Caregiver Grief and Bereavement
Watching his father, who has Alzheimer's disease and a PhD in English, disappear "one brain cell at a time," was an emotionally wrenching experience for Robert Matsuda, a Los Angeles-based musician. So was his decision last year to place him in a nursing home.
"It wasn't only the everyday strain of caring for him," Matsuda says. "I was grieving for who he was and who he is now. Nothing is happening the way I expected or planned. I'm coming to terms with that, but it's very hard."
The palliative care team that helped him care for his father didn't make Matsuda's grief go away. But it did help him find his way through it.
"Because I was talking with the people -- the nurse, the social worker -- on the palliative care team, I was looking at my future, too," he says.
Susan Adler cared for her husband, Joel, in their Wisconsin home until he passed away last year. "First there was the grief of knowing he was going downhill," she says. "Pragmatically, I mourned his loss before he died ... Now I'm mourning his death."
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. "Grief and bereavement are very individualized. Everyone's experience is different," says Liane Fry, LFMT, program manager for the Center for Grief Care and Education at the Institute for Palliative Medicine at San Diego Hospice.
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 move from one stage to another.
"This isn't a linear, predictable process because stages loop around and come back again and again," says MD, Christine Hudak, associate director of Summa Palliative Care and Hospice Service in Akron, Ohio.
Many factors influence how long people mourn, such as how the loved one's illness progressed, how long the caregiver provided care, and whether the caregiver has a good support system.
Fry says that grief symptoms from 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.
"If they are still grieving intensely and not able to function well at the one-year mark, this might be the time to get professional help," she says.
When grief symptoms do not 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.
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