Simulated end-of-life journey delivers emotional insights

Maine hospice and health care professionals, medical students and even loved ones can broaden empathic responses via virtual reality.

 


 
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Pull the headset over your eyes and the world around you fades. You have become 66-year-old Clay Crowder, and you are dying.

Your doctor looks into your eyes and quietly explains that medical treatments aren’t working. The lung cancer has spread. You have four to six months left.

Later at home, you doze while listening to your wife and two daughters discuss your care with a hospice worker. As death nears and pain intensifies, you see what’s happening inside your body. Your lungs and rib cage begin to heave rapidly. Medication eases your discomfort. Your breathing returns to a slow rattle.

Family members gather around your bed. You hear them talking. Prompted by a hospice nurse, your wife tells you that it’s all right to let go.

“It’s OK, honey,” she says. “You’ve got your girls here.”

A still from Embodied Labs’ virtual-reality simulation of the death of Clay Crowder, a fictional creation, shows the terminally ill man’s two daughters, left, and his interactions with a hospice nurse.

It’s tough being Clay, a new interactive, virtual reality video that lets the participant go through one man’s end-of-life experience. Hospice of Southern Maine and the University of New England are using the computer simulation lab as a learning tool for health care professionals, medical students, hospice workers and patients’ loved ones.

A box of tissues is always nearby.

“It’s powerful,” said Susan Mason, clinical services manager for Hospice of Southern Maine. “I’ve been a hospice nurse for five years and I was truly shocked at how much I hadn’t considered before I went through the experience as Clay. You truly feel like you’re in it.”

David Carey, chaplain for Hospice of Southern Maine in Scarborough, interacts with a virtual-reality video depicting the final moments of a terminally ill man’s life. Users say the simulation by Embodied Labs is powerful.

Clay Crowder, family man and military veteran, is the creation of Embodied Labs, a Los Angeles-based company that has produced several computer sim labs designed to put people in a patient’s body.

The University of New England in Biddeford has been using the company’s virtual reality technology for nearly two years, to help medical students better understand what it’s like to experience health problems as common as hearing loss and as devastating as Alzheimer’s disease.

Now, Hospice of Southern Maine, based in Scarborough, is using the Clay lab to give staff and family members a better sense of what it’s like to die. Even the most experienced hospice caregivers can find themselves reaching for a tissue and learning something new.

Hospice CEO Daryl Cady said she believes the Clay lab has the power to change the way people feel about death and hospice care, especially for younger generations who are familiar with virtual reality technology.

“It’s so important that people understand how hospice can help at the end of life and not fear it,” Cady said. “If they take just 30 minutes to put on the VR goggles and stand in the shoes of someone with a terminal illness, just think of the change that could make.”

POPULATION AGES, DEMAND GROWS

Cady said the Clay lab also gives hospice staff and volunteers an opportunity to witness the conversations that happen when a physician delivers a terminal diagnosis and the family dynamics that often come into play.

Jaye Van Dussen, community liaison for Hospice of Southern Maine, comforts David Carey after he watched a virtual-reality video depicting the final moments of a terminally ill man’s life.

Such education and outreach is expected to become increasingly important as Maine’s population continues to age and demand for hospice care grows.

Maine’s population is now solidly the oldest in the nation, with the highest median age of 44.7 years – meaning the younger population is dwindling – and tied, with Florida and Montana, for the largest proportion of residents age 65 and older – 19 percent of the state’s 1.3 million people, according to the U.S. Census.

Hospice of Southern Maine’s clinical teams – nurses, social workers and others – visit about 200 patients daily, up from about 130 patients daily just three years ago. Last year, the agency cared for a total of 1,641 patients – either at home or at Gosnell Memorial Hospice House in Scarborough – a 2 percent increase over the previous year, according to the nonprofit’s annual report.

Maine’s use of hospice services has grown steadily in the last decade, Cady said. When Hospice of Southern Maine started operating in 2004, about 9 percent of Medicare-eligible Mainers used hospice services, placing the state at 49th in the nation. By 2013, 57 percent of eligible Mainers were accessing hospice care and the state had moved to 25th in the nation, according to Medicare data.

“The Clay lab will help us educate the community about the end-of-life experience,” Cady said.

BASED ON FAMILY EXPERIENCE

Inside the Clay lab, with the virtual reality goggles over your eyes, you experience the transitions that patients and family members must make throughout the dying process.

When the doctor says you have a few months to live, you turn to your left and see the pained look on your wife’s face. To your right, your feisty daughter presses the doctor to explain why surgery is no longer an option. Your family is adamant. They won’t let you just “fade away.”

