Month: March 2019

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Atheist awed by humanity amid religious rituals of death

Even for an unwavering nonbeliever like myself, a couple of days last week were very close to a religious experience as we watched my wife’s mother, Ruth Aylward Pommer, 87, pass from this life into what she so fervently believed would be glory in the next.

Farm in winter.

by Rick Snedeker

Observing the initially distressful but finally serene end of a purposeful life robustly lived was both moving and humbling, a replaying of nature’s endless symphony of life and death far beyond any human capacity to halt or reverse it. Reality in perpetually unstoppable motion.

I come from a small family, but Ruth’s extended clan is relatively vast, so it was a beautiful and compelling thing to see the legions of daughters and sons, grand-kids and great-grandkids and great-greats, other relatives and friends filter into the room to hold vigil, voice rosary prayers, tell stories, and say their final good-byes.

It was particularly magnificent to see Ruth’s children closely arrayed around her bed, eyes red with anguished concern, stroking her hair, dabbing her brow, whispering soft encouragements into her ears, carefully watching her for signs of pain or distress so they could immediately do what was required to ease it. This is love expressed in its deepest, most primal, most authentic form.

Although I have spent long hours reading and writing about the unsubstantiality of supernatural ideas, as Ruth slipped quietly away I still realized once again what I already knew — that spiritual yearning is as universally human as rage against injustice. And it is powerful. So powerful.

When the kindly young priest from Ruth’s small farming community delivered the words of last rites in respectful, gentle tones, and anointed her forehead and palms with holy oil, it felt ancient, almost primordial. It felt natural to embrace any ritual, any hope that would make this not a sad end but a beginning of something profoundly better.

For many people, few things in life are as terrifying as its end, and the attendant possibility of immortal nothingness, or, worse, endless suffering. This is why most Christians, including, as Ruth was, Catholics, focus their lives on not displeasing God and improving their chances of being heartily welcomed by St. Peter in Paradise one blessed day.

I get it, especially after this past week, after seeing fervent faith up close in ways I rarely do, at a time of great angst and sadness over the passing of a woman much loved and honored in her lifetime. Even I mourn the end of her life in a personal way. Aside from the courtesy, respect and kindness she always showed me, the big-city alien grafted onto a small farming town by way of a happenstance meeting with her daughter in a far-away land, she also gave me another treasured gift: acceptance. From the beginning, she went out of her way to make me feel part of the large family she headed.

So, there I was at the end of her life, a most secular fellow in the midst of a most religious tribe, and I must say, it was terribly moving.

The funeral service in a breathtakingly lovely community church was fittingly transcendent, with its respectfully hushed tones, the great-grandchildren singing “Amazing Grace” in the choir loft, the candles and incense, readings from Ecclesiastes (“To every thing there is a season …”), the well-said sermon that honored and treasured Ruth’s long life. People came from far and wide to attend, some driving for days to reach the church.

And there was comfort food in church halls after the wake and funeral service and then the burial gathering the following day an hour away, where she was to be laid to rest with her husband. Food is part of the ritual of human passing, where pleasure and pain, good memories and sad immediacies, converge for sustenance of those who have been left behind.

As I went through this process, though from a further emotional remove certainly than Ruth’s immediate family, I still appreciated the essential value of such loving rituals and heavenly yearnings in helping survivors move on and face their next existential challenge. I tried to not focus on the reality that these painful passages also can bring out the worst in us.

So, although nonbelievers can often be antagonistic toward faith, I am reminded that it is pointlessly unkind and destructive to ever denigrate something so visceral and nurturing to people’s lives, whatever one’s philosophical differences.

I was thinking last week, as I waited patiently with others for the inevitable, that at such times theology and religious doctrine seem irrelevant, even as they precisely structure the final proceedings of a life lived out. What matters is love, remembrance and, as necessary, forgiveness.

Complete Article ↪HERE↩!

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How Grieving Impacts Sleep

If we have the capacity to love, then we have to face grief as well, along with how it manifests in our lives—particularly through sleep.

 

BY Lisa Smalls

Losing a loved one is one of the most painful life events we endure, where grieving is a natural and recurrent phase of life for us all. If we have the capacity to love, then we have to face grief as well, along with how it manifests in our lives—particularly through sleep. Poor sleep can go hand in hand with grieving in a downwards spiral, where physical and emotional symptoms of grief can intensify when sleep issues are not addressed. Grief can be momentary or become complicated grief  over time, where advanced symptoms of grief can be emotional, physical, as well as cognitive.

