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Bereavement

5 Facts About the Stages of Grief

You may have heard that grief occurs in set stages: denial, anger, depression, ,bargaining, and acceptance. However, no two people grieve in the same way so how can we classify everyone into certain stages?

Instead of grief looking like this:

It often looks more like this:

Not everyone experiences all of the stages of grief, and some people may hit a stage farther down in the list and revert to one earlier in the list. These “stages of grief” are merely a tool to help us identify what we are feeling after experiencing a loss. These stages were developed by a Swiss-American Psychiatrist named Elisabeth Kübler-Ross. She wrote a fantastic book entitled On Death and Dying in 1969, where she discussed the 5 stages of grief. You can read more about her biography and pioneering grief studies by checking out this link. For now, we are going to dive into what each stage looks like.

Denial Stage

“This can’t be happening.”

“But I feel great! How can I have cancer?”

“I just saw Grandpa last week and he seemed fine. I can’t believe he died last night.”

It is completely normal to rationalize your overwhelming emotions. This is a common defense mechanism that helps absorb the blow of the immediate shock.

We tend to block out the truth and hide from the facts. This is a temporary response that carries us past the first wave of pain we experience after a loss. Once you explore the situation surrounding your loss, reality tends to set in. There’s no time limit on the denial stage. It’s your body’s way of protecting itself.

Be open to seeing reminders of your loved one, as painful as it may be. Visit the gravesite, look through old pictures, listen to their favorite songs, or wrap yourself in your loved one’s favorite clothing or blanket. Talk through your denial with family, friends, or a grief counselor.

Anger Stage

“This is all your fault!”

“It’s Nana’s fault she got lung cancer. She smoked 10 packs/day for 65 years! Now she’s gone and I have to deal with all of this pain.”

“Dr. So-N-So didn’t do anything at all to cure Aunt Susie’s COPD! It’s his fault she died!”

In the “anger stage” we tend to search for someone to blame, feel intense guilt ourselves, and lash out at loved ones or even the decedent. As the numbing effects of the denial stage wear off, you may not be ready to cope with the loss of a loved one, so you express your intense pain as anger. Your anger doesn’t have to be logical or invalid. For example, you are mad at Dr. So-N-So for not curing Aunt Susie’s COPD when you know he did what he could but COPD can’t be cured.

Honor your anger! Allow yourself to be angry and express it! We don’t mean pick a fight with someone. Express your anger in a healthy manner- go for a run, try out a kickboxing class, find a solitary place and just scream. Don’t keep your anger all bottled up. Explore it in a way that doesn’t harm yourself or others. Talk through your anger with family, friends, or a grief counselor.

Bargaining Stage

“What if we went for a 2nd opinion? Would Grandma still be here?”

“What if I am nicer to everyone and start doing community service, God? Will you spare Uncle Jim’s life?”

This bargaining stage of grief may seem silly, but it serves an important purpose. It provides a temporary escape from the pain you are experiencing and provides hope. This temporary escape gives you time to adjust to the realness of the situation. Sometimes when attempting to bargain with God, feelings of guilt aren’t far away.

Talk to family, friends or a grief counselor about your bargaining hopes and wishes. They may be able to provide you with some perspective and help you through this phase.

Depression Stage

Intense sadness, decreased or increased sleep, reduced appetite, loss of motivation.

Depression usually occurs when reality officially sets in. This stage feels like it lasts forever, because our grief transitions into present-day and the depression hits on a level much deeper than anything experienced thus far in the grief stages. It’s important to know the depression experienced in the stages of grief is not a sign of mental illness. However, if you are experiencing suicidal thoughts or actions, please seek immediate professional help!

Give yourself time to feel your emotions. Don’t let anyone tell you to “get over it” or simply “move on”. In order to healthily heal, you must acknowledge your pain. Avoiding your depression associated with grief can transition into chronic depression, anxiety, substance abuse, or other mental/physical illness. Talk to family, friends, or a grief counselor to express your feelings. You can even do something creative to express these feelings; write a letter to your loved one, create a photo album or scrapbook of your loved one, create a playlist of your loved one’s favorite music or music that reminds you of him/her, or volunteer at a place your loved one thought was special or a place that took care of your loved one.