Later, you wind up in the emergency room after a serious fall. A compassionate nurse explains some of the benefits of hospice care. Mostly it’s about doing what you’re able to do and keeping you comfortable.

“It comes down to how you want to spend the time you have left,” she says.

Embodied Labs was started in 2016 by four young technology entrepreneurs. CEO Carrie Shaw, a medical illustrator and health educator, was just 19 years old when she helped care for her mother, who had early-onset Alzheimer’s.

That experience prompted Shaw to wonder if putting health care providers in their patients’ skin might make them more effective. Her older sister, Erin Washington, designs the company’s curriculum.

First, the company produced a sim lab experience called Alfred James, a 74-year-old African-American man with advanced macular degeneration and high-frequency hearing loss.

Next, they created Beatriz Rogers, a middle-aged Hispanic woman who progresses through the early, middle and late stages of Alzheimer’s. Clay Crowder is their latest.

LINKS TO UNE, MAINE HOSPICE

All three sim labs are required viewing in the geriatrics education program at UNE’s College of Osteopathic Medicine, one of the few med schools in the nation that require significant training in aging-related health issues.

“Students are always amazed at the experience of becoming Alfred or Beatriz or Clay,” said Marilyn Gugliucci, director of UNE’s geriatrics program. “It’s always interesting to see how they respond to Alfred’s frustration that his doctor is treating him as if he has cognitive impairment when he doesn’t. He just can’t see or hear well.”

Embodied Labs, UNE and Hospice of Southern Maine have developed mutually beneficial relationships, Gugliucci said.

The Clay lab was created after a team from Embodied Labs spent 48 hours at Gosnell House, interviewing staff members and witnessing all that they do, similar to the experience that several UNE med students have each year.

More recently, another team from Embodied Labs spent 48 hours in the dementia unit at the Maine Veterans’ Home in Scarborough, where UNE med students go to learn what it’s like to live in a nursing home, Gugliucci said.

The team’s experience will be woven into the next virtual lab, which will feature a Muslim woman who has Parkinson’s disease and Lewy body dementia, the second most common form of dementia after Alzheimer’s disease.

‘WHAT ACTIVE DYING LOOKS LIKE’

The Clay lab is presented in three segments: terminal diagnosis, decision to start hospice care and death.

“You see what active dying looks like, including what actually happens to the body,” Carrie Shaw said. “Our goal was to make something that’s not scary or grotesque, but it is informational.”

The last segment takes place in Clay’s bedroom.

Again, you are Clay.

Your eyes are nearly closed and your vision limited as family members and caregivers come and go. You hear them talk about your cold feet and your blue hands. Your daughter wonders if you need a feeding tube. The hospice nurse quells her concerns about your declining need for food.

Your death is shown symbolically. An imaginary great blue heron that has visited you before, capturing your fading attention to this world, appears again and flies off from the foot of your bed.

You watch the rest from above as your wife and daughters take turns saying goodbye.

The hospice nurse returns to bathe and dress you in your military uniform. She speaks to you in a gentle, now familiar voice, as if you are still alive.

 

“Mr. Crowder, we’re going to take care of your body now, OK?” she asks.

Your experience as Clay Crowder ends as your casket, draped in an American flag, is wheeled out of the house.

Complete Article HERE!

The Death Doula

Traverse City doula Krista Cain guides people in … and out of the world

By Molly Korroch

“The human brain learns from stories,” says Traverse City birth and death doula, Krista Cain. As she sits with a mug of hot herbal tea at Cuppa Joe in the Village at Grand Traverse Commons, she explains her own story and the not-so-strange duality of her business, Sweetwater Doula, this way: Everyone experiences birth and death. Whether you’re experiencing them directly or through someone close to you, they’re an inevitability. They’re both also mammoth experiences marked by extreme emotion, hospital visits, and ceremony. Each of these experiences, she says, is a wave that smacks our bodies and minds repeatedly back down into the fray. Each is exhausting. But, she asks, “Why not ride [that experience] and let it take you in the direction you want to go? I want my teaching to be a surfboard.”

A doula is not a medical practitioner. A person working as a doula is not a doctor or a midwife; he or, more commonly, she is a guide.

Doula is a Greek word that was appropriated in the ’80s to describe a female assistant,” says Cain, but the definition has since expanded to describe someone who helps others during intimate emotional and physical events. Becoming a doula isn’t something with a hard start or stop, like a medical degree or a teacher certification. It’s common life experiences. “Walking people through life is a softer line,” she says.

Cain’s own line toward becoming a doula wasn’t a direct one. She originally hails from Southern California. She has a background in education and worked as a high school math teacher before coming to Michigan. But when she and her husband, who grew up in Traverse City, moved to northern Michigan in 2011, Cain, who was pregnant at the time, had a jarring resolution: “I’m not here to teach math. I’m here to teach people.”

