GUIDEPOSTS THROUGH GRIEF HELPFUL INFORMATION FOR THE RECENTLY BEREAVED

The days, weeks and months that follow the death of a loved one can sometimes be surprisingly difficult. Coping with the losses and challenges associated with the • Community Care Hospice death of a loved one can feel akin to being routed miles off the Interstate and into • Hospice of Central Ohio unfamiliar territory without a map. We believe that just as a good map could be quite • Ohio’s Community Mercy Hospice useful on an unexpected road detour, having a “map” as you enter the territory of • Ohio’s Hospice at United Church Homes grief and loss can be very beneficial as well. While everyone’s grief experience will • Ohio’s Hospice LifeCare be uniquely personal, knowing what the “territory of loss and grief” looks like can • Ohio’s Hospice Loving Care be very reassuring. Much unnecessary suffering can be prevented through accurate • Ohio’s Hospice of Butler & Warren Counties information and realistic expectations. • Ohio’s Hospice of Dayton • Ohio’s Hospice of Fayette County The articles that follow are designed to provide you and your family with helpful • Ohio’s Hospice of Miami County information about various aspects of the grieving process. Also included is information about grief support services available through our Pathways of Hope grief “GRIEF IS NOT A DISORDER, counseling centers as well as a list of helpful books and internet resources. You will A DISEASE OR A SIGN notice that the center insert provides current information about specific grief support or grief education groups as well as information related to upcoming memorial OF WEAKNESS. IT IS AN services. Throughout the coming year, you will continue to receive our quarterly EMOTIONAL, PHYSICAL AND newsletter, the “Bridge,” which will provide additional information about grief and SPIRITUAL NECESSITY, THE carry the most current information about groups and other services. PRICE YOU PAY FOR LOVE. Please know that it truly has been our privilege to care for your loved one. It THE ONLY CURE FOR GRIEF IS remains our privilege to remain available to you and your family as you make the adjustments and adaptations that will be required in the coming months. TO GRIEVE.”

— Earl Grollman

INSIDE

2 A Bill of Rights for 6 Sleeplessness: A 12 When to Seek Grieving People Common Concern Professional Support 3 Grief 101: A Basic 7 The Loneliness of Loss 13 Individual Grief Primer Counseling: What to 8 The Needs of Grieving Expect 3 Make Self-Care a Children Priority 14 Bereavement Support 9 Helping Grieving Groups: Could They Be 4 The Experience of Children Right for Me? Grief: More Than 10 Signs of Healing Feelings 15 What Others Need to 10 The Cemetery: To Visit Know 5 How We Grieve: or Not to Visit? Understanding 15 When Will the Grief Differences 11 Facing the Problem of Get Easier? the “Stuff ” 5 Setting Appropriate 16 Additional Expectations 12 Frequently Asked Bereavement Questions About Resources 6 Planning for Difficult Pathways of Hope Days

NW_HOD_20200612_Guidepost_09~1179.indd 1 6/19/20 10:07 AM A BILL OF RIGHTS FOR GRIEVING PEOPLE

1. ou haveY the right to grieve in your own way and at your own pace. Although grieving people may find many commonalities with one another, no two people grieve in exactly the same way or at the same speed. No one can tell you how you “should” grieve or at what pace.

2. You have the right to whatever grief emotions you are feeling. Sadness, anxiety, anger, confusion, relief and guilt can all be part of the grief experience.

3. You have the right to cry without apologies. We seem to be hard-wired for tears as a way of releasing and expressing pent-up emotions.

4. You have the right to talk about your grief as well as the right not to talk about your grief. Talking can be very healing, but you do have the right to choose what and with whom you want to share.

5. You have the right to treasure your memories, stories and relationship with your loved one.

6. You have the right to be honest when asked about how you are doing.

7. You have the right to take care of yourself and do what is right for you. You can rest, slow down and choose which invitations you want to accept and which you choose to decline.

8. You have the right to do things differently. You can change the furniture around, eat at different times, revise or let go of “traditions” for the time being - or forever.

9. You have the right to laugh and enjoy life. Joy can be present in the midst of sorrow just as sorrow can be present in times of joy and celebration. Allowing your attention to be directed into the moment and away from sorrow does not mean you have forgotten your loved one.

10. You have the right to express, nurture or explore your spirituality. Grief can be a catalyst for spiritual growth. Sometimes loss can leave us questioning our beliefs and assumptions. This process, though at times uncomfortable, may lead you to a deeper and more meaningful spirituality.

