Losing a long-term spouse can be deadly, studies show

Broken heart syndrome occurs when the heart is stunned by sudden, acute stress and its left ventricle weakens. Instead of contracting into its normal arrowlike shape, the left ventricle fails to function, creating a more rounded, potlike shape.

By Sandee LaMotte

The world has joined Queen Elizabeth II in sorrow over the loss Friday of her husband of seven decades, Prince Phillip, the Duke of Edinburgh, just two months shy of his 100th birthday.

The duo was a loving and close-knit couple. The Queen told guests at a luncheon on their 50th wedding anniversary that Phillip had “quite simply, been my strength and stay all these years.”

With the loss of what the Queen called her husband’s “constant love and help,” attention has now turned to the Queen’s well-being. The death of a loved one is a blow at any time, but losing a spouse after many years of togetherness can be especially difficult.

Studies have shown that surviving spouses can suffer from sleep disruption, depressive episodes, anxiety, impaired immune function, and overall poorer physical health.

For those concerned about the Queen in her time of great personal loss, many may be wondering if there is medical evidence of grief impacting one’s health.

Broken heart syndrome is real

Known as stress-induced cardiomyopathy, “broken heart” syndrome is a documented medical condition.

Broken heart syndrome occurs when the heart is stunned by sudden, acute stress and its left ventricle weakens. Instead of contracting into its normal arrowlike shape, the left ventricle fails to function, creating a more rounded, potlike shape.

First described in 1990 in Japan, a broken heart looks so much like a Japanese octopus trap called a takotsubo that doctors began calling the condition Takotsubo cardiomyopathy.

“The heart actually changes shape in response to acute emotional disruption, such as after the breakup of a romantic relationship or the death of a loved one,” New York cardiologist and author Dr. Sandeep Jauhar told CNN in a prior interview.

In most cases, however, when the acute emotional stress dissipates, the heart recovers and goes back to its normal shape, Jauhar said.

“But I’ve had patients who have developed acute congestive heart failure, life-threatening arrhythmias, even death from this condition,” Jauhar said. “I think it’s the clearest example of how our emotional lives directly affect our hearts.”

The syndrome is most commonly experienced by women (90% of cases are in women), by people with a history of neurological problems, such as seizures, and by people with a history of mental health problems.

‘Widowhood effect’

There is another medical reality that can occur when a long relationship ends, studies have shown.

“The increased likelihood for a recently widowed person to die — often called the “widowhood effect” — is one of the best documented examples of the effect of social relations on health,” wrote Dr. Nicholas Christakis, who runs the Human Nature Lab at Yale University and coauthor Felix Elwert, a professor of sociology at the University of Wisconsin, Madison, in a seminal 2008 study.

The risk of an elderly man or woman dying from any cause increases between 30% and 90% in the first three months after a spouse’s death, then drops to about 15% in the months that follow. The widowhood effect has been documented in all ages and races around the world.

Christakis and Elwert followed a representative sample of 373,189 older married couples in the United States from 1993 to 2002 and found that “widowhood does not raise the risk of all causes of death uniformly.”

When a partner died a sudden death, from say an accident or infection, the risk of death by the surviving spouse rose, the study found. The same was true for chronic diseases such as diabetes, chronic obstructive pulmonary disease (COPD) and lung or colon cancer that required careful patient management to treat or prevent.

However, if a spouse died from Alzheimer’s disease or Parkinson’s disease, there was no impact on the surviving partner’s health — possibly because the spouse had adequate time to prepare for the loss of their partner.

Regardless, “the death of a spouse, for whatever reason, is a significant threat to health and poses a substantial risk of death by whatever cause,” Christakis and Elwert wrote.

What can be done

Support is key to how well someone may cope with the death of a spouse. Many people find that grief counseling can help, according to the US National Institute on Aging.

In the United Kingdom, people can obtain psychological therapy without a referral from a general practitioner. The UK’s National Health Service suggests reaching out if you have had a low mood for more than two weeks or the methods you’re trying yourself are not helping.

The AARP (formerly known as the American Association of Retired Persons) also has these suggestions for survivors.

Don’t put on a brave front: Surround yourself with people for whom you don’t have to pretend to be OK. “Grieving is an act of great courage and strength; it is not for the weak,” the AARP said.

Be kind to yourself: Try to get enough rest. “The more significant the loss, the more profound it is and the longer the recovery process,” the AARP said.

Expect a range of emotions, not just grief: According to the AARP, “your feelings may run the gamut from sad to mad to despair to occasional glimpses of happiness — and back again. If you are able to feel only sad, you will get stuck in perpetual despair.”

Don’t hide from people: “Grief is a lonely enough process without also isolating yourself,” the AARP said. Try your best to connect to friends and family and let them help. “When caregivers embrace the idea that seeing friends makes them hardier, then they no longer suffer guilt over having fun,” the association said.