Her transition into teaching about birth and death began with a certification in the Lamaze technique, which she still teaches alongside her workshops in birth and death. As she taught, she began to see that there were some holes in her personal experience with birth: She had never attended a birth other than her own. Her training as a birth doula began from a desire to offer even deeper knowledge and empathy to her clients.

Likewise, another life experience led her to expand her business to include not only guidance in birth but also in death. In particular, experiencing the death of her young goddaughter showed her how helpful it is to approach death in whatever way makes most sense to the person experiencing it. Death is certain, yet always feels unexpected.

Cain began training as— what she calls — a “death doula” in 2016, with an organization based in California called Bridging Transitions. The mother of one of its founders lived on the Leelanau Peninsula before she passed away in 2016. Cain was able to participate and assist the family during this time. She learned about both the scientific and social nature of death and dying.

Funeral Director and owner of Life Story Funeral Home, Vaughn Seavolt, worked directly with Cain during the funeral for a family who wanted to participate in all aspects of their father’s death. He said he sees a lot of value for both the person passing and the loved ones left behind.

“Having a death doula participate made it very meaningful for the family,” says Seavolt, “I think that it’s very rewarding and very healthy for families who want to participate as much as they want to.”

Cain says birth and death are extremely social experiences, and a doula helps with the social needs and pressures surrounding these major life transitions.

“A doula is a person who is skilled to walk beside you — your family, your partner — to meet your needs as you go through these changes,” says Cain. She will help you and your family in whatever way you need, from deciding what sort of service you want (do you even want a service?) to finding a place in the refrigerator for all the casseroles you’ve received.

“It’s not all about green burials,” says Cain. “You can do this with a body preserved in formaldehyde. You can do this with someone who’s been cremated.” On her website, Cain talks about how the ceremony surrounding the death of a loved one can be exactly what you make of it. It can take place at a funeral home, the hospital, a loved one’s home — whatever makes most sense for your situation. It can have as much or as little religion as is right for you and your family and friends. “There are religious traditions that guide the day, and there are ways you can walk alongside those traditions to serve the needs of the people who are carrying them out,” says Cain.

Most importantly, she provides both information and validation for your personal choices. In birthing and dying, what is right for one person might not be right for another, and that’s OK, Cain says.

Explains on of Cain’s birth clients: “It is also refreshing to hear people talk openly and without judgment about ‘taboo’ topics like postpartum depression and mental health counseling, miscarriage and infertility.”

Cain is adamant about empowering her clients through education. “We have a right to know about this stuff,” she says, “[both the] transformative experience of it and the nuts and bolts.”

A quick internet search reveals that end-of-life doulas are on the rise. There are lots of names for it: “end-of-life transition guide” or even “midwife of the veil,” but Cain prefers to keep things simple and bypass the poetry.

“Right now I straight up say ‘Death Doula.’ The reason I say that is because it’s really reallyclear. I don’t want to have to be that blunt, but we’ve done such a good job at covering it up.”

She’s working to uncover these topics, though she recognizes that it takes a fair amount of bravery to approach them openly. Cain often hosts workshops in both life and death. Who are they for? “Anyone with a life span!” she says, laughing. “If you’ve got a life span, you might at some point want to consider thinking about these things.”

Matters of Life and Death
Want to learn more about Cain, her services, or upcoming workshops? Check out www.sweetwaterdoula.com.

Complete Article HERE!

Heartbreaking Photo Series Documents the Raw Final Moments Owners Spend With Their Dying Pets

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Any pet owner will tell you that losing them is as great a pain as losing any member of the family. It’s in these moments we’re at our most vulnerable. One brave photographer has taken on the task of capturing such fragile moments in a series that documents owners struggling to cope in the last moments of their animal’s life.

Ross Taylor’s powerful new series is one that’s sure to bring a tear to the eye of any pet owner. His inspiration came after being “profoundly moved” by witnessing a friend struggle with the deteriorating health of her pet and her subsequent decision of euthanasia. The collection of images, he says, explores the intimacy of the human-animal bond, specifically “the last moments before and after the passing of a pet at home with their owner.”

Leigh Zahn fights back tears as she lays with her dog, Spencer, in her lap a final time, just moments after Spencer passed.
“She’s always been my companion. Coco was there for me when he was on deployment,” said Rebecca Cassity, as she fights back tears. Her husband, Drew, was in the military. Dr. McVety reassures her with a hug and consoling words: “This is better treatment than any one of us would get.”