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NW_HOD_20200612_Guidepost_09~1179.indd 2 6/19/20 10:08 AM GRIEF 101: A BASIC PRIMER MAKE SELF-CARE A PRIORITY Bereavement means that we are THERE IS NO TIMETABLE FOR deprived, robbed or stripped of GRIEF. It takes as long as it takes. You may find it difficult to take care someone or something of high per- While the intense pain that often of yourself while grieving. Business sonal value. In other words, it’s the accompanies acute grief may be details to deal with, lack of energy, objective state of having suffered expected to abate over time, there and lack of desire can present a loss. will always be times when the loss significant challenges to walking is remembered, missed positively and deliberately in the early days of grief. Paying attention Grief refers to our internal and and grieved. to the basics of self-care — nutrition, external reactions to loss. hydration, exercise, rest and social CHILDREN DO GRIEVE, support — is essential. Mourning is the way in which we ALTHOUGH THEY EXPRESS IT express our grief. DIFFERENTLY THAN ADULTS. Their Strategies that can help in the reaction to loss and understand- healing process include: GRIEF IS A NATURAL RESPONSE TO ing will differ according to age and n Take care of yourself physically. LOSS and a normal consequence development. Age appropriate of our ability to love, connect and information about death and grief Have a check up with live fully. We do not grieve that coupled with sensitive support your physician. which isn’t important to us. It is can help. n Exercise daily. Even a slow, the link between loss and peaceful walk can help you relax. moving forward. KNOWING THAT THERE ARE WIDE VARIATIONS IN WHAT IS n Eat well and wisely. GRIEF IS EXPERIENCED AT MULTI- “NORMAL” CAN HELP. Inaccurate PLE LEVELS. It affects us physically or faulty information about the n Lower expectations of yourself. grieving process leads to as well as emotionally and spiritu- n Take one day at a time, one goal at unrealistic expectations, which can ally and impacts our thinking a time. and behavior. unnecessarily add to pain and suffering. n Keep a written journal. THERE IS NO ONE RIGHT WAY TO It doesn’t have to be ‘professional,’ GRIEVE. Response to loss is highly GRIEF IMPACTS NOT ONLY THE just honest. individual, based on personality, INDIVIDUALS DIRECTLY INVOLVED, n life experience, personal beliefs but also their social connections Trust your own sense of timing. and expectations, as well as other and support system. Relationships n Participate in pleasant activities factors unique to the individual are changed after loss, and it is you enjoy. and their relationship with whom normal to reassess, change or even or what is lost. Everyone grieves in end some relationships. n Seek new routines and interests. his or her own way. n Discover what you need from GRIEVING PEOPLE SOMETIMES others and ask. GRIEF CAN BE EXHAUSTING. The NEED TO LOOK OUTSIDE THEIR energy that grief requires takes USUAL SUPPORT SYSTEM to find n Embrace your spirituality. its toll in fatigue, irritability and the understanding and information n Pamper yourself. A massage can forgetfulness. Attention to the they need. Grief or other support do wonders! basics of self-care — health, groups, books, internet resources nutrition, rest and exercise — and professional counseling can n If possible, avoid making major facilitates the healing process. be of benefit. decisions like moving or changing jobs during the first year of grief. FLUCTUATION IN FEELINGS, n Join a support group. ENERGY AND COPING IS TO BE EXPECTED. The ups and downs are n Don’t hold back your tears – crying often unpredictable and are a can be very therapeutic. normal part of the grief experience. n Find ways to hold on to hope.

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NW_HOD_20200612_Guidepost_09~1179.indd 3 6/19/20 10:08 AM THE EXPERIENCE OF GRIEF: MORE THAN FEELINGS

The personal impact of What you may experience physically loss can be wide-ranging. What you may experience Grief is expressed not only behaviorally n Physical pain through feelings, but also through physical sensations, n Physical exhaustion n Tearfulness thoughts or cognitions, n Tightness in the throat n Sleep disturbances changes in behavior. While and/or muscles everyone grieves in their n Appetite changes own way, there are some n Heaviness or pressure in the chest n Restlessness common experiences that n many bereaved people Lack of energy n Withdrawal/isolation normally experience. n Hollowness in the stomach n Vivid dreams of loved ones Although these experiences may be grief related, it is n Breathlessness n Searching very important the griever n Heart palpitations n Avoiding reminders of loved one have a complete physical n exam to rule out other Weight loss or gain n Procrastination causes of such symptoms. n Periods of nervousness n Desire to run away or become very or even panic busy to avoid the pain of loss n Hyper-sensitivity to noise n Digestive disturbances What you may experience cognitively

n Loss of sexual desire n Forgetfulness or hyper-sexuality n Losing things n Susceptibility to physical illnesses n Confusion “THERE IS n Difficulty concentrating What you may experience SACREDNESS IN n Auditory/visual hallucinations emotionally TEARS. THEY ARE n Difficulty processing information n Shock/numbness NOT THE MARK OF n Fearing losing control n Denial WEAKNESS, BUT OF n Recurring memories POWER. THEY SPEAK n Sadness MORE ELOQUENTLY n Anger/fear What you may experience spiritually THAN TEN THOUSAND n Guilt TONGUES. THEY ARE n Relief n Search for meaning THE MESSENGERS n Anxiety n Crisis of faith OF OVERWHELMING n Mood swings n Confirmation of faith GRIEF... AND n Loneliness n Anger at God UNSPEAKABLE LOVE.” n Concerns about afterlife n Guilt/forgiveness — Washington Irving

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NW_HOD_20200612_Guidepost_09~1179.indd 4 6/19/20 10:08 AM SETTING APPROPRIATE EXPECTATIONS

Each person’s journey through grief is You will grieve for many things both You may have a lack of self-concern. unique, personal and painful. In an effort symbolic and tangible, not just to “speed up” the grief process, many the death alone. You may experience grief spasms, acute grievers will put unnecessary pressure upsurges of grief that occur suddenly and expectations on themselves. Others You will grieve for what you have lost with no warning. may add additional pressure, mistakenly already and for what you have lost assuming that the bereaved “should” be for the future. You may feel as if you are going crazy. further along in their grief. Appropriate You may be obsessed with the death and expectations, such as the following, can Your grief will entail mourning not only preoccupied with the deceased. normalize the grief journey and help in for the actual person you lost but also for the healing process. all of the hopes dreams and unfulfilled You may find yourself acting socially in expectations you held for and with that ways that are different than before. You Your grief will take longer than most person, and for the needs that will go may find that there are certain dates, people think. unmet because of the death. events and stimuli that bring upsurges in grief. Your grief will take more energy than you The loss will resurrect old issues, feelings would have ever imagined. and unresolved conflicts from the past. Others will have unrealistic expectations about your mourning and may respond Your grief will involve many changes and You will have some identity confusion as inappropriately to you. be continually developing. a result of this major loss and the fact that you are experiencing reactions Certain experiences later in life may Your grief will depend upon how you that may be quite different than what temporarily resurrect intense grief. perceive the loss. you expected.

