How a child views the death of a parent
When a parent dies, a child’s sense of security and survival is threatened. The child is suddenly forced to deal with issues of illness, mortality and life after death – issues even adults find hard to face – long before they’ve had a chance to acquire the coping methods they’ll learn throughout life. As adults, we want to support and nurture the grieving child, but where do we begin?

A child’s grief is different
Dr. Cynthia L. Long (formerly Cynthia Long Lasher) – a Lutheran minister and grief specialist – reminds us that children grieve differently than adults. “Children grieve in spurts,” observes Dr. Long. “It’s a blessing, because to endure a terrible loss with no relief would just be too much for a child.” For instance, she’s found that playing helps children deal with their pain in a way that’s familiar to them, “sort of rationing out their pain by focusing on something else for a while.”

In her book, Death is No Stranger: Helping Children Grieve, Dr. Long offers practical strategies for guiding children through their grief. Among them:

• Avoid euphemisms. Talk to the child gently, in clear, direct language.
• Avoid use of the word “should.” Don’t say, “You should be happy,” or “You shouldn’t cry.” Such admonitions aren’t helpful for grieving children or adults.
• Allow children to be sad. “They desperately need someone to talk to about what they’re feeling, rather than making them feel they’re ‘wrong’ somehow,” says Dr. Long.

Resources to help children cope with grief
For more resources to help children cope with grief, contact your local hospice or pediatrician’s office, and visit the Cincinnati Children’s Hospital Medical Center website, where you’ll find a recommended reading list of children’s books about grief.

Source: NewsVirginian.com

The timeless (but seemingly opposing) observations of both men continue to ring true in 21st century culture. Music arouses passion and awakens long-forgotten memories; leads soldiers into battle and celebrates their victories; whispers children to sleep at night and enlivens their play during the day. Nothing can rival music in its ability to capture the joys of new love – or the anguish of love lost.

Music and Grief
Music’s power to convey the full spectrum of emotions is a comfort to many people coping with bereavement following the death of a loved one. Perhaps a song will call to mind the person who died, or perhaps it will help the bereaved to express painful feelings when words simply fail. Some people may use music for meditation or relaxation as they try to cope with or take a break from the intense emotions of grief.

Joy Berger is a music therapist and the director of education and volunteers for Hosparus Inc., the community hospice of Louisville, Kentucky, southern Indiana and central Kentucky. In a recent lecture on Death, Dying and Bereavement, Berger spoke about the importance of music in bereavement.

In her address, Berger told her audience that music’s role in bereavement comes from the fact that music is “a universal language,” and that the music we listen to is “always autobiographical.” The unique memories evoked by certain songs help transform the “past into the present,” according Berger.

Quoted in Scientific American, renowned neurologist Oliver Sacks of Columbia University puts it another way: “(Music) really seems to be as important a part of human life and communication as language and gesture. . . It is a way of connecting one consciousness to another.”

And that communication and connectedness are the things that sustain bereaved listeners as they navigate through their grief.

With such a wide spectrum of “normal” in the grieving process, how can we know when grief is spinning out of control? Bereavement counselors and therapists who differentiate normal grief from “complicated grief” are leading a movement to establish “Prolonged Grief Disorder” as a new mental-health diagnosis for clients who, six months after the loss of a loved one, are showing no signs of being able to recover or move on with their lives.

Normal response or mental disorder?
Holly Prigerson, who studies bereavement at Dana Farber Cancer Institute, says the key symptom that makes Prolonged Grief Disorder different from depression or anxiety is an intense yearning. Prigerson says that normal grief is “wanting what you can’t have. That hankering and yearning and pining and craving for something that you think is essential to your sense of happiness and well-being.”

In complicated grief, the intense yearning, preoccupation with the deceased, and feelings of emptiness do not lessen with time. In other words, complicated grief is the inability to recover after the death of a loved one. Prigerson’s research suggests that 10 to 20 percent of Americans who suffer a loss experience prolonged grief.

The current Diagnostic and Statistical Manual of Mental Disorders (DSM) defines grief as the normal response to loss rather than a medical diagnosis, and doctors are not paid to treat it. If complicated grief is approved as a new disorder, symptoms and treatment protocols would be established, and doctors could be reimbursed for treating patients with the disorder.