Emotional Wellness

Grief alone can wreak havoc on your emotional wellbeing, causing depression and anxiety that makes it hard to sleep. Sleep is a fundamental part of the grieving process that helps heal your emotions, so a lack of sleep is particularly dangerous. Specific emotions are encountered at every stage of the grieving process, where quality sleep helps you process and navigate these feelings. So grieving makes sleeping hard, but you still need sleep to recover from grieving!

Physical Wellbeing

The physical symptoms of grief are less discussed but are highly significant, where proper sleep helps your body mend faster. In addition to poor sleep, symptoms include a weakened immune system, heart problems, alcohol and substance abuse and depression. Your physical symptoms of grief can cause sleep deprivation but will also worsen without sufficient sleep. If you are experiencing advanced symptoms of grief that must be addressed and healed by better sleep, take the steps within your power to improve sleep. For example, create an ideal sleep space. Eliminate noise and light pollution, invest in your sleeping structure, and stick to a regular bedtime. The quality of your waking life depends on how you invest in your sleep life.

Cognitive Ability

Grieving can cause you to experience hazy thinking as part of temporary cognitive impairment. Your mind and body are actually protecting you from experiencing too much at once, particularly when the loss of a loved one is sudden. In this state of mind, you can make snap decisions or act out in ways that are not like you. Sleep helps you restore a clear mind and act like yourself again.

Grieving doesn’t always mean you will experience insomnia or sleep deprivation though. Sometimes excessive sleeping is common as well. Every person faces their grief in different ways; however, the amount and quality of your sleep is commonly affected and is symptomatic of grief. Some people actually sleep more, where people who are facing overwhelming emotions are often reluctant to get out of bed and face the realities of everyday life. Retreating to bed can be an escape when you are working through so many exhausting emotions, but often in these cases, the quality of sleep is still low. Nightmares and dreams of your loved one can also be difficult to handle or process. When many of those grieving see their loved ones in their dreams or nightmares, it can be mostly unsettling where such dreams do not provide closure.

We even sometimes prepare for grief when someone we love is fighting cancer, which is a process that can be emotionally overwhelming and cause sleep issues as well. Thought leaders on grief are starting to recognize grief as both a process and a disease, where studies show that grieving can cause poor sleep that can become a chronic disturbance. Know when to ask for professional help in order to protect yourself and properly heal your mind, body and soul.

Complete Article ↪HERE↩!

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We Must Do Better for Grief-Stricken People

Grieving raises your risk for illness, even death

By Kevyn Burger

Bereavement is an old-fashioned term, harking back to an era when family members who lost a loved one dressed in black, literally wearing their grief for all to see.

Today, mourning a death has few rules, traditions or identifiers. But research indicates that a significant loss is deadly serious, putting the grieving at higher risk for serious health problems, and even their own premature death.

For more than a decade, Dr. Toni Miles has studied the impact of bereavement. A physician with a Ph.D. in public health, Miles is a professor of epidemiology at the University of Georgia and director of its Institute of Gerontology.

As the boomer population ages and more individuals live with grief, Miles believes the time is right to look at bereavement care as a public health issue that can buffer the negative impact of loss. Her research also identifies effective strategies to support the bereaved.

In this interview, Miles explains how bereavement affects people’s health and mortality and what we can do to better help those who are grieving.

Kevyn Burger: What toll is taken by the loss of a close family member?

Dr. Toni Miles: Critical losses are destabilizing and accumulate over time. The death of a significant loved one — by that I mean a parent, spouse, sibling or child — increases your own risk of dying.

I’m not talking about the anecdotal story of an older couple that dies within twenty-four hours of each other. I’m using a large data set of people fifty and older, studying people who report they’ve lost someone close in the last twenty-four months. At a population level, those people are two times more likely to die over the course of a lifetime than someone without that loss.

What else does the data show?

The rates for premature death are highest in the first two years after the loss. The research also shows that the younger you are when you lose someone important to you, the worse it is for your health. The elevated mortality risk for children who lose a parent goes up fivefold. In our models, losing a child, even an adult child, statistically carries a high risk of morbidity.

It sounds like time, in fact, does not heal these wounds.