Complete Article HERE!

We Weren’t Meant to Grieve Alone

We’ve been deprived of the last moments with loved ones and in-person gatherings to mourn together. What can we do to heal?

By Susan Gubar

Swans do it, chimps do it; even elephants and whales do it. They fall in love and then after their beloved dies, they grieve. Human beings differ only to the extent that we have inherited rituals that help us deal with a shattering emotion. But what happens when those rites must be relinquished or reinvented during a plague year?

This question started to haunt me when a member of my cancer support group, Barbara, dropped out of our Zoom meetings. Hospice nurses had been helping her at home and now she was actively dying from ovarian cancer. How could our group continue to connect with her? I left messages with my name and phone number on her answering machine. I sent an email with that information — perhaps her two adult sons would access her account — but received no response.

In the past, I had sat by the bedside of dying group members and later attended religious services or life celebrations. Now, I found myself grieving the sorry fact that I had not been able to say goodbye to Barbara. After news of her death reached us, I grieved that I did not even know how to reach her family to tell them what a compassionate companion she had been.

The experience made me appreciate if not the curative then at least the consoling value of vigils, wakes, burials, funerals and memorials, each in its own way an event staged to help us stay attached and then begin loosening our ties to the ever-receding dead person. While sitting by a deathbed holding a hand, while standing in a cemetery as a coffin or urn is lowered into the earth with a prayer or a poem, while hearing a memory recalled at a funeral, we treasure the person who had been and gain comfort from others who share our sorrow. Most of these ceremonies have been canceled during the past year.

A new book on grief by the psychologist Dorothy P. Holinger is useful in thinking about the impact of the termination of mourning rituals, although it was written before the pandemic. The book, “The Anatomy of Grief,looks at how grief can wreck the brain, the heart and the emotions of the bereaved, a word that signifies those who feel robbed.

“Grief,” Dr. Holinger explains, “is the price we pay for love.” To be bereaved is to be robbed of the loved one and of the world and the self that had existed when they were alive.

Dr. Holinger’s book made me consider how normal or resilient grief differs from pandemic grief. The distinction reminded me of the bifurcation Sigmund Freud made between mourning — a healthy coming to terms with loss — and melancholia — a dysfunctional passage mired in misery. For in pestilent times, as Shakespeare put it, “grief lies all within.”

At any stage of history, to be sure, grief can destroy the world of survivors who cannot eat, sleep, think clearly, or go about their daily business. Grief can also obliterate identity. Who are we when we are no longer our parent’s child, our child’s parent, our sibling’s brother or sister, our partner’s partner, our friend’s friend? During a lockdown that isolates us by forbidding physical proximity, grief finds no outlet. We are deprived of the last moments in which we can see, touch, hear or speak to the beloved as well as subsequent days and months when we can cry, laugh, hug and reminisce with friends and family.

Dr. Holinger provides a taxonomy of different types of grief — some 17 varieties in all — many of which plunge the mourner into lingering preoccupation with the lost loved one. To use some of her terms about troubled forms of grieving, in a pandemic grief that cannot be made manifest may be “anticipatory” (death is expected), “disenfranchised” (mourners may not be acknowledged), “postponed” (sorrow remains unexpressed) and “forgotten” (loss goes unacknowledged).

When Judy Woodruff, the anchor of the PBS “NewsHour,” pauses each Friday night to memorialize five people killed by Covid-19, she acknowledges that she uses these individuals as representatives of a much larger population. In doing so, she encourages us to entertain the unimaginable fact that more than 500,000 Americans have died from the coronavirus, leaving innumerable widowed, orphaned and heartbroken survivors.

Those who mourn people who died during the pandemic but not from it are also affected. Like many survivors, the members of my cancer support group devised a way to communicate our grief over Barbara’s death. Each of us wrote a letter to her family that we collected and gave to Barbara’s oncologist, who forwarded the packet to her sons.

A few weeks later, I confronted a more fraught death. My former husband, a very dear friend, died unexpectedly, probably from a heart attack. It was a shock to his intimates but especially to our two daughters, neither of whom lives where he did. With travel an impossibility, how could we honor his memory? How could we find solace in each other? How could we bury his remains or sort through his things or close down his apartment?

These challenges have taught me how feeble and how effective electronic solutions can be. In an attempt to join together, the girls organized a series of Zoom shivas, the weeklong condolence calls in which many Jewish mourners engage. But our online meetings felt desiccated without an influx of visitors bringing food, drinks, flowers and a steady supply of embraces, kisses, jokes and tears. Yet a month or so later, the photographs, music and storytelling at a Zoom memorial arranged by the girls did console us as well as many of their father’s far-flung relatives and friends.

