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    Caregiver Grief and Bereavement

    Grief is our normal, natural, and necessary response to loss. Its flip-side, bereavement (or mourning), is the process of responding to, and ultimately surviving loss. Both grief and bereavement are individualized experiences, and experts say everyone's experience is different.

    How We Grieve

    We tend to grieve along a spectrum of grieving styles. One end of the spectrum has been called "intuitive grieving," characterized by outbursts of emotion and the need to talk about one's feelings. The other end has been called "instrumental grieving," characterized by a focus on doing things that help one cope.

    But it's not one or the other for most people. Healthy grieving almost always is some combination of both styles.

    Since the 1960s, people have talked about the stages of grief and bereavement -- denial, anger, bargaining, depression, and acceptance. But for most people, grief isn't a linear process of moving from one stage to the next. Instead, stages tend to loop around and come back again and again.

    Many factors, including how the loved one's illness progressed, how long the caregiver provided care, and whether the caregiver has a good support system, have an influence on how long people mourn.

    Grief symptoms associated with an expected death -- anger, numbness, crying, sleepless nights, mood swings, aches and pains, forgetfulness -- tend to peak around the six-month mark, then taper off.

    When symptoms don't fade over time, a person may be suffering from what psychologists call "complicated grief." If it's been several months since the loss and your feelings are still so strong that you can't resume your normal routine, it's time to talk to your doctor or to seek psychological counseling.

    A Helping Hand

    For caregivers whose loved one is in a palliative care program, the team's social worker, grief counselor, and spiritual counselor are available to help and support caregivers during their loved one's illness and after the loved one has died.

    Part of what the palliative care team does is look for situations or triggers that might indicate a caregiver is having difficulty or that might complicate the grieving and bereavement. Then the team will help the caregiver look at options and alternatives to ease the grief and sense of loss.

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