself for grief?

Anticipatory grief is a well-documented phenomenon in grief counseling, said Dr. Katherine Shear, the founder and director for the Center for Complicated Grief at Columbia University. But usually researchers study anticipatory grief in environments like hospices, where loss is imminent. What many of us are experiencing right now is more nebulous. Dr. Shear cautioned that spiraling into anticipatory grief for a loss that may not even happen is likely to be unhelpful.

Of course, even if you do not lose a family member or friend in the pandemic, that does not mean you will not experience grief. At its core, grief is a reaction to a change that you didn’t want or ask for, said David Kessler, a grief expert and author of many books on the subject, including his most recent, “Finding Meaning: The Sixth Stage of Grief.”

Even those who have not lost family members are experiencing some level of loss in the pandemic, he said, from the disappointment of missing in-person experiences and holiday celebrations to the losses of our jobs and even our homes.

“The problem with comparisons in grief is if you win, you lose,” Mr. Kessler said, adding, “and the world is big enough for all our griefs.”

Inoculating yourself against feelings of loss may prove harder than getting a routine vaccine. “Grief is as unique as a thumbprint. What works for one person may not work for another,” said Deanna Upchurch, the director of clinical outreach services at the Providence-based hospice HopeHealth. Still, should the worst happen, knowing what tends to help others could help you gird yourself — even just a little bit. If doing something feels better to you than doing nothing, consider this your packing list for a grief go bag.

Practice Experiencing Your Emotions.

“In our culture, we tend to think painful emotions are bad,” Dr. Shear said. “But that’s really not true. It’s true that they’re painful, but we can learn from them,” she said. Next time you feel something unpleasant, take a moment to sit with it and think about why you’re feeling the way you’re feeling.

Mr. Kessler suggests looking to the animal kingdom for inspiration on learning to live with uncomfortable emotions. After his 21-year-old son died suddenly in 2016, Mr. Kessler was watching a documentary on buffalos. The documentary noted that buffalos run straight into oncoming storms.

“Because they run into the storm, they minimize the time they are in the discomfort. We live in a society that minimizes grief. Unlike the buffalo, we try to stay a mile ahead of it, but it’s just always there, chasing behind us,” he said. Consider, instead, being willing to run into the rain.

Shower the People You Love With Love.

Maureen Keeley, a professor of interpersonal communication at Texas State University, has been studying the final conversations between family members for nearly 20 years. In that time, one theme has emerged over and over again: “We need to tell those we love that we love them,” she said.

This advice sounds so simple. And yet, when I tested it out by calling my best college friend to tell her how grateful I was for her friendship, the gears gummed up. (Instead, I asked about her new cat.) To which, Dr. Keeley gave me this advice: “Grow up.” Telling someone how much they mean to you may feel a bit awkward. Go on and reveal the mushy bits of your soul. Most people enjoy hearing how much they matter, and saying it now saves you from having regrets later.

Nurture Your Network.

“We are not meant to be islands of grief,” Mr. Kessler said. Everyone grieves differently, and even within your grief there may be periods when you wish to be alone and periods when you really need a friend. When the latter happens, having a sturdy network to lean on is so important. “We need to know our loved one’s life mattered, our loved one’s death mattered. It brings us meaning to see our pain witnessed in someone else’s eyes,” he said. Now is the time to make time for friends.

Some people need something to look forward to. Others find thinking about the future overwhelming, said Ms. Upchurch. If you’re currently planning what to serve at your post-vaccine dinner party, you’re likely in the first group. Knowing that can help you put things on your schedule that will bring you joy in a dark time. If, however, you’ve been getting through the past year of social distancing by not thinking too far into the future, you may be better served by just allowing yourself to stay in the moment, taking each day as it comes.

Find a Natural Space.

Even if you’re generally not the outdoorsy type, a tiny slice of nature can be helpful in navigating grief, said Sonya Jakubec, a professor in the school of nursing and midwifery at Mount Royal University in Calgary, Canada. Dr. Jakubec studies the impact of natural spaces and parks on patients and caregivers. As she reported in a chapter she wrote on grieving in nature for the book “Health in the Anthropocene: Living Well on a Finite Planet,” she took palliative care patients and caregivers out for a walk near where they worked.