Still, there is nothing virtual about death. Perhaps families like ours can gather together on future anniversaries of the death, what in Yiddish is called the yahrzeit.

If, as after other national catastrophes, public memorials are erected to commemorate the suffering inflicted by the pandemic, they will need to honor the dead as well as all the mourners bereft of their bereavement.

Complete Article HERE!

When an Estranged Relative Dies, Some Face Grief, Regret and Relief

Some have regrets over unfinished business. For others, the end of an unhappy and complicated relationship just comes as a relief.

By Caitlin Kelly

When the phone call came from my mother’s nursing home, I knew there could be only one reason. She had died at 85, sitting in her armchair watching television.

I was her only child, but we hadn’t spoken, or even tried to be in touch, in the previous decade. She was a Mensa member, a world traveler of independent means and a voracious reader. She was also a person with bipolar disorder and alcoholism. Worn out by decades of dealing with both, which meant years of chaos and broken plans, I had finally, reluctantly, exhaustedly, just given up trying to have a relationship.

For every anguished iPad farewell made to a dying Covid patient, or during another Zoom funeral or someone dearly loved and mourned, there are many people like me, estranged from their parents, children or siblings when those family members pass away. And because of this, we may not grieve the same way people typically expect. For some, the end of an unhappy and complicated relationship just comes as a relief.

When Karl Pillemer, a gerontologist at Cornell University who wrote “Fault Lines: Fractured Families and How to Mend Them” surveyed 1,340 Americans in 2019, he found that 27 percent of them were estranged from a family member. “Shame, isolation and embarrassment pervade family estrangements,” he wrote.

Now working on a new study of how estrangement affects grief, Dr. Pillemer sees among those studied “unfinished business” and “bereavement-related regrets.” “They have more complicated grief,” he said in an interview. His advice, when possible, is to consider reconciliation, especially if death is expected or imminent, asking the question: “Will I feel better if I do this?” He said “anticipated regret” is very common. “People talked about it a lot. Will I miss the chance to reconnect?”

For Harriet Brown, author of “Shadow Daughter: A Memoir of Estrangement,” her mother’s death at 76 was emotionally complicated. Ms. Brown had left home at 16 and never returned. But the day we spoke, the ninth anniversary of her mother’s death, Ms. Brown said she had cried. “She wasn’t a good mother to me. I never felt mothered, so it’s a different kind of grief about what is never going to happen. I miss what I longed for and that I never had,” Ms. Brown said.

She did try to visit her mother in the hospital, where she was sedated and on a ventilator, hoping to offer moral support to her father and sister. But when Ms. Brown saw her mother again she “felt such terror” instead, realizing anew why she was estranged, and glad of her decision to end the relationship.

Kaitlyn Luce, an artists’ manager in Nashville, lost her father, then 64, in October 2015, when she was 25. He had suffered a massive stroke and was in a Florida hospital. “A 15-hour drive is a long time to think about what you’re going into,” she said. Her father, who had alcoholism and bipolar disorder, had been physically and verbally abusive to her for years, Ms. Luce said. “I hadn’t been speaking to him for about a year and had told him I didn’t want a relationship with him. I really couldn’t put up with it anymore.”

She went to his hospital room, but didn’t see or speak to him. “I immediately broke down,” she recalled. “One of the things I tried to figure out was how I was going to say goodbye to my dad since the possibility of him coming through this was slim to none. I didn’t have a good answer.”

Ms. Luce and her brothers and a paternal aunt did hold a funeral for her father, a former D.J., gathering up photos and playing some of his favorite songs. “What I wanted to remember was when life was good, when times were fun,” she said. “What felt right to us was remembering the times that were really good and he was really, really fun. It did make it easier.”

She has done “a lot of therapy” since his death and still struggles with “a sense of confusion” about how to process his death and her feelings about him. “He couldn’t help himself because he was so sick,” she said. “He was doing the best with the tools he had.”

Yet, “overall,” she added, “a very large feeling I had was a sense of relief. I’d spent all 25 years of my life holding my breath, waiting for the next unpredictable thing he would do or say.”

Estrangement splinters families, sometimes even more so after death. For the British therapist Bernadette Wright, her father’s death came as a relief. She said he had long been “a tyrant, very abusive in every way.” She left home at 18 and moved to Germany, never returning. More than 30 years later, she was on vacation in Spain when her mother called to tell her that he had died. His funeral was announced on the radio in the small town in Ireland where he was born.

“It was difficult for my mother because she was there without her four children,” Ms. Wright said. “A friend of his gave his eulogy. People thought we were absolutely dreadful that we didn’t come. We begged my mom to keep it low-key as no one knew us anyway. We were all brought up in London.” Her mother was angry and embarrassed by their absence, she said, but their self-protection mattered more.