Acceptance Stage

“I’ll never be okay with losing my grandma, but I cannot let my grief control my life.”

Acceptance does not mean you are “okay” with the loss of your loved one. Most people don’t ever feel “okay” about losing someone they love. The acceptance stage is still a process, it isn’t a final stage with an ending.

Understand that the acceptance is learning to live with the new normal in your life, not that you must be “okay” with the loss. Be patient with yourself. It may take some people years to reach this stage, while others may reach it quickly and bounce back to denial several times before fully accepting the new norm. Talk to family, friends, or a grief counselor to help reach the acceptance stage and come to terms with your new normal.

Unfortunately, grief and loss are some things everyone experiences at one point in his/her life. St. Anthony’s Hospice offers FREE grief support and counseling to anyone, not just families of hospice patients. We believe everyone should have a safe and healthy way to manage their grief. Please call us at (270) 826-2326 or visit our bereavement page

 

Sources of photos found on photos. 

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Grief

Grief comes in all shapes, sizes, feelings, etc. No two people grieve the same, and it’s a very tricky subject to maneuver around. 

When a loved one passes away, it often feels as though your whole world collapses. You turn to others for a kind word and they think they are helping, but sometimes their words may get twisted in a way that sounds hurtful; but you know their intentions are good.

If you search online for the “stages of grief” you’ll see the commonly referred to “7 Stages of Grief” nicely listed out. 

  1. Shock and denial.
  2. Pain and guilt.
  3. Anger and bargaining.
  4. Depression.
  5. The upward turn.
  6. Reconstruction and working through.
  7. Acceptance and hope.

There are other websites out there that list the 5, 7, or 12 stages out, but we will stick to the 7 stages since they are commonly heard.

With there being 7 “stages”, it appears as though each person experiencing grief will move through these quickly and easily with no chance of backsliding. This is often not the case. 

As you can see, some people can get to any stage and either jump forward a stage or two, or even back all the way back down to stage 1. Grief is a healthy way to express your emotions after a traumatic loss, no matter the pattern you take to heal.

Luckily, St. Anthony’s Hospice offers bereavement counseling and support groups to help you through it. And it’s free and open to everyone in the community- not only families of St. Anthony’s patients! Please give us a call at (270) 826-2326 or visit our website here to learn more. In addition, we have some Helpful Bereavement Links on our website. 

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He Only Takes the Best

“God saw he was getting tired,
And a cure was not to be,
So he put his arms around him,
And whispered “Come with me”,
With tearful eyes we watched him suffer,
And saw him fade away,
Although we love him dearly,
We could not make him stay,
A golden heart stopped beating,
Hard working hands to rest,
God broke our hearts to prove to us,
He only takes the best,
Although his heart stopped beating,
His love will always remain,
His absence puts upon our hearts,
A very heavy strain,
For now he is in a place of everlasting rest,
We just have to understand that God,
He only takes the best.”
-He Only Takes the Best, by Jimmy Arnold

If you have been to the Lucy Smith King Care Center lately, then you have seen this beautiful lantern at the nurses’ station. It is a loving reminder that “He Only Takes the Best” and even if you are laughing and having a good time with your loved one, someone may be saying goodbye to theirs.

If you or a loved one is in need of hospice, palliative, or bereavement services please call us at (270) 826-2326.

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Forgiving at the End of Life

Many sets of siblings have heard “apologize to your brother/sister!” Or some may have used the ever-so-famous get along shirt, as pictured below.

We all remember this vividly. The mumbled and not so sincere “I’m sorry”, usually accompanied by a forced hug, prior to mom or dad releasing you and your sibling to go play. These moments we all remember so well are used by parents as teachable moments to teach kids about saying sorry, meaning it, and forgiveness. Teaching kids these lessons often goes well since they usually have something small to apologize for such as not sharing a toy.