That’s true. The risk never goes away; it does not return to the expected level of the general population that has not experienced such a loss. Even when you adjust for age, the risk stays higher. When we measure this at a population level, we believe that five percent of the deaths that happen in a year are attributable to a loss; by that I mean, they might not have died if they didn’t have this loss in their background.

What’s the physical toll of grief?

Bereavement is this feeling of profound loss; it’s having a giant hole in your soul. You are living with this feeling that you didn’t have before this event. Your physiology is perturbed. People gain or lose weight, their sleep is disturbed. They take up smoking again. Grief sends people to the doctor and the hospital.

And, sooner or later, everybody loses a significant loved one.

If people started turning purple with each loss, we would be able to see it in front of us. Some people are lavender, others are like an eggplant.

After studying the risks and outcomes of elevated mortality from a public health perspective, I say we are in the midst of a hidden epidemic.

What can be done to help?

We need bereavement care for the grief-stricken. We need to take care of the people around the deathbed, not just the person in it. Bereavement care is a therapeutic strategy that can build resilience. There are things you can do that are non-pharmacological that counter the negative effects of loss. (People) need permission to grieve and help processing what they’re experiencing, from professionals or from people who care.

Do we collectively do a good job caring for bereaved people?

Not at all, but we could. I want this research to influence policy. I’m looking for ways to interject bereavement care into our society. We can use this knowledge to lower that known elevated risk. For example, the literature shows us that the loss of a family member significantly increases stress hormones in pregnant women. Knowing that can be huge for practitioners. It can change how a mother-to-be is cared for.

What are other risk factors that impact the health of survivors?

A death can mean a financial loss to the household. In the statistical model, we found that people who were getting money support from the deceased and take a financial hit are more likely to get sick and die. We often overlook that.

From a practical standpoint, what can we do to help a friend or neighbor who is mourning the loss of a significant loved one?

Encourage physical activity. I say, walk the bereaved. This is something a friend or neighbor can offer after a loss. Show up and say, ‘Let’s take a stroll.’ Movement cuts the risk of negative outcomes in half in our (research) models in people over fifty. The data showed a benefit derived from any type of physical activity. Activity also decreases the instances of insomnia, and if you can sleep, you can heal.

What about the gesture of bringing food after a funeral?

A lot of comfort food is fatty and salty. Every recipe in Georgia starts with, ‘Fry a pound of bacon.’ When my bother-in-law died, I thought, ‘These people are trying to kill us.’ Don’t bring the casserole with the cream sauce. Bring a nice bowl of fresh fruit.

Any ‘don’ts’ to keep in mind when expressing sympathy?

To a person, those who are bereaved say, ‘Don’t tell me you know how I feel.’ Even if you think you do, they won’t buy it. It will only anger them.

Be prepared to listen, but not everyone wants to talk. In the movie First Man, the Neil Armstrong character lost his young daughter. Five years later, her death comes up in a group setting. It brings her back to him and he has to leave. He goes home and is looking at the moon when a friend shows up and asks, ‘Do you want to talk about it?’ Armstrong replies, ‘No, that’s why I came here.’ That moment is very illustrative. He needed his friend to just sit quietly and be a presence for him. Sometimes that’s good enough.

Complete Article ↪HERE↩!

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The power of language

Explaining dying and death to kids

When we told the kids that we lost grandpa last night, our 5-year-old immediately jumped up and started trying to find him.

Adults tend to use euphemisms, or “code words,” to talk about illness, dying and death. They often do this to soften the news they’re sharing. This can be confusing for children in ways that you might not expect. Because their experience of sickness is usually minor like a cold or ear ache, they may not understand the illness is serious. Or they may not understand the person has died and won’t move or breath again.

This table provides suggestions of clear words and phrases to use.

Explaining life-limiting illness

I explained to the kids that even though I really wanted to play with them and walk them to school the way I used to. I can’t because of the cancer.

More than a cold
When adults explain that someone is sick or ill, children might think this is much the same as an everyday cold or flu. For this reason, it’s important to name the illness or condition. 

Name the illness
Use the words cancer or heart attack. This:

  • Helps even the youngest children understand this is different from a cold or flu.
  • Gives children a name for the changes they are seeing in the person.

My dad is much more tired than usual because of the cancer.

  • Decreases the opportunity for misunderstandings.