“People have this obsession with forgiveness,” Ms. Wright said. “You can forgive, but you don’t have to forget. You don’t have to have that toxicity back in yourself.” Those who have never been estranged often judge those who are, and very harshly, Ms. Wright added. “But you haven’t lived my life. It made me ill every time I saw my father.”

Ms. Wright has, though, mourned her father, feeling “huge grief,” but less for the man he was than the loving parent she never experienced. “That’s what you’re grieving for. The childhood you never had, the mother you never had, the father you never had.”

Funeral directors also face their own challenges when someone estranged dies, said Kari Northey, a funeral director in Wayland, Mich., with 18 years’ experience. She has seen unattended funerals and their aftermath. “Every funeral home has a shelf of unclaimed ashes. Unclaimed individuals are becoming a bigger situation. Even if they pay for the cremation, they never pick the ashes up.”

Ms. Northey urges those estranged at death from a loved one to “take a moment of looking at that person with fondness. That one good moment is what you grieve. Everyone is a gleam in someone’s eye at some point. At some point in their life, they were a good person.”

It’s helpful to see a body or coffin, she added. “Seeing is believing. If you don’t get that, it can hold back a lot you need to process through.” But if an angry relative who is the one who is paying for a funeral refuses to allow others access, “we end up as gatekeepers,” Ms. Northey said. “We sometimes have to be the person inflicting hurt. We’re constantly saying no when we want to say yes.”

Even as vaccinations are helping to curb the pandemic, there are still hundreds of patients dying of Covid every day, often alone. Dr. Pillemer suggested that hospice workers, chaplains, doctors and palliative care givers ask each one: “When did you last see your child or sibling or parent?”

He added, “There needs to be professional level training since no one wants to talk about estrangement, we need more professional awareness and education. There’s a great silence around the subject.”

Joshua Coleman, a psychologist in private practice and senior fellow with the Council on Contemporary Families, suggested finding a way to “make sense of these conflicted feelings.” His new book, “Rules of Estrangement,” is a guide for parents whose adult children have cut them off, the most common pattern of estrangement, he said.

“There’s a temptation to feel really misunderstood and hurt and also judged by society,” he said. “People have to reckon with it and make sense of why they have chosen to become estranged when they were treated in a cruel, excluding or hostile way by their family. You need to develop your own strong narrative and have people in your life who support that. Nobody who hasn’t been estranged really knows what it’s like.”

I fled my mother’s care at 14, frightened of her mental illness and worn out from coping alone with her breakdowns. I went to live with my father and I never lived with her again. Experience had taught me I couldn’t feel safe with her. In later years, living by choice many thousands of miles apart in different countries, we did enjoy some calm and loving visits, for which I am grateful.

In many ways, I am still very much her daughter — bold, adventurous and curious. Those are the memories I am glad to carry.

Complete Article HERE!

What Is Anticipatory Grief and How Do You Cope with It?

By Stephanie Sengwe

With loss comes grief. Whether it’s losing a loved one, a beloved pet, a job or even the dissolution of a relationship, grief can (and will) rear its ugly head. So why is it that in certain cases, like terminal illness, you can feel grief before the loss? While it’s easy to chalk your emotional rollercoaster up to the extenuating circumstances—medical bills, caretaking, etc.—you may also be going through what is known as anticipatory grief. So what exactly is anticipatory grief and how do we cope? We tapped a therapist to help us understand.

What exactly is anticipatory grief?

According to Diane Brennan, LMHC, a therapist at Life & Loss Mental Health Counseling anticipatory grief is “the grief we experience before the loss actually happens.” “Think about it as the thoughts, feelings, emotions and behaviors that we have that are anticipating a loss will happen.” While it’s most common in situations where people are preparing to lose someone, you can also experience feelings of anticipatory grief when you’re expecting a major change in your life such as being furloughed from work or an impending divorce.

How does it differ from “regular” grief?

When someone we love dies, we’re conditioned to expect (to some degree) a grieving process—looking through their old clothes, perusing photo albums, marking off anniversaries and birthdays. However, since anticipatory grief occurs before the actual loss, it can be much harder to spot, especially because oftentimes, if you are caring for someone with a terminal illness or dealing with the stress of contemptuous divorce, there are a lot of logistical things to take care of. Keeping track of your emotional well-being takes a back seat. “Sometimes people don’t even recognize that what they’re feeling prior to a loss is grief,” Brennan shares.

Who does anticipatory grief affect?

It can affect anybody coping with the prospect of loss—children of an impending divorce, partners of a sick spouse or owner of a business on the brink. But when it comes to terminal illness, it’s important to remember that anticipatory grief can also affect the person dealing with the terminal illness as the idea of their mortality becomes a reality.

How do you spot anticipatory grief?

