Anticipatory Grief

It is common for loved ones to begin feeling the effects of loss and grief before a death actually occurs. These are normal reactions to current and future losses. Losses can include those associated with caring for someone with an illness, changes in relationships, and the anticipated loss of a loved one. This anticipatory grief may actually help you prepare for the losses and decrease the intensity of grief after the death occurs.

Causes of Anticipatory Grief
Some of the causes of anticipatory grief are related to fears and actual or possible losses, such as:

• Loss of social life
• Loss of companionship
• Loss of usual eating, sleep, work, and recreational habits
• Loss of independence
• Loss of control, such as, being able to care for yourself or a loved one
• Fears related to life without your loved one
• Fear of losing present family structure, such as head of household, the family matriarch, or frequency of visits from family members
• Fear of starting over 
• Fear of the unknown

Signs and Symptoms of Anticipatory Grief
It is normal to experience recurring or combinations of signs and symptoms of anticipatory grief. Some of the signs and symptoms of anticipatory grief may include the following:

• Feelings of guilt
• Tearfulness 
• Constant changes in emotions 
• Anger 
• Depression 
• Feelings of emotional numbness 
• Anxiety or feelings of fear 
• Changes in sleeping and eating habits 
• Poor concentration 
• Forgetfulness or poor memory 
• Loneliness 
• Denial 
• Acceptance 
• Fatigue

What You Can Do
There are things you can do which may be helpful for working through the anticipatory grief process. Some suggestions may include:

• Go for short walks when possible
• Write in a journal
• Plan for the future
• Seek spiritual assistance if needed
• Talk to someone such as friends, family, or clergy. 
• Make changes only as needed but put off major decisions when possible
• Do the things you want to do now. Forget the chores that you can do later. 
• Spend time with your loved one, friends, support group and family
• Seek help from your family, friends, and/or a hospice volunteer to arrange some time to spend doing things you enjoy
• Call your Arbor Hospice team if anticipatory grief feels overwhelming or you want to talk about your feelings
• Attend a caregiver support group

Sometimes it may feel that the grief process will not end as you experience loss. Please feel free to call Arbor Hospice's grief support services with any questions or concerns. You are not alone.

Grieving National Loss

If you are a parent today, you are well-versed in all things Dora. I learned this over the weekend at my niece’s daughter’s three-year old birthday party. For my husband and me with our son, who will soon celebrate his twenty-fourth birthday, it was Aladdin. We still will watch it on occasion and it makes us laugh as much is it did originally, and I still sing along about a whole new world.

That is one of the aspects that make news about the untimely death of comedic genius Robin Williams so unsettling. I have commented on this before but it bears repeating in this situation. In a "traditional" hospice setting, we are typically serving families with loved ones who are diagnosed with cancer or another terminal illness that has had a long, slower onset. Our "typical" patient is age 75 or older. This makes us baby boomers pretty comfortable – we are serving our parents, not our own generation. And while the amount of time patients and families access hospice is short – it is available for six months, but often families only access services for up to 14 days due to a variety of barriers – it is generally anticipated that there is going to be a death in the family.

This death in our national family was certainly not anticipated, at least not by those outside Robin’s immediate family. As a social worker by discipline, I am compelled to mention the serious illness that is depression, how silent its symptoms can be, how manic swings can be masking other serious issues, and how self-medicating behaviors create other challenges for the person and their family. Robin was such an accomplished actor and comedian in his field – many people will wonder with all of his success – awards, money and fame – what would drive him to take his own life? That is the inconsolable depths of despair that is depression left untreated, and why we need to address it as much as we address any other serious, chronic illness.

Grief support during any loss is important, and it is especially so during a sudden loss such as a suicide. I continue to be drawn to the news reports to witness others recollections of Robin’s impact on their lives, and remember how he impacted mine and my family’s – and I keep remembering other films he was in that I enjoyed. As we know too well, that’s part of the grief journey. I urge others to access support services, grief support services, or health care services depending on our need to ensure our well-being. We cannot help others when we don’t take care of ourselves.

This post was written by Gloria D. Brooks, Arbor Hospice President and CEO. You may contact Gloria by commenting below or emailing her at gbrooks@arborhospice.org.

Lessons from Loss - One Year Later

The one-year anniversary of a parent’s death is a milestone for any adult child.  Bearing witness to a year of "firsts" without your parent: of birthdays – yours and theirs; of holidays, big and small; of national and political events; and of family happenings; all of which would have had an impact on them and of which they would have influenced your response to, can be an emotional roller coaster. 

As I conclude the one year anniversary of the death of my mother this week on July 23, I am struck by the dichotomy of how hard and how easy it has been to let go of her memory. As the ten-day period approached of the time she was admitted to the hospital to the time she died, I found myself reliving moment-by-moment what happened last year and dreading what was coming each day. 

There was the call that she needed to go to an emergency room; then having her admitted to the hospital; the subsequent cancer diagnosis; then a call that she was in organ failure post-surgery; and finally the decision to bring her to The Residence of ArborHospice for the last 36 hours of an incredible life.  

Physically feeling nauseated each step of the way, I had to remind myself that I knew what the outcome was this time, and I had some control.  I also am astounded at how much I have learned from my mother since her death, and wish I could tell her in person how much I appreciate those lessons.  