HOW WE GRIEVE: UNDERSTANDING DIFFERENCES

How do we know how deeply someone Experience and research with bereaved is grieving? Because not everyone individuals suggests that there are grieves in the same way, it is sometimes two general styles of grieving. For difficult to understand a grieving heart, individuals who are INTUITIVE grievers, especially when the more obvious grief is an openly emotional experience. emotional signs of grief seem to be These people may struggle with absent. If we assume that grief always emotions that always seem too close presents itself in certain ways, we may to the surface; they are open to talking incorrectly assume that the absence about their loss and physically appear of particular behaviors indicates an to be saddened and de-energized. absence of grief or a lack of feeling. INSTRUMENTAL grievers are people who process their loss through physical comforting and lots of How a particular person grieves is activity, and thinking through their interpersonal support, while another determined by a host of factors specific loss experience. They often feel as sibling may cope by taking charge of to that individual. Prior experiences emotionally wounded as their intuitive tasks related to the loss and appear with loss, age, gender, coping abilities, counterparts, but their pain is much less reticent to acknowledge their feelings. spiritual belief system and cultural obvious to the casual observer. Neither style is ‘better” than the other. conditioning are but a few of the many When we can recognize and respect factors that influence how any one These styles exist along a continuum. the differences, we are better able to person will react to the loss of a loved Most of us lean toward one pole or the support one another through the one. Those individual factors are as other of the continuum with very few territory of loss. unique as our fingerprints, so it should individuals relying completely on one come as no surprise that grieving or the other style. In any given family individuals may appear very dissimilar in you are likely to see both styles of how they respond to loss. grieving—one sibling may require 5

NW_HOD_20200612_Guidepost_09~1179.indd 5 6/19/20 10:09 AM PLANNING FOR DIFFICULT DAYS

The first year following the death of activity that acknowledges the loss your loved one will continue to influence a loved one is full of “firsts” involving and honors your loved one’s memory. you for the rest of your life. Acknowledging birthdays, anniversaries, holidays and Lighting a remembrance candle, releasing and experiencing the special “difficult” other special occasions. Memories of balloons, visiting the cemetery, printing days honors their memory and your past times stand in stark contrast to the a memorial in the newspaper, planting a enduring love. present. Facing these “firsts” without tree or other plant, wearing something a loved one predictably heightens that belonged to your awareness of loss and feelings of grief and loved one or writing a anxiety. For many, the anxiety associated letter are but a few of with anticipation of the upcoming “first” the options you turns out to be worse than the might choose. experience itself. Some find that By recognizing that certain days can be planning a trip to a new difficult and planning ahead, you can and different place or make a choice to live with your grief planning activities that rather than be consumed by it. First of are different from what all, acknowledge the day and its special was done in the past meaning and special memories. Give can be a good choice. yourself permission to be sad — leaning into grief can be less exhausting than Have faith in your trying to avoid it. decision-making and trust your feelings. You Many have found it helpful to plan an can rest assured that

SLEEPLESSNESS: n Try to keep to a sleep schedule —­ go to bed A COMMON CONCERN and get up at the same time every Problems with sleep are commonly an day to help set issue during the early stages of grief. healthy body rhythms. You may have trouble falling asleep or n If you have trouble may awaken frequently in the night, getting your mind to “shut down,” unable to fall back to sleep. These play relaxing music. n problems often resolve as the grief Practice simple relaxation techniques and start winding down at least one process progresses. But lack of sleep n Avoid smoking or drinking caffeine hour before bed. can cause a multitude of challenges. several hours prior to bedtime. Grief, in itself, is exhausting and n Ban anything stressful! emotions and decision-making are n Avoid the stimulation of exercise more difficult when sleeplessness and within two hours of bedtime, but do physical fatigue are present. find some time during the day Continued sleep problems may be If you have persistent insomnia, a to exercise. an indication of underlying grief complete physical exam is probably a issues that are not being handled good idea. In some cases, your n Avoid stressful conversations or in a healthy manner. Speaking physician may prescribe medication decision-making before bedtime. with a bereavement counselor or temporarily to help you sleep. But the attending a support group may following strategies may also prove to n Don’t go to bed “overstuffed.” assist in putting you on the path to be helpful: a healthy grief journey.

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NW_HOD_20200612_Guidepost_09~1179.indd 6 6/19/20 10:09 AM THE LONELINESS OF LOSS

Loneliness is an integral part of grief. Someone very precious has been lost and the companionship, comfort and purpose they provided are suddenly gone, replaced by a sense of emptiness and aloneness. In the beginning, the loneliness may not be quite as noticeable when supporters are still providing the “Three C’s”: Calls, Cards and Casseroles. But as time goes on, longing for your loved one and the resulting loneliness may grow very heavy indeed.

Loneliness is part of the transition from the past to the future. The ending of the previous life with your loved one forces you into a “new normal” and also new beginnings. But until that new life fully develops, clinging to endings is natural and may be filled with loneliness.