“Many of them had never considered the idea of going for a 20-minute walk break,” she said. After the field trips outdoors, 93 percent said they agreed or strongly agreed that natural spaces provide emotional comfort. Dr. Jakubec has seen similar results with grief groups that meet outside. “Parks and nature feel like a container that is large enough to hold our grief,” she said.

Thanks to vaccines and hospitals having more tools to treat critical patients, it’s possible that the bump we’re all bracing for will never arrive.

Still, it’s worth fortifying yourself now, because grief is an innate part of what it means to live a full and rich life as a human.

“Generally, grief is a lifelong experience that changes over time,” said Ms. Upchurch. Still, humans can be surprisingly resilient. That resilience will help you weather whatever else the pandemic has in store — cracks and all.

Complete Article HERE!

Never say die

By Kristi Nichols

In March, at the beginning of the COVID-19 pandemic, I emailed my oldest son a list of my financial details, a copy of my will, and my advanced medical directive. I thought it was the prudent thing to do in case I contracted the virus and died. Almost instantly, I received his reply: “Is everything alright, Mom?” I had not expected this response and thought it was a good time to have a conversation about death.

As my children were growing up, I made sure to keep the subject of sex in the conversation. I knew that for my children, having sex was inevitable, and there were important discussions to have before it was too late. I wasn’t worried that talking about sex would cause them to have sex; I was more worried that not talking about it might make their lives more difficult. Sometimes it was uncomfortable, but the more we talked, the more approachable the subject became. It’s the same with death. Learning to talk frankly about death and dying takes the burden off everyone. The thought of me, my family members, friends, or anyone dying is uncomfortable, but we need to talk about it.

As the COVID pandemic death toll continues to rise, more people are contemplating their own death, the death of loved ones, and dying in general. Never has there been such a need to talk about death and dying. We have become a society in which talk about death is taboo. We are born, we live, and then we die. We don’t speak openly about this natural series of events; rather we allude to it. The subject has become a source of discomfort. We avoid talking about it directly, just like sex. For some reason, we no longer die. We “pass away.” Why can’t we simply die?

Birth and death used to be a family, community, and religious event. Death was not hidden in a hospital or “care” facility. Discussions about dying and death were not just between a few family members and a medical professional. People were directly and personally involved in caring for dying relatives. Conversations were necessary to plan futures. Death was considered a natural thing and not a forbidden subject. The word “hospice” derives from the Latin word “hospitum,” meaning hospitality or place of rest and protection for the ill and weary. Essentially, going home.

Death as a taboo is taking its toll. When a dying person has not been able to talk about their death, it becomes an unnecessary source of anxiety and depression. These conversations need to be about practical concerns as well as fear, pain, and loss. When final wishes have never been discussed with family members, they are hard-pressed to make decisions at the end of their loved one’s life. Creating living wills and advanced medical directives is a good way to get the conversation started. Once the subject is broached, it may create more opportunities to express emotions and answer questions.

The psychiatrist Irvin Yalom describes four ultimate concerns: death, isolation, loss of freedom, and meaninglessness. These are the most important concerns of the living, and even more concerning for someone approaching the end of life. Why not encourage conversations regarding these deep subjects. What does it mean to those aging or experiencing a fatal illness when the subject of death is taboo? Should they be embarrassed to acknowledge their own mortality? Should they be kept silent about what concerns them most? How can there be dignity and grace in dying when we can’t talk about death?

Our society’s obsession with perfection renders many people unwilling or incapable of dealing with the painful realities of life, especially death. To embrace the human experience means embracing the full spectrum of life’s events, including death. Dealing with mortality can be overwhelming, but approaching death doesn’t have to be arduous. We shouldn’t have to worry about upsetting or protecting others when we need to talk about important things.

I believe the way forward is for us to go back to acknowledging death as what naturally happens at the end of life. We need to revive our conversations about death. It will take courage. It is difficult to face our own mortality and that of those we love. It is always sad and often frightening. Conversations about death remind us that one day, those we care about may no longer be around and maybe, we will die before them. Let’s remember to enjoy and appreciate them now and cherish every moment we spend together! Now is also the time to plan a good death.