Uncle Rob has an illness called cancer. It started in his lung so it’s called lung cancer. Cancer isn’t like getting a cold or the flu. It doesn’t spread from one person to another. Cancer doesn’t work that way. You can still touch mom, hug mom, share food with mom, and you won’t get cancer from her.

Explain the impact
Use clear language to explain how the illness is affecting the person. For example:

Aunt Barb has an illness called ALS. It’s causing her body to not work properly.

If the illness is affecting the person’s thoughts and behaviours, let your child know this:

You may have noticed that your grandma has been acting differently. I’ve noticed that she gets angry more easily. This is because the cancer is in her brain, and this changes her mood and behaviour.

Outline how to behave
Let them know if they need to behave differently than usual when they are with the person who is ill:

I know one of your favourite things is to get in my lap and read stories. Because of the cancer in my bones, I can’t hold you on my lap like I used to, which I feel sad about. Let’s try lying beside one another instead.

Explaining dying

Telling Emma that I’m dying was so hard, but it was important to me that she was prepared for the changes she’s going to see in me as I get closer to death.

When the body dies, it never works again
Your aunt has a lot of cancer in her body, which is causing her body to not work properly. The cancer is stronger than all of the medicines that can be used to try to get rid of cancer. Eventually your aunt’s body will stop working, and her body will die. When the body dies, it never works again.

Address common misunderstandings

  • Sometimes children worry that talking about dying makes it more likely that the person will die. Reassure them that this isn’t so.
  • Let them know that the person who is ill isn’t dying because they didn’t “fight hard enough” or “try hard enough” to stay alive.
  • If it’s true, explain that they very much want to stay alive, but unfortunately the illness is too strong.
  • If the illness is one that not everybody dies from, explain this to your child. For example, Grandma may be dying from cancer but Aunt Shahina also has cancer but is not dying from it.

Explaining death

We totally confused our kids by trying to explain the afterlife without first explaining what happens to the body when someone dies.

We worried about how much to tell the kids. We didn’t want to scare them with too much information.

Where did he go?

It’s important to use the words dying and death. Passed away or passed on can be confusing and too abstract for young children to understand. If we say that we lost grandpa or mom is gone, children often wonder:

Gone where?

Why aren’t we looking for him?

Did I do something to make her leave?

When is she coming back?

Explaining to young children

Start by explaining what happens to the physical body.

When a body dies, it stops working and can never work again.

The body doesn’t think or feel anymore so it doesn’t get cold or hungry and it can’t feel pain.

The body can never come back to life.

It’s best to explain that “the body” includes the person’s head. Young children often think that “body” means from the neck down – and so they may mistakenly imagine the body of the person who has died with no head.

To show them the difference between being alive and dead, ask them to jump up and down, breathe in and out, and feel their own heart beating.

When a person dies, they can’t jump around, they stop breathing and their heart can’t beat or work anymore.

Discussing cause of death

If your child asked what caused the death, give an honest and simple explanation.

Your sister was hit by a car. Her body was so injured that she died.

Your uncle had a heart attack. This caused his heart to stop working and he died.

Unless they ask, you don’t need to describe what happened in detail. If they do ask, let their questions guide which information to give, and answer them honestly.

How these conversations help

As difficult as these conversations were, they’ve actually brought us closer together. I feel the kids trust that I’ll include them when hard things are happening in our family.

  • When you’re willing to discuss difficult topics, your children learn that:
  • Hard conversations can happen safely.
  • They’re a valued member of the family.
  • They can talk with you about life’s most challenging experiences.

Complete Article ↪HERE↩!

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How to prepare yourself for a good end of life

By Katy Butler

My parents lived good lives and expected to die good deaths. They exercised daily, ate plenty of fruits and vegetables, and kept, in their well-organized files, boilerplate advance health directives. But when he was 79, my beloved and seemingly vigorous father came up from his basement study, put on the kettle for tea, and had a devastating stroke. For the next 6½ years, my mother and I watched, heartbroken and largely helpless, as he descended into dementia, near-blindness and misery. To make matters worse, a pacemaker, thoughtlessly inserted two years after his stroke, unnecessarily prolonged his worst years on Earth.

That was a decade ago. Last month I turned 70. The peculiar problems of modern death — often overly medicalized and unnecessarily prolonged — are no longer abstractions to me. Even though I swim daily and take no medications, somewhere beyond the horizon, my death has saddled his horse and is heading my way. I want a better death than many of those I’ve recently seen.

