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How Grief Is Incorporated into the Plan of Care

When it comes to dealing with grief, there’s no one-size-fits-all approach. Everyone grieves differently, and grief can affect individuals, families, and a person’s entire social circle. The grieving process can be especially complicated for those who are homebound or on hospice with a terminal illness.

Creating a plan of care for home care or hospice patients must also incorporate grief. By including grief in an individual’s plan of care, we are able to meet the holistic needs of patients and support them throughout the process.

Home Health & Grief

Home health services allow patients to comfortably remain living in their homes with the support of exceptional medical professionals. However, individuals with chronic conditions or recovering from an illness may also experience grief, especially during the early stages of adjusting to a new life.

Patients may grieve the loss of the life they once knew, which comes with a set of new emotions to tackle. After an injury, illness, or surgery, it can be difficult for patients to adjust to changes in abilities and personal freedoms/independence.

hug

As we develop a plan of care for individuals receiving home health care, it is vital to consider this grieving process. By acknowledging this grieving process, home health professionals can actively support healing and find supportive ways to improve the mental wellness of these patients. It is important to remember that healing looks different for every patient, and no timeline can be associated with processing grief.

Hospice Care & Grief

Hospice care is focused on supporting patients with terminal illnesses to be as comfortable and pain-free as possible. When an individual is put on hospice, grief can occur both personally and for family members. Many families of patients experience anticipatory grief before an impending loss. This type of grief can cause individuals to feel many unexpected emotions: fear, sadness, loneliness, anger, and more.

Coping with grief can look different for every patient and family member. What brings one person comfort may not help another.

Creating a personalized hospice care plan is one of the ways our hospice team can help support individuals and their families experiencing grief. From providing emotional support to additional resources, there are many ways hospice care can support grieving individuals.

To take things a step further, we offer a helpful bereavement program, which can support families during a difficult time in their lives. We provide one-on-one support, supportive phone calls and in-home support sessions to help each individual manage the grieving process and begin their healing process.

Personalized Care Plans to Support Grieving Process

Whether you’re grieving a change in abilities or the loss of a loved one, each person’s grieving process is entirely unique. We incorporate grief into the plan of care for both home health and hospice patients. To learn more, contact us anytime to learn more about how our home health and hospice care can help support you and your loved ones through any stage of grief.

Person’s meditating hands in a grassy field

Importance of Self-Care In Grief

We all grieve differently, but one thing remains true for everyone: the importance of taking care of yourself. Whether you’ve found yourself in a state of just going through the motions or you’ve put all your focus on taking care of your loved ones, it can be easy to put your own needs on the back burner when facing the loss of a loved one.

However, it’s absolutely imperative that you take time to focus on yourself, too. In honor of Mental Health Awareness Month, we are discussing the importance of self-care throughout the grieving process.

Mental Health Awareness Month

Mental Health Awareness Month dates all the way back to 1949 when the National Association for Mental Health (now known as Mental Health America) first organized the observance in the month of May to help raise awareness and lessen the stigma attached to mental illness.

For a long time, society looked at mental illness as being just one thing. There was always a negative stigma attached to the term, and people often thought of those living with a mental illness as having ‘gone mad’. However, that is simply not true. Over time, we’ve learned more about the many layers and types of mental illness.

Mental illness is the term used to describe mental health conditions that impact a person’s mood, thinking, and behavior. Common mental illnesses include:

How Grief Impacts Mental Health

Losing a loved one can be a traumatic experience. You may feel as though you lost a part of yourself and that your life will never be the same. While there is some truth to this, it’s important to remember that you are still here and must go on living your life.

“We don’t move on from grief. We move forward with it.

–          Nora McInerny

Feelings of sadness, anger, loneliness, and hopelessness are all common throughout the grieving process. However, these feelings can sometimes develop into chronic grief which can in turn become a mental illness. In some cases, grief can lead to depression.

Symptoms of chronic grief can include:

How Self-Care Improves Mental Health

Self-care used to be thought of as bubble baths and pampering yourself, but there is much more to self-care. Just like the grieving process, self-care can look different for everyone. But the overall concept is to take care of yourself physically, mentally, and emotionally.

To take care of yourself physically is pretty simple: eat a well-balanced diet, drink plenty of water, exercise regularly, and practice healthy hygiene habits. However, taking care of yourself mentally is a little less cut and dry. This is where it really differs from person to person. To take care of yourself mentally and emotionally, you need to take time to do the things that make you feel good and happy. Hobbies are a good place to start when focusing on taking care of yourself mentally. Maybe you enjoy sitting outside and reading a good book, maybe you are an artist, maybe you enjoy taking long walks with your dog. Whatever it is that leaves you feeling happy and fulfilled, do it!