The images were taken in Tampa Bay, Florida throughout 2017-18 and involved working closely with the families involved. The pet owners seen in the images were aided by veterinarians from Lap of Love, a pet euthanasia service that allows for a peaceful passing at home. Founded by Dani McVety, the organization has been working with Caring Pathways, all of whom Taylor expresses utmost gratitude for. “It couldn’t be done without their willingness to participate and belief in the project… They have my respect,” Taylor said.

In one of the most intense moments I’ve ever witnessed, Wendy Lehr cuddled beside her dog, Mimosa, shortly after she passed. The muffled sounds of her cries filled the empty room as she nuzzled against her face. She cried out: “Oh my baby, oh my baby. What am going to do without you?”
“It’s tough saying goodbye,” said Carrie Peterson after she dropped sunflowers over the grave of her dog, Asia. The smell of freshly turned earth is what I remember and how peaceful Asia looked within it.

While difficult, the at-home euthanasia process can be one that mitigates some of the painful reality of the end of life. It’s worth noting that the vets I’ve worked with are some of the most compassionate people I’ve met and always offer the families a chance to have a respectful moment afterwards with their beloved pet. It’s in stillness of these moments that I sometimes felt the most emotional for everyone involved.

Bob Zahn touches his dog, Spencer, just moments after the dog passed. His wife, Leigh, left the room immediately, as it was too much for her to take. “She’s going to take it harder maybe than the loss of her parents. Your parents can tell you when something’s wrong, but your dog can’t.”
Vanessa Gangadyal consoles her son, Ian, 8, while her husband, Michael Gangadyal, pets their dog, Ally, shortly after its passing.
“When I was sick, she knew something was wrong,” said Bob Lutz about their dog, Heidi, who looked up at them moments before she was euthanized due to recent substantial declines in health. His wife, Cindy, added: “she helped take away our pain.” At right, watching, is their other dog, Winnie.

If you were as moved as we were by this powerful series, you can see more of Taylor’s work (some of which saw him nominated for a Pulitzer Prize) at his website and Instagram.

Complete Article HERE!

Schools fall short when it comes to helping students in grief

– here’s how they can improve

Children’s understanding of death expands as they grow and develop.

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An adolescent experiences the death of his mother after a lengthy illness.

When I ask what services he would like to receive from the school, he initially says he didn’t expect special treatment, would be embarrassed by counseling from the school mental health staff and wouldn’t feel comfortable if many of his teachers asked to talk to him about his grief.

At the same time, the student felt as though the school should somehow take his situation into account.

“I don’t know what the school should do,” the student told me. “But I just lost the person I love most in my life and they act as if nothing happened.”

In my many years as a developmental-behavioral pediatrician who specializes in school crisis and child bereavement, I believe this dilemma – that is, the need to do enough but not to overwhelm the grieving student or the adults who are trying to help – represents a major challenge for America’s schools.

The need for recognition by trusted adults of their loss, a genuine expression of sympathy and an offer of assistance is often what students seek after a major loss – but too often don’t receive.

A common experience

Loss is very common in childhood – 9 out of 10 children experience the death of a close family member or friend and 1 in 20 children experience the death of a parent.

In contrast, teacher preparation to support grieving students is uncommon. In a recent survey conducted by the American Federation of Teachers and the New York Life Foundation, 93 percent of teachers reported that they never received any training on how to support grieving students. They identified this lack of training as the primary barrier that prevented them from reaching out to grieving students in their class and offering the support they knew they needed. Worried that they would do or say the wrong thing and only make matters worse, some educators chose instead to say and do nothing.

In recognition of this problem, I offer a series of insights and recommendations that teachers can adopt to make the school experience less stressful for students who have recently lost a loved one. Although the advice is aimed at educators, surviving parents or caretakers or anyone who cares about how to help bereaved students can use this advice to advocate on their behalf.

The consequences of inaction

Saying nothing says a lot to grieving children. It communicates that adults are either unaware, uninterested or unwilling to help. It leaves children confused about what has happened and how to react. It leaves children unsupported and forces them to grieve alone. Adults should reach out to grieving children and let them know that they are aware and concerned and are available to provide support and assistance.

What not to say

Anything that starts with “at least” should probably be reconsidered – “at least she’s not in pain anymore” or “at least you still have your father” are generally not helpful comments. It suggests that the adult is uncomfortable with the child’s expression of grief and is trying to “cheer up” the grieving child in order to limit the adult’s own discomfort. Don’t encourage children to hide their feelings or reactions, and don’t feel that you have to hide your own emotions. Be genuine and authentic. Tell grieving children that you are sorry about their loss and ask them what they are feeling and how they are doing.

There isn’t anything you can say that is going to make everything right again for a grieving child. So, listen more than you talk. Other guidelines of what not to say – and what to say instead – to grieving children can be found in “The Grieving Student: A Teacher’s Guide.”