I have to acknowledge, however, that we did not have the type of relationship where I could have told her in person.  I am so thankful that a week before she was admitted into the hospital, we had a half-serious phone conversation in which I acknowledged that she might have been right about something for the past thirty years – we both laughed, and moved on to another topic.   

One year later, having grown in knowledge about that topic, I am grateful she had me learn about it the way she did.  She was not perfect, as none of us are, but was wiser than I gave her credit for.   

Now this year of mourning is over, and while we never truly are done on our grief journeys, I know that the intensity of the journey will change.  Some days will be worse than others, but I know with support from family and friends who have been on this journey before me  that I too will be able to remember more of the moments that bring smiles and laughter than tears.

This blog entry was written by Gloria D. Brooks, Arbor Hospice President & CEO. You may contact Gloria by commenting below or emailing her at gbrooks@arborhospice.org.

Remembering The Legacies of Great Generation Dads

In a recent post by Arbor Hospice volunteer, Dennis Sparks, he outlined how we can fashion legacies through life choices and actions. Dennis also noted the importance of preserving the stories of a family's heritage. He has applied his talents in patient care settings, making audio and video recordings that will stand as remarkable keepsakes.

We are in a time of exodus for a great generation. But men and women born in the first third of the 20th century did not spend much time contemplating their legacies. They worked hard--often with their hands and backs, and often under the duress of worldwide upheaval: the Great Depression, World War II, Booms and Busts and yes, Bubbles.

As the Condolence Note Coach, I encourage everyone to observe, remember, and share. The result--when stories are retold, provides tremendous comfort and insight to persons who grieve. Father's Day nears, and I decided to gather legacy stories of "great generation" Dads. Listening for legacies will be helpful when the time comes to write a condolence note.

Some legacies hold admiration for a character quality

“The memory of my dad’s love for my mother, is a legacy I cherish,” Lyn shared. Though that love was evidenced throughout her life, Lyn remembers her father, Ellis, during his home hospice care: “Even when he was sick and in bed, he wanted to be sitting up, out of the bed, ready to greet his wife when she came home.” The memory is bittersweet for Lyn, long-divorced, but she believes in the "gold standard" for all marriages.

“Daddy was a giving person,” Libby shared, and described how he was never too busy to be helpful, playful or community involved. “Chores were set aside to play a board game or croquet; to ferry me to piano lessons and recitals,” she continued. “I admired him greatly; he’d think nothing of hosting a crab feast in our yard for a big crowd of the Penn Daw Fire Dept. Auxiliary.”

Some legacies are rooted in wonderful experiences

Larry shared, “The legacies my father, Joseph, passed on to me and my seven siblings were not tangible things—like a pocket watch or money—but much more valuable: an all-encompassing value system. I grew up during the Depression, and my dad was busy keeping bread on the table, but found time to nurture our imaginations, our skills, our characters, and our spirits. To me, these legacies never tarnish, never depreciate, never decay throughout life.”

“When I was a boy, I was my dad’s “tag-along” buddy,” remembered Ray. “We’d go to places like the VFW Post, the Knights of Columbus Hall, the barbershop, and bricklaying side jobs at the homes of his friends. I enjoyed being a part of "Alfie’s" world, listening to conversations while having some pop and chips. Dad’s legacy was showing me how to be a good buddy.” Friendship and helping go together, in Ray’s view: “When I help a friend cut down a dead tree or fix a plumbing problem, I know my dad is smiling down on me.”

Old-fashioned, practical advice is a common legacy

“My dad was one to share a few pearls of wisdom,” Christine chuckled. “My favorites are:

1. Honesty is the best policy.

2. Don't leave for tomorrow what you can do today.

3. If you don't have to stand---sit. If you don't have to sit---lie down.”

Bev grew up in a family business where everyone was involved. “My parents gave me so many life tips, like:

• Take pride in your work and, finish what you start.
• If you can't pay for it with one week’s pay you can't afford it (except for a house and a car.)
• Try to accept others for who they are and remember, we are all different.

And there are legacies that read like an eHow page

“My dad, who was raised on a sugar beet farm, told us that the WHOLE apple is good, and sure enough he would eat the whole thing. And now, I do too.” Christine recently learned that the apple seeds are very nutritious. “People give me surprised looks, and I explain,’that’s what my dad taught me.’”

 

Beverly, just shy of 60, has never been in an accident, thanks to her dad’s bald instruction: “Drive like everyone is out to kill you.”

These most-prized legacies are weightless yet fill the heart. In writing a condolence note when a friend has lost a father (in this example,) recognize something you perceive to be a legacy. It may be an first-hand observation of the man, or a quality of character adopted by the child. Here are some suggestions:

“I could sit for hours listening to your Dad's stories about ____. He will be greatly missed.”

“Your father’s carpentry tools will never grow rusty. Like him, you’re ready to help …”

"Your dad greeted everyone at the church door with a cheery ‘_______’’”

“I remember watching you work on that Camaro, with your Pop …"

"Your father inspired me to volunteer at _____ by his work with ______, "

 

This blog post was written by Deborah R. Chappa, the Condolence Note Coach. She works in a Livonia, Michigan funeral home and is an author, blogger and instructor on writing condolence notes.