People going through anticipatory grief can show a greater deal of irritability; they tend to anger quicker, and they may even have feelings of guilt. Says Brennan: “It can be marked with a lot of anxiety, you feel more on edge, a greater degree of sadness. There’s a lot of crying and feelings of hopelessness. Most people don’t make the ‘Oh, this is grief’ connection.”

Are there any positive sides to anticipatory grief?

“For some people, anticipatory grief can be marked with a bit of denial or deep anger about the situation,” Brennan explains. “But, when someone gains an acceptance that this is happening, it can allow them to experience joy and have conversations that are deep and meaningful and allows them to say goodbye.” Just like regular ole’ grief, it’s complicated.

3 Ways to Cope with Anticipatory Grief

1. Join a support group

A supportive group of family and friends is a priceless asset when you’re going through a tough time, but oftentimes they’re in the trenches with you as well. Finding a support group or an association where you can get support may be a better option. “If someone you love has an illness like Alzheimer’s or dementia, there are associations that you can turn to that can offer support, understanding and guidance for what you’re going through,” guides Brennan. Organizations such as the American Cancer Society, the National Multiple Sclerosis Society as well as national mental health hotlines such as Substance Abuse and Mental Health Services Administration, are all great resources to help you through.

2. Make time in your day to acknowledge what you’re grateful for

Coming to terms with the impending death of a loved one can be overwhelming but finding a good balance between your grief and your gratitude can make the road less daunting. “It helps if you can acknowledge your grief on a daily basis, but also focus on one thing you’re grateful for,” Brennan advises. “There are going to be some days that are draining every bit of energy from you but try to find that balance as best you can.” Consider starting a gratitude journal or a meditation where you focus on the things you’re thankful for. 

3. Have the conversations you’ve been holding in

Did you steal their car when you were 16 and never told them? Were you the one who scuffed their favorite pair of sneakers but let your little brother take the blame? Knowing your loved one is reaching the end of their life can grant you the opportunity to tell them all the things you never professed in the past. Conversations can be as shallow or as deep as you want them to be. And hey, if you had a particularly no-holds-barred relationship with no secrets, letting them know just how much they mean to you will be more than enough.

Last Responders Comfort Others, While Managing Their Own Grief

by Lindsay Wilson

When Tom Belford’s mother died in May, her family was faced with the impossible task of limiting her funeral to 10 people. Belford, who is the owner and funeral director of John. A Gentleman Mortuaries and Crematory, recalled the difficult months leading up to his mother’s death.

“From March until May nobody was allowed in the building, and she was on the second floor. So we couldn’t go up to the window or anything,” he said.

The end of a life is a difficult time under any circumstances, but COVID-19 has made grieving even more difficult.

“COVID is taking people suddenly, and it’s affecting the families that have suffered, that go through a death at a time where maybe they shouldn’t,” Belford said.

Belford said in many cases families are losing people who are in their 50s and 60s due to complications from the virus.

“We’re here to help them make that first step back to a normal life after suffering a loss,” he said.

Chapel, 1010 N. 72nd St location (Real Yellow Pages)

John. A Gentleman has seen a steady number of virus-related deaths since the beginning of the pandemic, from March or April through today. Though numbers in Omaha aren’t what New York City or cities in California are seeing, deaths have risen from this time last year, according to last responders such as Belford.

Though the increase in business has been a change, the way Belford and his staff handle virus-related deaths has stayed the same.

“We practice something called universal precautions. We treat everyone as if they had COVID.”

These precautions, which include personal protective equipment used for both funeral directors and the deceased they are working with, have kept Belford’s staff safe since the beginning of the pandemic.

“We don’t treat anybody differently because they had COVID,” he said.

While the practices in caring for the deceased haven’t changed, funeral services have changed, in some cases dramatically, due to the virus.

“The biggest changes we see in the services is the social distancing,” Belford said. “For a while, the services were limited.”

Casket selection, 7010 N. 72nd St location (Real Yellow Pages)

Many churches and chapels continue to limit the capacity of funerals for everyone’s safety. In response to this, John. A. Gentleman has broadened its focus to include videocasting of services for loved ones who are unable to make it to the service.

“Before this started, we had one or two cameras for filming services,” Belford said. “We have six or seven now.”

Recorded services are helpful to many family members, but one important aspect of support is still missing.

“The families,” Belford explained, “they can’t socialize and get the support from their friends. And that’s probably the biggest disappointment families will see. Our interactions are the same. The care we give them is the same. But the care they get from their friends is different.”

Limiting social contact in a time of grief also directly curtails the level of support families would normally receive at the funeral and beyond. John A. Gentleman had to pause its bereavement programs due to the virus, though they recently started back up.

Many families are postponing memorial services for their deceased loved ones until after the virus is under better control. In March and April, some families planned to postpone services until summertime. But then those were pushed back, too. Some families are now pushing memorial services to summer 2021.

“Everybody’s pushing things back,” Belford said. “Hopefully the shots will come in and everybody will get vaccinated.”