Engage peers

Peers want to – and can – be an important source of support to grieving children, but often are unsure what to say or do. Provide them advice on what to say and practical suggestions on how to be helpful. This will help grieving children obtain critical peer support and decrease their sense of isolation. It will also reduce the likelihood that peers will instead ask repetitive and intrusive questions or tease grieving children.

Offer academic accommodations

Grieving children often experience a temporary decrease in learning ability. They may be tired from not being able to sleep, have difficulty concentrating and learning new material, or may be experiencing significant disruptions in their home environment that make it difficult to study or complete homework.

Grieving children should view school as a place of comfort and support, especially at a time of loss. If they are worried about failing, school becomes instead a source of additional distress. Teachers should offer educational support before children demonstrate academic failure. Check in more frequently to make sure that they are learning new material and are able to keep up with the workload.

Talk to other teachers, instructors and coaches and try to help grieving students balance all of their responsibilities. If the student needs to prepare for an important concert, then maybe academic teachers can lessen some of their assignments. Grieving students may need to have their workload decreased or modified temporarily. If a major report seems overwhelming, substitute with shorter and more manageable assignments. If it’s hard for them to stay on task to complete an individual project, consider a group project that might promote peer support.

Be more sensitive

Teachers can also introduce activities with more sensitivity. For example, if you are going to do a project for Mother’s Day, introduce the activity by telling students that you realize some children may not have a mother who is alive or living with them. They can still complete the activity remembering their mother, or can choose to focus on another important female family member. This will also help students whose mothers may be deployed in the military or incarcerated, or away for other reasons.

Help children manage grief triggers

Many things may remind grieving children about the person who died and cause them to temporarily feel a resurgence of their grief. It may be a comment made by a teacher or a peer, such as “I went shopping with my mother this weekend,” or a portion of a classroom lesson, such as a health education lesson that references a similar cause of death.

Holidays such as Thanksgiving or the winter holidays tend to involve spending time with loved ones and may accentuate the sense of loss. Let students know that these triggers may occur and set up a safety plan. Students may be given permission to step out of the classroom briefly if they are feeling upset and worried that they will not be able to contain their emotions. Work out a signal to communicate when this occurs that doesn’t draw attention to the student. Make a plan for where the student will go and who they can talk with. If students know that they will be able to leave, they often feel less overwhelmed and will be more likely to remain in class and stay engaged in the lesson.

For more information

The Coalition to Support Grieving Students offers free learning modules on a wide range of issues related to grieving students, including videos and written summaries. Schools can also learn more about how to help grieving students through the Grief-Sensitive Schools Initiative.

Complete Article HERE!

Washington bill would make it legal to compost human remains into soil

Recomposting would let people skip traditional burial and cremation practices for a greener option.

A computer-rendered vision of what a Recompose facility would look like.

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Would you prefer to be cremated or buried in a casket? Washington might give residents an additional option if it becomes the first US state to legalize an unusual end-of-life practice — composting human remains.

“Recomposting” — which advertises as more environmentally friendly than traditional funeral practices — is a process where a human body is quickly decomposed using heat-loving microbes and beneficial bacteria.

The temperature is kept at 131 degrees Fahrenheit (55 Celsius) for 72 consecutive hours. The remains are then added into soil that can be used as mulch for trees, flowers and other plants.

Washington State Sen. Jamie Pedersen, a Democrat, plans to introduce a recomposting bill in January, NBC reports.

If passed, the bill would legalize recomposting in Washington so citizens could choose an alternative to the traditional methods of burial and cremation of human remains.

The Seattle company Recompose would be responsible for the actual composting of human bodies. 

In 2017, Pederson introduced a similar bill but says it failed due to opposition from religious groups, according to NBC.

Neither Sen. Pedersen or Recompose, the company that would be responsible for the actual composting of human bodies, responded to a request for comment.

“The transformation of human to soil happens inside our reusable, hexagonal recomposition vessels,” the Recompose website says. “When the process has finished, families will be able to take home some of the soil created, while gardens on-site will remind us that all of life is interconnected.”

During the recomposting process, bodies are screened for non-organic materials like metal teeth fillings, pacemakers and artificial limbs, which are recycled whenever possible.

The entire process takes a month, and can produce a cubic yard of soil per person, according to Recompose.

While this may sound ideal to people wanting an environmental-friendly option to burial, not everyone can go through the recomposting process. Some pathogens (like the bacteria that causes anthrax) may be resistant to the composting process, so people with certain health conditions may be ineligible.

While recomposting has yet to be made legal in the US, “green burials” (bury human bodies without chemicals) are legal in all 50 states. Currently, recomposting a human body is legal in Sweden.