In this I’m not alone. According to a 2017 Kaiser Foundation study, 7 in 10 Americans hope to die at home. But half die in nursing homes and hospitals, and more than a tenth are cruelly shuttled from one to the other in their final three days. Pain is a major barrier to a peaceful death, and nearly half of dying Americans suffer from uncontrolled pain. Nobody I know hopes to die in the soulless confines of an Intensive Care Unit. But more than a quarter of Medicare members cycle through one in their final month, and a fifth of Americans die in an ICU.

This state of affairs has many causes, among them fear, a culture-wide denial of death, ignorance of medicine’s limits, and a language barrier between medical staff and ordinary people. “They often feel abandoned at their greatest hour of need,” an HMO nurse told me about her many terminally ill patients. “But the oncologists tell us that their patients fire them if they are truthful.”

I don’t want this to be my story.

In the past three years, I’ve interviewed hundreds of people who have witnessed good deaths and hard ones, and I consulted top experts in end-of-life medicine. This is what I learned about how to get the best from our imperfect health care system and how to prepare for a good end of life.

Have a vision. Imagine what it would take you to die in peace and work back from there. Whom do you need to thank or forgive? Do you want to have someone reading to you from poetry or the Bible, or massaging your hands with oil, or simply holding them in silence? Talk about this with people you love.

Once you’ve got the basics clear, expand your horizons. A former forester, suffering from multiple sclerosis, was gurneyed into the woods in Washington state by volunteer firefighters for a last glimpse of his beloved trees. Something like this is possible if you face death while still enjoying life. Appoint someone with people skills and a backbone to speak for you if you can no longer speak for yourself.

Stay in charge. If your doctor isn’t curious about what matters to you or won’t tell you what’s going on in plain English, fire that doctor. That’s what Amy Berman did when a prominent oncologist told her to undergo chemotherapy, a mastectomy, radiation and then more chemo to treat her stage-four inflammatory breast cancer.

She settled on another oncologist who asked her, “What do you want to accomplish?” Berman said that she was aiming for a “Niagara Falls trajectory:” To live as well as possible for as long as possible, followed by a rapid final decline.

Berman, now 59, went on an estrogen suppressing pill. Eight years, later, she’s still working, she’s climbed the Great Wall of China, and has never been hospitalized. “Most doctors,” she says, “focus only on length of life. That’s not my only metric.”

Know the trajectory of your illness. If you face a frightening diagnosis, ask your doctor to draw a sketch tracking how you might feel and function during your illness and its treatments. A visual will yield far more helpful information than asking exactly how much time you have left.

When you become fragile, consider shifting your emphasis from cure to comfort and find an alternative to the emergency room.

And don’t be afraid to explore hospice sooner rather than later. It won’t make you die sooner, it’s covered by insurance, and you are more likely to die well, with your family supported and your pain under control.

Find your tribe and arrange caregivers. Dying at home is labor-intensive. Hospices provide home visits from nurses and other professionals, but your friends, relatives and hired aides will be the ones who empty bedpans and provide hands-on care. You don’t have to be rich, or a saint, to handle this well. You do need one fiercely committed person to act as a central tent pole and as many part-timers as you can marshal. People who die comfortable, well-supported deaths at home tend to have one of three things going for them: money, a rich social network of neighbors or friends, or a good government program (like PACE, the federal Program of All Inclusive Care for the Elderly).

Don’t wait until you’re at death’s door to explore your passions, deepen your relationships and find your posse. Do favors for your neighbors and mentor younger people. It doesn’t matter if you find your allies among fellow quilters, bridge-players, tai chi practitioners, or in the Christian Motorcyclists Association. You just need to share an activity face-to-face.

Take command of the space. No matter where death occurs, you can bring calm and meaning to the room. Don’t be afraid to rearrange the physical environment. Weddings have been held in ICUs so that a dying mother could witness the ceremony. In a hospital or nursing home, ask for a private room, get televisions and telemetry turned off, and stop the taking of vital signs.

Clean house: Hospice nurses often list five emotional tasks for the end of life: thank you, I love you, please forgive me, I forgive you, and goodbye. Do not underestimate the power of your emotional legacy, expressed in even a small, last-minute exchange. Kathy Duby of Mill Valley was raised on the East Coast by a violent alcoholic mother. She had no memory of ever hearing, “I love you.”