What Do You Say To A Grieving Person?

What do you say to a grieving person, particularly when he or she is someone you do not see often?

I found myself facing that question recently as I set off to visit an acquaintance who I spent time with a couple of times a year and whose husband had died since our last visit.

Do I express sympathy, which may evoke sadness and tears? Or do I wait to see if she brings it up?

During Arbor Hospice grief support groups, I have heard participants express anger when others don't acknowledge their loss or say the name of a loved one. I have also heard participants express frustration when someone expresses sympathy at a time when they are unprepared or unable to acknowledge the feelings that they experience.

It makes sense that some of us are confused about what to say to our grieving friends and acquaintances. So, I asked Arbor Hospice Grief Support Coordinator, Melissa Schultz to offer her perspective based on her work with countless grieving individuals and as someone who has herself lost loved ones.

Here's what Melissa told me:

"First and foremost, be sincere. Don't try to force sentiment that doesn't exist and speak from the heart. I think it's important to acknowledge the loss, despite the fact that it can be uncomfortable. Pretending that everything is normal leads to an incredibly awkward conversation, or lack thereof.

We often hear people say, 'I don't want to make them sad.' The fact is, they're going to feel how they do regardless of whether you bring it up. When you acknowledge the loss, it tells them that you truly care about how they're doing, and you're not just asking to be polite.

Keep in mind that context is key. If you start to discuss your friend's grief and she tears up, ask if she would like to continue talking. Let her know that you may not understand what she's going through, but that you're willing to listen.

Offering your presence to a grieving individual is one of the greatest gifts you can give."

What did I do? As my acquaintance and I greeted one another, I said, "You've been on my mind. How are you?" She took care of the rest.

This blog post was written by Dennis Sparks, Arbor Hospice volunteer. You may contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.

The Death Of A Spouse At A Young Age

When we get married, many of us expect to live into old age with our spouses. The death of a spouse early in their life leads to a unique bereavement experience for the survivor. When a spouse dies in their 30s, 40s or 50s, they leave behind someone who is much younger than our typical widowed population. Many are parents of very young or school-aged children. The surviving spouse is tasked with newfound singledom and the reality that the hopes and dreams of growing old with their partner will no longer be fulfilled.

This new role as a single young person can lead to protest from the survivor, a very understandable reaction after being robbed of one's partner in life and co-parent. This experience can feel unfair; it was not one's choice to be single and deal with the responsibilities that two once shared. The experience can be isolating; many grief groups for widow and widowers are geared to an older population who is in an entirely different life stage. The loss of a young spouse is overwhelming; young bereaved spouses have work and child-rearing opportunities that often leave little time to grieve. Finally, even in the face of extreme loneliness, many survivors find it difficult to even think about dating again, much less find the time to do so.

Fortunately, there are resources available if you or someone you care about is struggling with this type of loss. This list is by no means exhaustive, but it may be a good place to begin.

Websites:

• www.youngwidow.org
• http://youngwidowsandwidowersblog.blogspot.com/
• meetup.com has a young widow and widower group in the Livonia, MI area as well

Support Groups:

• Arbor Hospice offers Loss of Spouse groups frequently throughout the year. These groups are open to people of all ages, and many include both young and older bereaved spouses.
• Circle of Hope group for young widows and widowers at New Hope Center for Grief Support in Northville, MI.
• If you have kids, Ele's Place offers grief groups for children ages 3-18 in Ann Arbor, Grand Rapids and Lansing, MI. A parent group meets concurrently and offers the opportunity to discuss the experience of losing one's spouse and parenting grieving children.

Books:

• I'm Grieving As Fast As I Can by Linda Feinberg: A guide for young widows and widowers through the normal grieving process that highlights the special circumstances of an untimely death. Young widows and widowers share thoughts and dilemmas about losing a loved one, what to tell young children experiencing a parent's death, returning to work and dealing with in-laws.
• Getting to the Other Side of Grief by Susan Zonnebelt-Smeenge & Robert De Vries: Both authors had spouses die at young ages; she is a psychologist and he is a pastor, and they each discuss various topics from their respective perspective, specifically written for both widows and widowers.
• How To Go On Living When Someone You Love Dies by Therese Rando: From the publisher: "Mourning the death of a loved one is a process all of us will go through at one time or another. But whether the death is sudden or anticipated, few of us are prepared for it or for the grief it brings. There is no right or wrong way to grieve; each person's response to loss will be different. Now, in this compassionate, comprehensive guide, Therese A. Rando, Ph.D., bereavement specialist and author of Loss and Anticipatory Grief, leads you gently through the painful but necessary process of grieving and helps you find the best way for yourself.

This blog post was written by Becca White, Arbor Hospice Grief Support Coordinator. You may contact Becca by commenting below or emailing her at rwhite@arborhospice.org.

Traveling Solo Tips

When individuals lose a loved one who was their primary travel companion, the idea of taking a solo trip can be overwhelming. Adjusting to life after a loved one passes is very difficult. Often times, the death of a loved one requires individuals to take on new challenges. It takes time and patience to get comfortable without your loved one being a part of your daily life.