Complete Article HERE!

My sons’ grief at a friend’s death has forced me to see I can’t shelter them forever

One thing never ceases to strike fear into the heart of parents: the idea of our kids dying before us

The idea that someone could be in your life one day and gone the next was incomprehensible to Jo Davies’ sons.

By Jo Davies

I was at the grocery store the other night when my younger sons and I ran into my next-door neighbour toting his six-week-old son.

After cooing over Junior’s beautiful blue eyes and his adorable expressions for a bit, one of my boys asked to touch the little one’s cheek. My neighbor hesitated for a moment and then declined, saying the baby hadn’t yet had his second round of vaccinations.

I was shocked for a moment, then smiled, reminding myself we were dealing with that most nervous of Nellies: the first-time parent.

Whether you have kids or not, you’ve likely heard the stereotype of the hyper-responsible first-time mom or dad jumping to boil the baby’s pacifier the second it touches the floor or rushing to the ER for every uptick in temperature.

Undoubtedly, this initial hyper-vigilance serves a purpose: it’s Mother Nature’s way of ensuring the survival of the species. All parents go through it, and most get over it.

There’s one thing, however, that never ceases to strike fear into the heart of parents: the idea of our kids dying before us.

A few weeks ago, my sons’ classmate died at the age of 15.

He was a nice boy — quiet and respectful and kind. His death was unexpected, shocking and a heartbreaking introduction into the ways of grief not only for my two sons, but their school community as well.

At this point in their young lives, my sons haven’t experienced the death of anyone close to them except for their grandparents. That was obviously upsetting for them, but their father and I were able to help them to rationalize it, because their grandparents were much older than them; they’d lived a good life and left a legacy for which their many friends and family would remember them fondly.

When their friend died, however, it was virtually impossible to come to terms with it.

Despite the best efforts of their teachers and school counsellors, my boys were at a loss. The idea that someone could be in your life one day and gone the next was incomprehensible to them.

I asked myself: knowing what I know about death (my father died suddenly when I was 24), how can I make the death of their friend make sense to them? I came to the conclusion that I can’t.

There is no way to make sense of such a tragic circumstance, to find a silver lining. All I can do is try to help them cope with what’s happened.

To that end, I’ve done my best to read up on teenage grief, so I can be useful to my sons.

I’ve learned that, as with adults, teenage grief is as unique as each individual who experiences it. It can’t be dictated or forced to fit someone else’s conception of what’s appropriate.

I’ve also realized that for teenagers, grieving is just one more complication in an already turbulent period of life. The death of a close friend can cause them to question their own, newly formed identities as young adults; to ask questions they might never have considered before about life and mortality.

What’s been hardest for me in this process is watching my sons come to the realization that life, at its core, is uncertain. There are no guarantees of happy, long lives for the ones you love, even if you wish there were.

Up until now, their teenage brains (with their still-developing sense of consequences) have helped to make them feel invincible, or if not invincible, at least unconcerned with thoughts of dying — which seemed to me to be as it should be. Kids should be able to live their lives without constantly thinking about death and dying.

 

Now they know words like “hearse” and “pallbearer” and “condolences.” They have witnessed the depths of a parent’s grief as they listened to their friend’s mother describe all the ways she will miss him.

They’ve also been surprised by kindness from unexpected quarters; friends they didn’t know cared who gave them a hug or a tissue.

They have learned a lot of things over the past few weeks, as have I.

Mainly, I’ve learned that there was still a part of me that thought I could keep them safe from the harsh realities of life. I can’t, and that hurts.

However, just as I taught all three of my sons to use a spoon, to tie their shoelaces and to say “please” and “thank you,” I can teach them other things that are even more useful.

I can teach them to value each day they have on this earth, to be grateful that they knew their friend, and to be happy they were good friends to him during his short time here.

I’m pretty sure those are lessons worth learning.

Complete Article HERE!

As baby boomers age, ‘we are in for a death boom.’

Grief expert urges support for mourning workers.

Bobbi Manka, right, works with her colleague Jen Gallois, left, at Tyson Fresh Meats on Dec. 11, 2018, in Elgin. Manka’s co-workers helped her following the death of her husband, Dan Manka, in January 2016.

By Alexia Elejalde-Ruiz

Bobbi and Daniel Manka were settling into bed after a night out dancing when Daniel stood up, clutched his chest and gasped, “911.”

Just like that, Bobbi Manka lost her husband of 44 years and gained “a hole in my heart that will never be replaced.”

But she has found comfort where she didn’t know she would: at work.

Grief after the death of a loved one inevitably follows people to work, where employers and co-workers often are unprepared to handle the immediate sorrow or the surges of pain that ambush mourners at milestones like birthdays and holidays.

