Guidance to Grief

Guidance to support people in mourning and grief:

Difficult times call for care and love, and that is exactly what we want to offer here. We carefully choose each word, so that you can see that space as a place where you can rest your soul, but also where you can find the best words to care for someone who is close to you and suffers from the pain of loss.

Speaking of mourning is not easy, and for many of us it will be the first time that we will talk about death in such a close way. We hope that all the words you will read here will be seen by you as protective features, which we put in your hands, like a sunscreen or a coat, items that you choose to protect yourself from the weather outside.

The words we choose to appear here serve to take care not only of your body, but especially of the soul that inhabits your inside, your soul and the soul of those around you, whether they are patients, family or friends. So, consider that everything you will read here will be words from soul to soul.

To begin, we need some important considerations:

  • Grief is a process, not an event. It is not a set of symptoms that happen with someone’s death and disappear over time, precisely because each grieving process is absolutely unique and unrepeatable.
  • Grief is a process of reconciliation with life and with ourselves, a time of learning in which we will need to make many adjustments, whether internal, external or spiritual. And that time does not follow the clock, since it is an absolutely unique time, which always depends on the references and experiences of a lifetime of those who live this experience.

We believe that every life matters, and that is why, as we said at the beginning of this work, we offer you this material, which we want you to see as a lap where you can rest, and also where you can find friendly words that help you take care of those is close to you. We hope that our words can help you to make the crossing of that time with us, because together we are much stronger.

Physical experiences:

It is common for people who experience a grieving process to commonly experience several physical changes, namely:

  • Changes in the sleep cycle;
  • Loss of appetite;
  • Alteration of immunity;
  • Different bodily sensations;
  • Dry lips;
  • Tireness and loss of energy.

Pay attention to your body’s wisdom, and listen to what it has to say. If you need to, rest and take care of yourself gently, as the grieving process can make you feel more exhausted, and at this stage it is very important that you do what you can or that makes sense to you.

It is important to consult a doctor, if unusual physical symptoms appear, but only seek hospitals if necessary; if possible, contact your doctor over the phone to ask for directions on how to proceed.

In this way, take care of your body, eat a healthy and balanced diet, and try as much as possible to provide spaces for rest and perform some form of exercise, if possible and safe for you.

Psychological experiences:

In the course of the grieving process, it is common and expected that you can experience a set of alternating emotions and thoughts. Some bereaved people describe the experience as an “emotional roller coaster”.

The grieving process happens as if we were dealing with two great moments all the time, sometimes dealing with the pain of loss and the most painful emotions, sometimes dealing with distraction and learning new tasks. This movement of dealing with these two sides of the same coin is part of the mourning process, it is normal and expected.

Often bereaved people feel that they are “going crazy” simply because they are dealing with many emotions simultaneously, but this alternation of emotional states is expected and healthy, provided we observe their frequency and intensity.

We can feel that we are doing well, managing to perform a new or already known task, such as going to the market or paying bills, and suddenly we feel intense emotional pain, with painful images that come to mind, and in those moments it is important to recognize our pain and embrace it with love, as we would with a beloved son or father.

What is expected is that in the first days, the bereaved person lives more intensely a state of torpor, like a dream or a nightmare, and only after those days the “chip will fall”, so that little by little he will face the reality of the facts.

Although there is no way to predict how people will react to grief, here are some of the emotional, cognitive and behavioral reactions that can be expected in this process:

  • Emotional reactions: grief, sadness, fear, anger, guilt, joy, relief, compassion, revolt, etc.
  • Cognitive reactions: difficulty concentrating on things other than loss, impaired recent memory, etc.
  • Behavioral reactions: avoidance of activities that bring more pain or suffering or, on the other hand, activities that help to remember the person who died, loss of appetite, altered sleep cycle, feeling of alarm, etc.

Let’s add here how our employees can get the specialized help they need so they can get through this delicate moment.

Social Experiences:

In social terms, mourners commonly experience additional challenges, as they may experience a departure from social work ties, which can significantly affect family income. In times of pandemic by COVID-19, this can be an additional challenge.

In times prior to the pandemic, it is common for mourners to have social support through the participation of family, friends and acquaintances in important public rituals, such as funerals and burials. These events have, among other functions, to help us realize the reality of the loss, give the social support we need and pay homage to the legacy and history of people significant to us.

In COVID-19 times, bereaved people may not be able to receive visits from loved ones, nor participate directly in funerals and burials, due to the official recommendation to avoid agglomerations. All of this can hinder the process of adapting to the new reality, as if the news of death was a dream or a nightmare.

Without being able to have a body to play and to make goodbyes official, mourners can experience additional challenges to their grieving process, so it is very important that there are alternatives to these goodbye processes.