How does one cope with the loneliness? In learning to be alone, there is not one “right” plan. However, there are several guidelines “THE RISK OF LOVE IS which might prove helpful. n Joining a grief support group is a LOSS, AND THE PRICE great way to connect with others in a OF LOSS IS GRIEF — BUT meaningful way. Grief often makes one THE PAIN OF GRIEF IS n A first step is accepting that you feel alienated from others as they feel will feel lonely. You miss your loved “no one could possibly feel as I do.” ONLY A SHADOW WHEN one and long for things to be the Gathering with others experiencing COMPARED WITH THE similar losses provides a safe same once again. Acknowledge the PAIN OF NEVER RISKING loneliness as being a natural part of environment to express your deepest the grief process. feelings and concerns. It also gives an LOVE.” opportunity to comfort others. n A second step is to reach out. — Hilary Stanton Zunin Reaching out is a good cure for n Understand that there is a difference loneliness. It will probably be between being alone and being lonely. difficult, as the loss of a loved one Most of us need some time to ourselves to leaves us drained and often feeling recharge and renew. Time alone is often a insecure about ourselves. Many necessary part of the adjustment process. bereaved individuals report great Learning to distinguish the difference satisfaction in volunteering, taking between the experience of being alone classes, or renewing old or forming and the experience of loneliness can help new friendships. you identify appropriate coping tools.

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NW_HOD_20200612_Guidepost_09~1179.indd 7 6/19/20 10:10 AM THE NEEDS OF GRIEVING CHILDREN The grief of children can be painful to THE SECOND MOURNING THE FOURTH MOURNING NEED observe, often leaving adults feeling NEED IS TO FEEL THE SADNESS. HAS TO DO WITH HELPING lost for ways to help. Alan Wolfelt, Children do not have to feel sad all the CHILDREN ACCEPT THAT THEIR Ph.D., a noted expert in grief, discusses time because, quite frankly, it isn’t very LIFE IS DIFFERENT NOW. mourning needs for children who have much fun to feel sad. Children should Loss changes children’s lives as well as suffered a significant loss. Recognizing be allowed and encouraged to have their families. Children need to know and supporting these mourning needs fun and feel good. Adults should be that they are safe and will be cared for, can help children heal through their aware that children process difficult despite the changes. While life will journey of grief. feelings differently than adults and what never be the same again, it is important looks like “play” and fantasy may, in children understand that doesn’t mean THE FIRST MOURNING NEED IS fact, be the means by which children that they will never be happy again. TO ACCEPT THE DEATH. express and cope with feelings of grief. It’s difficult for any child to accept that Caring adults need to make themselves THE FIFTH MOURNING NEED their loved one is gone and that available to children when they do ENCOURAGES CHILDREN TO their life will be forever changed. have their sad moments and give them THINK ABOUT “WHY” THIS LOSS Children may try to imagine that the permission to express their sadness. HAPPENED. loss never really happened; this is OK This is a very difficult question to and perfectly normal. Children are likely THE THIRD MOURNING NEED answer, especially for a child. Lacking to revisit their loss at various points in IS TO REMEMBER THE PERSON information and life experience, their development due to changing and WHO DIED. children too often come to damaging maturing cognitive and social skills. Adults need to encourage children to “explanations” and conclusions based Eventually, with time and support from talk about the person who died, share on misinformation and conjecture. trusting adults in their life, children will memories, and look at pictures. Children should be encouraged to talk to learn to accept the reality and finality of a trusted adult about the “whys” in life. difficult loss. THE SIXTH MOURNING NEED INVOLVES ALLOWING OTHERS TO HELP THE CHILD WHO HAS SUFFERED A LOSS; NOW AND ALWAYS! It’s important for children to have adults in their lives that they can trust and who are always there for them — no matter what. The process of grief is hard work, which is why it’s important to assure the consistent availability of supportive people who can help during difficult times. Children should know that it is OK to ask for help.

“GRIEVING IS A JOURNEY THAT TEACHES US HOW TO LOVE IN A NEW WAY NOW THAT OUR LOVED ONE IS NO LONGER WITH US. CONSCIOUSLY REMEMBERING THOSE WHO HAVE DIED IS THE KEY THAT OPENS THE HEARTS THAT ALLOWS US TO LOVE THEM IN NEW WAYS.” — Tom Attig, The Heart of Grief

NW_HOD_20200612_Guidepost_09~1179.indd 8 6/19/20 10:10 AM HELPING GRIEVING CHILDREN