Whether traveling by air, land or sea, here are some tips to think about before going it alone:

• Get comfortable on your own. Before traveling long distance, venture out alone within your community, visiting museums, attending movies or plays or taking a walking tour. This will build your confidence and comfort, and help you rediscover the joy of your favorite activities.
• Start with shorter trips. Visit family or friends within a day's drive and get comfortable with your ability to travel on your own. Notice how many people are also traveling solo and know that you are not alone.
• Find ways to make meal times more enjoyable. If it's especially tough to eat dinner alone, consider having your main meal at lunch when many others are also dining alone and make the evening meal a small one in your room. Eat in hotel restaurants, as there are often a number of solo diners.
• Pack lightly since you will often be carrying your own luggage. Go for your smallest, lightest piece of luggage and only bring items that are essential for your trip. Be sure to pack comfortable shoes and tuck copies of your travel documents in a separate suitcase or bag.
• Safety first. Leave your itinerary with a friend or family member and check in with that person on a regular basis by phone or email.

What other tips do you have to share with fellow solo travelers?

This blog entry was written in conjunction with Arbor Hospice's Workshops for One grief support workshop.

Teens and Grief

What impact can the death of a loved one have on an adolescent?

Adolescence is an exciting, yet anxiety-provoking time for both teenagers and their families. The death of a loved one can throw a wrench into typical developmental tasks such as identity formation, separation from parents, and exploring one's career options. A loss can:

• Alter one's identity: A teen may wonder, "Am I still a brother? Can I continue to be an athlete? Can I trust the world, the community or my family?"
• Lead to exaggerated or hidden emotions: A death can impact the expression of emotion during an already highly emotional time. Feelings about the death may be exaggerated, stuffed out of awareness or a mixture of the two. A teen may hide their true feelings from parents and be more expressive with peers.
• Create a "big man/big woman" syndrome: This is commonly manifested as a teen takes on adult responsibilities, feels that he/she is now the leader of the family or denies the emotional toll of the loss.
• Produce risky behaviors
• Lead to helplessness and feeling overwhelmed
• Influence proximity to home: some teens may stick closer to home and others may desire to be away.
• Drive an adolescent to spend more time with peers

A loss experienced in childhood or adolescence can lead to:

• Impaired relationships with others
• Stunted emotional development
• Inability to cope in a healthy way with future losses
• Decreased academic performance
• Juvenile delinquency
• Gang involvement
• Substance abuse
• Suicide

So how can caring adults help grieving teens?

A basic understanding of the grief process is helpful.

• Grief is holistic; it's any reaction to a loss: emotional, behavioral, social and cognitive.
• Grief is a process, not an event.
• There is no right or wrong way to grieve.

Be genuinely interested in the grieving teen.

• Offer a listening ear or to help in some way.
• Be open with your body language, your mind (teens are easy to judge), and your heart. Perhaps the teen will want to discuss their loss with you or something completely different.
• Know that you are helping no matter the topic, as showing that you genuinely care about their pain will in most cases encourage communication.

Finally, if you sense any thoughts or behaviors that can lead to the teen harming themselves or others, take action.

This blog post was written by Becca White, Arbor Hospice Grief Support Coordinator. You may contact Becca by commenting below or emailing her at rwhite@arborhospice.org.

Is It Possible to Compare Our Grief With That of Others?

It is a natural tendency to compare our experiences and feelings to those of others, including grief at the death of a loved one.

The death of a child is usually regarded as the most devastating loss, followed by the death of a spouse, then a sibling or perhaps close friend, and finally a parent, particularly if the parent is elderly.

Several years of co-leading Arbor Hospice grief support groups has taught me that it is often more complicated than that, though.

Some people, for instance, who deeply love their spouses are able within a year or two to reconcile the loss and move on to a "new normal." Others who have lost, say, elderly parents - even in cases of long-anticipated deaths - may be surprised to find themselves grappling with the meaning and implications of that loss for much longer than they anticipated.

I have learned that:

• Each person's grief is unique. While there are commonalities that link grieving people, we grieve and cope with loss in different ways.
• That means that it is impossible to provide a precise timetable for grief or to predict with certainty what grieving individuals will experience, sometimes even in the next day or hour.
• The only one who can truly understand the meaning of a loss is the grieving person.

With the best of intentions and desire to comfort, people will sometimes say to a grieving person, "I understand what you are going through because I lost my (fill in the blank) last year." Grieving people are quick to point out - at least in the safety of grief support groups - that no one really knows what they are experiencing.

In many ways, our grief is as unique as a fingerprint and as unpredictable in its path as a tornado.

While we may have sympathy and empathy for the suffering of others, we cannot know another's grief sufficiently well to compare it to our own or that of others.

That is both a humbling and empowering understanding because it allows us to see people in their uniqueness and to treat them with the respect that is their due.

What have you learned about grief and grieving from your own losses or those of others?

This blog post was written by Dennis Sparks, Arbor Hospice Volunteer. You may contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.

Who Can Benefit From Arbor Hospice Grief Support?

Call me biased, but I believe everyone can benefit from some form of grief support following the death of a loved one. It seems like the biggest misconception about grief support is that it's therapy. To me, the word "therapy" implies dealing with physical or mental pathology.

