Bereavement

A Therapeutic Intervention Facilitating Connection in the Context of Life-Limiting Illness

Elizabeth Dougherty - 13th Annual Innovations in Palliative Care

This video provides a brief overview of an expressive arts project that I complete with families of all ages, following the diagnosis of a life-limiting illness, through to end-of-life and into bereavement. Presented at the 13th Annual Innovations in Palliative Care – Leadership, Courage & Community. McMaster University. Department of Family Medicine. Division of Palliative Care. Faculty of Health Sciences (November 2016). This project serves as a therapeutic intervention facilitating communication and honouring connections in the context of life-limiting illness and can be completed by anyone, anywhere at any time. 

It’s a profoundly intimate experience when we are allowed to care for someone… that compassionate connection can transcend so many barriers, and can sometimes even transcend suffering. That connection can be extraordinary.

We all have a role to play in helping to honour someone’s legacy. I believe as Health Care Professionals, like those we care for - we can be courageous in the face of illness, and vulnerability and uncertainty…

We can step out from behind the protection of our roles and in doing so, provide invaluable opportunities for families to connect, and collectively process experiences from time of diagnosis through to end-of-life and into bereavement. 

Source: You Tube. A Therapeutic Intervention Facilitating Connection in the Context of Life-Limiting Illness

Treating troubled family dynamics reduces complicated grief

“Professor David Kissane, who heads the department of psychiatry at Monash University in Melbourne, has developed a family-focussed model of grief therapy to prevent complicated bereavement. A trial published in the Journal of Clinical Oncology earlier this year found the therapy reduced the severity of complicated grief in high-risk families and the development of prolonged grief disorder.

Professor Kissane says bereavement therapy for families is more effective than therapy for individuals when grief is being perpetuated by dysfunctional family relationships. He says the most common family configuration he sees is parents and their children, but for some families it includes a neighbour, grandparents or aunts and uncles.

‘Family centred care is based on the idea that families that grieve together stay together and they heal their grief very well,’ he tells Palliative Matters.”

64 New Year’s Resolutions for Grievers

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“One of my favorites was a beautiful comment from Jeannette Brown, a Buddhist, who explained that “rather than make resolutions for grief, every morning and every evening we pray (by chanting, our form of prayer) for the happiness or repose of all of the deceased. We believe that if we continue our growth and pursuit of happiness, our deceased family and friends will continue to become happy as well”.   I love that sentiment so much, but as someone who just barely manages to commit to a shower every day, resolutions admittedly help keep me on track.

Whatever is right for you, grief resolution or no grief resolution, we hope you find the list of ideas… helpful in thinking about how you will grieve in the new year.”

Grief: Special Days and Holidays. @VictoriaHospice

"After someone dies, you may find that your grief surfaces again and again. Often this seems to happen ‘out of the blue’ and it may feel like an unwelcome intrusion. You may have been enjoying yourself one moment and then be in tears the next. You may also notice that certain days, holidays or public events are more likely or return..."

~Grief: Special Days and Holidays

Tips for Coping with Grief at the Holidays @WhatsYourGrief

"Because the holidays are tough for all of us, the least we can do are share our tips and tricks with one another to make the season just a smidge more tolerable." ~What's Your Grief

Children's Grief Awareness Day November 17, 2016 #CGADHOPE

"Children's Grief Awareness Day is designed to help us all become more aware of the needs of grieving children — and of the benefits they obtain through the support of others. Children's Grief Awareness Day is an opportunity to make sure that grieving children receive the support they need.”

An Innovative Approach to Family-Centred Legacy Projects

I am a Palliative Social Worker and for the past 17 years have had the privilege of caring for people facing a life-limiting illness.  It is an intimate and profound experience - sitting alongside people as they face end-of-life.  They share their hopes and fears - about living and dying - and about caring for and leaving behind those they love.  Trying to protect their families while also wanting to prepare them.  Grieving these losses begins at time of diagnosis.

I recognize the importance of creating safe spaces and making time to have these essential conversations.  A specific legacy project creates opportunities for the individual and family* to do just that - to hold on, while letting go.  We meet together to explore the impact of the illness, to talk about goals and plans, to acknowledge their grief and honour connections.  This project can be completed with families large or small, and include children of all ages.  That Project? While the results have been profound, the activity is, quite simply, creating a “Hug”. 

The physical embrace of a Hug is comforting for anyone in a time of need.  In this instance, it is a creative legacy project that can be completed by anyone, anywhere at any time and is then exchanged as a lasting memento.  The Hug can be taken to any significant place or event: to school, a little-league playoff game, during an admission to hospital or hospice, or even once someone has died, these hugs can be buried or cremated and remain with a loved one forever.

