SUPPORT CANADIANS LIVING WITH CANCER
Grief and bereavement
Grief, bereavement and mourning are all used to describe the reaction to losing someone you love, but they have slightly different meanings. Both bereavement and mourning are part of grieving.
Grief is a normal reaction to the loss of a loved one. It can also be a reaction to the loss of relationships, physical ability, opportunities or future hopes and dreams.
Bereavement is the state of having suffered the loss of a loved one. It is the time after a loss during which grief is experienced and mourning occurs.
Mourning is the external expression of grief. It includes rituals that mark someone’s death, such as funerals, wakes or memorial services. Mourning is strongly influenced by a person’s religious, spiritual and cultural beliefs and practices.
Everyone grieves differently. The way you grieve will depend on:
- whether the death was expected or unexpected
- your relationship with the person who has died
- your personality and your cultural, spiritual and religious beliefs
- how you have coped with loss before
- the support systems in your life (family, friends and spiritual, religious and social communities)
Grieving is not a single emotional experience. It is a process through which we learn to cope with the loss of someone (or something) in our lives. It’s important to remember that there is no “right” way to grieve. No one can tell you how you should grieve, when you should feel certain emotions or in what order. Your grief is a very personal experience, and your feelings do not have to follow any path but your own.
During the grieving process, you may have many different emotions:
Shock and numbness - Even though death may be expected when someone has advanced cancer, the actual death may still come as a shock to you, especially if it was sudden or happens sooner than expected.
Sadness, loneliness and isolation - The sadness of grief is a deep sense of loss. Some people have a sense of emptiness or being left alone by the person who died. During grieving, many people withdraw from others, especially in social situations.
Anger - It’s not unusual to be angry after someone dies. You may be angry that the person left you, that they didn’t fight the cancer “hard enough,” or that they won’t be there for a special life event (for example, a wedding or graduation). You may also be angry at yourself because you didn’t visit the person often while they were ill, or you weren’t there when they died. You may also be angry at your god or fate for the person’s death.
Relief - If the person who died had been ill or suffering for a long time, you may feel a sense of relief that the struggle is over. You may also feel thankful that the stress of being a caregiver is over. These feelings are normal, and you shouldn’t feel ashamed or guilty about them.
Guilt - You may feel guilty about something that you said, or didn’t say, to the person who has died, or that you didn’t do enough to help them while they were alive.
Confusion - You may have problems concentrating or remembering things. You may feel like you’re walking around in a fog or that you are not yourself. This is a normal reaction to grief.
Grief can also cause physical symptoms and reactions:
- trouble sleeping
- Some people may have dreams or “visions” of the deceased person, or hear their voice.
- eating less or eating more
- Some people have physical signs of anxiety, including tightness in the chest and shortness of breath.
- feeling tired or weak
Anticipatory grief is the grief that occurs when the person with advanced cancer or their family expects death to happen. It includes many of the same thoughts, feelings and emotions that can occur after a death.
Anticipatory grief can give you time to slowly get used to the reality of your loss. It can give you a chance to complete unfinished business with the dying person or strengthen your relationship with them.
Grieving can be a very painful and long process. Given time and support, you will begin to heal, accept the loss and adjust. There is no set time period for grieving. Most people find that their emotions and physical symptoms of grief start to lessen between 6 months and 2 years after their loved one has died.
To cope with grief, you can:
- Let yourself cry as often as you need. It is part of the healing process, not a sign of weakness.
- Allow yourself to feel sadness, pain, anger and any other emotions. Don’t let others tell you what you should be feeling.
- Take care of yourself by eating well and exercising.
- Limit the amount of alcohol or other drugs you use. These may cause other emotional problems and make your recovery from grief slower.
- Be gentle with yourself. Forgive yourself for all the things that you may have said or done, or didn’t say or do.
- Talk to and get support from others who have experienced a loss.
- Prepare for the emotions that may come up on birthdays, anniversaries and holidays.
- Take a break from grief – you don’t need to be focused on it all the time. Go to a movie or concert, take a hot bath, read or listen to music.
Some people have a very hard time adjusting to their loss. Complicated grief is grief that does not improve or gets worse as time passes. People with complicated grief have trouble moving on with their lives and may become depressed.
If you have complicated grief, it’s important to get help. Speak to your family doctor about treatment. You may also find it helpful to speak to a mental health professional.
Children often grieve longer than adults, but they may not show their feelings. Grieving children may keep busy with their activities, and families think they don’t really understand or have gotten over the death. Children often can’t think through their feelings like adults can, and they may have trouble putting their feelings into words.
Children often wonder:
- if they caused the death to happen
- if they are going to die
- who will take care of them
These tips can help you support children as they work through their grief:
- Be open and honest with children about death. Tell them what they may expect if a loved one is about to die.
- Use simple and direct explanations about the death. Answer their questions truthfully. Use proper words like “died” or “death” instead of words like “passed away,” “gone to sleep for a long time” or “has left us.” Some adults may prefer these phrases, but they are likely to confuse children because they won’t know what they mean.
- Include children in planning the funeral or memorial service, if they want to be involved. Don’t force them if they don’t want to participate.
- If they’re worried, reassure them that they aren’t going to die or that they won’t be left alone.
Simply being a teenager is a very stressful time, without adding grief to it. Rather than talk to their parents about their grief and sadness, teens may find it easier to talk to their friends or other important adults in their life.
Teens generally feel invincible and that death can’t touch them. While they may not talk about being upset, they may express their grief by using alcohol or drugs, or by taking risks such as driving too fast or engaging in unsafe sexual behaviour. They may start doing poorly at school or lose interest in their normal activities.
Some basic tips to help teens work through grief are:
- Let them know that grieving is normal.
- Let teens react to the loss in their own way and in their own time.
- Reassure them that strong feelings like anger are normal.
- Don’t try to force teens to talk about their feelings until they’re ready. Give them time and space to process their feelings.
- Listen carefully when they are ready to talk.
- Try to keep up some normal routines. Even in grief, make sure they have time for regular activities and seeing friends.
- Sometimes teens may act out or use drugs or alcohol.
- Set limits on behaviour and actions.
- Let them know what is and what isn’t acceptable.
- Tell other adults in the teen’s life (such as teachers and coaches) about the loss.
- Encourage them to talk to someone, even if it’s not you. There may be teen groups for grief support available in your community or online.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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