When Duby was in her 40s, her mother lay dying of breast cancer in a hospital in Boston. Over the phone, she told Duby, “Don’t come, I don’t want to see you.” Duby got on a plane anyway.

She walked into the hospital room to see a tiny figure curled up in bed — shrunken, yellow, bald, bronzed by jaundice, as Duby later wrote in a poem. Duby’s mother said aloud, “I love you and I’m sorry.”

Duby replied, “I love you and I’m sorry.”

“Those few moments,” Duby said, “Cleared up a lifetime of misunderstanding each other.”

Think of death as a rite of passage. In the days before effective medicine, our ancestors were guided by books and customs that framed dying as a spiritual ordeal rather than a medical event. Without abandoning the best of what modern medicine has to offer, return to that spirit.

Over the years, I’ve learned one thing: Those who contemplate their aging, vulnerability and mortality often live better lives and experience better deaths than those who don’t. They enroll in hospice earlier, and often feel and function better — and sometimes even live longer — than those who pursue maximum treatment.

We influence our lives, but we don’t control them, and the same goes for how they end. No matter how bravely you adapt to loss and how cannily you navigate our fragmented health system, dying will still represent the ultimate loss of control.

But you don’t have to be a passive victim. You retain moral agency. You can keep shaping your life all the way to its end — as long as you seize the power to imagine, to arrange support and to plan.

Complete Article ↪HERE↩!

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Anticipatory Grief

What do we feel when a loved one is in the very last stage of their lives? What do people who are dying feel when they realize that their time here is nearly over? That process – emotional grief is what we refer to as anticipatory grief. It is the anticipation and grief reaction to understanding that someone or yourself are about to die. Not specifically in the next few moments, but in the months to come. In this post, we discuss anticipatory grief and the grieving process.

What is Anticipatory Grief?

Anticipatory grief is the emotional response to the pending death of a loved one. It is a very powerful form of grief and occurs both in the loved ones of someone who has a terminal illness and in the person who is suffering that illness.

This is a response to the realization that that person or yourself is going to die and that the hope of being cured has diminished. Anticipatory grief is not always about the actual loss of life. It can accompany a major change in peoples lives such as having to have a limb amputated or when a woman must have a mastectomy and feels that her femininity is dying.

What Are the Signs and Symptoms of Anticipatory Grief?

There are five stages of grief and those include:

  • Denial – Sometimes when faced with death, we deny that the situation is as serious as it is. We cannot accept that death is a possibility or that someone who is dying will eventually die. Instead, we might push them to try harder or resent them silently for not trying harder or resent those around them for not trying harder. “If only” statements are common. If only, I had done more… If only I had taken the time… If only I had talked to the doctor…
  • Anger – Anger can be uncontrollable and rage-like. It can be directed at the person who is dying or at the people caring for that person – doctor, caregivers, etc. The response is after an accusation and can be violent – physical or emotional – outbursts.
  • Bargaining – There is the thought that you can make a deal in exchange for something more. ” I can give you more money if you give me better medication – strong chemo, etc. The idea of death is not solidified at this point. There is still the desperate clinging to hope for things that have not yet been identified or discovered – A new drug, a new procedure, a new chance.
  • Depression – We understand now and the regrets of what we have said, the time we have wasted, the little things that mean nothing are now a weight that pulls us downwards. For those who are about to lose a loved one, this depression may cause us to not want to see the person, or to take the blame for their loss upon ourselves. These are darker emotions.
  • and Acceptance – We have accepted the fact that nobody is to blame, that there is nothing left to bargain for, and that despite our sadness we or our loved one is going to die. It is a calming of the angst that we have felt. It is often a recognizable and reconciliation period we discuss forgiveness or give permission to someone we love so that they can die. It is about dignity and hope and while sad, is an uplifting from the depressed period through which we have passed. It is a coming to terms with death and the loss and sometimes it is a deeper understanding of what death is – a part of life.

Coping with Anticipatory Grief

One of the first things to understand about anticipatory grief is that it is a very normal process. You have not done anything wrong. The fact that you are grieving means that you care.

Be willing to talk with other people about what you are feeling. In Hospice, the idea is to treat the entire family because anticipatory grief is very powerful. If hospice is not available, talk to your clergy or begin to see a therapist. There are support groups that can help and many are free of charge.