Children and teens often feel alone often uncomfortable talking about and isolated with their grief. Many feel their grief. One does not need to sorrow, sadness, anger, confusion and be artistically gifted to benefit. longing for their loved one while at the Art activities can also provide same time struggling to make the many a creative way to make objects necessary adjustments caused by the that help maintain cherished loss. Sometimes children and teens memories as well as honor the life are hesitant to show their feelings to of their loved one. The completed other family members because “I do project provides the parent(s) or not want to upset them or make them guardian an object that is like a cry.” Caregiving adults, in the throes “window to the soul,’ facilitating of their own grief, may find it difficult better understanding of and to know how to best support their support for their child. children. Children, sensitive to the pain of their caregivers, may give the false CAMPS AND MINI-CAMPS appearance that they are relatively provide bereaved children and unaffected and may actively avoid teens a fun-filled camp experience acknowledging how deeply they are with other children and teens affected by their loss. Sensitivity who have suffered similar losses. about being viewed as “different” Bereavement camp experiences can help can prevent them from feeling children learn new coping strategies comfortable in sharing their and connect with other kids who have experience or expressing feelings experienced loss. Opportunities range with their friends. from Mini-Camp, day camp and overnight camp experiences. All offer traditional Pathways of Hope offers a variety camp activities such as swimming, of services designed specifically hiking, crafts and opportunities for to support grieving children grief support that are customized to and teens. kids. Mini-Camps are one-day programs that provide a mix of fun coupled with INDIVIDUAL GRIEF grief support for children and teens. COUNSELING provides a safe Information is available by contacting environment where children your local Pathways of Hope services. can express their thoughts and feelings about the loss. HEALING PATHWAYS Grief counseling sessions SCHOOL-BASED may include grief-related PROGRAMS bring grief art therapy activities. Art support to the school setting. activities provide a non- Partnering with area schools, threatening, creative and Healing Pathways serves grieving enjoyable avenue that opens children in their school community, up expression of thoughts providing grief support groups and feelings about the death and other bereavement services and insights into how they are to students impacted by loss. If coping. One of the powerful you would like your child’s school qualities of art making is to institute on-site grief support, that it does not rely on words please contact us and we will work to communicate difficult with school administrators to feelings and experiences. This explore the feasibility of Healing quality makes it especially Pathways programming at your healing for children and child’s school. teens, many of whom may not have the vocabulary to express their feelings and experiences in words or are

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NW_HOD_20200612_Guidepost_09~1179.indd 9 6/19/20 10:11 AM SIGNS OF HEALING n You feel comforted by sharing n You notice a decrease in the feelings of memories with others. fear and anxiety.

Grieving people are often fearful that n You realize that you are no longer n You recognize that you don’t have the intense pain of early grief will never crying every time you hear or speak to hold on to the pain as a way of abate. Pain, whether emotional or phys- your loved one’s name. staying emotionally connected to your ical, focuses attention on itself, causing loved one. us to overlook the signs that healing is n You can reach out to help proceeding, despite the presence of pain another person. n You can experience a memory that and sorrow. Like the “hidden pictures” warms your heart. n You feel less need to visit in a child’s puzzle book, when you know the cemetery. n You are able to take pride in your what to look for, it becomes easy to see success at meeting new challenges. what was right in front of your eyes. A few of these signs include: n You are more willing to visit the grave n You realize that the time spent site when it had previously been too crying is decreasing. hard to go. n n You become aware that your You can forget the loss for a short time physical energy is slowly without feeling as if you are betraying returning. your loved one.

n You recognize that you can n You can enjoy the small pleasures of remember what you just read. life — a sunny day, a beautiful sunset or time with friends or family, without n You can concentrate on something feeling guilty. other than your loved one for longer periods of time. n You begin looking forward to future events and plans for the future. n Your appetite starts to return.

n You can laugh at a good joke.

n You realize that you are sleeping a little better.

THE CEMETERY: TO VISIT OR NOT TO VISIT?

Once the funeral is over and their loved For many others, visiting the cemetery It is important to remember that one is laid to rest, grieving people provides no solace. It is not at all visitation practices are in no way often find themselves struggling with uncommon for grieving people to avoid reflective of the intensity of someone’s guilt and other uncomfortable feelings revisiting the gravesite for some time grief or the love and respect accorded related to cemetery visitation. There are after the funeral. When ready, the first to the deceased. Respecting and no set “rules” about how to handle this visit to the cemetery after the funeral supporting the different needs, views aspect of loss. People differ widely in can be an important milestone in their and preferences of ourselves and others how they cope with this as well as the grief recovery. in the grief process is the key. other challenges of grief. For others, visiting the cemetery brings For some people, frequent or even daily neither comfort nor aching pain, but trips to the gravesite are an important rather a sense of emptiness. For these part of their healing process. As the people, the cemetery may serve more as acute symptoms of grief begin to abate, a site where a life lived is permanently the need for daily or weekly visits may recognized and memorialized rather decline, to be replaced by more flexible than a place of emotional or physical patterns of visitation. connection to a deceased loved one.

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NW_HOD_20200612_Guidepost_09~1179.indd 10 6/19/20 10:11 AM As we move through life, most of For many people, letting go of us collect an array of personal personal effects is a gradual process, possessions and “treasures” that most easily handled in stages. One link us to fond memories and our widower decided that he could start personal histories. Wedding rings, by donating his wife’s socks to a FACING photos, mementos and souvenirs are homeless shelter. “I know that socks THE all examples of “linking objects” that are desperately needed and besides, ground us in our past while making it I’m not too attached to her socks” was PROBLEM psychologically safer to move into the equation that it made possible for OF THE the future. him to start the process of deciding “STUFF” what to hold onto and what to let go of. One of the most difficult tasks As he continued his donations over a facing bereaved survivors involves period of months, he found comfort in deciding what to do with the knowing that his wife was continuing deceased loved one’s clothing and to make a difference in the lives of personal possessions. Unfortunately, those in need. the bereaved often feel pressured by others to dispose of these very For some, identifying the clothing that personal belongings before they are is connected to the most cherished ready. The unsolicited offer of help to memories is a starting point. One “clean out the closets” carries with it woman found great comfort in wearing the message that grief can be “cured” her mother’s coat — “It has helped me by eliminating the physical reminders to imagine I was wrapped in her arms of a loved one. Attempts to quickly as I went through the hard times that erase personal reminders of a precious followed her death.” relationship cannot heal the empty void created by a death. Choosing favorite pieces of clothing to save or to convert into coverlets, Part of the healing process involves quilts, throw pillows or teddy bears is making decisions about what is a comforting option for many. For important to retain and what no longer some, the creation of memory boxes is needed or wanted. Learning how and filled with treasured mementos can be when to “hold on while letting go” is of value. One widow had Santa Claus an integral part of the healing process. dolls created for each of her children Decisions that are made under the and herself by a talented artisan, who cloud of fresh grief are too often cause fashioned beautiful keepsakes out of for later regrets. the clothing of the deceased and WHEN AND HOW YOU small mementos such as cuff-links, MEET THE CHALLENGE One helpful strategy for deciding fishing lures and other personally OF “HOLDING ON WHILE what to hold on to and what to let go meaningful items. of involves the use of three sorting LETTING GO” WILL BE “piles” — what you definitely do want As with all aspects of grief, there is no INFLUENCED BY THE TYPE to keep, what you definitely do not timetable or one “right” way that suits want to keep, and what you’re not sure everyone. When and how you meet the OF PERSON YOU ARE AND about. Box or bag up what you don’t challenge of “holding on while letting YOUR OWN PERSONAL want and either pass it on to others or go” will be influenced by the type of GRIEF EXPERIENCE. to a charity that accepts used goods. person you are and your own personal Some things you may simply want to grief experience. discard to the trash. Expect that on the first go-round you are likely to find a lot that you just aren’t sure about. That’s fine — just box it up and pack it away for a few months and then repeat the process.

