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Showing posts with label bereavement. Show all posts
Showing posts with label bereavement. Show all posts

Funeral Directors Help Facilitate Grief

When a person dies, the world seems to continue right along as though nothing has happened, and to the bereaved this experience can be isolating. A funeral director helps the family by making sure that their beloved is cared for and honored while facilitating the organizational and legal aspects of the arrangements. According to Worden, “often the immediate family members are in a dazed or numb condition and the service does not have the positive psychological impact that it might have.”2 While this can be an issue, these families still benefit from just being with those support them through their loss. They want to be comforted. They want to be with those who understand their loss. The funeral is a supportive place to show respect for the dead, and surviving family and friends.

Do you think Americans need to be more open to public displays of grief? 
 

The funeral home and or cemetery are the socially acceptable places for mourning. This leaves Americans with few places where it is acceptable for grief to be displayed openly. In American culture, we are taught to hold back public display of pain so we do not make others uncomfortable. We are encouraged to shed tears privately, out of sight. This can create disenfranchised grief. Worden recommends, “some type of ongoing contact with these families might be considered for the purpose of grief counseling.”2 The funeral meets a family’s spiritual, psychological, and social needs as they share the pain of losing someone loved. The funeral rite gives us a universally understood social tradition to observe for coming together. Thus, the funeral is one of the few events where people are not judged as harshly for showing emotion. This makes the funeral director's job of creating conducive atmosphere for healing all the more important. By offering the bereaved a place to address these feelings, funeral directors help to facilitate grief and allow survivors to find meaning through the funeral rite. 

How have funeral directors helped you or a loved one
Do you think Americans need to be more open to public displays of grief? 

² Worden, J.W. (2009). Grief Counseling and Grief Therapy. A Handbook for the Mental Health

 

Portland Oregon Support Network

Aging, End-of-Life and Bereavement resources in and around the Portland Metro area.

In-Home Hospice


  • Southwest Home Care and Hospice
    100 E 33rd Street, Suite 201 Vancouver, WA 98663
    360-696-5100
  • Serenity Palliative Care and Hospice
    6975 SW Sandburg St., Ste. 190 Portland, Oregon 97223
    503-639-0600
  • Specialty Comfort Care
    503-747-3021
  • Community Home Health and Hospice
    "Keeping pets and Families together during Hospice"
    14508 NE 20th Ave #201, Vancouver, WA 98686
    360-253-4626

  • In-Home Health Care


    In-Home Medical Equipment

    • Long Term Loan Program
      104 SW Clay St, Portland, 97201
      503-233-9511
    • All in One Mobility Home Medical Equipment
      12833 NE Airport Way, Portland, OR 97230
      503-255-5005
    • Adventist Health Home Medical Equipment
      5835 NE 122nd Ave, #105, Portland, OR 97230
      503-261-6070


    Food Delivery


    Family Caregiver Daytime Respite Care

    • Lambert House
      2600 S.E. 170th Ave., Portland OR 97236
      503-760-2075
    • Marie Smith Health & Social Center
      4616 N. Albina Ave. Portland, OR
      503-335-9980


    PERS - Home Medical Alert Services

    • Columbia Medical Alarm Inc.
      Offering Philips Lifeline service to the Portland / Vancouver Areas
      503-644-4736