Some of the shortcomings can be linked to insufficient bereavement leave policies, but often what fails is the human response to a suffering colleague.

“We have become an increasingly death-denying society,” said Amy Florian, CEO of Corgenius, a Hoffman Estates-based organization that trains businesses on how to help grieving clients and employees. “And when we don’t talk about it, we don’t know how to do it well: how to accompany people through grief.”

Florian said employers would be wise to prepare for the impact of grief on business as aging baby boomers, who are staying in the workplace longer, move toward the end of life.

“We are in for a death boom, we are in for a dementia boom,” said Florian, a fellow in thanatology, the study of death and bereavement. “All of these things are going to happen but firms are not prepared for it.”

Being prepared includes understanding that grieving individuals will cope differently, and employers should accommodate their unique needs, Florian said.

Nearly 90 percent of employers say they offer paid bereavement leave — usually three days for an immediate family member — but that’s not nearly enough time for many people, especially when the death is sudden, she said. Employers might want to consider more generous policies as well as expand them to accommodate deaths beyond immediate family, as losing an aunt or friend can be just as devastating if the relationship was close, Florian said.

No federal law requires employers to give workers time off to grieve, though Illinois has a law, which went into effect two years ago, that provides up to 10 working days of unpaid leave for the death of a child at companies with at least 50 employees.

Florian said employers also should not expect grief-stricken employees to function normally when they return to work, as their concentration is shot, their minds are disorganized and they may be prone to making mistakes. Some employees will need additional support for a month or two once they’re back on the job, such as flexible work schedules, more breaks, adjusted expectations and someone to catch errors, with the assurance that their performance reviews won’t suffer, she said.

Educating co-workers on how to best support a grieving colleague can also help. Many people fumble awkwardly as they try to express sympathy, or avoid the topic altogether because they don’t know what to say, Florian said.

“What is often very shocking for people to learn is that ‘I am so sorry’ is not the best thing to say when someone dies,” Florian said. “The focus is all wrong, it’s on the comforter and not the griever.” Better to ask about the person who died — what they were like, how it happened, making sure to use his or her name, she said. If someone doesn’t want to talk about it, they will close the door on the conversation, she said.

Bobbi Manka pokes her head into Scott Leckrone’s office at Tyson Fresh Meats on Dec. 11, 2018 in Elgin. Leckrone, Manka’s boss, and other colleagues provided emotional support to Manka after her husband died in January 2016.

Manka, 64, who lives in Genoa, a town about 65 miles northwest of Chicago, said she was surprised to discover how often people didn’t ask how she was doing after her husband died suddenly of a massive heart attack two years ago.

“They are afraid that they might trigger something and you might start crying,” she said. “Even if I did, it would have been a good thing.”

But Manka, an administrative assistant in the Tyson Foods sales office in Elgin, was pleasantly surprised at how her colleagues stepped up during her crisis, even though she’d worked at the company only two years at the time and no one from the office had met her husband — the kind of guy “who would take his shirt off and give it to anyone,” she said.

Her boss and a colleague not only attended his “celebration of life” but stayed through the event and got to know her family, she said. When her three days of bereavement leave were up and she couldn’t bring herself to return to work, she was given an extra week off unpaid. She was eager to return when she did.

“My world had been rocked so incredibly hard that coming back to work helped me, because the house was so empty,” Manka said. “Work was my safe place for a long time.”

As she struggled to adjust to her new reality, Manka sought counseling from Tyson’s chaplaincy program, a network of 100 chaplains employed by the company to help Tyson workers navigate life challenges. She found solace in the Bible verses she was given and the advice about how to help her children through their grief as she dealt with her own.

Small kindnesses in her office of 12 have made a big difference, she said. On Manka’s first birthday after her husband’s death, her co-workers presented her with a big cake and card, and told her “we want you to know you’re part of the family,” Manka said. On her wedding anniversary, or when anything happens that triggers memories, her boss can detect a shift in her mood and urges her to take a walk and clear her head.

Such accommodations pay off in the long term, Florian said.

“People who felt they were treated compassionately during times of grief are incredibly loyal to their employer,” she said.

Grief last year cost employers an estimated $113.27 billion in reduced productivity and on-the-job errors, a calculation that takes into account not only the deaths of loved ones but also other traumatic losses such as divorce or home foreclosures, according to the Grief Recovery Institute, an organization based in Bend, Ore., that trains therapists and counselors in grief recovery.

That estimate is up from $75 billion the last time the nonprofit released its Grief Index in 2002, a increase driven by inflation as well as changing workforce demographics as the population ages, said Operations Manager Ed Owens.

