Types of Grief

Anticipatory Grief

When a person or family is expecting death, it is normal to begin to anticipate how one will react and cope when that person actually dies.

Sudden Loss

Sudden unexpected loss can temporarily overwhelm or even immobilize anyone.

Complicated Grief

When the duration of grief is prolonged and interferes with a person’s ability to function, grief can become “a way of life.”

Stages of Grief

The commonly accepted stages of grief were first written by Elisabeth Kubler-Ross in her 1969 book "On Death and Dying".

Denial

“This cannot be happening to me”. Complete disbelief is a common reaction to a terminal diagnosis.  You refuse to accept what is happening

Anger

“Why is this happening to me?” You feel like the unlucky one, angry at fate, at God, at the Doctor or at yourself for not doing enough. “If only” questions and regrets are common.

Bargaining

“Make this not happen and in return I will…” You promise anything if only God will let them live.

Depression

“I am too sad to do anything.” Deep sadness is an inevitable part of loss. 

Acceptance 

Accepting death as a part of life. Your loved one is gone and will never come back. You will go on living and make a new life for yourself.

Responding to Grief and Loss

Sometimes grief is immediately overwhelming, other times the depth of sadness and pain is not realized until several weeks or months after a loss when the permanence of the loss becomes very real. Life does not get back to normal. Grief can affect every aspect of life, physically, mentally, emotionally and spiritually. Every survivor is vulnerable. Some struggle with strong emotions. Many experience guilt, both for things they did and things they didn’t do.  Some are angry at God. Many feel disorganized and can even forget, for a moment, that a death happened. The intense, all consuming response to grief eventually will subside.

Managing Grief and Loss

• Accept that you are grieving and be open to your feelings.
• It’s ok to cry, and to be angry at your loss.
• Take care of yourself: eat well, exercise, get enough sleep and get back to doing the things you enjoy. 
• Reach out to friends, go to a movie, take a walk or just visit.
• Plan ahead, expect that holidays, birthdays, anniversaries will be difficult.
• Don’t let anyone tell you how you should feel, including you. This is your journey and you are handling this situation the best way that you can.    
• Redirect your focus by keeping busy or by helping others.
• Postpone making major decisions.
• Join a support group - an opportunity to talk with people who understand.
• Remember that every hospice program offers grief counseling to the family for up to one year following the loss. Many hospice programs offer bereavement services to the community, whether or not your loved one died under hospice care. 

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 Supporting Someone who is Suffering from Grief and Loss  

• Our immediate response is to ask, “Are you ok?”, when someone suffers a loss. “Are you ok?” is difficult to hear for someone suffering a loss because they are not ok. The best thing that you can do is acknowledge their loss, “I am sorry for your loss, I am thinking of you, I am here for you”.
• Don’t expect a response from someone who suffered a loss when you reach out in-person, phone call or text. Those suffering a loss are feeling overwhelmed. They need time and will reach out when they are ready.
• Once they reach out, listen to them. Let them do the talking. When someone suffers a loss having someone listen to them, uninterrupted, is therapeutic for them, being able to express their emotions.
• Acknowledge their feelings and remember everyone grieves differently. Responding with “I am so glad you are able to share your feeling with me”, is the right response.
• Understand that life for them has changed and that getting back to normal will take time.
• Reach out over the next few months, not just the first few weeks. When someone is suffering a loss, it’s the months that follow that can be the hardest.
• Be specific when offering assistance. “What can I do for you” is not helpful. Being specific gives someone who suffered a loss permission to accept assistance.  
• Remember holidays, birthdays and other special events. A phone call or card means a lot.
• Don’t be afraid to share happy or funny memories with someone who has suffered a loss.

 Learning to accept loss is never easy. Eventually those who suffer a loss will come to realize that they have started to heal.

They are alive and that life does resume after the loss.  

Grief Support Resources and Publications

CHAPCA provides publications for grief support on our CHAPCA RESOURCES LIBRARY page.  There, you will find helpful booklets on the following topics:

Talking to Kids About Death: A Guide For Grownups helps readers talk to kids about death, whether they are a parent or any adult who knows a child facing loss. The information can apply to an expected loss or a death that has already occurred.

Heart-Shaped Pickles: Gentle Grief Support for Kids and Grownups is a true story about little Jenny’s continued connection to her grandpas through her discovery of heart shapes all around her. Invites kids to color, encouraging creativity. Includes a discussion guide and “8 Things Kids Can Teach Grownups About Grief.

Seasons of Grieving: A Guide to Grief at the Holidays validates that holidays can be particularly difficult for those who have lost a loved one. This booklet provides helpful coping strategies for special occasions, with sections devoted to winter holidays, other major holidays, birthdays, and anniversaries.

Grieving for Your Pet: A Guide to Understanding Pet Loss gently yet clearly explains the often disenfranchised grief process for those who have lost a pet, helping them understand their grief, find comfort, and move forward with hope. An affordable resource for pet hospice programs and veterinarians.