When adults need to forgive another, that’s where it can get complicated than simply not sharing a toy. Sometimes there’s years of resentment and pain that is difficult to get over. Forgiveness is a critical part in healing; forgiveness at the end of life is more critical since it can benefit both parties.

The Importance of Forgiveness at the End of Life

Hospice clinicians witness all kinds of things with patients- love, tender moments, pain of unresolved conflict, and forgiveness from both patients and families. They watch as an estranged son comes back to the father that hurt him in the past, grab his hand, and have one final heart-to-heart with forgiveness on both ends. Not only do the clinicians witness these beautiful moments, but they also witness the patient reaching out for one final chance at forgiveness, only to have their loved one reject the call.

There can be many reasons the loved one doesn’t want to forgive the patient such as past abuse, addiction, neglect, or many others. Even in difficult situations such as these, there is value in forgiving at the end of life.

How Does Forgiveness Help?

Forgiveness is beneficial for both mental and physical health. Mentally, forgiveness doesn’t mean “forgiving and forgetting”, but it does mean letting go of the resentment and anger you have been harboring against that person.

While forgiveness isn’t the easiest thing, St. Anthony’s offers Chaplains to help steer through the complex emotions you may feel. You may have to forgive your loved one multiple times to feel the relief. Once you completely forgive, you may experience many physical changes that include:

  • Lower blood pressure
  • Lower anxiety and stress levels
  • Reduced symptoms of depression
  • Better immune system (which we all need especially with COVID and the flu)
  • Improved mental health
  • Allows for healthier personal relationships

When Forgiveness Fails

While forgiveness benefits all parties, it also can’t be rushed. When approaching end of life, time becomes a factor. Those who were wronged need to forgive on their own terms. You can start on the forgiveness route by apologizing sincerely and taking responsibility for your own actions by offering an explanation of why the event happened and how you wish to make amends.

It’s important to give the wronged person the chance to express how the situation affected them. This can be difficult to hear, and even say, it’s a necessary part of the process.

Even with a sincere apology, the hurt person may not forgive. While this may hurt, forgiveness may not be immediate. Follow the lead of the hurt party and give them the space needed to process the apology and heal.

Seek out a therapist, chaplain, or social worker for more guidance to move forward and forgive. If you have any questions about hospice care, please call us at (270) 826-2326.

 

 

 

Photo source: https://www.google.com/search?q=get+along+shirt&rlz=1C1CHBD_enUS850US850&source=lnms&tbm=isch&sa=X&ved=2ahUKEwjG1PLTqMTtAhVGaM0KHaPXDf8Q_AUoAXoECBMQAw&biw=639&bih=564&dpr=1.5#imgrc=4aDicGV_7eWKSM 

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Grief and the Holidays

The holidays are a trying time, now in a pandemic, and even more so when you lose a loved one. The first year a loved one is gone is completely different- the first Christmas, Thanksgiving, birthday, etc. without your loved one around or calling you.

Last year we shared 14 ways to cope with grief during the holidays and we wanted to hit on those again.

  1. Realize this year will be different. Don’t compare this holiday with the nostalgia of past holidays. Acknowledge that the holidays may not be the same as those in the past.
  2. Expect emotions to intensify. Accept the likelihood that the holidays may be painful.
  3. Plan ahead. Pace yourself. Set realistic limits and lowed expectations. It is okay to say “no” to things like sending cards, decorating, and buying gifts.
  4. Be flexible and patient to yourself and others.
  5. Tell others what you need. Others may not know how to help you and need to be told what to do. Communicate your needs!
  6. Be gentle with yourself. Give yourself permission to feel whatever you feel.
  7. Remember your physical needs. Don’t abandon healthy habits like exercising, eating right, and getting plenty of sleep.
  8. Make new holiday rituals. When you do things differently, it tells others that your life is different. Light a candle, walk, pray, or do whatever feels right for YOU!
  9. Honor traditions. Let family know what traditions are meaningful for you and which are painful. It is okay to let some traditions go.
  10. Take 5 minute “mini mental breaks.” Sit down, practice deep breathing and simply close your eyes. Alternatively, go for a walk, listen to music, or meditate.
  11. Stay involved. Meet together as a family and share what each needs to make these holidays special and be willing to change the normal routine. In 2020, please be sure to follow COVID guidelines to keep yourself and family members safe.
  12. Lean on your faith (or family) for strength. Touch base with your spirituality (or family members if you are not spiritual). Both can bring comfort, strength, peace, and wisdom. Explore what gives your own life meaning.
  13. Remember to remember. Celebrate the memory of your loved one in a way that helps you cope.
  14. Find moments of joy. Remember that your loved one would want nothing but your happiness over the holidays. Don’t feel guilty to laugh, joke, or find joy in the simple things.