How to recognize complicated grief
According to the National Institutes for Mental Health (NIMH), the following symptoms may indicate complicated grief when they persist, with no sign of abating, for more than six months following the death of a loved one:
•    Strong yearning for the person who died
•    Waves of intense sadness and longing
•    Feeling of disbelief or difficulty accepting the death
•    Avoiding people, places or things that call to mind the loss
•    Pervasive bitterness or anger
•    Feeling intensely alone or lonely
•    Inability to control thoughts, memories, or images of the person who died
•    Seeing life as empty or meaningless without the lost loved one
•    Belief that grieving less would be a betrayal of the deceased

Study to explore complicated grief in older adults
In April, NIMH began recruiting 200 older adults who suffer from unrelenting symptoms of complicated grief to participate in a four-month, non-drug clinical trial. Dr. M. Katherine Shear of Columbia University is the psychiatrist conducting the study. “The death of a loved one can take an especially devastating toll on an older adult,” says Shear. “Older people may experience a cascade of losses as their social circles become smaller. The death of a spouse, adult child, friend, parent, or sibling — along with the social, financial and medical issues that accompany it — can throw an individual into a discouraging downward spiral. People who continue to struggle with bereavement after more than six months may be experiencing complicated grief. We believe we can help.”

Source: Reuters, WBUR.org

Throughout her illness, Katie had remained upbeat, documenting her experience through blog posts and photos, although the pain was sometimes excruciating. Karen Reider, Katie’s partner of 10 years, stood faithfully by and encouraged Katie to fight. Although doctors warned there would be no cure for Katie, Karen told her – and believed – that the cancer was something they just had to get through, that they would, indeed, get through it together, and that the best of life was yet to come.

When Karen received a phone call in late June telling her that Katie’s tumor was “97% gone,” she was ecstatic but not surprised. This was the result she had been waiting for. Tragically, however, the cancer claimed Katie’s life a mere 16 days later, and when death struck, Karen’s world came crashing down.

Picking up the pieces
Compounding the tragedy of Katie’s death were the two young sons she left behind. As a now-single parent, Karen faced the unimaginable responsibility of caring for her sons while trying to find her own path through grief. Three months after Katie’s death, Karen started to blog. She described the early months of her bereavement in vignettes all too familiar to those who have been there: losing her keys, her wallet, her memory; once-close friends who never call, and more casual friends whose unwavering support she came to rely on.

Grief is a complex emotional response to loss, and each person’s experience of grief is unique. By the end of October, Karen concluded that admonitions to avoid major decisions for a year and other grief-by-number tips were “a bunch of bunk.” She wrote in her blog:

…never in my life have I found myself more open or with these thoughts, feelings, inspirations..and so I say WHY NOT?  Why surpress these fresh ideas when I’m MOST willing to act on them, to live in ways I’ve never imagined, always dreamed…maybe I’m far off..and I welcome your thoughts but I tell you again MEDIOCRITY is NOT FOR ME..I will not settle.

People to see, lessons to learn
How, then, would Karen and her sons navigate through their grief? By hitting the road. Five months after Katie’s death, Karen quit her job as a pricing analyst at BMW, gave away or sold many of her possessions, and left the New Jersey apartment she and Katie called home. She bought a blue 2006 Honda Odyssey, packed up 4-year-old Aiden and 2-year-old Koen, three suitcases, bins of toys and books, and a small high-definition video camera.

This was something Karen and Katie had always wanted to do together; Karen put a black-and-white photo of Katie in one of the van’s visors and clipped Katie’s glasses to the other, and she and her sons set off to travel the country, visiting friends and family and seeing the sights along the way. Recently Karen told an interviewer that, although she will never understand why Karen was taken so young and so tragically, “What I know is that it happened for a reason, and that I have to live in a spectacular way in honor of her suffering so greatly. I can’t just shrivel up and die. I have to do something great.”

As the first anniversary of Katie’s death approaches, Karen and her sons have traveled to Florida, Louisiana, New Mexico, Texas, Arizona, California, and Ohio. She has shot hours of video (http://www.youtube.com/noretakes), which she uploads for Cincinnati filmmaker Robert Parish, producer of the documentary show “In the Tank,” to edit and post on YouTube. Through her blog, she’s been a source of inspiration and strength to countless readers. And on her journey, Karen has rediscovered the things that are most important to her: “What I’m going to take with me at the end is my memories and my experiences, not my things,” she says.

The latter was the case for Kristy Davis and her dad. When Kristy’s terminally ill mother was discharged from the hospital and admitted to home hospice care, Kristy and her dad responded to the emotionally charged situation by staying busy. When the going got tough, they went shopping.

Shopping for an answer
Kristy’s dad purchased and upgraded gadgets and systems around the house to provide comfort and make life easier for his wife and her caregivers. When Kristy was besieged by feelings of sadness and helplessness over her mother’s suffering, she set up a laptop at her mom’s beside, “just in case she wanted to do any typing.”

In the days following her mother’s death, Kristy and her dad jumped into action planning the funeral. They purchased and configured components for their computer and sound systems, as well as an LCD projector to show the PowerPoint presentation created by Kristy’s sister for the funeral.