Research shows the more you practice self-care, the more confident, creative, and productive you are. This also leads to experiencing more joy, making better decisions, building stronger relationships, and communicating more effectively. Overall, you will be in a better frame of mind, making you a better version of yourself. This is not only good for you, but it’s also good for those who depend on you.

When you take time to take care of your whole self (physically, mentally, and emotionally), it will help you to process your feelings of grief in a healthier way.

How Hospice Can Help You in Your Grief Journey

Always remember that you do not have to face the journey of grief alone. Lean on friends and family to help you through. Don’t be afraid to talk about your feelings. Sometimes we feel the need to be strong for those around us. If this is the case and you would feel more comfortable talking to someone outside the family, lean on the support of your hospice bereavement team. Our kind, compassionate bereavement coordinators are always available to talk or just listen. Never hesitate to reach out.

If you or someone you love is struggling with their feelings of grief and would like to talk to one of our bereavement coordinators, please contact us at (804) 358-3480.

Young woman consoling elderly loved one

April Is Bereaved Spouses Awareness Month

By Jacquelyn Buffo, MS, LPC, CAADC

Losing a loved one to a terminal illness is one of the most painful experiences you can go through. The loss of a spouse or partner is traumatic for many people, and the grief journey can feel overwhelming, confusing, and painful. However, each person grieves and works through the grieving process at their own pace and in their own way. If you are grieving the loss of a partner or spouse, you are not alone. The month of April is Bereaved Spouses Awareness Month, observed since 2008. Bereaved Spouses Awareness Month provides support and resources for bereaved spouses.

The difficulty of losing a spouse is followed by a grieving process that can be challenging for many people. Grief is a process and includes many different types of symptoms, some more severe than others. Feelings such as shock, sadness, numbness, and even guilt can occur after losing a spouse. Your experiences of grief may be different than others, and it is dependent upon factors specific to you. Grief can present as intense emotions and can also present in behaviors.

For example, bereaved spouses may experience:

How Hospice Care Can Help 

There is no right or wrong way to grieve, and support and help are available to you. An available resource along your journey of bereavement is hospice care. Hospice can help spouses prepare for the impending loss of a loved one. The hospice’s bereavement team can also help spouses after a patient passes. The mission of hospice care is to deliver compassionate, quality care to individuals with terminal illnesses and support the families through the caregiving phase and bereavement process.

Many spouses spend a significant amount of time and energy caring for and tending to their ill partners. But unfortunately, they may overlook their own needs and feelings during this time. Utilizing the hospice team as a source of support can help spouses tend to their emotions and needs when it is difficult.

If you are struggling with the loss of a loved one, it is vital to get the help and support you need. First, talk to a trusted family member or friend about what you’re going through. Loved ones can be strong sources of validation, support, and compassion. You can also talk to your doctor if you notice a change in behavior and mood or if you are having difficulty performing the normal activities of daily living, such as showering regularly and eating. Your doctor may be able to provide you with medication and can also provide you with referrals to a grief counselor or support group near you.

Sources:

  1. Mourning the Death of a Spouse | National Institute on Aging (nih.gov)
  2. Missed Opportunity: Hospice Care and the Family – PMC (nih.gov)
Close up of girl hugging her legs and sitting by the window with view of holiday lights outside in the background

Tips for Navigating Grief This Holiday Season

The holiday season is here, and what is a time of joy and togetherness for most can be a time full of sadness and grief for others. The holidays are meant to be spent with those we love, so how can you be expected to feel like celebrating when someone you love is no longer there to celebrate with you?

If you are missing a loved one this holiday season, here are some tips to help you take a step back from the grief and survive the holidays.

Tip One: Be prepared for grief triggers.

Let’s be honest, they are everywhere during the holidays. Preparing for these triggers and having a plan for coping with them can sometimes make the triggers more manageable as you encounter them.

Tip Two: It’s okay to take a break from togetherness.

Plan to get some space from the holiday chaos if you need it. Being surrounded by family and friends is great, but all at once can be emotionally overwhelming and hard to overcome. Don’t feel guilty about your grief. It is important to be conscious of your limits and take some time to recollect yourself.

Tip Three: Seek gratitude.

The holidays are a time to gather together, eat good food, and share what we’re thankful for. If you’ve recently lost a loved one, it can be hard to feel thankful when you are grieving. Although you may be focusing on the loss, try to remember the good things that relationship brought into your life. Search for that gratitude.

Tip Four: Decide which traditions you want to change or keep.