Although tantamount to making a scarf, it is more importantly symbolic of the outstretched arms of a loved one, it becomes a personalized “Hug”.  The components are basic… a flat sheet, markers or fabric paint, scissors and willing participants.  After laying a sheet on the ground, one person lays on top of the sheet while another traces around their outstretched arms and hands.  After sitting up, lines are drawn connecting each arm and then taking scissors, cut along the outline.  Each Hug is then adorned with messages and images of the shared connection and becomes a tangible expression of their love. 

I have completed this activity with anyone wanting to participate, whether ambulatory or bed-bound.  For those who are bed-bound, after carefully sliding a sheet behind their shoulders, the family tenderly helps to hold and trace their outstretched arms and hands.  Throughout this activity, the individual and family share stories and a profound connection, with each gentle movement and precious memory cultivating an incredibly intimate experience.

Language, distance or time do not serve as barriers.  I have completed this activity when families speak a language different from my own.  Despite communicating through an Interpreter, the conversation remains seamless throughout as the family creates a beautiful and moving tribute while supporting each other in their shared love and grief.  This supportive intervention has also bridged great distances, even though families were thousands of miles apart, they completed and sent their personalized hugs via courier to be at the bedside of their dying loved one.  I have also completed this project with children following the death of a parent (many of whom had not been informed about the disease or prognosis in advance).  Although a parent - or any loved one might die before the family has an opportunity to have these conversations, it is so important to facilitate therapeutic activities to collectively express their grief while honouring the connection with their loved one.  

While this “Hug” is essentially an expressive arts project, it creates and holds significant therapeutic value for all involved.  It is a collaborative experience for the family to honour connections while preserving a legacy.  Though each experience is unique, what remains universal are the shared laughs, tears and a multitude of stories - whether with a partner, children, grandchildren, siblings, parents, cousins, friends (or all of the above), they create reminders of shared experiences, connections and precious memories. 

I believe as Health Care Professionals, we can provide invaluable opportunities for families to connect, and collectively process experiences from time of diagnosis through to end-of-life and into bereavement.  I feel extraordinarily privileged that families allow me into their lives - however brief, I hold that time as sacred and do all I can to foster these connections while honouring the legacy of those living and dying.

(family* is defined by the individual - be it partner, children, parents, siblings, neighbour, friend, etc.)

If You’re Grieving, You’re Not Alone. Here Are 15 Stories That May Help.

“There is no schedule for when you should feel certain emotions, or be over others. Choose to stand up for you and the rest of your life, and choose to move on. You don’t have to figure out how you’re going to get through the rest of your life. Just focus on staying in the game and moving forward now. It is normal to cry and be depressed, but you need to keep putting one foot in front of the other.” 

The Quiet Blessing of Grief That Never Ends

“If you’re feeling sorry for me, please, don’t. During the hours I was tossed by this unanticipated wave of sorrow, I knew I could tolerate my sadness. Time has taught me that these waves come — and then go.

Perhaps more surprising, even as I lay curled in a soggy heap, I felt grateful for this wallop of forever-after grief. It provided reassurance that my sister hasn’t faded to a beloved, but distant, memory. Instead, for those hours, Pooz was once again a vivid presence in my mind and heart. There was pain, yes, but there was also the solace of knowing that she is still very much with me.

I count that as a blessing. Amen.”

How To Support A Young Person Through Grief

“This early interaction with death is overwhelming, but a pivotal point for learning. This grief acts as a blueprint for not just how these young people process death, but their approach to the many challenges they will face in life.

If you are struggling to help a teenager with their grief, know that your concern is evidence of your care. There is nothing that can make this not awful, so don't make your aim to stop the tears, but rather to support them in what they need. Respecting their needs shows them that you believe in their ability to know what's best for themselves. You're doing good.”

Camp Erin Hamilton. Fun #Camp for #Children and #Youth with #Grief #Support and #Education @moyerfoundation

“Camp Erin Hamilton is an annual three-day camp experience offered at no charge and facilitated by professional staff and trained volunteers of the Dr. Bob Kemp Hospice and Bereaved Families of Ontario - Hamilton/ Burlington. The camp is for children ages 6 to 17 who have experienced the death of someone close to them. Camp Erin Hamilton combines a traditional, high-energy, fun camp with grief support and education.”