    Mobile Medical Services

    • American Medical Response
      503-231-6300


    Advanced Directives


    Bereavement Support and Classes

    • Portland Adventist Medical Center Grief Classes/Support Meetings
      10123 S.E. Market St. Portland, Oregon 97216
      503-251-6105
    • Providence St. Vincent Hospital Medical Ctr.
    • 10 to 11:30 a.m., first and third Tuesdays, Pastoral Care Conference Room
      7 to 8:30 p.m., second and fourth Tuesdays, Conference Room 3
      9205 S.W. Barnes Rd., Portland, Oregon 97225
      503-291-2261
    • Tuality Community Hospital
      Surviving the Loss
      335 S.E. 8th, Hillsboro, Oregon 97123
      503-681-1700
    • Health & Lifestyle Center
      1885 NW 185th Ave, Aloha, OR 97006
      503-215-6595
    • SW Washington Medical Center
      Grief and Bereavement Support Group
      P.O. Box 1600
      Vancouver, Washington 98668
    • Providence Portland Medical Center
      11 a.m. to 12:30 p.m., first and third Tuesdays, Pastoral Care Conference Room
      4:30 to 6 p.m., second and fourth Tuesdays, Pastoral Care Conference Room
      4805 NE Glisan St., Portland, OR 97213
      503-215-1111
    • Providence Willamette Falls Medical Center
      1:30 to 3 p.m., second and fourth Tuesdays, Providence Willamette Falls Community Center
      1500 Division St., Oregon City, OR 97045
      503-656-1631


    Children's Grief and Bereavement Care

    • Legacy Hospice
      2275 NE McDaniel Lane McMinnville, OR 97128
      503-220-1000
    • Camp Erin - Grief Support for Kids
      6410 NE Halsey St., Suite 300 Portland, OR 97213
      503-215-2273
    • Me, Too. and Company Children's Grief Support Group
      P. O. Box 10796, Portland, OR 97296
      503-228-2104



    Physician Aid in Dying - Resources and Information

    Dying with Dignity


    Blogs



    News and Magazine Articles

    Other Refences


    If you know of or offer other resources you feel would be helpful for folks, please let us know so we can add them to this page.  We thank you for your input.

    Lakota Sioux Thoughts on Death and Dying

    Wikicommons/SiBr4
    A wonderful example of the Living Funeral is the tradition of the Lakota Sioux people of South Dakota. They accept death as part of the natural order of life. They identify more with their consciousness and allow themselves to disengage from their bodies. They see life’s journey as its end goal, and appreciate that life is always on the edge of death.


    Wikicommons
    Prior to death, the Lakota Sioux make sure to forgive. They ease tensions by making amends. They release loved ones from feelings of guilt for acts they may have committed against them. They make a point to accept each others faults and thoughtfully collect their precious family heirlooms to distribute to their family members. The gifts passed on to decedents are meant to be passed on down the line each generation. Thus, each member becomes a caretaker of the family heirlooms rather than the singular owner. As one approaches death, one of their folkways requires that traditional foods be eaten as part of purifying oneself for death. This is the time for handing down family recipes.

    At the time of death, family, friends, and neighbors will all crowd into the critical care unit hospital room (which can be difficult.) It is their tradition to show respect and appreciation for their relationship by being at bedside to say farewell. Once all are there, the dying person lets go. They believe death is but a transitional period, and that their energy is released into the world to become once again part of nature.


    The year following the death is a trial period for the family. The bereaved must strive toward exemplary behavior. They will avoid controversy, jealousy, anger, and licentiousness at all costs because it is believed that one's true character emerges at the time of grief. Throughout the year, the family will also prepare for the death anniversary party by collecting items and money. 

    The death anniversary party is partly a memorial service and partly a tribute to the individuals who showed kindness to the departed loved one and the family. The guest of honor (this might be the best friend of the deceased), will carry a picture of the deceased to show it to all who attend. After a memorial service, the atmosphere changes, and the event becomes festive and joyful. Attendees will share a meal as they share happy memories and stories about the deceased. At the end of the party, attendees are honored by gifts - former belongings of the deceased's.

    Please share your thoughts on the Lakota Sioux tradition. What did you find to be most helpful? What personal family traditions do you feel are helpful or healing?

    Funerals and Memorials Support Surviving Friends and Family


    When a person dies, the world seems to continue right along as though nothing has happened, and to the bereaved this experience can be extremely isolating. The funeral custom provides a social function where friends and family of the bereaved can gather to offer support. "The funeral service has the effect of drawing a social support network close to the bereaved family shortly after the loss has occurred, and this kind of social support can be extremely helpful in the facilitation of grief".² The social support provided during the funeral rite, can provide encouragement to the bereaved in considering the adjustment to living without the lost loved one.