Acknowledge that things will be different this year. Some holiday traditions will remind you of your lost loved one, but it is okay to limit which of these you allow yourself to remember or not. Take time to prepare for which traditions will make you happy and which will overwhelm you.

Tip Five: Say yes to help.

Although you may normally be the one to host during the holidays, this year may be too much to take on alone after losing your loved one. Accept help when it’s offered. Remember that there is no shame in saying yes. Those who love you want to help.

Feel Joy Through the Grief

The holidays can be hard for those who have recently lost a loved one. Grief can be especially unavoidable during these times, but it is important to remember that you can still feel joy through the grief. Taking these tips into account can help you prepare for that grief and make your holidays more enjoyable.

Five Stages of Grief

Losing someone we love leaves us with feelings of unbearable pain, and while everyone grieves differently, there are five stages of grief that most people go through after experiencing a loss. Very Well Mind describes the five stages as follows.

Denial

The first stage of the grief process is denial. In this stage, we are trying to process the reality of the loss of our loved one. When we hear the phrase ‘denial,’ we assume it means we are attempting to pretend the loss does not exist. While this is denial, it is only a part of this stage. Experiencing denial also means we are trying to absorb and understand what is happening. When we lose a loved one, there is a lot of information to process at once. Denial attempts to slow down this process and take us through one step at a time to avoid the risk of feeling overwhelmed by our emotions. It takes time for our minds to adjust to the new reality of life without this person, and denial helps us to minimize the overwhelming pain of the loss.

Anger

Next, we move into the anger phase. Anger is very common to experience and tends to be the first thing we feel when we start to release our emotions related to loss. There is so much for our mind to process, and anger can serve as an emotional outlet. We become overwhelmed with feelings of sadness and vulnerability, and sometimes anger feels like the only way to express these feelings. We may also fear judgment or rejection if we admit that we feel vulnerable or scared so anger may feel like a safer way to express our emotions.

Bargaining

When we experience a loss, it is not unusual to feel so desperate that we are willing to do whatever it takes to alleviate the pain. This often comes in the form of bargaining, typically with a higher power. We often feel helpless, and bargaining can give us a perceived sense of control over something that feels so out of control. There are a variety of promises that people may make when bargaining. These can include things like, “God, I promise to turn my life around if you let this person live.” It is also common in this stage to recall times we said things we did not mean and wish we could go back and do things differently. We may also make drastic assumptions that if we had done things differently, we would not be in such an emotionally painful place in our life.

Depression

As the emotional fog begins to clear and panic begins to subside, we slowly start to really look at our new reality. At this point, bargaining no longer feels like an option, and we are forced to face what is happening. In this stage, the loss feels more present and unavoidable, and we feel it more abundantly. This can be extremely isolating, as we tend to pull inward as our sadness grows.

No one should ever have to face depression alone. If you or a loved one is struggling with depression, contact the Substance Abuse and Mental Health Administration (SAMHSA) Helpline at 1-800-662-4357 or the National Suicide Prevention Lifeline at 1-800-273-8255.

Acceptance

When we reach the stage of acceptance, it is not that we no longer feel the pain of the loss. It means we are no longer resisting the reality of our situation. Feelings of sadness and regret can still be present once we have reached acceptance. However, the emotional survival tactics of denial, bargaining, and anger are less likely to be present.

We All Grieve Differently

Not everyone will experience each of these stages, while others may linger in one stage longer than others. It is important to remember that we all grieve differently. Your grief is unique to you, just like your relationship with the person you lost is unique. It is perfectly acceptable to feel whatever you are feeling.

If you or a loved one would like grief support, please contact us to learn more about our bereavement services. You do not have to face this alone. We are here for you.

COVID-19 and Guilt

By: Michael Larrimore, Director of Bereavement and Chaplain Services

“Guilt is perhaps the most painful companion of death.”

-Coco Chanel

Feelings of Anger and Guilt

Anger can be a common emotion we experience when we have lost someone close to us. We seek someone to blame or someone to hold responsible, someone who could have altered fate to erase what happened, and sometimes our target is the person looking back at us in the mirror. Guilt is a form of anger turned inward, and it can be one of the most challenging emotions to overcome. We look back on the time proceeding our loss, searching for something we missed, what we could have done differently, or ways we could have convinced our loved one to seek out a different course of action. Sometimes we look back and wish we had said something that we kept inside or kept something inside we regret saying

The Impact of COVID-19 on Guilt

Guilt is complex, and since the beginning of the COVD-19 pandemic it is more pervasive than ever. We might feel guilty because we were unable to visit a loved one during their final days, even if this was a result of precautions or restrictions outside the realm of our control. We might feel guilty for not taking the threat as seriously as we should have, ignoring or forgetting to take the appropriate precautions. Maybe we feel guilty we survived the virus when so many others, including people we knew or loved, succumbed to this terrible disease. This last form is often referred to as “survivor’s guilt,” and it can be very common among people who live through difficult or traumatic events. We are often ill-equipped to deal with any loss, but no one was prepared for something as widespread as COVID-19.