If there is one thing I know as a psychotherapist, it’s that talking about our fears eases them. It allows us to be more honest, candid, and at peace. By talking about difficult subjects such as death, you will likely learn that you are not alone and that someone is waiting to have that conversation with you.

Complete Article HERE!

Covid Strikes Clergy as They Comfort Pandemic’s Sick and Dying

Pastor Marshall Mitchell of Salem Baptist Church in Abington, Pennsylvania, got his first dose of the covid vaccine in December. He believes it’s his spiritual duty to his congregation and community to take precautions to avoid covid-19.

By Bruce Alpert

The Rev. Jose Luis Garayoa survived typhoid fever, malaria, a kidnapping and the Ebola crisis as a missionary in Sierra Leone, only to die of covid-19 after tending to the people of his Texas church who were sick from the virus and the grieving family members of those who died.

Garayoa, 68, who served at El Paso’s Little Flower Catholic Church, was one of three priests living in the local home of the Roman Catholic Order of the Augustinian Recollects who contracted the disease. Garayoa died two days before Thanksgiving.

Garayoa was aware of the dangers of covid, but he could not refuse a congregant who sought comfort and prayers when that person or a loved one fought the disease, according to retired hairstylist Maria Luisa Placencia, one of the priest’s parishioners.

“He could not see someone suffering or worried about a child or a parent and not want to pray with them and show compassion,” Placencia said.

Garayoa’s death underscores the personal risks taken by spiritual leaders who comfort the sick and their families, give last rites or conduct funerals for people who have died of covid. Many also face challenges in leading congregations that are divided over the seriousness of the pandemic.

Ministering to the ill or dying is a major role of spiritual leaders in all religions. Susan Dunlap, a divinity professor at Duke University, said covid creates an even greater feeling of obligation for clergy, because many patients are isolated from family members, she said.

People near death often want to interact with God or make things right, Dunlap said, and a clergy member “can help facilitate that.”

Such spiritual work is key to the work of hospital chaplains, but it can expose them to virus being spread in the air or sometimes through touch. Jayne Barnes, a chaplain at the Billings Clinic in Montana, said she tries to avoid physical contact with covid patients, but it can be difficult to resist a brief touch, which is often the best way to convey compassion.

“It’s almost an awkward moment when you see a patient in distress, but you know you shouldn’t hold their hand or give them a hug,” Barnes said. “But that doesn’t mean that we can’t be there for them. These are people who cannot have visitors, and they have a lot they want to say. Sometimes they are angry with God, and they let me know about that. I’m there to listen.”

Still, there are times, Barnes said, that the despair is so profound she cannot help but “put on a glove and hold a patient’s hand.”

Barnes was diagnosed with covid near Thanksgiving. She has recovered and has a “better understanding” of what patients are enduring.

Dealing with so much suffering affects even the most hardened doctors and nurses, she said. Billings Clinic staffers were devastated when a beloved physician died of covid, and rallied behind a popular nurse who was seriously ill but recovered.

“We’re not only taking care of the patients; we are also there for the staff, and I think we have been an important asset,’’ she said of the hospital’s chaplains.

In Abington, Pennsylvania, Pastor Marshall Mitchell of Salem Baptist Church said he believes part of his spiritual duty is to persuade his congregation and the broader African American community to take precautions to avoid covid. That is why Mitchell allowed photographers to capture the moment in December when he received his first dose of a vaccine.

“As pastor of one of the largest churches in the Philadelphia region, it is incumbent on me to demonstrate the powers of both science and faith,” he said.

Mitchell said he might have credibility in convincing other African Americans, who have been disproportionately affected by covid, that a vaccine can save lives. Many are skeptical.

The politicization of covid precautions such as masks and social distancing has put many pastors in a difficult position.

Mitchell said he has no patience for people who refuse to wear masks.

“I keep them the hell away from me,” he said.

Jayne Barnes, a chaplain at the Billings Clinic in Montana, says it’s awkward not to touch or hug a covid patient in distress. But sometimes she cannot help but “put on a glove and hold a patient’s hand.”

Jeff Wheeler, lead pastor of Central Church in Sioux Falls, South Dakota, said that his church encourages mask-wearing and that most congregants comply. However, the underlying tension is reflected in his message to members on the church’s website:

“As we move forward, we simply ask you to avoid shaming, judging or making critical comments to those wearing or not wearing masks,” it reads.