In addition to 14 ways to cope with grief during the holidays, we wanted to re-share Thomas Emerson’s video on bereavement support and grief. For those who do not know, Thomas is one of our Chaplains and our Bereavement Coordinator. https://www.youtube.com/watch?v=D4GI0X-IBhg

Holidays can be hard, here at St. Anthony’s we want to make them a little easier for you! We offer bereavement support for 15 months after your loved one passes away! We also take referrals anytime- day or night- and visit patients anytime a need arises outside of their scheduled visit. Give us a call at (270) 826-2326 to see how we can help you or a loved one.

 

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Childhood Cancer Awareness Month

September is a month of many things- the unofficial and official start of fall, back to school month, a super fun song by Earth, Wind & Fire, and the official month of the Virgo. Most importantly, its Childhood Cancer Awareness Month.

Childhood cancer is the leading cause of death by disease for children under age 14, according to St. Jude’s website. We all know of a child or family that has been directly impacted by this horrible disease.

We’ve put together some facts about childhood cancer to help raise awareness.

The awareness ribbon for childhood cancer is gold.

43 children in the US are diagnosed with cancer every day.

Around the world, at least 300,000 children and teens are diagnosed with cancer every year. That is over 800 children and teens diagnosed daily.

It is estimated that 10% of children with cancer developed it due to a genetic mutation.

Childhood cancer survivors are twice as likely to suffer from chronic health conditions into adulthood.

1 in 285 children will be diagnosed with cancer by the age of 20.

Childhood cancer research only receives 4% of the budget from the National Cancer Institute.

(facts sourced from- https://www.alexslemonade.org/childhood-cancer/about-childhood-cancer/facts and https://www.stjude.org)

Children with cancer can receive concurrent care, which is aggressive treatment along with palliative care. This type of care ensures the child is kept comfortable while fighting their cancer.

If you or someone you know needs extra help in symptom management, please give us a call at (270) 826-2326.

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Never Forget

May we never forget the tragedy of 9/11/01. It’s been 19 years and we can still remember where we were and what we were doing when news broke of the first plane crash.

Where were you when the world stopped turning?

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Saying Goodbye on the Phone

In an ideal world, family and loved ones would pass away quietly, in their sleep. They would be surrounded by loved ones and comfortable until the end. Sometimes with visitor restrictions or social distancing, we must tell loved ones “goodbye” over the phone or FaceTime.

This is the farthest thing from ideal. Many hospitals, nursing facilities, assisted living facilities, etc. try to accommodate family members who cannot be in the room when a loved one is imminent. Staff members will hold a phone up to the patient’s ear, use speakerphone, or turn on FaceTime to allow loved ones to say goodbye when they cannot be in the room.

How to Say Goodbye Over the Phone

Stay focused. Focus on your loved one and your relationship with him/her. Block out others in the room and talk specifically to your loved one.

Share the phone. If more people are needing to say goodbye, be sure everyone gets the amount of time they need. Allow others to have their moment.

“I love you” goes a long way. Three words pack a ton of meaning and emotion into them. Don’t hold back, say them as much as you want.

Thank them. It’s likely you’re on the phone because the person had a deep influence on your life. When you say thank you to them, you are letting them know how much of an influence they had on your life. Thank them for the love they have showed you or things they taught you.