Managing Feelings of Guilt

If you, like so many others, are struggling with guilt related to the pandemic, it can be difficult to find a way to shake how you are feeling. Here are a few things to keep in mind when you are trying to deal with your guilt feelings:

  • Is your guilt genuine or self-inflicted? Our guilt may be genuine if through action or inaction someone came to harm or was affected in a negative way. For many people guilt is self-inflicted, where we are seeking to have some measure of control over a situation that may be outside our control and blaming ourselves is easier than accepting there was nothing that could be done. Many events of the pandemic were outside of our control and acknowledging that can be a good way to start healing.
  • It can be important to forgive someone who has wronged us so we can move past it, and we must find a way to have compassion and forgiveness for ourselves and make amends if appropriate. Even if the person we feel we wronged is no longer with us, there are ways to seek forgiveness. We can find support through our personal faith, through loved ones associated with the person who is gone, or even by writing a letter expressing our regrets to the deceased.
  • It can be easy to get lost in the negative, but it is necessary to take time to look at the positive things we did or tried to do. Instead of beating yourself up for not being able to spend as much time as we wanted with the person, focus on the efforts you made to stay connected to them. Instead of wishing you could have done more to care for them, focus on all the things you did to help them. When you start to slip back into negative thoughts, try to reframe your thinking to positive memories and encouraging self-messages.

The above suggestions are just a few ways to start down the path to forgiving yourself and getting past your feelings of guilt. If you or someone you know is struggling with issues related to COVD-19 or any other difficult life event, there is help and support available in your community. You can call our agency anytime and our family support staff will help get you to the help you need. You can also reach out to the National Alliance on Mental Illness at 800-950-6264 or if you or someone you know is struggling with thoughts of self-harm please contact the National Suicide Prevention Lifeline at 800-273-8255.