Sheikh Tarik Ata, who leads the Orange County Islamic Foundation in California, said that the Quran calls for Muslims to take actions to ensure their health and that congregants largely comply with covid guidelines

“So, our members don’t have a problem with mask mandates,” he said.

Covid has hit the Orange County Muslim population hard, Ata said. Religion has become an important source of comfort for members who have lost their jobs and struggled with illness or finding child care.

“Our faith says that no matter how difficult the situation, we always have access to God and the future will be better,” Ata said.

Adam Morris, the rabbi at Temple Micah in Denver, said he has turned to online video to meet with congregants sick with the coronavirus. When meeting with his congregation members in person, such as during graveside services, he worries that with his mask on people might miss seeing the concern and compassion he feels for their plight.

He conducts in-person graveside funerals for a small number of mourners but requires all participants to wear masks.

Observant Muslims and Jews believe it is important to bury the dead quickly after death, Morris said.

“Some traditions and rituals must go forward,” Morris said, “covid or not.”

Complete Article HERE!

Mac study looks to help families discuss end-of-life care during COVID-19

By Maria Iqbal

Long-term-care staff are so swamped with COVID-19 protocols that end-of-life discussions aren’t occurring with residents and families, says a McMaster University professor.

Sharon Kaasalainen, a professor in the school of nursing, says she’s hearing from families that they’re feeling excluded from decisions about their loved one’s care.

“Compassionate care is missing because it’s all around public health protocols,” she said, noting the absence of these conversations is causing “serous concerns.”

Kaasalainen recently met with the Ontario Long Term Care Association and other long-term-care leaders to raise the issue. The point of compassionate care, she says, is to help people become more comfortable talking about death and supporting families through that process.

Kaasalainen’s research involves helping facilitate conversations about end of life in long-term care. She recently received funding to adapt her research for COVID-19, including by developing online tools to support those discussions. The goal is to help residents, families and staff prepare for decisions at the end of a patient’s life.

While COVID-19 poses major staffing challenges, Kaasalainen says palliative care also has to do with education and a home’s priorities.

Her study will pilot online tools at homes in three provinces. Locally, that includes St. Peter’s Residence at Chedoke on the west Mountain, where she expects to roll out the online resources in spring.

The tools in the study include pamphlets on conditions common to long-term-care residents to help both residents and families learn what to expect as a disease progresses.

Pam Holliday participated in an earlier part of Kaasalainen’s research. She says the tools taught her to ask care providers more specific questions about the health of her elderly mother, a resident at Shalom Village in Westdale.

Holliday says palliative care conversations can help even before a person’s death. In her case, her mother got sick multiple times, but bounced back.

“You try to make them better, but you try to make them enjoy what they have,” Holliday said about the approach.

She adds that the resources are particularly helpful during COVID-19, when there are restrictions on visits to long-term care.

“We’re totally reliant on staff communicating any changes with us,” Holliday said. “It’s (about) asking the right questions.”

Kaasalainen says care conversations can also include the type of music a person would like to hear when they’re dying and which loved ones are with them. But avoiding the discussions affects the quality of care during a patient’s final days and how families cope after a death.

“We’re seeing families very distressed, having to make decisions unprepared, and it leads to poor bereavement,” Kaasalainen said. “They have these lingering feelings of guilt and stress.”

In March, Kaasalainen is also planning to launch a national community of practice with the Canadian Hospice Palliative Care Association. It would bring together researchers, care providers and families in long-term care to discuss palliative care.

Her hope is to see families involved in care decisions feeling better prepared.

“The goal really is good death, peaceful death and families feeling guilt-free and prepared for death when it happens.”

Complete Article HERE!

Society’s End-of-Life Problem

Americans have unequal access to the benefits of advance care planning

By Mara Buchbinder

As COVID-19 death tolls mount rapidly, palliative care experts have urged Americans to have difficult conversations with loved ones about our end-of-life wishes. With death all around us, they have argued, it is now more urgent than ever that we plan for our deaths.

But in addition to having “the conversation” about end-of-life wishes, we should also grapple with deeper societal questions about who gets the privilege to plan.