It is important to consider that each person will say their goodbyes in a unique way, and that the suggestions given here are never seen as the most correct for people in mourning, as it is very important that they follow what their heart says and do things that make sense to them, or that would make sense to the person who died.

Here we give some suggestions on how this parting time can be done, in respect and homage to the person who died:

  • See old photos of that person, tell them how their life was, the meaning of this loss for each family member, as well as a space for sharing emotions and feelings related to that moment;
  • Perform small rituals like cooking special food, or attending masses or religious events online that make sense to that family, or that make sense to that person. The ritual, however simple, helps to create a healthy connection with the memory of the person who died.
  • Remember how that person liked to ritualize his losses, and discover in the story of the person who died how to celebrate his life, producing a kind of connection between him and all his loved ones;
  • Value that person’s biography, understanding that he is much more than his death, since before the last day there were days of life, and it is this life that must be remembered;
  • Having a free space for sharing painful emotions, validating normal grieving behaviors, space for crying together, singing songs that were part of that person’s history and remembering stories from her life, among other things.

It is very important that support for the mourner is sensitive to their needs, and that they do not encourage them to leave their mourning work early, but that it is a place for them to cry and regret the time they need, but also, on the other hand, don’t feel obliged to do this if you don’t feel like it.

Spiritual experiences:

It is common for bereaved people to look for meaning in their experience, but in special circumstances like COVID-19 it is possible that they wonder if it was just what happened to them, questioning any higher spiritual power.

They can feel that they are being punished or that they have been forgotten by God or any other spiritual force, and thus feel spiritually homeless, without the support to face reality.

Often, the bereaved will face the challenge of constructing many meanings for the loss, and so they can go looking for the culprits for what happened. Anger directed at God or a doctor can help you find quick answers to such troubling problems, and to make sense of events that have no obvious meaning in themselves.

Gradually, they will be able to reformulate their philosophical and belief systems, seeking to build reasons to forgive life, the health system, the government or, who knows, themselves. Guilt can paralyze them for some time, but it is important that they can gradually realize that they did what was within their reach.

There may also be a more frequent search for religious or spiritual explanations for what happened, and many people will find comfort in those answers, or will be dissatisfied with the answers they have always thought they have, looking for other religions or religious groups. There is still no right and wrong here, and it would be very painful to have to deal with the pain of grief and, at the same time, with people who assume the status of judges of spiritual beliefs.

If you are in the position of spiritual or religious counselor in your community, consider supporting people without imposing convictions, but respecting their need to cry and lament, and sometimes to come into crisis with their belief systems.

Your greatest job will be to offer your compassionate and human presence, attentive and non-judgmental listening and a willingness to understand that this is usually a temporary reaction, and that you can help a lot more if your respectful silence was a space of loving and delicate comfort. . Remember that the sacred always dwells in silence.

If bereaved people are atheists, it is very important that you can also help them to receive non-religious spiritual care in order to help them connect with nature or another sacred source of comfort and meaning for them.

Atheists can have spiritual support through meditation, contemplation of nature, or simply by realizing that someone cares about them, without trying to convert them or lead them to a set of beliefs that does not make sense to them. Consider that the mere silent presence, even if it is by means of brief phone calls, can be the most valuable space of care for the soul.

How to talk about difficult news:

In our culture, talking about death is almost always a challenge, but it is very important that we know that speaking the words “death”, “grief”, “loss” will not attract these experiences to us, but that talking about it can help develop greater intimacy with these themes, which are part of life.

So, it is important that we avoid euphemisms, because in view of the enormity of a loss such as that provided by the death of a person by COVID-19, it is important that we use the correct words.

Following the recommendations of the authorities, people who experience losses during a pandemic are possibly unable to go face-to-face to their religious group, and must remain in isolation to avoid contamination by other family members or even other people in society.

In addition, these people will eventually need to deal with the lack of in-person social support from neighbors and friends, and many of them will not be able to be physically at funerals and burials. If we avoid speaking the right words, we can bring more confusion and do not help in coping with what actually happened in their lives.

If we avoid telling the truth or using the right words, we can eventually convey the message between the lines that we believe that the bereaved person cannot cope with the reality of the facts, which can make them feel even more insecure. On the other hand, we need to help her deal with this reality with increasing confidence in herself.

However, if we are to always speak the truth to people in mourning, we will also need a good dose of delicacy and show ourselves available to listen, much more than to give answers that resolve the suffering. Being present, with ears available, is one of the most beautiful forms of presence that we can offer.

Even if we do not know what to say and what to do, simply listening and recognizing how difficult this time is already a great form of help, which mourners always appreciate, since it is common to report that old friends become avoid the person, or change the sidewalk when they see you approaching.