    By acknowledging all of one’s family, friends and neighbors that remain available in one's social circle, one may find reassurance and comfort in the fact that they are not alone. The communities promise to attend funerals establishes emotional stability, security, and support in facing death. To not hold a funeral is not to observe this sacred pact. If "people have an aversion to death, they have a persistent sense of despair and hopelessness"¹, The funeral rite gives us the opportunity to act for others as we would wish them to act for us. When we grieve for others, we grieve for ourselves. "We attempt to master the storms of life by finding palatable reasons for our personal suffering. With the discovery of meaning comes the possibility of restoration".¹

    We want our presence to be missed, our deaths to be mourned, and for life to have meaning. It explains why we host funerals and grand memorials. We yearn to be remembered. Our lives must have had held some meaning. Attending a funeral reminds us that we will someday merit the same honor, respect, and display of affection.


    Please share your thoughts on supporting a friend or loved one who is grieving. What did you find to be most helpful? What advice can you share with others?




    ¹ Roussell, J.O. (1999). Dealing with Grief: Theirs & Ours. Staten Island, NY: Alba House.
    ² Worden, J.W. (2009). Grief Counseling and Grief Therapy. A Handbook for the Mental Health

    Funerals Aid Healthy Grief

    "True healing can not take place without the journey through the grieving process"¹. An important role of a funeral is to facilitate grief. "If [the funeral] is done well, [it] can be an important adjunct in aiding and abetting the healthy resolution of grief"². As our culture is "largely death-denying and death-defying"¹, making the loss real to the bereaved is a very important task of mourning. Accepting the reality of the loss is the very first task of mourning to be achieved. "There is always a sense that it hasn’t happened"².

    Perhaps we find it easier to deny the death, and to believe it has not happened, but the funeral provides a place in which this denial can be directly addressed. People must "come full face with the reality that the person is dead and will not return".² By seeing the body of a lost loved one, it helps "bring home the reality and finality of death"² to us. The funeral practice provides a setting in which viewing the deceased is appropriate, acceptable and healing.

    In American culture, we have been taught to hold back public displays of mourning so as not to make others uncomfortable. We are encouraged to shed tears in private. This isolation can lead to unhealthy grief. Our funeral homes and cemeteries provide a venue in which mourning can take place socially. The funeral service setting can assist the bereaved in expressing the feelings and thoughts about the departed. At the funeral, the bereaved is provided an opportunity to engage in discussions about the dead, to hear or share eulogies and other stories about the deceased. The need to express one’s feelings in a safe place is important in promoting grief, and we should give people "permission to acknowledge and express emotions".¹ "The funeral service can help the grief process, as it allows people to talk about the deceased".²

    Please share your thoughts on funerals and or viewings. How do you feel they aid the bereaved survivors? What else do you think is helpful to survivors in accepting such a loss?

    ¹ Roussell, J.O. (1999). Dealing with Grief: Theirs & Ours. Staten Island, NY: Alba House.
    ² Worden, J.W. (2009). Grief Counseling and Grief Therapy. A Handbook for the Mental Health 

    Re-imagine Sympathy Gifts

    When a cousin's husband died recently, many friends sent her sympathy cards, flowers and/or gift baskets. Local friends and neighbors brought her a variety of cakes, chocolates and wine. Most of the food she received consisted of sugary breaded items (like cupcakes, muffins and cookies) and as a gluten free person, she could eat very little of it. 

    We were surprised that no one thought to bring her any food of nutritional sustenance like meat dishes, salads or vegetables. Although she was eating very little at the time, she did not feel like cooking anything. It was unfortunate that the foods she received appeared more like Valentine's Day goodies than sympathy gifts. Sympathy foods really should be more nourishing. 


    Please share your thoughts about Sympathy Gifts.

     
    Have you received gift baskets of desserts after a death in your family or have you sent desserts to a bereaved friend/family member? What can we do to improve sympathy gifs to be sure they nourish the bereaved?