Fortunately, Belford and his staff are currently on a waitlist for vaccinations and hope to receive their first shots in the next couple of weeks. In the meantime, Belford is more careful to protect himself and his family from the virus than the average person.

“I wouldn’t say I’m freaked out, but I would say that I’m cautious.” Belford said. “I’m very cautious about where I go and what I do. I have a big bottle of sanitizer in my car.”

Note of thanks, photo from John A. Gentleman

Being a funeral director is a tradition that has passed down for three generations in Belford’s family. While the virus has changed the way he conducts his services, one tradition that remains is the mortuary’s memorial plantings at Lauritzen Gardens, which Belford said is part of the service for every funeral. But even that has been altered slightly. The dedications are now posted online.

The coronavirus has rendered many aspects of life a moving target, and for last responders, more changes are likely to come. However, Tom Belford is prepared to continue to adapt to support families even as his own family mourns their loss. “No matter what happens to people, we’re here to help them,” he said.

Complete Article HERE!

How can we grieve our loved ones without our traditions?

By Niamh Delmar

In Ireland, wakes, removals and funerals have been an integral part of our culture. Giving the deceased a ‘good send off ‘ has been a final tribute to those who have passed. Offering our condolences, food and practical help is an inherent part of our culture.

In the past, churches have heaved with mourners and locals gathering to pay their respects. Celebrations of life, humanist services and scattering of ashes have facilitated a communal mourning. Over the years, soup and sandwiches in the pub after, morphed into meals in a hotel.

The rituals of a burial or cremation are an important part of our humanity and the grieving process. As well as handshakes, hugs and pats on the back, mourners meet people who knew the deceased at different times in their lives. Life stories are elaborated on.

The rituals of a burial or cremation are an important part of the grieving process.

The Irish wake has been passed on through generations. It facilitates the dead and the alive to come together. Traditionally a room in the person’s house is prepared, beside a window to let the spirit leave to its eternal journey. Candles are lit at the foot of the person and the corpse is dressed in their best clothes with rosary beads in their hands.

Prayers, tears, laughter, song and drinking all feature in the presence of close family or the whole neighbourhood and friends. Historically, the deceased was kept in the room for three nights with someone always attending it. There was a lead keener who would cry over the body then others would join in and wail. A wake is a mix of sorrow and celebration, but sadly has been curtailed by this pandemic.

COVID-19 has hijacked our customs around death. Rituals, such as kissing the deceased, open caskets, condolence books and even transport to the funeral have all been impacted. Churches that once heaved have now just a few pews filled with masked mourners while everyone else is watching or crying at a screen, lining a road or standing outside. The solace of connection has been taken.

Mary Cunniffe, branch manager with Massey Brothers funeral directors talked with me about the adapting they have experienced over the past year. Supporting employees at this ‘other’ frontline has been a focus as they have been exposed to suffering, while also trying to keep themselves safe from infection. Some have vulnerable people at home living with them.

Mary commented that grief has been compounded by not having had a chance to have said their goodbyes or words that were left unspoken. People have not been able to give the large repose to honour their dead. Another fall-out from restrictions is that people are unable to visit the bereaved, help hold their grief, or help with practicalities.

All of this is part of the grieving process and eases the suffering. Crying on a shoulder, sharing a cup of tea or a drink, recounting stories about the deceased carries those mourning. Landmarks such as death anniversaries, the deceased birthdays and significant dates have passed unmarked. Suffering and loss has traumatised our nation.

Dying during the pandemic with social distancing and other measures goes against our core nature. Grief has been intensified among those who are left to handle the idea of their loved ones dying alone. Holding the hand of a dying person is comforting to both.

It exacerbates grief when those close to the person can’t attend to their needs, get to know the doctors and nurses or advocate for them the same way. The role of human contact in dying and grieving is powerful. Health care workers have borne the additional brunt of this pandemic by witnessing patients dying without the usual presence of loved ones.

End of life
It is time for dying, funerals and grieving to be looked at in different ways and for us to be prepared for the aftershocks of COVID and non-COVID related deaths during this pandemic and its restrictions. Conversations can be initiated to ensure choices are made and wishes observed.

More palliative care at home is of enormous benefit to overstretched hospitals and provides comfort to the dying and their loved ones. Sharon Foley CEO of the Irish Hospice foundation has said that surveys reveal 75% of people would like to die at home but only 25% do. 

More personnel, such as Chaplains and end of life carers, are needed in Hospitals and play a significant role at the end of life and also play a supportive role to the medical team.

Hospices provide holistic care and dignity to the patient, and look after the needs of loved ones. More of this type of intervention is needed. Ten million euro was awarded to the voluntary hospice sector recently which helps bolster the loss of fundraising monies.