Talking is a release and grief is very much like a deep pressure that we contain until we explode. Talking relieves that pressure and helps us to see grief for what it is and to recognize why we feel what we do. Talking is good for the entire family and for the patient.

It is important to acknowledge that this is a loss for everyone involved. This is not specifically about giving up the fight, but a reorganization of your options and the tools available to preserve the quality of life and the dignity of the person who is dying. It is a way to make good use of the time that is left and to focus on being good to yourself and to your loved ones.

If you are facing a terminal illness, be sure to set up a support system for the people around you. As you move closer to death it is these people who will help you to handle the pressure and the stress. It is also wise to set up a support system that cares for the people around you. Many will carry the burden of death silently so as not to burden the person who is ill with their grief. Knowing that now, enables you to build a team that cares for all of you.

Grief is a natural part of being ill and facing a terminal illness. It can be devastating and paralyzing, but by recognizing what it is and how it works empowers you to handle it.

Complete Article ↪HERE↩!

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There Are No Five Stages of Grief

When my father died, I wanted desperately to know the timing of this thing. But grief doesn’t have a timeline.

By Andy Kopsa

I got a text message from my father.

My first thought: impossible — that old man doesn’t know how to text.

My second thought: impossible — my father is dead.

My dad died on Sept. 4 — a Tuesday — just a month shy of his 82nd birthday. He was a farmer, just like my grandfather, and was the hardest working man I knew.

There are four of us kids; my brother and I just over a year apart, then a five-year gap and two sisters back to back. My father took a subtle approach to parenting. This resulted in my mother screaming on various occasions, “Leo, get those kids off the top of that barn/tree/tractor/wagon!”

He lived long enough to grudgingly retire, my brother taking over the farm where we were all raised, as was always understood. Dad couldn’t stay away from the farm, puttering around in the huge back garden; planting various squash (or as he pronounced it, “skwarsh”), potatoes and tomatoes; wrangling grandkids to till, plant or pull weeds.

I always figured dad would die on a tractor or performing some other farming-related task. I looked back down at my phone, afraid to read the message because for one moment so bright and terrifying I allowed myself to think: What if?

I opened it. It was from my nephew letting me know he took over my father’s telephone number; he couldn’t bear the thought of it going to someone else. I let myself cry fully then, relieved it wasn’t my father texting from beyond and shattered because he wasn’t.

As an investigative reporter, it is my job to get to the bottom of things, to make sense out of stacks of police reports, pages of legislation, histories and patterns to produce articles — a distillation of findings and interviews arranged in neat articles hopefully interesting and easy to understand.

I started researching grief. I wanted desperately to know the timing on this thing. When would I stop dropping to my knees (out of the blue) and crying so hard for so long that my ribs hurt?

My research turned up the five — or seven, depending on the source — stages of grief. It revealed ways of grieving and ceremonies that were supposed to ease this time in my life. I was to be reassured, according to one theory, that everyone dies, that life is death, therefore grief will come to us all.

There is nothing less profound than pointing out the inevitability of dying to tie us all together in suffering.

I found out my father was dying in late April. It was still a bit chilly as I walked around my Upper West Side neighborhood that day. My phone buzzed and it was my mother, calling with results from the decisive test, though I can’t remember which one. Blood work? CT scan? Or was its ultrasound?

I answered, and my mother asked: “Are you home?” No, I wasn’t home, and no, I wouldn’t wait until I get home to call her back.

I sat on a bike rack at a familiar location down the block. I can still feel heat climbing the back of my neck to the tips of my ears, the way my gut plunged. We didn’t have the official diagnosis yet, but I knew it was the worst news. My mother told me they found something on his pancreas.

Nearly 75 percent of patients with pancreatic cancer die in the first year. Dad died within five months.

I started grieving before my father died. I learned there is a name for this: anticipatory grief. The worst thing about anticipatory grief is that no one gets it unless they have been through it.

Friends tried to understand as I raged on the phone, bawling. I got startlingly angry with people I love very much, loudly telling one friend to stop trying to relate to what I was going through and just listen, for Chrissakes. Every time my phone buzzed, my heart seized: This was the call, I just knew it. I asked to be taken off mass text chains. My nerves couldn’t take many more reply-alls.