    Memorial Art Therapy

    Art and its Usefulness as Therapy

    Art is a form of communication, traditionally a visual language or assemblage of marks, sounds, ideas or feelings, which may not be communicable as interestingly, or provocatively in written form. Art therapy is a branch of art focused on an individual’s subjective, introspective experience of creating the art. The soothing and cathartic experience for the maker of the art and its lack of expectations make it an accessible and sought after form of therapy for those seeking emotional release from a grief experience.

    Art therapy assists the bereaved to gain insight about themselves through the making of art. The art therapist conducts not to critique the art produced, but to evaluate and support survivors’ needs to come to terms with an emotional trauma that is otherwise too painful to investigate through other forms of therapy. The art provides a space of projection, a filter for comfortable self-examination that can be enjoyable and approachable for all participants.

    Although we all share a human experience, because of culture, social stratification, the individuality of experience requires the establishment of a baseline from which to evaluate emotional wellness, world constructs, attitudes and outlook. Art media serves as a tool of experiential control for therapy. Additionally, symbols reveal associations and metaphors. Under the guidance of an art therapy counselor, the bereaved can use various media to express feelings related to their grief that would otherwise be too difficult to confront in a safe and or approachable manner. The art allows them to separate the event and or feelings from themselves to gain insight and perspective.

    Working with Bereaved Couples

    “Change creates loss and grief is how we react.” When one person in the relationship is ready to move on but the other is not, one person can crush the other’s self-esteem or prevent the grieving person from working through their grief at a healthy pace. Unreasonable expectations can lead to animosity and negative or destructive behavior. Working with couples to achieve understanding is of utmost importance because an unhealthy recovery from bereavement can lead to the disintegration of the relationship. Inadequate social or psychic support in events such as SIDS (Sudden Infant Death Syndrome), conflicted feelings after a suicide, or ambiguous unresolved losses like a kidnapping or runaway, often manifest in difficulties in sustaining the relationship. These types of loss are especially traumatic on relationships due to a lack of coping skills. Results from these losses may be low self-esteem, depression, questioning of one’s own faith, sleep disorders, poor impulse control, drug abuse, and other types of chronic emotional pain.

    According to Rogers, “Grief is inherent in living – a part of our human experience. It does not need to be ‘fixed,’ ‘treated,’ or ignored. Grief needs to be lived as a normal emotional response to loss. It will be unique to each of us and there is no ‘normal’ timetable to ‘complete’ the process. Emotional trauma can lead to unhealthy coping behaviors that further put strain on relationships. Signs that a loss is not fully being resolved are mummification of the deceased’s room, or intense psychological responses to the deceased’s name coming up in conversation. When a partner’s mourning process is disregarded by the other partner, their family, and or friends, the misunderstanding leads to isolation, and intense psychological pain.

    According to Elizabeth Kubler-Ross’ five stages of grief theory, grievers heal at different rates, passing through the stages of grief inconsistently. Each person will process grief differently and this can lead to problems in communication, resulting in negative interactions. For example, one spouse may be in denial of a loss and unwilling to accept the truth, while bargaining with God to bring back a lost loved one. The other spouse who has accepted the loss may have fallen into a depression. Consequentially, neither is able to meet on the same level with the loss and their inner world is threatened, with feelings of helplessness and isolation. This can sometimes lead to self-destructive behavior or betrayal, with the added risk of the relationship ending.

    Sometimes a spouse can be a reminder of a traumatic event or loss. He or she may physically look a lot like the lost love one or he or she may have broke a sacred confidence that will never be regained. Bereavement can also be tied to an addiction, incarceration, domestic abuse, gambling, infidelity, etc. One may not bear to see, hear or be reminded of them without flashing back to the distress. In such cases, if the relationship is to survive, couples must find a new normalcy of living and establish a mutual respect and understanding of each other’s grief surrounding the loss event.

    Couples can share unresolved anger and guilt through art making. Art allows survivors to objectify pain and healing from their bereavement through discussion and symbolism. Art allows the bereaved to express issues that may never have been addressed. Therefore, the survivor recovers because the making of art gives power to the artist. The introspective nature of the art necessitates nonjudgmental discussions in a safe, and supportive environment. Although the loss event may always be lying silently under the surface, relationships can emerge stronger when grief issues are transcended.