Studies have shown that simple acts such as sitting, rather than standing, at a patient’s bedside can have a positive impact. Open communication between healthcare workers and families is essential. Gathering information about the patient’s life story, likes and interests can facilitate connection with those who are treating and caring for them.

End of life can be personalised with photos of the person nearby, their favourite music being played and the use of technology for loved ones to be in regular contact. The medical team can have their photos and names on their uniforms to ease the distress of being treated by people in full PPE gear. Hospice professionals assert that hearing is the last thing to go so talking, music and other aural activities can be soothing interventions.

While public health is a priority, limited visitation policies and funeral restrictions need be constantly reviewed to provide dignity to those who are nearing the end of life and solace to those grieving. Restrictions compound the process of grieving, increasing the risk of various psychiatric conditions, such as PTSD, depression, anxiety and suicidal ideation.

It also increases the risk of complicated grief or prolonged grief disorder, as not being able to say goodbye to a loved one is a risk factor. It helps if the funeral can be personalised with input from those who can’t attend and a virtual platform can be arranged where people can leave messages, memories, poetry, song and photos in honour of the deceased.

Outlets for children to express emotions can be encouraged. Regular scheduled virtual meet-ups to remember the person’s birthday, anniversary and other landmarks maintains connection. It is never too late to have a memorial, and some people I have spoken with are planning these at a later, safer stage to celebrate the person’s life.

Professionals involved with the bereaved can benefit from training in grief counselling and assessing complicated grief. We all need to be mindful of how we use the word ‘loss’. It has been thrown out there carelessly. While there have been so many losses experienced throughout this pandemic, the loss of a holiday is not at the same level as not being able to be at their loved ones bedside at the end.

Health care workers and the frontline
Counselling is also essential for those who have been at the frontline and exposed to trauma. Compassion fatigue is intensified, without the support of families being present, while a patient is ill or dying. Comforting patients with the barrier of PPE, having difficult conversations and substituting loved ones is a huge emotional responsibility. And moral injury is a systemic problem when frontline workers become frustrated as they are unable to provide care, at the level they were trained, due to constraints.

Significant distress arises when a person has to go against their value system. Psychological PPE is fundamental to protecting the mental health of the frontline. It involves assessment, identification, intervention and monitoring of staff. Debriefings, peer support, support groups, self-care practices have all been found to be beneficial.

Professor Neil Greenberg, Consultant Occupational Psychologist, trauma specialist and Forensic Psychiatrist at King’s College London has called for better identification of vulnerable workers and access to evidence- based treatment. Many others are involved in end of life care such as the funeral sector, clergy, carers and social workers.

There is, and will be collateral damage, but the systems in place within each setting can alleviate adverse symptomatology.

Communities, individuals, society, organisations and policies can interconnect to provide end of life dignity, ways to facilitate after life rituals and identify and support the bereaved. Ar dheis Dé go raibh a n-anamacha.

Complete Article HERE!

Grieving Through Laughter

Sarah Weaver has combined tragedy and comedy in her webcomics as a way to cope with the death of her older sister

Sarah Weaver in Polson, Montana on Oct. 17, 2020

By Ashley Nerbovig

Monotony was kindling for Sarah Weaver’s burning grief.

After the June 2010 death of her older sister, Melissa Weaver, in a plane crash in Northwest Montana, Sarah would fumble over familiar questions such as, “How many siblings do you have?”

The tragedy shook Sarah’s entire worldview. For years she plodded along. She moved to Washington D.C. and took a job creating retirement policy at the U.S. Department of Treasury. Her boss would tell her the work she did made a meaningful difference. But Sarah didn’t see it. In 2016, she wondered whether she’d chosen where she was, or if she’d just ended up there.

In two years, Sarah traveled to 45 countries on six continents. When her travels ended, she returned to Polson, settling near where Melissa lived before she died. And now, 10 years after the plane crash, Sarah is using her webcomic, “Adventures with Vrah” to write about death, depression and diarrhea.

The combination of tragedy and comedy was appealing.

“It’s what has helped me cope and move through my own grief,” Sarah, 32, said. “I think it might help other people, or hope that it will help other people.”

Sarah was living in London at the time and staying with her aunt and uncle. She was about a week into an internship when she opened a Facebook message that read “Sarah, I’m so sorry to hear about your sister. Let me know if I can do anything.”

Sarah Weaver’s webcomic “Adventures with Vrah.”

The cryptic message left her scared and confused. The surreal feeling stayed with her as she got ahold of her parents. They were already in Polson with Sarah’s other two siblings, Emily and Joe, trying to get more information about the whereabouts of Melissa’s plane.

On June 27, 2010, Brian Williams and newly licensed pilot, Sonny Kless, picked up Melissa and her friend Erika Hoefer for a sightseeing trip over Glacier National Park. A woman reported seeing the plane, but no one reported seeing it crash. Officials believe the plane lost lift over a box canyon near the National Bison Range, roughly 100 miles south of the West Glacier entrance to the park, and dropped out of the sky.