Yet employers are rarely proactive about addressing grief in the workplace, and typically only seek help when an employee has died and co-workers need support, said David Fireman, executive director of the Center for Grief Recovery and Therapeutic Services in Chicago’s Rogers Park neighborhood.

“If I had my druthers, (grief training) would be a built-in component to employee orientation,” Fireman said.

While the aging population is one source of workplace grief, another is the city’s violence. Fireman’s organization last year counseled students and faculty at the Chicago Waldorf School after a teacher at the school was killed by a stray bullet while she waited at a nearby Red Line station. He continues to be available to them because “grief is a process and there might be delayed reactions,” he said.

GrieveWell, a nonprofit in Ann Arbor, Mich., that provides grief training to employers and peer-to-peer support for grieving adults, is trying to raise the profile of grief as an “unspoken public health issue” with dangerous consequences if it is not addressed, said Amy Milanovich, former executive director.

Unresolved grief, a clinical term that refers to intense mourning that persists for a long time and interferes with daily functioning, has been linked to an increase in heart disease, stroke and cancer, she said.

The workplace has become increasingly important as a source of support as community traditions that used to surround people in mourning have been cut short amid a social expectation to get back to life as usual, she said.

“Everyone around is someone who could be in grief and everyone needs to be someone who can support them,” Milanovich said. In addition to conducting business lunch-and-learns on the topic, GrieveWell offers a deeper training in active listening for employees who want to be the designated ear colleagues turn to in time of need.

ComPsych, a Chicago-based provider of employee assistance programs, has seen a steady increase in crisis counseling calls about bereavement, likely because employers have become more aware of the need for mental health support, spokeswoman Jennifer Hudson said. Employees over 60 are the most likely of all age groups to seek bereavement help, the company’s data show.

Eric Freckman, a certified financial planner in Palatine, said grief training at his firm has led to improved relationships with clients, who often find themselves navigating unfamiliar bank accounts and investments when a spouse or parent passes away. Increasingly, grief strikes even before death as more people live longer with diminished capacity, he said.

People tend to make emotional decisions around money, especially when they’re grieving, so it takes empathy to guide them to the best decision, Freckman said.

“There’s the answer in Excel of what they should do,” he said. “But getting people to actually do that is very difficult.”

Financial adviser Eric Freckman, left, meets with Keith Leust, of Barrington, at the Guillaume & Freckman office on Dec. 27, 2018, in Palatine.

Freckman said he used to be “sort of terrified” of talking with clients about their loved one’s death, and would avoid it by sticking to discussing numbers. But after training with Florian at Corgenius he feels comfortable engaging in conversations about the loss — “How did you find out?” he asks. “What was it like for you?” “Are there phone calls we can make for you?” — and leaving the paperwork to later meetings. Ninety percent of clients want to talk, and the care shown has helped solidify trust, he said.

“We keep track of people’s birthdays, we try to call and let them know we’re thinking about them, that we know it’s a hard day, the first Christmas alone,” he said. “It’s all relatively simple stuff when you think about it.”

The simple stuff can make a big difference, Florian said. She knows from experience.

Florian was 25 and a new mom to a 7-month-old boy when her husband, John, went to a business meeting and never returned. A farm insurance agent, he was killed when his car was struck broadside on a rural Iowa road on a sleety February night.

“I felt like my future had simply evaporated in an instant,” Florian said. “And nobody knew what to say to me.”

Florian, a stay-at-home mom at the time, felt “every breath was different” after that day, as she adjusted to the empty pillow, the coffee for one, the realization that “anyone could die at any time.”

She felt alone as many people avoided talking about her husband after the funeral. She was grateful to those who did, especially when they said his name.

“It’s such a comfort to know that John’s life made a difference, that someone remembers besides me,” she said. “That his death left a void in the world, not just my life.”

Florian noticed the various ways well-meaning people’s support was insufficient. They’d ask if she needed anything, but she felt bad taking advantage of those offers, worried she’d be a burden. More helpful, she said, was when people identified what needed doing and offered to do it, such as shopping for groceries, weeding the garden or babysitting her son.

Florian recalls working with a financial professional who would change the subject when she started to tear up. So she was impressed when another financial planner, on their first meeting, looked at her file and said: “I see that you are widowed. Tell me about John.”

Her experience propelled her to get a graduate degree in pastoral studies and advanced certification in grief counseling, and she taught ministry courses on death and grieving at Loyola University for 11 years.

Decades after John’s death, Florian is remarried, and her sadness lives alongside her joy. She can still be sent into a sobbing fit in the grocery store aisle when she hears a certain song – and that’s OK.

“The point of healing is not to forget,” she said. “The point is to remember.”

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