    Group Dynamics

    Bereavement groups bring trauma survivors of diverse personalities together in a dynamic setting of openness and self-expression. However, to maintain a healthy healing environment for group members, art therapists must manage the various strengths and weaknesses to provide effective therapy sessions. Therapists must be cautious about dysfunctional personalities to prevent them from derailing activities and must also place a priority on keeping the calm, therapeutic atmosphere necessary for effective grief work to be accomplished. Effective therapy groups collaborate well together and support one another to achieve their individual and collective emotional growth and wellbeing.

    The bereavement coordinator may not have much flexibility as to who is a part of the group. Group members will often be of varying levels of maturity in their grieving process and personalities may clash due to the dynamic material engaged in the therapy work. Thus “in the various weekly sessions with each new expressive art there may be discussion on reconstruction of meaning.” The individual personalities within the group can add to facilitating or impeding growth. One goal as an art therapy group facilitator is to recognize group members’ emotional states and personal limitations, which reactions are normal or abnormal, and how to guide group activities towards promoting growth, personal wellbeing, and a supportive environment that facilitates grief work being undertaken.
    In discussing group dynamics, Rogers (2007) discusses different personality archetypes encountered in the bereavement group setting including:

    • The Advice giver – Use of domineering language
    • The Self Righteous Faith Moralizer – Use of guilt or supernatural unknown to manipulate behaviors.
    • The Talker – A self-absorbed person who monopolizes the group’s time seeking approval.
    • The Challenger – A person who looks for fault with everything.
    • The Small Talk – A person who uses chitchat to avoid uncomfortable topics.
    • Speaker of the group - An overpowering personality speaking out of turn and thereby taking over the group.

    The therapist’s understanding of these common personality manifestations is vital to plan each session to avoid dangerous situations. As Rogers points out, “as family, friends, and caregivers, the only gift we have to offer those who are grieving is the quality of our attention.” So an art therapist must manage the personalities of their groups as well as facilitate effective therapy. “Combining the support of the group and the use of physical and creative activities offer the grievers what they need most: acceptance and nonjudgmental listening.”

    As Rogers points out, “the final session is Ritual, which is designed to bring the course together and allow healing through creative expression and ritual.” A grief group session may be closed out with the making of art and or a review of the art created. This art may be related to the discussions of the day, and can be an enjoyable conclusion to each session that group members will look forward to. The repetition of the activity also allows members to collect their thoughts and investigate feelings and or ideas in a group setting and nonjudgmental collective manner.


    Ref:

    Rogers, E. J. (2007). The Art of Grief: The Use of Expressive Arts in a Grief Support
    Group. New York, NY: Taylor & Frances Group, LLC.
    Kubler-Ross, E. (1969). On Death and Dying. New York, NY: Simon & Schuster


    Dementia is Identity Theft

    Over the past few years, my grandmother has steadily declined into dementia. Although she is still with us in body, she is no longer with us mentally. The grief I feel over losing her began with those first episodes of her mental decline and continues to plague me in different ways as the disease takes hold in more destructive ways.


    The loss of my grandmother began when she started to forget the little things. The woman who baked me a birthday cake every year from scratch, no longer even remembered to send a card, much less baked period. She could scarcely recall small things like where I was living at the time. (I’d moved a few times as her decline began.) When I would call, she’d often ask me to stop by for dinner even though she’d long before stopped cooking. This also illustrated the fact that she had forgotten the logistics of where we were in relation to each other. (I was in the Midwest, and she was on the west coast.)


    A holiday visit later that year confirmed grandmother's dementia was progressing. She had begun to regress into a childlike state. She was unable to wait for the family to leave for a restaurant, but began taking cookies from a cookie jar. While the family chatted before heading out to a restaurant, she continued to interject “When are we going to eat?” When my mother arrived, she said to her, “You’re so fat.” When my mother poured glasses of wine, she asked for one even though she had not drank wine for over 20 years. (Once she got the glass of wine, she clearly did not want it, she just didn’t remember she didn’t drink it any longer.) When I returned an uneaten serving of chips into their original bag, she copied me and began returning her uneaten portion of chips back into the bag as well.