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NW_HOD_20200612_Guidepost_09~1179.indd 11 6/19/20 10:11 AM FREQUENTLY ASKED QUESTIONS ABOUT PATHWAYS OF HOPE

Q: WHAT IS PATHWAYS OF HOPE? Q: ARE COUNSELING SERVICES Q: HOW MUCH DO YOU CHARGE FOR PROVIDED BY STAFF OR YOUR GRIEF COUNSELING SERVICES AT A: Pathways of Hope is the grief VOLUNTEERS? PATHWAYS OF HOPE? counseling service for all Ohio’s Hospice patients, families and A: Pathways of Hope counseling A: Most Pathways of Hope grief friends, as well as those in our staff members are professionally counseling services are offered without communities who are anticipating trained and licensed social workers charge. Although we do charge a or have suffered the loss of a or professional counselors, with nominal registration fee for some loved one. Our mission is to offer additional training and expertise camp programs, financial aid is always bereavement support, information related to grief and loss. Trained available in situations of hardship. The and education to bereaved volunteers serve in other roles costs of our services are supported individuals and families. within Pathways of Hope, through the generosity of community but not as counselors. donors. While not expected, donations Q: WHO CAN TAKE ADVANTAGE OF are always gratefully accepted to offset PATHWAYS OF HOPE SERVICES? the costs of materials and services. A: Pathways of Hope services are

offered to all who are bereaved in our communities, regardless of whether Ohio’s Hospice services have been used.

Q: DO YOU PROVIDE SERVICES TO WHEN TO SEEK PROFESSIONAL SUPPORT PEOPLE WHO ARE DEALING WITH LIFE-LIMITING ILLNESS? Although normal grief can be a painful lapsed, you are unable to feel interest process that at times feels like an or joy in other things or other people. A: Yes, grief support services are emotional roller coaster, there are times n You are plagued by distressing available to individuals and when professional grief support may be memories or disturbing thoughts. families facing the challenges of a needed. Some of the “red flags” that life-limiting illness. signal the need for professional support n You feel anxious and worried much of include: the time.

n Q: WHERE ARE YOU LOCATED? n You feel “stuck” and unable to see Anger and bitterness related to any change in either the intensity of the death are impacting your A: Pathways of Hope services are relationships with others. available from all Ohio’s Hospice your grief or progress in adjusting to affiliate locations and in sites your altered circumstance. n You feel like you are falling apart or throughout the communities n You find yourself using alcohol, your life is spiraling out of control. we serve. Please call for current medication or other drugs to cope. n You find yourself engaging in information. n You have active suicidal thoughts. behaviors that are not good for you. n n Your physical health is being Others express concern for you impacted by your grief. and encourage you to seek professional assistance. n You feel overwhelmed or immobilized n by the demands of daily life. You think you need professional help. n You continue to struggle with accepting the reality of your loss.

n You are plagued by feelings of guilt and remorse. A call to Pathways of Hope n You feel isolated with no one will link you to caring, to turn to. compassionate support, whether your concerns are for n You feel hopeless about the future. yourself or for someone else n Even though sufficient time has you love. 12

NW_HOD_20200612_Guidepost_09~1179.indd 12 6/19/20 10:11 AM INDIVIDUAL GRIEF COUNSELING: WHAT TO EXPECT