 

Grief is a normal, natural response to loss, even though a person might feel like they are going crazy after a loved one dies. I blame our grief-avoidant culture and a lack of understanding about the grief process when I need to reassure people that no, you are not going crazy. Grief support is just that- support. A collaboration between the bereaved and the grief professional. Arbor Hospice offers many types of grief support in order to help people cope with the death of a loved one.

Grief is a tremendously isolating experience. One of the ways to overcome social isolation is to join a grief support group. ArborHospice offers a variety of support groups for adults throughout the year. This winter, we are offering groups that specifically address the loss of a spouse, parent, or child. We are also offering a group called "general loss" that is open to any bereaved adult, regardless of the relationship to the deceased. We frequently hear from grief support group participants that the most beneficial aspect of their group experience is that everyone in the room "gets it"- they don't need to explain why their loss is so significant because everyone comes to the table with a shared understanding of what it's like to experience the death of a wife, child, father, sibling or friend. Participants also report that it's very helpful to learn more about the grief process, as well as ways to cope with the loss and continue to include the deceased in their lives. Group members frequently decide to keep meeting on their own after the staff-led group sessions have concluded.

All of our groups are free of charge and open to the public. The groups are limited to 12 participants to guarantee equal time for everyone, and meet once per week for 6-8 weeks. Our general loss group begins February 4 and is still accepting registrations. If a loss of spouse, parent or child grief support group sounds like something you're interested in, we will be offering those groups again in the future. Check our website for the most up-t0-date information.

A grief support group isn't for everyone. Another option is our quarterly "Grief 101: What to expect when grieving" session. Grief 101 is more educational in nature and provides participants with information and resources. The presentation covers what is normal during the grief process, strategies for coping, suggestions for self care, and provides an opportunity to ask questions. If you are a "just the facts, ma'am" type-of-person or are inclined more towards a classroom-style presentation versus a processing group, then Grief 101 is for you. Our next Grief 101 presentation is Tuesday, April 22 from 7-8:30 pm at the Pittsfield Library in Ann Arbor. Call 734-794-5375 to register.

Support groups and Grief 101 presentations are just two examples of the grief support services Arbor Hospice has to offer. For more information on all of our grief support services, please check out our website.

What type of grief support have you found helpful as you've grieved the loss of a loved one?

 

This blog entry was written by Becca White, Arbor Hospice Grief Support Coordinator. You may contact Becca by commenting below or emailing her at rwhite@arborhospice.org.

Beginnings That Follow Endings

It can be hard for those who have experienced a significant loss to believe that deep sadness and hopelessness can eventually give way to joyful memories, to hope for a better future, and even to new beginnings.

But my volunteer work with Arbor Hospice grief support groups over the past five years has taught me that these outcomes are possible for the vast majority of participants, as inconceivable as that may seem at the time of the loss.

We are naturally accustomed to thinking of our lives in a linear way - beginning, middle and end. We are born, we complete important life tasks and we die.

Grieving individuals, though, have shown me that we can think of life's inevitable endings in a different way, a prelude to new beginnings that more often than not lead to a kind of fulfillment that may not have seemed possible during grief's darkest days.

The interval between the suffering of an ending and the uncertainty of a new beginning is often disorienting, a time that William Bridges in his book Transitions calls "the neutral zone."

Bridges describes the neutral zone as "an important empty or fallow" period in one's life that offers an opportunity for self-renewal that can lead to an improvement in the quality of the new beginning which will eventually emerge.

Because this growth isn't automatic, however, Bridges recommends solitude and retreat to listen for "inner signals" that will help us understand what we really want at this time in our lives, and to ponder "what would be unlived in your life if it ended today."

A glimmer of the new beginning, Bridges says, may come in the form of an image, impression, idea or comment that resonates and provides direction.

Sources of guidance

In my experience, and from what others have told me, inspiration and guidance can be found in long walks, time spent in nature, journal writing, meditation and various spiritual practices among other activities.

Grieving individuals may also benefit from exploring their new-found insights with family members and friends, support groups or therapists.

This combination of inner wisdom and community support often leads the bereaved out of the neutral zone into new ways of celebrating holidays and special events, an expanded social network or even college degrees and new careers, to name just a few examples.

Through these processes and others, those who have been forever changed by loss learn how to incorporate sustaining memories of their loved ones into these beginnings, a blending of enduring love with new possibilities that offers hope during difficult times.

How have you experienced the "neutral zones" of your life, and by what methods do you sense the seeds of emerging beginnings?

This blog entry was written by Dennis Sparks, Arbor Hospice Volunteer. You may contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.

Three Books To Use With Grieving Children

A book is a very simple and versatile tool to use when talking to children about the end of life and  their grief. Over the years, I have found myself recommending three books time and time again. Here's a brief description of each book and when I typically use each one.

When Dinosaurs Die: A Guide to Understanding Death
by Laurie Krasny Brown & Marc Brown

When Dinosaurs Die is written at a young reading level and appropriate for both anticipatory grief and bereavement. What I love about the book is that it's broken into short chapters that address very specific aspects of death and grief. For example, "Why does someone die," "What does alive or dead mean," and "Ways to remember someone." The book can certainly be read straight through, however, it's nice to flip to one chapter to address a particular topic. The illustrations are kid friendly and the language is straightforward. The dialogue between the adult and child dinosaurs will give adults good ideas for what to say with their children. If you purchase just one book, this is the one I would suggest. You can find the book here.