A flight plan wasn’t filed before the four left, which made it difficult for rescue teams to know where to look. Sarah remembers hoping Melissa would be found alive. But their mother, Kathy Weaver, said she knew the moment she heard the plane went missing that Melissa was dead, even if a very small part of her thought that if Melissa did survive the crash, she would do anything to come home. She’d walk on two broken legs, Kathy said.

After three days of searching, the crash site was found. The plane had caught fire. Melissa, Hoefer, Williams and Kless all died in the crash.

“For years I’d hope that they were wrong,” Sarah said. “I’d think, ‘Everything was burned, so how do they even know it was the right plane?’”

Melissa, who was the oldest of the four Weaver siblings, was 23 when she died. Sarah, 21 at the time and 18 months younger than Melissa, was thrust unprepared into the oldest sibling leadership role. Emily Weaver, who was 19, had finished her first year of college. Joe, 17, was still in high school and living in Billings with their parents, Kathy and Dan Weaver.

Sarah Weaver with her sister Melissa.

For Sarah, a large part of working through the Melissa’s death was scribbling down her thoughts and doodling. It started as a way to keep memories of Melissa fresh, a way to help her siblings remember Melissa, who was four years older than Emily and six years older than Joe. Sarah wasn’t an artist. She’d studied finance at UM. But, after she showed one of the comics she’d made to a friend, he encouraged her to share it online. She launched her comic site in 2016, and since then her style has continued to evolve. One of the inspirations for her series was Allie Brosh, the creator of “Hyperbole and Half” and a fellow University of Montana graduate.

Years before Melissa died, Sarah watched a movie about a wife who called her husband’s cellphone and listened to his voicemail while crying in bed. It was one of the saddest things she’d ever seen, she said.

“So when Melissa died, I remember thinking back to that scene and being like, ‘I’m in the sad movie,’” Sarah said.

Sarah would still call Melissa and send her Facebook messages until one day when she called, a man answered. Melissa’s cellphone number had been reassigned to a stranger. It was devastating, but Sarah didn’t want to stop calling her sister, so she kept calling Jeff. She pretended they were lifelong friends. Jeff usually hung up on her.

One day, she got a text from Jeff’s son, telling her she was freaking out his dad and to please stop calling. She did, but she still hopes that Jeff will realize one day why she called so often and they’ll become friends. She never explained why she had “his” number. She never told him about Melissa. The comic she made about the experience with Jeff is one of her family’s favorites.

“It was just easier to play a character, a game — it was too sad,” Sarah said. “What if he did care why I was calling him?”

As Sarah’s perspective on Melissa’s death evolved, so did the webcomic. It stopped being about who Sarah was without Melissa and became about Sarah.

After spending two years abroad, Sarah returned to live in Polson. She set up a Patreon for her webcomic and thinks about turning it into a book one day. In moments of uncertainty, she wonders if it’s wrong to link her career path to her sister’s death, but ultimately she hopes her art could help people.

Sarah Weaver’s webcomic “Adventures with Vrah.”

Emily understands Sarah’s doubts but believes in her mission.

“The fact of the matter is, it happened, and we have to make as much good of it as we can,” Emily said.

Melissa’s death set off a chain of events, including unexpectedly positive developments. For one, Emily transferred from Carroll College to the University of Montana to live with Sarah after Melissa’s death and met her husband there. But the family members were isolated from one another in their grief, Emily said, and it took awhile for them to repair themselves. Every year that passes, it gets better.

The family got together this year on the 10th anniversary of the plane crash. For the first time, it felt like it wasn’t just about being sad about Melissa’s death, Emily said.

“It feels like everyone’s gotten through some of their grief,” Emily said, “and that let us come back together as a family.”

The siblings’ father, Dan, said his grief over Melissa’s death is like a heavy coat he has to wear year round. It unnerved him at first that Sarah was going to write about it. Over time, though, he’s gotten more enjoyment from Sarah’s comic. He learns things about the kids that he’d never known.

The public nature of the comic has been beneficial to Sarah. Beyond people writing to say how her comic helped them, having it as her full-time job forces her to be frank with people about her life. The process of writing and explaining it to people, sometimes in different languages, made it easier to answer the questions that stumped her after Melissa died.

Before she and her husband took their two-year trip all over the globe, they’d gone on a shorter trip to Indonesia. There, a woman asked Sarah what she did for work. When Sarah showed the woman a translation of her comic’s themes, the woman pointed to the word “depression” and said, “Yes, I know this.”

“It helps me,” Sarah said. “It’s powerful when someone can say, ‘I know, maybe, a piece of your pain.”

Complete Article HERE!