Dealing with a bereaved person simply reminds us that we are finite, that we are susceptible to getting sick too, and perhaps that is the biggest source of our difficulties. However, if we let fear paralyze us, we miss an opportunity to grow in the face of adversity.

We hope that this booklet can give you the necessary courage not to get away from bereaved people, but to approach them to discover with them what they need to face their difficulties. Only the person experiencing this process knows what he needs, and a question that can help in this dialogue is: “Is there anything you need?”

You can offer to shop or simply call once a day, but it is very important that you do not forget to follow the health recommendations or the authorities in your region, so as not to put your health at risk. Just do what you can to help, and it will always be more than enough to make the person feel supported and understood in their grieving process.

What not to say to a bereaved person:

When talking to someone who has lost a loved one, avoid cliché phrases such as “Be strong!”, “Don’t cry”, “He wouldn’t want to see you cry”, “Don’t be like this, we want to see you smile” or “You need to get rid of all his clothes and move on ”.

Statements like these do not help, as they discourage the mourner to continue in a normal and healthy grieving process, since he starts to feel compelled to abandon a necessary experience for him.

We know that it is very painful for a family to see a mother of a family, for example, to cry longing for her husband most of the day, but nothing prevents someone from going to bed with this woman, I am simply hugging her and crying with her, or just from time to time just take new tissue paper.

Avoiding ready-made phrases that discourage the experience of grief only increases the person’s sense of confusion and pain, and he often feels powerless to leave his state.

It is important that the troubled people around you try to understand what feelings arise when seeing someone loved in distress, and also try to take care of those feelings.

Sometimes, we may feel very powerless for not being able to resolve that suffering, but we can help a lot if we are simply a silent company and trust the time and pace of that particular person.

Just say you are there, ask silently what that person needs, offer a lap and gently help him dry his tears, if that makes sense to you, or just cradle him in your arms or on your lap. Gradually, the person will regulate emotionally and may be distracted.

But understand that she will return to experiencing similar pains, requiring additional patience and care, and that is why it is very important that those who care for the bereaved person also have time to pause and rest, since they will also be required to care for that person, to deal often mourning and having time to rest and be distracted too.

Grief does not have a specific time to end, but that most acute emotional pain tends to give way to moments of greater distraction and engagement with new activities, but remember that special days can be emotionally difficult, such as the bereaved person’s birthday or that of the person who died, or even on holidays.

On these dates, it is important that the bereaved person feels that he is understood, that he is protected and that no one will demand more from him than he can give, and therefore that he can be cared for and encouraged to do only what makes sense to him.

These special days can be used to honor the memory of that person who died, or even for simple rituals in the privacy of families, such as seeing old photos, telling stories or simply talking about that meaningful existence.

Care for Children in grief:

Children should not necessarily be spared from frank conversations about suffering or loss, as they can express feelings and thoughts similar to adults. There is no right or wrong way to talk to children about these topics, because it will depend on the emotional development of each child and their unique characteristics.

Children can also present their suffering through regressive behaviors, such as peeing in bed again, or they can communicate their internal state through spontaneous drawings or through their play.

The important thing is that whenever an adult begins to deal with the reality of the facts, that he avoid whenever possible to indefinitely postpone the moment of talking to the children of the family, because they usually perceive the changes that have happened, and in their fantasies they can consider that they are the main cause of all problems.

This conversation should take place in a safe space for the child, with people he / she trusts, and should always start from what the child already knows has happened. The conversation can start like this:

– My son, do you remember that daddy left home sick, with shortness of breath?

– Yes, Mom, I remember. What happened to him, mom?

– He was taken to the hospital, taken care of by people who did everything they could for him, but he got so sick that he couldn’t resist, and died.

– He won’t be back, Mom?

– No, my son, but it will always be in our hearts. Remember the day he said he would always be taking care of us? He will continue to do this.

– And how do we know he takes care of us, Mom?

– Put your hand on your heart. Do you feel it hitting?

– Yes mom.

– Whenever you have any difficulties, put your hand on your heart, and Dad will be with us, taking care of you and me.

It is very important that families are encouraged to use the word “death” with children, and explain that the person who died will not return, but that they add religious explanations that make sense to them, as long as they belong to some religion.

But it is important to avoid explanations such as “turned into a little star” or “Daddy in Heaven took”, because very young children tend to use these metaphors to the letter, and may be angry with God or simply climb on the roof of the house to get closer to the stars.

A child we know, who lost a pet, received the following response from his mother: “It was God who took him to Him, my son”, to which the child argued: “And why would God want a puppy without life?” So, it is important that we use the right words, and only then add religious explanations, as long as they make sense for the family.

Very young children may have difficulty understanding that death is an irreversible, universal phenomenon or that death means that the body is no longer functioning. So explanations may be required sometimes, until the children understand that that person has died and never comes back.