Even after the funeral, the shopping spree continued. Eventually Kristy realized that the buying and busy-ness were merely ways to avoid confronting the tremendous loss she and her father shared. When the money for electronic toys ran out, Kristy and her dad were forced to find another way to bond.

What now?
Their conversations were awkward, but they spent time together on long drives and over meals. Eventually they began to communicate via email, and they talked about the sorrow and loss they shared. Kristy’s dad, a retired Air Force colonel, was even able to tell his daughter of his enduring and unconditional love for her for the very first time.

The experience of Kristy and her dad isn’t unique – grief is hard work, and humans often rely on one or more defense mechanisms to help them get through. But in the end, as Kristy and her dad discovered, the only way out of grief is to go through it, and sharing helps to light the way.

Nancy Sherman, Director of Bereavement Services for the Center for Grief & Healing with Hospice of the North Shore, says support groups provide an answer for many people. According to Sherman, support groups “offer a safe place where people who are hurting come together to work through their grief.” Supportive family members, friends and therapists have their place in grief recovery, but drawing support from and giving support to others who are going through the same thing provides a kind of help one can’t find elsewhere. According to one support group member cited by Sherman, “Hearing how others feel makes you feel you’re not alone.”

Still, people are often wary of participating in groups, according to Sherman. Many are simply uncomfortable with the notion of talking about their feelings in front of others, while others hold misconceptions about support groups that prevent them from opening themselves to the relief and healing a group can offer. Following are five popular myths about grief support groups, countered by reality.

Myth: Everyone in the group has to talk.
Reality: Although the group is formed on the premise that talking through your grief is helpful, no one is forced to talk. Grief groups are non-threatening gatherings, and many people are helped simply by listening.

Myth: My grief isn’t as severe (or important, or serious) as others.
Reality: Although grief is a universal experience, everyone’s grief is different. Bereaved individuals are encouraged not to compare themselves to anyone else. The common bond is the need for help in coping with grief.

Myth: A grief support group will be depressing.
Reality: In fact, many find the opposite to be true. Group participants feeling relieved and uplifted when they realize they are not alone in their emotions. Groups provide a supportive environment where people can feel release their emotions to make room for healing.

Myth: My loss happened a long time ago; I’ll feel silly to bring it up now.
Reality: Grief follows no timetable. Many milestone events – weddings, anniversaries or birthdays, for example – can trigger memories that make the loss feel painfully new. A support group can help people cope with a loss, no matter when that loss occurred.

Myth: Grief support groups are only for the families of people who received foster care.
Reality: Although grief support groups are often (but not always) sponsored by hospice organizations, services are usually open to anyone who has experienced a loss, often at no charge or for a small fee. The generous donations of grateful participants help support these programs.

In truth, then, support groups offer hope for the future to anyone who’s grieving. To find a support group near you, contact your local hospice organization.

Kinder, gentler bill collectors
DCM Services of Minneapolis is a collection agency that works exclusively on deceased accounts, according to the company’s website. Abandoning the aggression and intimidation often associated with collection agencies, DCM Services trains its staff to use empathic listening and effective communication techniques to recover payments from bereaved survivors. Agencies like DCM Services are often successful in collecting from survivors, largely due to goodwill and a desire on the part of the family to “do the right thing.”

In most states, under most circumstances, a survivor has no legal obligation to pay the debts of a deceased spouse, parent or child. A reputable agency won’t deliberately mislead survivors, but the agency is under no obligation to tell the family they don’t have to pay. And not all collection calls come from legitimate, reputable agencies.

Scam alert: preying on the bereaved
In Mississippi, scam artists posing as bill collectors recently tried to strong-arm grieving families into paying non-existent debts on behalf of their deceased loved ones. This wave of fraudulent collection attempts resulted in several calls to the Better Business Bureau of Mississippi; in 2002, a similar scam targeted families in at least 14 states.

Should you receive a call from someone seeking payment on a debt owed by a deceased loved one, remember:

• If you haven’t been a cosigner on credit accounts with the deceased, you are not obligated to pay. If you’re unsure of your obligation, talk to a lawyer.
• Get the name, address and telephone number of the collection agency, and check with the Better Business Bureau to make sure the company is legitimate.
• Ask the caller to provide written proof of the debt – who is the creditor, how much is owed, and why the caller is turning to you for payment.
• Do not give the caller your Social Security or bank account numbers or other personal information. If the debt is legitimate, the creditor should follow proper court procedures to file a claim against the deceased’s estate.
• If you can’t verify the identity of the caller, or if you’ve fallen victim to a scam, contact your state’s attorney general.

Take Schoedinger Funeral and Cremation Service in central Ohio, for example. Schoedinger – the first funeral home in its area to offer live streaming funeral webcasts and archived video for family members and friends who are unable to pay their respects in person – is just one of many funeral service providers across the country who’ve ventured into webcasting in recent months.