    Just three months after that visit, when her health took a sharp downhill turn, she was no longer caring for herself as she once did. The woman who refused to leave the house before reapplying lipstick and some perfume, the woman who had her hair styled once a week and got manicures every other week, now had not only begun neglecting her appearance, but also stopped showering altogether. Together my mother and I had to help her to wash and dress herself. The woman who cared for mom, and then me, the woman who helped raise me when I was young, now required our care as the “adults”.


    Around that same time, she had begun requiring the use of diapers during the night. She could no longer awaken in time to use the restroom in the bathroom at night. Even now as she is in a good senior care facility, she continues to say its too much trouble to shower. She also continues to refuse to have her hair styled or cut, although she did agree to let the manicurist paint her nails “Munsters” green (a color my grandmother chose). A conservative woman, I only ever saw her wear various shades of pink on her nails. I would have found it amusing if it weren’t so damn depressing.


    When we went through my grandparent’s house to sort items out once she was moved to the senior care facility, I found that personal hygiene items I had been sending her as gifts over the last few years (perfumes, cosmetics, skin and hand care gift sets), sat either barely used, or completely unopened. It saddened me to see the items I knew she would have enjoyed in earlier years, the things I handpicked to gift her, weren’t even valuable enough to take with her when she left her home.


    I grieve the loss of the opportunities I will never have again because my grandmother’s dementia has changed her from the functioning person she once was. I will never learn how to make her buttermilk pancakes from scratch nor her baked chicken or many of her Midwest styled recipes she knew by heart. I will never get to learn more about her family history. I will never again have the opportunity to shop with her to pick out things, from the most special (my wedding gown) to the least important (a bed comforter). Knowing these things will not happen again has led me to hold onto her old cookbooks and the last items we shopped together for, back when she was still herself.


    I am angry with myself for not making the most of those opportunities when I had them. I’m angry for not learning how to cook the dishes she excelled at. I’m angry for not writing more family stories down, and for those I did record, for losing them. I am remorseful for the one time I refused to eat the birthday cake she baked me because I was being an obstinate teenager, refusing to cheat on my low-fat diet. I cannot change any of these things, and that saddens me greatly.


    In many ways, the loss of opportunities is what saddens me most of all. My grandmother is still here, and could potentially have still contributed to sharing her knowledge and experience with me if she hadn’t had dementia. No one sees these things coming. We see the life expectancies lengthening, and devoid of any serious illness, we think our loved ones are going to be here for years to come. Perhaps this is denial. Nevertheless, with that mindset we never get to make the most of each and every moment. I wish I had.


    These days, I fear visiting my grandmother for I am afraid of how much worse she will have become. On a visit in September last year, I was shocked to find she no longer knew who my husband was, even though she was my one and only matron of honor in my wedding just a few years earlier. (I had no bridesmaids or maids of honor, just her.) On my father’s visit a few months earlier, she was able to connect the fact that he looked like someone she'd known, but she didn’t realize it was indeed him. Although she did recognize me on my visit, I could not truly have a conversation with her because she says very little, smiles and every few minutes pats her hand on the table or taps fingers on the table. During our luncheon at her senior care home, she said she wasn’t hungry, then proceeded to take French fries off my plate. She ordered a slice of blueberry pie and when my husband’s apple pie arrived, she wanted that instead. Throughout our visit she continually asked who my husband was.


    What I have found interesting in this experience of grief is how it continually keeps changing. Each time I adapt to one loss, I face an entirely new one. I have adapted and adjusted through the grief of accepting the littlest things lost (my forgotten birthday, her no longer cooking or shopping), to the grief of seeing her own care of herself and the ability to function decline. I’ve adapted to the grief of seeing her forget people in the family, to the grief of finally accepting that the opportunities I’ve lost with her are gone and will never reoccur. My grief continues to change and evolve as I see her dementia slowly taking hold in more destructive ways. I grieve the loss of her memory as it continues to fade away and I grieve the loss of my grandmother as the person she once was.