In normal situations, it is known that there is no harm in children participating in funerals or burials, and we have seen many of these children use that time to nestle on the pillow of the person who died a note of farewell or a letter of declaration of love. It also helps the child to realize what happened, as long as he has been consulted if he wants to go to this final farewell. Children should not be forced to go to burials, but we should also avoid separating them from that moment without consulting them first.

We have often taken some of these children to explain what a burial or wake is, and we often explain that the person who died does not feel pain or shortness of breath, that their body will be in a wooden box, and that it will be the last time we will see this body.

After all this, we ask if the child wants to go. Often the answer is yes, and then in that case it is important for a child-trustworthy person to be willing to stay with them, and to return home when the child says that it is enough for them.

However, in times of pandemic by COVID-19, with the guidance of avoiding agglomerations, funerals may have many restrictions or even be suspended, and then children and adults will not be able to participate in these moments.

In this case, children can be invited to take part in the same rituals of love and farewell as adults, and to draw pictures for the person who died or simply draw their feelings so that they can be shared without judgment with the whole family.

Identifying risk frameworks and forwarding:

People who eventually need additional professional help sometimes experience some or several of these vulnerabilities:

  • Many young children at home, without social support to care for them.
  • Lower social class.
  • Little or no professional occupation.
  • Intense anger.
  • Suicidal thoughts.
  • Extreme self-disapproval.
  • Lack of current relationships.
  • Abuse of alcohol and other drugs.
  • Exposure to unnecessary risks.
  • Exposure to very painful traumatic situations.
  • Do not rejoice over anything or, on the other hand, avoid dealing with suffering all the time.

It is very important that the demand to seek additional help is built with the bereaved person very carefully, with conversations that can happen in the following terms:

– You are telling me that it is being very difficult for you, aren’t you?

– A lot, time is passing and I just get worse, I can’t be happy with anything.

– So let’s look for a glimmer of light… What do you think about looking for specialized help together for you? Seeking help from a professional who can help you is an act of love, it is a way of honoring the person who is no longer here, making your story a space of care and love. Don’t you think it’s a good idea?

– I think so.

– Then we will find out together the person who can take care of you, but I want you to know that you can always count on me, and that from time to time I will be able to call you. What do you think?

The tone of voice must always be friendly and the person must always show availability, without entering the condition of a judge. Delicate conversations, which respect the limit placed by bereaved people, but help them to recognize the need for help, when it is needed, is usually the best strategy, especially when there are many risk factors and the person is faced with many challenges to deal simultaneously.

Self-care:

When caring for someone in mourning, you may be faced with painful feelings and emotions, which concern unfinished tasks in your own history. It is important that you realize these feelings and take care of them with love, as you also need to give yourself care and rest time.

More than that, you are not expected to be a superhero or not to be afraid, as only human beings can really help other human beings, and it is important that you can also give yourself love.

Look for moments of pause for you, rest and eat healthy, because times of crisis call for delicate care, and delicacy is a very special form of love.

Seek additional expert help for you, if necessary, and consider that you are also important. Take care of yourself spiritually, try to make yours a journey of growth, and then you will be fulfilling your mission in this world.

And always count on us, as you always did. We are here to support and help you with what you need, as we have always been, out of love and a deep commitment to our common humanity.

Grief is not a medical condition

Grief is not a medical condition, but a human experience, and the best way to care for a bereaved person is through an attitude of boundless compassion and an attitude of non-judgment and unconditional love. There is no easy answer to suffering, and trying to make people better from one moment to the next can only make them even more confused. Grief is a natural, human, existential process, and possibly bereaved people will need a lifetime to learn how to deal with the great change that has happened in their lives.

Healing stories

Transforming the way we tell stories and integrating a new continuum of sense of meaning and value is often a healing factor in the grieving process. Often, if you don’t know what to say or do, just be there and encourage the person to continue talking, telling the story as many times as they need, dealing with their emotions and relearning how to live with the big change that happened in their life . Being present is the best way to help, through an active attitude of compassion, full acceptance, active listening and non-judgment.

“The most beautiful people we know are those who have known defeat, known suffering, great struggles, losses and yet have found their own way out of the depths. These people have an appreciation, a sensitivity and an understanding of life that can fill them with compassion, tenderness and a deep loving concern. Beautiful people don’t come by chance”.  Dr. Elisabeth Kübler-Ross

Declaration and Call-to-Action on Palliative Care & COVID-19

Witnessing, with the rest of the world, the overwhelming physical, social, emotional and spiritual suffering COVID-19 is inflicting on infected persons and their families globally;

Recognizing that palliative care is aimed at prevention and management of serious health-related suffering;

Observing with great concern that the persons infected with COVID-19 are isolated from their families, and may never see them again;

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