Jungle Journey: Grieving and Remembering Elenaor the Elephant by Barbara Betker McIntyre

Jungle Journey is appropriate for bereaved children and young teens, and I have typically used this book to explore different ways people grieve and cope with loss. The book discusses the death of Eleanor (a parental figure) in simple terms. What I really likes is that each of her animal friends has a very distinct emotional and/or behavioral reaction to her death. I find that youth easily identify one or two animals that grieve like they do. After outlining each animal's grief response, the book transitions into ways the animals mourn and support each other as they continue on with life. The illustrations are beautiful and the book normalizes a variety of grief reactions. Jungle Journey is a wonderful tool to facilitate a discussion or art-based activity about grief and healthy coping. Find the book here.


The Invisible String by Patrice Karst
The Invisible String is appropriate for children, teens and adults in both anticipatory grief and bereavement situations. It's my favorite "back door" grief book because it talks about how even though we may be separate from our loved ones (for whatever reason), we are never truly alone and always connected by an invisible string of love. I frequently use The Invisible String with children who are having fear/separation/anxiety issues to reassure them that they will always be connected by love and memories. Adults seem to be profoundly touched by this book's message as well. The Invisible String is a great reminder that no matter what life brings us, we can trust that the love we have for family and friends will be with us forever. You can find the book here.


This blog entry was written by Becca White, Arbor Hospice Grief Support Coordinator. You may contact Becca by commenting below or emailing her at rwhite@arborhospice.org.

Talking to a Child About Death and Dying

I'd like to share a bit about grieving children. I frequently talk to parents and other adults who are concerned about children in hospice families. Naturally, adults tend to be protective of their children and when a family member is dying, this protectiveness tends to intensify.

If you are struggling with breaking the news to a child that a family member is terminally ill, keep in mind your child may already be aware that something is going on - often children know much more than we give them credit for.

Though they may not have been explicitly told yet, children are very good at picking up information from conversations around them. Kids are typically aware of death in general. Remember when you were young, watching Saturday morning cartoons and seeing Wile E Coyote die several times in pursuit of the Road Runner? Children see death in popular media as well as in the animal world around them (think of a dead bird in the yard or a deer by the side of the road).

A child of any age has the capacity to understand the dying process, death and grief. I think oftentimes as caring adults, we get stuck making sure we say the perfect thing or worry that we will somehow harm a child if we bring up these sensitive topics. Our task is to use language appropriate to the child's age and developmental stage to help them understand what is going on. Children have the right to know that a loved one is dying; they deserve the opportunity to anticipate the death and grieve the loss the same as adults. Understanding the reality of death is the first task in anyone's grief process.

I'm sure you're wondering how to go about having these conversations. While this list is in no way exhaustive, here are some tips on what to say and how to say it:

• Consider using a film like The Lion King to help set the stage for the conversation.
• Talk about how all living things die: plants, pets and people. Death is part of the life cycle.
• Use simple, direct language: "Your aunt is very, very sick with cancer. She won't get better and she is dying. People from Arbor Hospice are helping her be more comfortable."
• Use the language of the illness i.e. the name of the disease, as well as the words "hospice," "dying" and so forth.
• Be honest.
• Avoid whispering or altering your tone. This adds to the stigma of terminal illness and death.
• Ask the child if they have any questions of if they are sad, scared, etc.
• Assure children of all ages that they did not cause the illness and they will be cared for.

If you would like more information, please let us know. Arbor Hospice has extensive resources available for additional information. Note that the needs of grieving teens are different and will be discussed in a future blog post.

What concerns do you have about talking to children about death and dying? If you've had these conversations with young people,  what did you say and how did it go?

This blog post was written by Becca White, Arbor Hospice Grief Support Coordinator. You may contact Becca by commenting below or emailing her at rwhite@arborhospice.org.

Tis' The Season: Life Lessons From The Dogs

Are you feeling a couple of "la's" short of a "Fa-la-la-la-la" this season? By all accounts, we have been thrust headlong into the midst of a socially-imposed time of celebration. That's just fine if one  feels like celebrating. During this arguably most joyous of seasons, it is good to remember in our midst are those who are hurting, grieving and wanting to curl up and wait for the season to pass. Others may be feeling numb or in denial, but that's a different topic altogether.

So, what do you do if you find yourself not feeling much like celebrating because you're experiencing

the pain of a loved one now gone? When my Mom died nine days before Christmas, I didn't give much thought to what the rest of my holiday season might look like. Oddly - or not - my dogs (shown above in the picture from that Christmas) were a constant reminder of the valuable lesson to go with the flow. I celebrated (aka played) when I had the energy and also took time to curl up and just be when that was more my speed. 

What simple lessons have you learned to help you balance loss during a season of hope?

For additional resources, please visit our grief support section on our website.

This blog entry was written by Laura Adams, Administrative Assistant with The Arbor Hospice Foundation. You may contact Laura by commenting below or emailing her at ladams@arborhospice.org.