Funeral video technology saves money, time, energy
As improved technology and affordable pricing provide the impetus for more funeral homes to consider offering webcasting and videotaping service, the demand for funeral webcasting is also growing. Economically, it’s a no-brainer: funeral webcasts start as low as $95 – a mere fraction of the cost of airfare, accommodations and other travel-related expense. Webcasting also saves energy and helps to reduce stress for mourners who are ill, afraid of flying or unable to take several days off work.

Funeral directors who embrace funeral video technology say that by allowing mourners who would otherwise be unable to attend a funeral to share the experience with loved ones, webcasting allows survivors to participate in an important part of the grieving process.

Ellery Bowker is the president of Director’s Advantage, a North Carolina-based company that provides technological products and services to the funeral industry. Part of funeral webcasting’s growing appeal is the fact that the Internet has become an integral part of daily life for many Americans at home and abroad, according to Bowker, who cited the case of a solider in Iraq who was able to watch his grandmother’s funeral in North Caroline via webcast.

For some, change isn’t welcome
Not everyone thinks funeral webcasts are a good idea, however. One Mansfield, Ohio attorney, calls the concept “demeaning,” while others worry that mourners entrenched in a couch-potato culture may avoid paying their respects in person, even when there are no obstacles to attending the funeral service, thus depriving family members of the in-person comfort and support they need at the funeral home.

Gay and Lesbian Cremation Urn

Grief is a universal experience, but in a scenario gay men and women know all too well, individual circumstances can complicate grief and intensify the suffering of the bereaved.

According to a study funded by the Irish Hospice Foundation and published in the International Journal of Palliative Nursing, doctors, nurses and clergy – those whose mission is to alleviate suffering – actually inflict emotional pain on grieving gay men and women by failing to acknowledge their relationships. Nursing experts who conducted the study at Trinity College Dublin found that “ … healthcare professionals and the wider community were complicit in reinforcing the invisibility of gay/lesbian bereaved people.”

A Case for Compassion
In an extreme example of the kind of behavior cited in the Irish study, a suit filed this month in the U.S. District Court for the Southern District of Florida illustrates the human cost of the insensitive, thoughtless or even deliberately cruel responses to gay couples and families by medical professionals and caregivers.

While vacationing with her family in Miami, Lisa Pond, a healthy 39 year-old, suddenly fell ill. She was rushed to Miami’s Jackson Memorial Hospital, where hospital staff prevented her partner Janice and their three adopted children from seeing Lisa until 8 hours after her admission. Janice produced the children’s birth certificates and a medical Power of Attorney signed by Lisa, all to no avail, in spite of the fact that the doctor who was treating Lisa acknowledged there was no medical reason to deny visitation.

Janice’s suit claims Jackson Memorial Hospital was negligent and intentionally inflicted emotional distress. The hospital has asked the Court to dismiss the suit on the grounds that the hospital has no obligation to allow visitors.

Even after Lisa died, when Janice attempted to obtain copies of the death certificate in order to file for life insurance and Social Security benefits on behalf of the couple’s children, her requests were refused by both the State of Florida and the Dade County Medical Examiner.

Photo Memorial Stone

When Howard Stidwill and his wife, Barbara learned their faithful friend had bladder cancer, they faced a harsh truth: the death of a beloved pet can leave a void as real, and often as deep, as the loss of a friend or relative.

The Stidwells shared their lives with Max, an English pointer, for more than 10 years. Upon learning that Max’s illness would eventually claim his life, Howard and Barbara set out to do everything in their power to keep him as comfortable as possible. Ultimately, Max’s condition worsened, and the Stidwells made the heartbreaking decision to euthanize him.

Losing Max left the Stidwells emotionally exhausted. Over time, Howard observed that “in society, there is this absence of recognition for the loss of a pet” – a condition that left the couple feeling all alone in their grief. Eventually Howard used his experience to help others by establishing a group where people can turn for support and information as they face the loss of a pet.

Strength in Numbers

One of grief’s most troubling aspects is the feeling that no one understands what you’re going through. In the case of pet grief, that belief may be solidly grounded in reality; friends and family members who don’t understand the very special relationship between people and their pets may invalidate pet grief with insensitive comments like, “It was only an animal.” Thus, the pain of losing a beloved pet is often complicated by feelings of isolation and resentment toward those who don’t understand.

While support for pet grief isn’t as common as support for many other issues, resources to assist bereaved pet owners are on the rise. The American Veterinary Medicine Association website offers a list of telephone hotlines for those who are grieving the loss of a pet, while a Google search will also yield many support options, such as this listing of General Pet Loss Resources.