My requests — please take me off mass texts; please, no phone calls, I don’t want to talk because I don’t have it in me; please, no cards, just please — offended some people. That reaction confused me and enraged me.

I told all this to my friend, a woman also named Andy. It made sense, she told me, because this death of a parent thing is bad and people don’t know how to respond. She said I am finding my tribe — the ones of us who watched our parents dying. This friend who knows, she said: “I laid in bed when my mother was down to 68 pounds with breath smelling like death.”

When I told my good friend Kristy about my father, she said: “Girl, let me tell you, watching your dad die ain’t nothing pretty.” Kristy knows. She watched her father waste away, dying three years ago from Parkinson’s disease.

I need these women and these women specifically. I don’t have to say a word and they understand. It saves me because I don’t have the patience or strength to try and explain, I don’t even have the right language.

In July, an EF-3 tornado ripped through Marshalltown, Iowa. I grew up in Beaman, about 18 miles northeast. Now living in New York, I watched the video footage pouring in: the clock tower sucked off the top of the county courthouse, roofs peeled back, hunks of metal turned into missiles.

As I watched shaky cellphone videos, I started to cry. What would happen to the Orpheum theater, where my father took me and my brother to movies, or grandma’s house, where we would stop after church on Sundays?

The day after my father died, my husband and I made a trip to Marshalltown for groceries. We decided to take a drive around and survey the tornado damage. It was incredible. I threw myself into our disaster tour, enjoying the destruction of other people’s things, greedily searching out the worst-hit blocks, the most destroyed buildings — I needed it all.

We turned onto Main Street to head back home, and I was talking fast to my husband in the passenger seat. I got louder; I was yelling now, driving, crying. I abruptly pulled over to the side of the road, alongside the destroyed courthouse, and I screamed and I screamed and I screamed. And then I stopped. Heaving, I accepted the Kleenex my husband silently handed me, I blew my nose, and we drove in contented silence the 18 miles home.

My father’s last day on earth was a rough one. I am convinced he overheard us talking about possibly taking him into the hospice. We couldn’t keep up the relentless pace his care required, even though we knew he wanted to stay home. I hated the idea, but we had to consider it. My mother thought so, too.

Then, my father spiraled quickly. One sister feverishly moved her flight up from London — she would be home the next day, she told my father on the phone, his face lighting up listening to her voice. My other sister, from Minneapolis, was on her way but was trapped sheltering under an overpass as tornado warnings swirled around Interstate 35.

I started a journal after my father was diagnosed. I wrote: “I just want him to feel good with the time he has left, I want him to find peace and acceptance. All I want is for him to not be scared.”

And, he wasn’t. My brother called the priest, and he was there within the hour. As he walked in, I heard my father say clearly and happily, “Well, hi Father, I was wondering when I would see you!” My brother and I knelt by his bedside as the priest gave my father last rites: three last sacraments culminating in final Holy Communion.

I lay in bed with him off and on that day. Gave him watered-down coffee through a straw — he winked, told me my coffee was better than Mom’s. I lay there, my father still warm beside me, and I looked out the window at the big tree in the backyard and told him I would remember to fill the bird feeders.

My research suggests there will be a period of adjustment as I try to find a new normal. So far my new normal has involved a variety of public and private acts of mourning. Some days my pain is like accidentally brushing fingertips across a hot iron, burning yet mercifully brief.

Other days I start crying over a bag of frozen shrimp at Trader Joe’s. Or like today, I stare out the back door at my wintry rooftop garden and think of summer tomatoes, the smell of dirt, of my father, and sob.

My phone buzzed. Another text from “Dad.” This time it was a picture of a squirrel teetering on the lip of a rusted old watering can. I laughed this time. I haven’t switched the contact name to my nephew’s yet, and I don’t know when or if I will. People may be tempted to file this under the denial phase of my grief. But they would be wrong. I know my father is dead, I was there.

But I get it. As Americans, we have been trained up to believe that grief is a process, something linear we are capable of understanding. But I am comfortable with my broken heart now after my dad’s death, comfortable even when my sadness reaches a maddening crescendo because that is when I get the gift of giving up.

There is relief for me now — not from sadness and pain — but from my own expectations of how I am supposed to feel. There is no timeline. There isn’t even a straight line, for that matter. And for the first time in my life, I am O.K. with that.

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