Grieving at the Holidays

My first response to the upcoming Thanksgiving holiday was to start thinking about what to cook. I love to create expansive holiday meals for my family and look forward to menu planning, decorating the table, choosing flowers and using family heirloom china that has memories attached to each serving platter, plate and cup.

Then, my thought turned to the realization that this would be the first Thanksgiving without my mother, who died four months earlier. This year, there would be no negotiating about whom to visit on what day for this family divided by a thirty-year-old divorce, with parents and siblings who don't get together at the same time. No discussion about what time to serve dinner to accommodate everyone's schedule. No admonishment to "not overdo it this year - cut back on what you are serving" meant to spare me from time and calories, not realizing how I loved this work and opportunity to create memories with my family.

And then, I realized my own self-care solution this year would be to get out of town. For this first post-Mom Thanksgiving, my husband, son and I will spend four days together in another city, focused on each other, grieving this loss in a different setting. For me, it will be important to remember all of the other Thanksgivings spent with my original and married families, and how important it will be to create a new normal.

I will certainly grieve and miss her presence this year. Yet, at the same time, I will also celebrate the 48 other Thanksgivings I had with her, and hope that I can now reinforce how important holiday traditions are with my own son, and create new memories for years to come.

This blog entry was written by Gloria D. Brooks, Arbor Hospice President & CEO. You may contact Gloria by commenting below or emailing her at gbrooks@arborhospice.org.

How Do Men Grieve?

"How do men grieve?"

Eleven women shifted slightly in their chairs to take in my response to a question posed by a participant in an Arbor Hospice Parent Loss Grief Support Group.

Several participants had expressed puzzlement or concern about how men in their lives grieved - or didn't seem to grieve - the loss of a loved one.

The fact that I was the only male in the group, which is not uncommon, speaks volumes in itself about how men grieve and don't grieve, and participants hoped I could shed some light on the matter.

I began by saying that I obviously could not answer for all men, and that in my experience the ways men responded to loss were as varied as the ways women responded.

I said I've known women who have not shed a public tear at the loss of a loved one as well as men who were tearful at the mention of loved ones many months and years after their deaths.

Having acknowledged the ways in which men and women are the same, I noted that many men had been socialized not to reveal their feelings.

I also shared my observation that some men prefer to engage in activities to express and manage their feelings rather than discussing them with others in support groups or other settings that feel artificial.

In your experience, how do men and women grieve differently?

This blog entry was written by Dennis Sparks, Arbor Hospice Volunteer. You may contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.

Grieving in Our Own Way and Time

They may have sat in their cars uncertain and reluctant to enter the building.

They may file into the meeting room filled with apprehension about the strong feelings of sadness they may experience there.

They are participants in an Arbor Hospice grief support group who have lost spouses or partners, children, parents, siblings or other loved ones.

I know from years of experience co-leading these groups that many tears will be shed on that first evening. I also know that many participants will report at our next meeting that the intervening week was a difficult one for them because of the emotions they experienced at that first session.

To better understand what draws participants to these groups given the strong feelings they may evoke, I asked Melissa Schultz, an Arbor Hospice grief support coordinator, what motivates individuals to attend.

She told me that for some participants it is the only place in which they can talk about their losses because the people around them were uncomfortable with the subject or thought that they had grieved enough. Some attend, she said, because they had previously experienced the benefits of social support in dealing with significant life issues.

Participants in these groups have taught me that there is no one right way to grieve, that we each do it in our own way and in our own time.

I have also learned that the vast majority of us who have lost loved ones find our way over time to sustaining memories, a process that is truly at the heart of a grief journey that is for each of us uniquely our own.

This blog entry was written by Dennis Sparks, Arbor Hospice Volunteer. You can contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.

Holiday Feelings of Disconnect

I was recently the co-facilitator for an Arbor Hospice grief support group where a participant noted that as more time passes since her mother's death, the more disconnected she feels from her. This was troublesome because the participant wanted to maintain connection with her mother while healing at the same time. In a way, she is receiving mixed messages: grief is supposed to get easier with the passage of time, yet, she feels that she is starting to let go of her mother in a way that she does not wish to.

I spent the rest of the evening pondering this notion of disconnection. Gone are the days where grief counselors are encouraging clients to completely sever the relationship with the deceased in order to heal. Our profession has shifted to the idea of continuing bonds, that is, maintaining a relationship with the deceased. Instead of a relationship of presence, we talk about a relationship of memories. However, there is still a forced, non-negotiable disconnection with our loved ones when we die, and oftentimes it's a disconnection that we do not ask for.

The holidays are upon us and this is a time of year when feelings of disconnection and loneliness may intensify. For me, I have felt an undercurrent of sadness amidst celebration during the months of November and December that I haven't always been able to pinpoint. Is it the colder, darker days? Financial strains of holiday shopping? Anxiety about upcoming family get-togethers? People missing their loved ones? I think it could easily be all of this and then some.