It may sound perverse to suggest that a cancer diagnosis could be a fortunate event, but cancer compels people to anticipate death in a way that many never will. Most people will never have the opportunity to choose when, where and how they die because death comes unexpectedly, or the circumstances impede planning. If anything, my research on the desire for control at the end of life has taught me that death, all too often, ignores our plans.

But planning has nevertheless been a prominent focus of nationwide public health efforts to improve end-of-life care over the past several decades. Advance care planning is a broad term that encompasses talking with loved ones and health care providers, appointing a surrogate decision maker and recording end-of-life preferences in writing. Advance care planning enables people to legally document their wishes—for example, to avoid life-prolonging treatment if one is unlikely to survive or to attain a certain quality of life—in case they become incapacitated.

Such planning is particularly important for COVID-19 because of the vital use of mechanical ventilation among the sickest patients. Contemplating decisions about life-prolonging treatment in advance takes on heightened importance in a climate in which critical care resources are scarce and in which intubation puts health care workers at increased risk for contracting the virus themselves.

Americans do not engage equitably in planning for the end of life, however. Black Americans consistently utilize less advance care planning than white Americans. The reasons for this include worse access to medical care, especially culturally sensitive medical care; religious beliefs and cultural values that favor leaving decisions to God; and mistrust in medicine rooted in historical legacies of mistreatment, experimentation, and racism. Yet without the benefit of planning, Black Americans are less likely to receive care consistent with their preferences.

These inequities are all the more painful in a year in which police brutality and anti-Black violence brought the Black Lives Matter movement to the forefront of public consciousness. The tragic deaths of George Floyd, Ahmaud Arbery, Breonna Taylor, Elijah McClain and many other Black Americans highlight not only a foreclosed opportunity to engage with death as an object of anticipation and planning, but also, more fundamentally, a systemic failure of white Americans to acknowledge and uphold the value of Black lives. When the system has failed and shortened Black lives at every step, can we blame Black Americans for a reluctance to engage with the very same system to plan for death? From this perspective, advance care planning may seem tantamount to acquiescence.

This is not to deny that advance care planning and communication with loved ones are important and useful goals for all Americans, regardless of race or age. I teach a seminar for second year medical students on Death and Dying in America, in which I ask them to interview a partner or family member about their end-of-life wishes. I don’t want my students—many of whom have never experienced the death of a loved one—to confront the discomfort of speaking with patients about death before having done so at home. This year’s exercise was particularly poignant, as several students had family members in ICUs, or working on the pandemic’s frontlines.

But I also ask my students to think critically about who gets the privilege of planning: to examine the cultural values that underlie the expectation for choice at the end of life and confront racial inequities in advance care planning. When we advocate for more conversations about death and dying, let’s make sure that a piece of this conversation is facing the tough questions about who among us will get to plan and choose.

Complete Article HERE!

She Lost Her Mom to COVID-19, Then Her Dad. Here’s How She’s Coping

Tracey Carlos is one of many people who has lost both parents (pictured above) to COVID-19 and is working to cope with overwhelming grief during the pandemic.

by Cathy Cassata

  • COVID-19 has taken the lives of multiple loved ones from some families.
  • Dealing with the death of more than one family member at a time is a concurrent crisis.
  • There are ways to deal with such grief.

Bob and Bano Carlos were married 53 years when they both died from COVID-19.

According to their daughter, Tracey Carlos, they were inseparable.

“As important as my brother and I were to them, they were everything to each other,” she told Healthline.

During a phone call on March 14, 2020, Carlos learned that her mom had a fever and that her father wasn’t feeling well.

“They lived in a retirement community in Florida and assumed COVID was in the West Coast and hadn’t reached the East Coast yet. Florida was downplaying it at the time, and so they continued to live their life,” Carlos said.

Both of Carlos’ parents tested positive for COVID-19, and both were intubated in the intensive care unit (ICU) on March 20.

Because her mother lived with myelodysplastic syndrome (MDS), Carlos knew the chances of her surviving COVID-19 were unlikely.

She died on March 25 at 73 years old.

Carlos lives in Olympia, Washington, and wasn’t able to travel to Florida to be near her mother before she passed. However, Carlos did get there in time for her father’s last days.