Wonderful #Books that #Help #Children #Grieve and Make Sense of #Death @brainpickings #hpm

“From Japanese pop-up magic to Scandinavian storytelling to Maurice Sendak, a gentle primer on the messiness of mourning and the many faces and phases of grief.”

#Grieving When You’re an #Introvert

"The process of mourning and grieving is hard for everyone, but there are elements of the losing a loved one than can feel especially difficult when you’re an introvert.

As an introvert myself, when I was mourning the death of my parents, so many of the traditional parts of the mourning process felt very invasive to me. For instance, people coming over to my house after the funeral. I had just been taking care of ailing parents and planning a funeral and now I have to have people over? I know that everyone meant well, but having people in my home, some of them I barely knew, felt very unsettling. And then came the inevitable questions, are you going to sell the house, are going to move and what are going to do now?"

MyGrief.ca helps you to understand and work through your #Grief. @VirtualHospice

"MyGrief.ca Because losing someone is hard. MyGrief.ca helps you to understand and work through your grief.

  • Confidential
  • Access in the privacy of your own home
  • Developed by families and grief experts
  • Stories from people who have "been there"
  • A resource for professionals"

The role of #Social #Workers in #Palliative, #end of life and #bereavement care. #hpm

"Social work is essential to palliative, end of life and bereavement care. Some social workers deliver specialist palliative care social work; many others encounter people who are close to or at the end of their life, or are becoming or are bereaved. Social workers have a great deal to offer". 

#Dying is Inevitable. #Living is Not. "#Love is Stonger Than #Death" Rest in Awesome Esther.

"Wayne Earl reveals the power of living and loving life by sharing the wisdom of his daughter, Esther Earl, who lost her battle with cancer just before her 16th birthday. Esther's courage, positive spirit and hope for the future transformed all who knew her. She showed the world what it meant to live life before death (via her well known vlogs and blogs) and that love is the engine of life. Esther Earl shared her spark of possibility with great generosity and was the inspiration for author John Green's #1 New York Times bestseller, The Fault In our Stars.

Wayne Earl recently authored the compelling life story of his daughter, Esther Grace, who succumbed to cancer shortly before her 16th birthday. Before she died, a deepening friendship with her favorite author, John Green, greatly encouraged her. The friendship also inspired Mr. Green, most notably in his writing of the world- renowned novel, The Fault in Our Stars, which he dedicated to Esther. The Earl Family founded the non-profit organization, This Star Won't Go Out, to help ease the financial burdens of families caring for children with cancer."

Things No One Told Me About #Grief

“No one purposefully neglected to tell me these things about grief. Loss, pain, sorrow, heartbreak, they are all simply topics that aren’t discussed in depth and that are experienced in both unique and universal ways. To say: this is how you will experience grief robs it of the unique, yet to say: this is how we mortals experience grief is to give the gift of not being alone. How do we talk about things for which there are no words, in any language that can capture the whole of it? The pain of tragedy burns so deeply and transformatively that we pander around in art, movies, poetry, flowers, songs, essays, trying to grasp the unfathomable. That’s what tears are for, they are the words of the utterly crushed…

No one ever told me that explicitly, either, but I think I’ve known it all along. That love both breaks and heals. Walking through loss with my daughter and sharing our grief is strengthening our relationship. Even though it won’t miraculously heal scars or close up black holes of loss, shared grief is what love looks like.”

The Unexpected #Grief Of The Unknowing

"Through all my self-doubt, and the grief I still experience, I am comforted knowing my mom knew my heart. She understood (more than I could have at the time) how typical, though ill-timed, my behavior was. Nothing changes a mother’s love."

How We #Grieve: the Messiness of #Mourning and Learning to Live with #Loss. @meghanor

“It’s not a question of getting over it or healing. No; it’s a question of learning to live with this transformation. For the loss is transformative, in good ways and bad, a tangle of change that cannot be threaded into the usual narrative spools. It is too central for that. It’s not an emergence from the cocoon, but a tree growing around an obstruction.”

On #Widower Watch. #hpm @otherspoon

"Marking family and personal occasions in this way has become increasingly important to all of us; these events intersect long, quiet weeks with laughter and company. And here’s the often unacknowledged benefit to keeping watch on a widower: With my grandparents dead and my friends all around my age, he diversifies my social life as much as I do his. He gives me a perspective on the city we live in that my peers simply don’t have. We spend our time together talking about our dissimilar lives and the things that matter to us, reminiscing about his many rich years, and looking up old poems in the vast library that lines the walls of his house. He is my friend and I miss him when I am away. As it turns out, nonagenarians are good company".