When You Are Grieving: A Guide to Understanding Loss helps the bereaved understand grief, find comfort, and move forward with hope. Sections include “Emotional Effects of Grief,” “Remembering Your Loved One,” “Grieving Children and Teens,” and more. Each section has practical “What You Can Do” bullet points.

When Teens Are Grieving: A Teen-to-Teen Guide to Understanding Loss this booklet shares teen author Jenny’s grief story, validating that teens have the right to grieve in their own ways. Grief counselors provide professional insights throughout. Based on the award-winning book, Weird Is Normal When Teenagers Grieve. 

 Barbara Karnes, End-Of-Life Educator - Grief and Loss Blog Posts

Barbara Karnes, RN Award Winning End of Life Educator, Award Winning Nurse, NHPCO Hospice Innovator Award Winner 2018 & 2015 International Humanitarian Woman of the Year. Barbara is an internationally respected speaker, educator, author, and thought leader on matters of end of life. She is a renowned authority on the dying process and a leading educator for families, healthcare professionals, and the community at large. Barbara has dedicated the last 40 years of her life to the education, care, and support of dying people and their loved ones. The most useful and important things that she's learned along the way have been distilled into her materials.

Each week, Barbara answers the questions that patients and families submit through her website: www.BKbooks.com.  Below, we've add some posts regarding Grief:

Podcast: Grief At The End of Life With Author and Specialist, Barbara Karnes, RN January 12, 2021 

"In our death ignoring society, COVID has put death right in front of our faces.  In modern time we haven't had to face this avalanche of dying..." Barbara Karnes, RN...Read more →

In A Time Of Overwhelming Loss... September 16, 2020

When someone we know or are close to dies we expect to grieve. We recognize our sadness but often we don’t recognize our impulsiveness to clean the house, or our...Read more →

Grief at the End of Life with Barbara Karnes, R.N April 14, 2020 

Barbara Karnes, R.N., nationally known writer and hospice nurse, joins us for our monthly show "Grief at the End of Life." Read more →

Grief During the Last Stages of His Life January 30, 2018 

From the moment of a diagnosis of a life threatening illness we begin grieving. We grieve not just the eventual losses that come with serious illness but the approaching death...Read more →

Does Everyone Need Grief Counseling? April 14, 2021 

Counseling is a support offering, a choice. Some personalities would never consider counseling. They would not be comfortable sharing their personal thoughts and life with someone else no matter how professional...Read more →

GRIEF- Struggling After Mom's Death February 11, 2019

Often after a person dies we forget that there is no perfect relationship, that there are easy times and difficult times. Somehow once a person dies we elevate them to...Read more →

BE GENTLE WITH YOURSELF ~ Grief and Guilt November 28, 2017 

What do I mean by being "gentle" with yourself? I mean forgive yourself for all the things you feel guilty about. Remember we always do the best we can with the information...Read more →

Reaching for the Far Side of Grief July 26, 2016

Dear Barbara, How does a person transition from caregiving after my loved one's death to restoring my balance, focusing on the new role for my life. Grief is not about...Read more →

Stuck in Grief  December 12, 2016

In normal grieving, time begins to lessen the intensity of the emotional pain of our loss. There is a process to grief (see My Friend, I Care) and although we never forget...Read more →

How Do You Let Go and Stop Feeling Guilty? October 11, 2016 

Guilt seems to come with loss. We burden ourselves with questions we can never answer, with “what if ” and “why didn’t I”. We repeatedly berate ourselves with “I should...Read more →

For Those With Heavy Feelings of Loss November 09, 2015

How to let go and stop feeling guilty? At first you probably aren't even aware of your feelings. When someone close to us dies, even if we are told it...Read more →

Spirit and the Body February 24, 2014

Comment: “My son has died!” You have been with people when they die. Your book, The Final Act of Living, talks about body and spirit. How do you know? I...Read more →

Podcast: Grief at the End-of-Life September 08, 2020 

Author and end-of-life expert Barbara Karnes, R.N. joins Dr. Michael Fratkin to discuss compassionate palliative care in rural areas.  Listen Here... Related Product is My Friend, I Care: The Grief Experience ...Read more →

The Emptiness of Grief September 24, 2013

Question: The emptiness left behind after a loved one dies. What do I do with it? Emptiness is one of the aspects of grieving, experiencing that hole in our life...Read more →

Grief for a Person with Dementia December 15, 2012

Question: Please talk about grieving the gradual but sure loss of a loved one with dementia. Perhaps you’ve heard it said: Having a loved one with dementia is the long...Read more →

Our Grief Door December 15, 2014 

Question: My father-in-law died a few months ago. I’m not thinking about him as much as I am thinking about my mother and brother who died years before. When we...Read more →

Grief and the Holidays November 20, 2012

Our seasonal holidays are here and for those of us who have had loved ones die this year the holidays will be a particularly challenging time. Something to think about:...Read more →

The Emptiness of Grief September 24, 2013

Question: The emptiness left behind after a loved one dies. What do I do with it? Emptiness is one of the aspects of grieving, experiencing that hole in our life...Read more →