So, what does one do to successfully navigate the holidays while grieving? The simple answer (if there is one) is to try to maintain some sort of connection with your loved one, especially if this will be your first holiday season without them. A former colleague used to encourage her clients to focus on the legacy of their loved on, more so than on the loss. Perhaps a way to stay connected is to continue with one or two holiday traditions your loved one really enjoyed: preparing their favorite Thanksgiving dish, playing their favorite holiday music, or taking over a role they once performed like lighting the candles on the menorah. Though they may be painful, these small acts are a way to keep your loved one alive and present during the holidays.

Arbor Hospice is offering special holiday workshops to provide more tips on coping with the holidays. The final two workshops will take place this Sunday, November 17 from 2-3:30 p.m. If you live near Ann Arbor, consider attending the workshop at Malletts Creek Library (3090 E. Eisenhower Parkway). If you live in the downriver area, consider attending the workshop at our office at 21647 Allen Road in Woodhaven. You can find more information about these workshops on our website.

If you have experienced the death of a loved on, what are some ways you have found helpful in coping with the holidays?

This blog post was written by Becca White, Arbor Hospice Grief Support Coordinator. You may contact Becca by commenting below or emailing her at rwhite@arborhospice.org.

The Courage to Grieve

Let's face it: loss hurts. The death of a loved one, the end of a romantic relationship or friendship, financial hardship, changing jobs - these are all common losses we experience. Sometimes, it can seem like life is a series of losses. In our fast-paced, over scheduled culture, it's easier to keep going without pausing to mourn the cumulative losses we face in our lifetimes. Who wants to take time to feel sadness, anger, guilt or emptiness?

Our society has become very grief avoidant. For example, most employers give three days of bereavement leave following the death of a close relative. We are expected to take a few days off, grieve and then return to work renewed and ready to pick up where we left off. We are encouraged to stuff our grief down deep inside so that we can be productive at work and remain engaged with life. I often talk to bereaved clients who intentionally stop their tears from flowing, drag themselves out of their houses to work, to school or to the community center to become immersed in anything but how they are feeling. Or, the exhaust themselves with exercise in order to be able to collapse into bed at night and avoid thinking about their loss.

It takes courage to open up to grief, to intentionally slow down and sit with its ugliness. And grief isn't just ugly. It's messy. It's unpredictable. It doesn't have neat stages, contrary to popular wisdom. Grief can be raw, unadulterated pain if it's allowed to express itself. And human beings don't like to feel pain, especially when the pain is holistic and affects our thoughts, feelings, behavior and spirit.

Experiencing the pain that comes as a natural reaction to loss is what we must do in order to move through the process and eventually heal. Moving through the pain is made easier with good social support, coping skills and self care. I would argue that even with those in place, something more is needed, and that's courage. The courage to know that perhaps it will be worse before it's better. Or that no matter how many people are willing to help and be supportive, the grief process is a path that ultimately must be walked alone. The courage to believe that you will be okay. The courage to keep reaching for life during the darkest days.

In the coming months, we will be sharing stories, experiences and hopefully inspiration for those trying to courageously live with loss. We encourage you to join our discussion by posting your own comments and sharing what you have encountered as you journey through grief.

This blog entry was written by Becca White, Arbor Hospice Grief Support Coordinator. You can contact her by commenting below or emailing her at rwhite@arborhospice.org.

This blog post was inspired by the writings of Judy Tatelbaum, grief expert and author of The Courage to Grieve and You Don't Have to Suffer. Visit her website or her Amazon.com page.

Why I'm a Hospice Volunteer

"The best way to find yourself is to lose yourself in the service of others." -Mahatma Gandhi

When I tell people that I'm a hospice volunteer, the most common response is, "I admire what you do, but I could never do it."

So, I'd like to take this opportunity to explain why I'm a hospice volunteer:

• I have always admired those who do hospice work. Nurses, doctors, social workers and spiritual care coordinators. In my view, they are as close to angels as I am likely to encounter in this earthly realm.
• I felt drawn to hospice work because I saw it was a way I could apply understandings and skills I had spent a life-time developing - to listen deeply and to trust people to find their own best way, a belief that people can learn important things until the very end of life.
• I thought it was likely that hospice patients and their families would teach me important lessons that could support me in navigating that passage when my time came to do so.

Five years ago when I first considered becoming a volunteer, I talked with a long-time Canadian professional colleague who has volunteered for many years at a southwestern Ontario hospice.

"As a volunteer, I provide a safe place for clients to share their emotions, which they sometimes were unable to do with their own families who are struggling with the imminent loss of a loved one," she told me. "I learned to focus less on the illness and more on the things I could bring to their lives."

She also described personal benefits. Hospice volunteering, she said, "helped me realize what's important and to prioritize my life on a daily basis. And I've been able to use what I've learned to support friends and family who are not part of hospice when they have gone through illnesses and losses in their own lives."

My responsibilities at Arbor Hospice include:

• Helping patients of all ages and their families preserve family stories and other important memories on video.
• Co-leading bereavement groups for individuals who have experienced the loss of a loved one.

Through these experiences, I have had the privilege of learning a great deal about end-of-life issues, lessons I will share with you in coming weeks about facing the prospect of death and about grieving those we have lost.

This blog entry was written by Dennis Sparks, Arbor Hospice Volunteer. You can contact Dennis by commenting below or emailing him at thinkingpartner@gmail.com.