Meeting with a grief counselor When you call to make your first and personal needs. This plan individually is the recommended appointment with a Pathways may involve a few more sessions, choice when the loss is very recent, of Hope grief counselor, you will education about what to expect or when grief feels overwhelming, be offered your choice of several in the grieving process, guidance unmanageable or interferes appointment times. If you are regarding helpful grief resources, significantly with the ability to seeking services for a child or teen, suggestions related to coping manage day-to-day responsibilities. you will be asked to meet with the strategies, “homework” assignments Uncertainty and misconceptions child’s grief counselor prior to the or possibly referrals to specialized about counseling services can create child’s first appointment. We will community services. In some cases, unnecessary barriers for many who ask that you complete some routine particularly for those involving might benefit from talking out their paperwork prior to your first meeting children or teens, art therapy concerns in a confidential setting in order to minimize the time spent techniques may be recommended with a professional bereavement in the first session gathering basic as a means of working toward counselor. Knowing what to information and attending to routine counseling goals. Most people are expect can dissipate unnecessary administrative tasks. We may mail pleasantly surprised to discover that anxiety and make the process more you the required forms or ask that a lot of progress can be made in just comfortable and predictable from you come a bit early to complete a few hour-long sessions. Many will the beginning. them prior to your appointment time. then make the transition to a grief group for ongoing support. In the At Pathways of Hope, grief During your first counseling session, event that long-term or specialized counseling is a straightforward your bereavement counselor will services are recommended, your process. Thanks to the generosity of spend a few minutes reviewing your counselor will work with you to locate community donors, our counseling information with you and the rest appropriate resources. services are offered without of the time will be spent exploring charge, thus eliminating financial your concerns and answering any obstacles and concerns about questions you may have. Your insurance coverage. counselor will work with you to identify your personal goals for counseling as well as a plan of action designed to meet your goals

YOUR COUNSELOR WILL WORK WITH YOU TO IDENTIFY YOUR GOALS FOR COUNSELING AS WELL AS A PLAN OF ACTION DESIGNED TO MEET YOUR GOALS AND NEEDS.

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NW_HOD_20200612_Guidepost_09~1179.indd 13 6/19/20 10:12 AM BEREAVEMENT SUPPORT GROUPS: COULD THEY BE RIGHT FOR ME?

Grief support groups offer bereaved The decision to attend a grief support If you are wondering whether one of persons opportunities to find comfort, group often feels like a big step. Feeling our grief support groups might be right hope and healing in a safe and a bit anxious and nervous about being a for you, it may be helpful to know what supportive group environment. Meeting “first timer” is quite normal. It may help participants have said when asked for with others who are facing similar to know that every member of the group feedback about their group experience. challenges can provide an effective recognizes the courage it takes to reach The following comments are typical: alternative to relying solely on friends out for support when you are hurting. and family for emotional support. When You will also discover that although the n “It helps so much to be able to people hesitate to avail themselves of group will be very interested in hearing share my grief and have others listen grief support services, their hesitation about your loss and concerns, they will and understand.” often centers on questions such as: leave it up to you to decide what and n “The time spent listening to others when you want to share. Discovering has been very helpful.” n What will the group be like? that the group is a place where you don’t have to pretend that everything n “It really helps to know I am not the n What if I don’t feel comfortable is OK can bring a real sense of relief. only person going through this.” about sharing? As for worries about tears, everyone n “Knowing that my grief is shared with n Will anyone in the group in the group knows that tears are a others and they understand better really understand what normal part of grief. You won’t be the than most really helps.” I’m going through? first or last person to need a tissue or two to dry your eyes. There is plenty of n “I am so glad I finally understanding to go with our supply decided to come.” of tissues. All of our support groups are open to anyone in the community who is coping with the loss of a loved one. It is strongly recommended that you wait two to three months after your loss to attend a support group. When loss is fresh and pain close to the surface, the pain of others may feel overwhelming — individual counseling, rather than group, is the recommended choice for support early on. Some groups require no pre-registration or commitment for a set number of sessions; it’s up to you how frequently you choose to attend. Other groups may require pre-registration and a commitment to a set number of sessions.

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NW_HOD_20200612_Guidepost_09~1179.indd 14 6/19/20 10:12 AM WHAT OTHERS NEED TO KNOW…

PLEASE DO! PLEASE DON’T! n Listen 80 percent of the time and n Force the mourner to put n Try to hurry people through talk 20 percent of the time. on a happy face by saying their grief by pressuring “You’re doing so well.” them to get busy or give n Allow the mourner to talk about away a loved one’s posses- their loss. n Tell the mourner what they sions. Their grief must be “should” do. n Accept their tears. done on their schedule, n Say “Call me if you need not yours. n Talk about your losses and what anything.” helped you adapt. n Delegate others to help. n Use appropriate physical contact. n Say “I know how you feel.” n Be patient with the griever’s story. n Use abrasive consolation, by n Use the deceased’s name. saying “There are other fish n Offer specific help. in the sea,” or “God works in mysterious ways.”

WHEN WILL THE GRIEF GET EASIER?

In the early days of the grief process, before the first anniversary. Special days Ohio’s Hospice’s Guideposts many grievers begin to think there and events can trigger grief for years Through Grief is published will never be relief from the intense, to come. Also common are sudden, quarterly for families, staff unremitting symptoms of grief. Sleep unexpected surges of grief around members and friends of Ohio’s may be disrupted, draining away such things as hearing a special song Hospice. your energy, motivation and desire. or spotting a favorite restaurant. The Kent Anderson, CEO Concentrating on the simplest of tasks griever gains experience in dealing with may sometimes seem beyond ability. upsurges in acute grief in healthy ways Ohio’s Hospice Longing, loneliness and sadness feel that allow the activities of daily life to The Pathways of Hope Grief like constant companions. As the days continue without too much disruption. Counseling Centers rely on the go by, other people in your life may individual and community donors express concern over the continued Looking for small signs of healing can who so generously support the intensity of your grief and may gently be helpful. Perhaps you find yourself services we provide. Thanks to suggest it is time to “move on.” You may laughing more or you begin looking your generosity, all Pathways begin to wonder if your grief is normal. forward to future events and plans for of Hope services are available the future. For most grieving people, without charge to serve the It is important to recognize that what healing occurs. Holding on to that hope bereavement needs of anyone in the communities we serve. is “normal” varies widely among and looking for small signs of healing Donations to support our services individuals. But generally, while intense can bring comfort during the heavy days are gratefully accepted at emotional, physical and cognitive of early grief. OhiosHospice.org. reactions are very normal in the early stages of grief, as time goes on, the “PATIENCE WILL SERVE YOU WELL griever usually finds such reactions AS YOU EXPERIENCE YOUR GRIEF decreasing in both intensity and AND MOURNING....OUR SOCIETY IS frequency. Grief often intensifies two to CONSTANTLY TRYING TO SPEED UP three months after the loss and again OUR GRIEF.”