“Dad lasted 30 days in the ICU, and we fully expected him to recover. He had COPD, but he practically forgot he had it because it [was managed] and wasn’t a major part of his life,” Carlos said.

Bob died on April 24 at 75 years old.

“It’s so hard to lose them both, but [the only] relief — and that’s hard to say — is that we didn’t have to tell Dad that Mom passed away,” Carlos said.

Losing more than one family member in a short time frame is considered a concurrent crisis, said Therese A. Rando, PhD, psychologist and owner of the Institute for the Study and Treatment of Loss.

“When the second person dies, the individual is still dealing with the loss of the first person,” Rando told Healthline.

This type of loss can lead to grief overload, or cumulative grief.

“We know this happens with both subsequential and nonsubsequential loss. Say two people die in an accident or fire. Your grief and mourning for Person A is complicated by the fact that you also have the burden of the grief and mourning for Person B, and that stresses you, adds to the traumatization, and reduces your support system,” Rando said.

Reviewing your relationship with the deceased is part of healthy mourning, she added.

“We go over it and think about the good, bad, happy, and sad times. Doing this is more challenging when you are reviewing Person A and that inherently means dealing with the loss of Person B, because they are also involved in that story you are reviewing,” she said.

Grief overload is a high risk factor for having complications with mourning.

While people who lose multiple loved ones will still experience the stages of grief — denial, anger, bargaining, depression, and acceptance — Dr. Leela Magavi, psychiatrist and regional medical director for Community Psychiatry, said the severity of the pain may be amplified.

“When individuals are overwhelmed with multiple losses, they are more likely to remain in the stage of denial for longer periods of time,” she told Healthline.

Magavi said they may engage in avoidant behavior by consuming alcohol or using substances to numb their pain.

“I have evaluated many children and adults who begin to stress and binge eat to alleviate their emotional pain,” she said.

The pressure to grieve both losses at once or equally can also add to the complexity of the situation.

“Each loss warrants time, reflection, and healing. If the individual had a complicated relationship with someone who passed, they may feel more guilty about this loss than the other due to their conflicting feelings,” Magavi said.

Conversely, she said they may feel shame and guilt if they don’t feel as saddened by one loss compared to the other.

“I remind individuals that there is no correct way to grieve,” Magavi said.

For Carlos, grief sometimes means mourning both of her parents together as well as separately.

“I used to talk to my mom every Saturday and I’ll find myself thinking, ‘Oh, I can’t wait to tell her this’ and then I realize I can’t tell her. And my dad had a job that involved him being a pirate at Disney World, so anything to do with pirates makes me stop and think of him,” she said.

Despite the notion that losing both parents is the natural order of life, Rando said research shows there are fundamental shifts that people make in the aftermath of losing their parents.

“When it’s a parent and you have a good relationship with them, you are incredibly impacted. Your parents know you from day one and you share such an incredible history. Losing them is a devastation of parts of the original family unit,” she said.

While the loss of both parents is complex, there are ways to cope. Below are some to consider.

Death during the pandemic, whether related to COVID-19 or not, can take more time to grieve due to shock, said Rando.

“I’ve done a lot of work on COVID death, and we see what we consider to be delayed grief for people. They haven’t had time to grieve because they have to focus energy on home-schooling kids, finding a job, keeping a business running, etc.,” she said.

Traumatization can cause post-traumatic stress disorder (PTSD) and anxiety.

“Try healthy anxiety management strategies like breathing, building things in life to offset distress, and self-care,” Rando said.

Magavi advises her clients to name their feelings out loud by describing what they’re feeling emotionally and throughout their body.

“They can make a log of their emotions and identify any triggering factors, which exacerbated their condition, as well as alleviating factors, which helped them feel better. This activity helps us learn more about what we feel, why we feel, and what we can do to combat helplessness and take control during this time of uncertainty,” she said.

For Carlos, anger and self-blame are her biggest emotions to work through.

“I’m angry at leadership for not informing the public about the seriousness of COVID, and at my parents because after their deaths I became aware that they were getting together with friends in their retirement community,” Carlos said.

She’s learned to let go of some of the anger.

“This is bigger than any of us. I get angry when I see people without masks and not social distancing, but we are all human and we all mess up,” she said.

Complete Article HERE!