Understanding adolescents can be a challenge and supporting grieving adolescents can be difficult. The feelings of grief may be intense and changeable. A grieving adolescent may be fearful of these feelings. It is common for a grieving adolescent to experience a certain amount of decreased ability to motivate themselves or concentrate for long periods of time. This can make school work challenging. Many grieving adolescents feel as if no one else can understand their feelings or situation. Grieving adolescents may isolate themselves, hold their feelings inside and pretend everything is fine. Some grieving adolescents may feel overwhelmed and unsupported and turn to negative behaviors as a way to cope with the pain they are experiencing. Thoughts of suicide, use of alcohol or drugs, and increased sexual activity are indicators of a problem adjusting to the death of their loved one.
There are many ways adults can support grieving adolescents. Grieving adolescents need the opportunity to share their story of grief. Find opportunities that allow adolescent to share. The more they keep their feelings inside, the harder it becomes to express them. Unexpressed feelings fester within our bodies and can lead to greater problems. Writing gives our grief words. Putting thoughts and feelings in journals, letters to the person who has died, poems, and stories gives the grieving adolescent an avenue to express feelings.
Music plays an important role in the lives of adolescents. Communicating through music can enhance our understanding of grieving adolescents. Certain songs elicit feelings, thoughts and memories related to the person who has died. Music can help adolescents share what they are experiencing with someone else and break through the defenses of grief. Adolescents may want to write original music in tribute to the person who has died or select music that reminds them of their loved one and discuss these lyrics.
Art provides another creative outlet for grieving adolescent to create a visual image of their feelings and their story of grief. They may want to create a legacy such as a quilt or a memory box. These visual images can open communication and provide a healthy grieving process.
Although it may be difficult to support grieving adolescents, accompanying them on their journey of grief is a life changing experience.
Tuesday, July 20, 2010
Friday, July 16, 2010
Caregiving and Grief
Here is a moving article by one of the bereavement center's grief counselors.
The Loneliness of the Longtime Caregiver
Carol Dikovitsky, SND, PCC, ATR-BC
Dorothy was glad that her parents had lived such long lives. They had supported her through the most memorable and difficult times of her life. They celebrated her achievements and helped to raise her children after her divorce. But now her parents were in their nineties, experiencing physical and mental health issues. Part of the problem was that they didn’t recognize ANY problem with continuing to live in their two-story home. THEY didn’t see the dust and clutter invading a previously immaculate house. THEY didn’t mind eating TV dinners nightly because her mother was no longer up to cooking. THEY didn’t worry about the possibility of falls and broken bones. An only child, Dorothy faced her parents’ increasing need for help with dismay. She still had a full time job. How could she provide help?
Dorothy talked with her parents about moving to a senior assisted living complex. Her mother was open to this; her father refused. “I’m going to die in this house,” he said. Next, she convinced them to hire a woman living on the same street to help with meal preparation, laundry, medications, etc. On the first day, after discussing menus and supplies, Dorothy left to buy groceries. While she was gone, her parents fired the caregiver. “Meals on Wheels” met a similar fate. So Dorothy became a part-time caregiver. She gave up many things in her own life. She could no longer see friends or make plans without considering her parents’ needs. She made sure they had food, clean clothing, a relatively neat house and took medications appropriately. She saw that their bills were paid. It was difficult to juggle her home life, her job and her parents’ increasing needs, but she did it. Her parents had done the same thing for her when she young.
Eventually, both parents declined to the point where they needed nursing care. Dorothy’s father fell, broke his hip and never recovered from his injury. Her mother’s dementia progressed - she could no longer argue against residential care. Dorothy managed these crises and continued to deal with finances and other needs.
When her parents died, Dorothy was chagrined to note that her primary emotion was relief. “Maybe when I’m not so exhausted I’ll be able to grieve,” she thought. However, after speaking with a grief counselor, Dorothy realized that she had been grieving all through the years of her parents’ long decline. The people who had loved and supported her, who were wise and humorous, had been disappearing for years. The worst part had been watching THEM realize that they were declining. When Dorothy accepted this, she was able to understand her feeling of relief. She missed her parents—she really did—but she had been missing them for a long time.
Dorothy didn’t know what to do with all her free time. She felt rootless and lacked a sense of purpose for each day. It took a while to rebuild her life, to call up friends or make spontaneous plans, to visit grandchildren or to travel. Eventually she began to volunteer for a cause she believed in, and her life took on a new rhythm of work, enjoyment, and purpose.
There are many “Dorothys” who are grieving the slow dying of elderly parents. If you are or have been a “Dorothy,” don’t hesitate to reach out for help. Many people find support groups focused on the death of parents to be helpful. One-on-one grief counseling may be appropriate as well.
Carol Dikovitsky, SND, PCC, ATR-BC
Dorothy was glad that her parents had lived such long lives. They had supported her through the most memorable and difficult times of her life. They celebrated her achievements and helped to raise her children after her divorce. But now her parents were in their nineties, experiencing physical and mental health issues. Part of the problem was that they didn’t recognize ANY problem with continuing to live in their two-story home. THEY didn’t see the dust and clutter invading a previously immaculate house. THEY didn’t mind eating TV dinners nightly because her mother was no longer up to cooking. THEY didn’t worry about the possibility of falls and broken bones. An only child, Dorothy faced her parents’ increasing need for help with dismay. She still had a full time job. How could she provide help?