— Alan D. Wolfelt, Ph.D., Healing Your Grieving Heart: 100 Practical Ideas 14 15

NW_HOD_20200612_Guidepost_09~1179.indd 15 6/19/20 10:13 AM ADDITIONAL BEREAVEMENT RESOURCES Given the wide range and variable quality of books about grief and loss, choosing a book about grief can be a daunting task. The following is a list of books and internet resources that may provide a helpful starting place. Books may be found at your local library or can be purchased through local or on-line booksellers.

BOOKS FOR ADULTS FOR CHILDREN AND TEENS

Ambiguous Loss: Learning To Live With Cinnamon Roll Sunday: A Child’s Story Of Anticipated Grief. Unresolved Grief. Jennifer L. Allen, LMFT., ATR-BC. Creating Space Independent Publishing Platform. Pauline Boss. Harvard University Press. I Have A Question About Death: Clear Answers For All Kids Including Children With Autism Bearing The Unbearable: Love, Loss, Spectrum Disorder Or Other Special Needs. Jessica Kingsley Publishers. And The Heartbreaking Path Of Grief. Joanne Cacciatore, PhD. Tear Soup: A Recipe For Healing After Loss. Pat Schwiebert, Chuck Deklyn, et al. Simon & Schuster. Grief Watch. I Wasn’t Ready To Say Goodbye: The Elephant In The Room: A Child’s Book For Grief And Loss. Amanda Edwards, Surviving, Coping, And Healing After Leslie Ponciano, et al. Creating Space Independent Publishing Platform. The Sudden Death Of A Loved One. The Good-Bye Book. Todd Parr. Little Brown Books for Young Readers. Brook Noel & Pamela D. Blair, PhD. Sourcebooks, Inc. Till We Meet Again. Julie Muller. Illustrated by Camryn Cox. Julie Muller. Option B: Facing Adversity, Building What Does Dead Mean? Caroline Jay and Jenni Thomas, OBE. Jessica Kingsley Publishers. Resilience, And Finding Joy. Sheryl What Happens When A Loved One Dies? Our First Talk About Death. Sandberg and Adam Grant. Penguin Jillian Roberts and Cindy Revell. Orca Book Publishers. Random House. Shattered: Surviving The Loss Of INTERNET RESOURCES A Child. Gary Roe. CreateSpace Independent Publishing Platform. www.dougy.org (for children and teens) The Hot Young Widows Club: Lessons On Surviving From The Front Lines Of www.nationalallianceforgrievingchildren.org Grief. Simon & Schuster/TED. www.compassionatefriends.org (for grieving parents/grandparents) The Unspeakable Loss: How Do You Live www.dailystrength.org After A Child Dies? DeCapo Lifelong Books. www.opentohope.com When Things Fall Apart: Heart Advice www.whatsyourgrief.com For Difficult Times. www.centerforloss.com Pema Chodron. Shambhala Publications. www.griefshare.org

For information and a schedule of current groups, please call your local Pathways of Hope Center or see the group schedule insert.

Pathways of Hope Grief Counseling Centers Community Care Hospice Ohio’s Community Mercy Hospice Ohio’s Hospice of Miami County 1669 Rombach Ave., Wilmington, OH 45177 100 W. McCreight Ave., Ste. 400, Springfield, OH 45504 550 Summit Ave., Ste. 101, Troy, OH 45373 937.382.5400 937.390.9665 937.573.2103 www.CommunityCareHospice.com www.CommunityMercyHospice.org www.HospiceofMiamiCounty.org

Hospice of Central Ohio Ohio’s Hospice of Butler & Warren Counties Ohio’s Hospice Loving Care 1565 Bethel Rd Columbus Oh 43220 5940 Long Meadow Dr., Franklin, OH 45005 56 South Oak St.,P.O. Box 445, London, OH 43140 740.788.1400 513.422.0300 740.852.7755 2269 Cherry Valley Rd., Newark, OH 43055 www.HospiceofBWCo.org www.LovingCare.us 740.788.1400 1585 E. Main St., Lancaster, OH 43130 Ohio’s Hospice of Dayton Ohio’s Hospice LifeCare 740.681.1000 324 Wilmington Ave., Dayton, OH 45420 1900 Akron Rd. Wooster, OH 44691 1166 Military Rd., Zanesville, OH 43701 937.258.4991 330.264.4899 740.454.0000 www.HospiceofDayton.org 1109 Eastern Ave., Ashland, OH 44805 419.496.0057 www.HospiceofCentralOhio.org Ohio’s Hospice of Fayette County 1263 Glen Dr., Ste. B, Millersburg, OH 44654 222 N. Oakland Ave., Washington C.H., OH 43160 330.674.8448 740.335.0149 www.LifeCareHospice.org www.HospiceofFayetteCounty.org

Ohio’s Community Mercy Hospice is a service of Ohio’s Hospice of Dayton. © 2020 Ohio’s Hospice, Inc. All Rights Reserved.

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