Grief. It’s a small word with a big effect. At worst it is crippling. At best it is nagging. And holidays seem to magnify the heartache that follows grief, regardless of when the loss took place. For some, pushing through the holidays and honoring time old traditions can be the perfect way to memorialize a loved one. But for others, creating and celebrating new traditions or skipping the holiday festivities altogether might be easier to bare. There’s no right or wrong way to grieve during the holidays. Even two people who experienced the same loss will grieve differently. Many factors, such as the relationship to the deceased; the surviving individual’s belief and spirituality; past experiences with loss; and the survivor’s willingness and ability to express their grief can impact each survivor differently. Regardless of how you choose to celebrate or not celebrate the holidays, the following steps can help you feel more prepared to handle your grief:
  1. Acknowledge that the holidays will be different.
  2. Acknowledge that the holidays will be tough.
  3. Communicate your holiday plans with family and friends so that they will know what to expect.
  4. Recognize that even family and friends within your own grief circle may have different plans for how they wish to spend the holidays. Seek to find common ground, establish your plan should the holidays become too much for either party, or choose to celebrate separately if their plans conflict with your level of comfort.
  5. Seek help from a friend that you trust who can be there for you without offering advice or trying to “fix” your grief.
  6. Say “yes” to help if you need the support.
Our wish for you this holiday season, and always, is that you can find joy amid sorrow as you remember your loved one.That nagging feeling in the pit of your stomach. The worry that you just can’t shake. The anxiety that you’re feeling. It’s easy to recognize stress, fear, and worry. But at its core, these feelings of stress, fear, or worry could really be expressions of an even deeper emotion—grief. During this time of uncertainty with COVID-19, we are grieving a loss of normalcy; a loss of safety; a loss of finances; a loss of health for people we love and care about deeply; a loss of milestone moments for our kids—graduations, proms, sports; a loss of connectivity to our family and friends; and a loss of events and regular activities that bring us together, allow us time to destress, or provide us with an escape from the daily grind. The list goes on and on with the challenges and changes that our new social distancing practices have put in place. It’s okay to feel these emotions and to recognize your grief. Recognizing your grief does not diminish all that you are thankful for. For example, you can grieve a loss of work but still be thankful for your time with your family—time that you might never would have taken, otherwise. Or you can grieve the expectation that you are now an employee, parent, and teacher all in the same moment while still being thankful that your children are home safe and that you have a job. Grieving one does not lessen your joy of the other. Seasons of life, even the really difficult ones, are not strictly one-sided or black and white. These moments are Bittersweet and point to the fact that something can be both bitter and sweet at the same time. Much like this, joy can exist, intertwine, and mingle right alongside our grief. We can feel the hurt and the loss, yet look around and find moments of joy, happiness and hope. This bittersweet feeling is one that our patients and families often describe. A loss of independence, health, and ability to perform tasks that bring joy can cause grief, but periods of togetherness, closure, acceptance, and comfort can provide sweetness and enrichment to the lives of our patients and their families. Our staff feels this complex grief too – grief upon our patients’ passing but also a comfort and peace that our patients and their families found moments of joy during a difficult time. In an article in the Harvard Business Review, grief expert David Kessler discussed these feelings of grief and how to combat those feelings. To summarize, he said:
  1. “Find balance in the things you’re thinking.” – Don’t just dwell in the worst-case scenarios. As it relates to the Coronavirus—think not just of the people who will be sick but also of all the people who will not because of our efforts to flatten the curve. As it relates to hospice – think not only of the passing of a loved one but also of the joy that your time with that person has added to your life.
  2. “Come into the present.” – In this present moment, your anticipatory thoughts are just that—thoughts, which may or may not come to fruition.
  3. “Let go of what you can’t control.”—Focus on what you can control. As it relates to the Coronavirus – practice social distancing, wash your hands, and don’t touch your face. As it relates to end of life– focus on what you can do, what you can enjoy, and what makes you happy.
  4. “Stock up on compassion.”—Fear and emotion manifest at pivotal times, such as a pandemic or at end of life. Recognize that a behavior may seem magnified out of fear. Give grace to those who behave out of character due to fear or emotion. Recognize them for who they typically are.
For the complete article from the Harvard Business Review, visit the link: https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief?fbclid=IwAR35_lZ8_xajIcqad-GfMTT6_Hcp_ytepXFah30uvVNMHnbri4RB6GmVPC4The Honest Truth About Grief Here are three honest truths about grief that everyone should know.
  1. Grief is forever. This is hard to hear, but vital to understand. The sooner you accept this, the sooner you will be able to adapt to and deal with your grief.
  2. It’s ok to not be ok. Grief is harsh, constant and overwhelming – especially at first. Let yourself feel those emotions and don’t be ashamed of it. Recognizing your grief allows you to be one step closer to conquering your journey with grief.
  3. Everyone grieves differently, so don’t be so hard on yourself. There is no one way to go about the grieving process. There are a lot of articles out there offering suggestions and remedies to help your grieving process, but it is important to find what works best for you. Simply because someone found relief in one method doesn’t mean you’ll experience the same result. Know that’s it’s ok to find comfort in things other may not understand.
Although the points discussed above were very raw and honest, here’s the good news: Although grief is tough and may not ever truly go away, it does change over time. Grief becomes a part of you, it mellows and, most importantly, it makes you stronger. Right now, you may think that what you’re feeling will never subside, but you will become genuinely happy again at some point. Life will go on.Alright. Breathe. Don’t panic. Valentine’s Day is just around the corner, and I know some of you are dreading this day. While this holiday can be tough enough for some of us, those who are grieving this Valentine’s Day may have it worse. While your intentions may be to spend the day alone and sad, I challenge you to push through and celebrate this day. Okay, hear me out. I understand that grief and Valentine’s Day don’t mix well but try these options for making it through yet another holiday without your loved one.
  1. Light a candle in honor of your loved one. It’s okay to think about them on this day and remember the love you had for each other. Allow yourself to be present in your loved one’s memory and feel all those emotions.
  2. Bring a card or flowers to someone else who is feeling down this Valentine’s Day. Redirecting your grief and trying to connect with those who are also grieving on Valentine’s Day can help you put a positive spin on the holiday.
  3. Invite a group of people over for a casual get together. Trust me, you aren’t the only one who doesn’t want to be alone this Valentine’s Day. Connect with others who are feeling the same way as you or those who may not have someone to be with this holiday.
  4. Have some quiet time. While surrounding yourself with loved ones on this day will be a huge help, it’s also important to take some time to yourself.
  5. Believe that next year will be a little easier. I promise, things will get better and it won’t always be this hard.
Valentine’s Day will never be the same without your loved one, and that’s okay. Planning ahead and incorporating some of these tips throughout the day can help relieve the stress and create a new meaning for this holiday. Just remember – Love never dies.

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