Dorothy talked with her parents about moving to a senior assisted living complex. Her mother was open to this; her father refused. “I’m going to die in this house,” he said. Next, she convinced them to hire a woman living on the same street to help with meal preparation, laundry, medications, etc. On the first day, after discussing menus and supplies, Dorothy left to buy groceries. While she was gone, her parents fired the caregiver. “Meals on Wheels” met a similar fate. So Dorothy became a part-time caregiver. She gave up many things in her own life. She could no longer see friends or make plans without considering her parents’ needs. She made sure they had food, clean clothing, a relatively neat house and took medications appropriately. She saw that their bills were paid. It was difficult to juggle her home life, her job and her parents’ increasing needs, but she did it. Her parents had done the same thing for her when she young.
Eventually, both parents declined to the point where they needed nursing care. Dorothy’s father fell, broke his hip and never recovered from his injury. Her mother’s dementia progressed - she could no longer argue against residential care. Dorothy managed these crises and continued to deal with finances and other needs.
When her parents died, Dorothy was chagrined to note that her primary emotion was relief. “Maybe when I’m not so exhausted I’ll be able to grieve,” she thought. However, after speaking with a grief counselor, Dorothy realized that she had been grieving all through the years of her parents’ long decline. The people who had loved and supported her, who were wise and humorous, had been disappearing for years. The worst part had been watching THEM realize that they were declining. When Dorothy accepted this, she was able to understand her feeling of relief. She missed her parents—she really did—but she had been missing them for a long time.
Dorothy didn’t know what to do with all her free time. She felt rootless and lacked a sense of purpose for each day. It took a while to rebuild her life, to call up friends or make spontaneous plans, to visit grandchildren or to travel. Eventually she began to volunteer for a cause she believed in, and her life took on a new rhythm of work, enjoyment, and purpose.
There are many “Dorothys” who are grieving the slow dying of elderly parents. If you are or have been a “Dorothy,” don’t hesitate to reach out for help. Many people find support groups focused on the death of parents to be helpful. One-on-one grief counseling may be appropriate as well.
Please contact us at thebereavementcenter@hospicewr.org or call us at 216-486-6838. We will be happy to suggest helpful resources.
Tuesday, July 6, 2010
Grief and Intellectual and Developmental Disabilities
Here is an informative piece written by our grief counselor, Robert Ballantine, MSW, DCC, D.MIN.,LISW.
The impact of grief is very real for individuals with intellectual and developmental disabilities. Unfortunately, not much attention has been given to the bereavement needs of these individuals or other people with special needs. Knowledge about ways to assist them is limited and written resources are few. In fact, the question has even arisen: does an individual with intellectual and developmental disabilities understand the meaning of death? Depending on the level of cognitive functioning, they may or may not understand the concept of death, especially its permanency, but they have a good understanding of loss and how it makes them feel. Most of these individuals have experienced losses throughout their entire life.
Difficulties may arise after a death when the individual starts feeling the physical, emotional, intellectual and spiritual impact of grief. Grief reactions may include behaviors such as: being overly tired, increased irritability, wanting to be alone, excessive crying, impatience, becoming angry easily, difficulty with house mates, being more aggressive and repeatedly asking the same questions. Depending on their cognitive and verbal abilities, they may not be able to say what is bothering them. Staff and family may often misinterpret the reason for the changes in behavior. They may assume the bereaved is being lazy, difficult or stubborn. The fact is that individuals with mental retardation have the same types of reaction to a death as those who do not have any disability.
Assisting these individuals can be challenging. Deciphering how and what they are communicating can be very difficult. Their responses cannot always be taken at face value. For instance, many individuals will answer all questions with a positive response. Time frames may be difficult to interpret. You may even notice the person having a conversation with the deceased. The death may trigger other losses. For example, if the individual has been living at home and the caregiver dies, he or she may have to be placed in a group home.
It is important to allow the individual to attend the funeral and/or visitation (even if special arrangements need to be made), to participate in rituals if possible, and to visit the cemetery. As with those of us who function normally, their grief journey also needs this kind of closure and support.
For persons with intellectual or developmentally disabilities, the grief journey may be different but the road is the same. Support and understanding is just as important in assisting them to successfully move through their journey as it is for everyone else.
The impact of grief is very real for individuals with intellectual and developmental disabilities. Unfortunately, not much attention has been given to the bereavement needs of these individuals or other people with special needs. Knowledge about ways to assist them is limited and written resources are few. In fact, the question has even arisen: does an individual with intellectual and developmental disabilities understand the meaning of death? Depending on the level of cognitive functioning, they may or may not understand the concept of death, especially its permanency, but they have a good understanding of loss and how it makes them feel. Most of these individuals have experienced losses throughout their entire life.
Difficulties may arise after a death when the individual starts feeling the physical, emotional, intellectual and spiritual impact of grief. Grief reactions may include behaviors such as: being overly tired, increased irritability, wanting to be alone, excessive crying, impatience, becoming angry easily, difficulty with house mates, being more aggressive and repeatedly asking the same questions. Depending on their cognitive and verbal abilities, they may not be able to say what is bothering them. Staff and family may often misinterpret the reason for the changes in behavior. They may assume the bereaved is being lazy, difficult or stubborn. The fact is that individuals with mental retardation have the same types of reaction to a death as those who do not have any disability.
Assisting these individuals can be challenging. Deciphering how and what they are communicating can be very difficult. Their responses cannot always be taken at face value. For instance, many individuals will answer all questions with a positive response. Time frames may be difficult to interpret. You may even notice the person having a conversation with the deceased. The death may trigger other losses. For example, if the individual has been living at home and the caregiver dies, he or she may have to be placed in a group home.
It is important to allow the individual to attend the funeral and/or visitation (even if special arrangements need to be made), to participate in rituals if possible, and to visit the cemetery. As with those of us who function normally, their grief journey also needs this kind of closure and support.
For persons with intellectual or developmentally disabilities, the grief journey may be different but the road is the same. Support and understanding is just as important in assisting them to successfully move through their journey as it is for everyone else.
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