Ask for forgiveness. Relationships are hard. We can hurt someone we love in large or small ways. Don’t dwell on the small things. However if something is weighing on you, be sure to apologize for it. Just keep in mind your loved one may respond positively, negatively, or not at all. Take ownership of your faults and know you did what you could to right the wrong(s).

Forgive. Your loved one may ask you for forgiveness for any pain they may have caused. They may not be able to speak due to advance in their state. Regardless of words or actions, you can tell your loved one that you forgive them and free yourself from carrying that burden for the rest of your life.

Relive memories. If you have time to move outside of the love, thankfulness, and forgiveness to relive some memories you two share. Talk about special holidays, trips you’ve taken together, favorite recipes, weddings, or outings you took together Laugh about inside jokes and particular memories. If you’re not alone on the phone, allow others to join in and share memories you all share together. It’s always important to surround your loved one with love and laughter, even in their final moments.

Last conversations are never easy, but they are something you take with you for the rest of your life. It’s always harder when you can’t be with your loved one in the end and you have to have your final conversation over the phone or FaceTime. Just reminding your loved one how much they mean to you, how loved they are, and that they will always be remembered in your heart goes the longest way.

If you or a loved one is in need of hospice, palliative, or bereavement care, please contact us at (270) 826-2326 to learn more.

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Advance Care Planning

Having your wishes heard and honored is always important, especially during a pandemic. Advance care planning is making decisions about the care you wish to receive, if you become unable to speak for yourself. These decisions are usually in writing and provided to family and your healthcare provider. The decisions you make about your care are put in an “Advanced Directive” which is a legal document that takes effect only if you become unable to communicate your wishes or speak for yourself. One could become unable to communicate healthcare wished due to serious injury or disease, regardless of one’s age. The legal documents help loved ones make decisions for you and help your healthcare provider know what type of medical care you wish to receive.

There are a few types of Advanced Directives one should have in place while healthy and of sound mind to make such important decisions. These documents include a Living Will and Healthcare (or Medical) Power of Attorney. A Living Will allows a person document his/her wishes regarding medical treatments at the end of life. A Healthcare (or Medical) Power of Attorney allows a person to appoint a surrogate or person he/she trusts to be the healthcare agent, who is authorized to make medical decisions on the person’s behalf.

Prior to your Living Will guiding your medical care, two physicians must certify that you are unable to make medical decisions, you are in the medical condition stated in the document (i.e.- terminal illness or incapacitated), or the state the document was prepared in/person’s residence could have other requirements.

Prior to your Healthcare (or Medical) Power of Attorney going into effect, your physician must certify you are unable to make decisions and if you regain the ability to make decisions, the surrogate cannot continue to make decisions and other requirements required by the state the document was prepared in/person’s residence.

St. Anthony’s Hospice has social workers who can assist patients and family with these documents. While our social workers are not attorneys, they do have the knowledge to make the legal documents easier for the average person to understand. They can also assist the family and patients with funeral arrangements, if they need help with that.

If we can help you or a loved one feel more comfortable or getting advanced directives in place, please call us at (270) 826-2326 or visit our website at https://stanthonyshospice.org/referral/.

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Why St. Anthony’s- Grief

Instead of the normal Why St. Anthony’s post, we wanted to talk a little bit about grief, especially with the pandemic still in full force.

Grieving is a natural part of life and at St. Anthony’s Hospice, we can help you along the way. St. Anthony’s offers monthly grief groups, child and adult grief counseling, grief support classes, and  Although the COVID-19 pandemic has thrown a wrench in our monthly grief support groups, our Bereavement Coordinator is still assisting people in their own homes. Unfortunately, our wee, kids, and adult camps are all cancelled due to the pandemic, but we normally have bereavement camps during different times of the year.

If you or a loved one needs hospice or palliative care, or needs help coping with the loss of a loved one, please call our office at (270) 826-2326. One of the best things about hospice care is the care isn’t only for the patient, it helps the family/caregiver as well! St. Anthony’s bereavement support continues for 15 months after your loved one passes away. Just another few reasons “Why St. Anthony’s” provides the best end of life care for patients and families.

Grief in Children [Infographic] | Crosswinds Counseling

Source listed on image.

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