We feel helpless in the presence of someone suffering.
The words “I’m so sorry for your loss” seem empty and meaningless but those are the words most of us use when we try to comfort friends or family members who are grieving.
Professional caregivers are trained in the area of communicating with family members and the individual who is terminally ill. In order to communicate effectively, you need to understand what grief is and understand its effect on relationships. The following information and suggestions were taken from my training with Beacon Hospice, located in Boston, MA, when I was learning skills for becoming a hospice worker.
What is grief ?
Grief is a natural process that is different for everyone. It’s a reaction to loss whether it’s physical (i.e.; a death), social (i.e.; a divorce), or occupational (i.e.; unemployment).
According to theorist Kubler Ross, there are five stages to grief:
* Denial-The person is unable to believe the loss is real.
* Anger- Placing blame on God, the doctor, even the deceased himself
* Bargaining-Making a deal with God, “If you let him live, I will…”
* Depression-sadness that can turn into a serious problem if it lasts more than 2 weeks.
* Acceptance-Accepting the loss and feeling a sense of peace.
What are the responses to grief ?
There are different responses to grief and the symptoms for each response vary but might include:
* Emotional Response: anger, hopelessness, anxiety, guilt, sadness, panic, numbness, emptiness, relief
* Physical Response: an increase or decrease in appetite, lethargy, headache or stomach ache, restlessness and sleep disturbances, crying, shortness of breath
* Mental/Cognitive Response: confusion, trouble concentrating, decreased attention span, difficulty accepting the loss as reality, continually thinking about the loss, memory problems
* Social Response: change in work performance, disinterest in others, withdrawal, fearful
* Spiritual Response: blame God, search for meaning in the loss and awareness of life’s fragility, experience the presence of the deceased, question one’s faith
People who are grieving can have behavior changes on a daily basis. One day they’re happy to see you, the next day they don’t want any visitors. Don’t take it personally because the grieving process can be a roller coaster ride.
Families trust professionals that know their loved one and every interaction should be positive and used as an opportunity to build trust. There are cultural differences and it’s important to be aware of them, but generally there are basic communications skills to follow, when comforting a family member who is anticipating loss or experiencing it.
Necessary caregiver communication skills:
* Be an active listener to the message, not the words
* Use eye contact
* Be present. You don’t have to say anything, just let the family member know you are there for them and listen. Be a strong shoulder, interact with positivity, and avoid jargon. Use their name, lean forward, hold their hand, smile. Be comfortable with silence.
* Be aware of your facial expressions and body language
* Have compassion and empathy. Allow the family member to express feelings without fear of criticism.
* Never say, “I know how you feel.” You don’t! Think of yourself as someone who is walking alongside the person who is grieving; not behind or in front of. Don’t tell them how they should feel.
* Witness the grief, but don’t participate. Model a different behavior. Act, don’t react.
* Have a sense of humor (when appropriate)
* Listen to the stories or be comfortable being still. Realize emotional and spiritual pain is necessary for healing.
* Don’t give advice unless the family member asks for it. If you don’t know the answer say, “I don’t know but I will find out who does.” Refer to the person’s physician, case manager, social worker or another member of the hospice team.
Don’t forget to take care of yourself.
* Make sure you are getting enough rest and respect your own needs.
Grieve on your own time; remain strong for the family member. Remember, all interactions should be positive!
These organizations provide information and referral service, resources on end-of-life care, brochures on hospice, volunteering, and bereavement.
1. Hospice Foundation of America Phone (800) 854-3402 Website www.hospicefoundation.org
2. National Hospice and Palliative Care Organization Phone (800) 658-8898
You can also call your local Social Security Administration, State Health Department, State Hospice Organization, or call (800) 633-4227 Medicare Hot-line to learn about hospice benefits.