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List of All Topics
Bereavement
This patient summary on loss, grief, and bereavement is adapted from the summary written for health professionals by cancer experts. This and other credible information about cancer treatment, screening, prevention, supportive care, and ongoing clinical trials, is available from the National Cancer Institute. The passage from the final stage of cancer to the death of a loved one is different for everyone. This summary describes loss, grief, and bereavement; the stages of grief; and methods for coping with grief. This summary also includes sections on children and grief.
People cope with the loss of a loved one in many ways. For some, the experience may lead to personal growth, even though it is a difficult and trying time. There is no right way of coping with death. The way a person grieves depends on the personality of that person and the relationship with the person who has died. How a person copes with grief is affected by their experience with cancer, the way the disease progressed, the person’s cultural and religious background, coping skills, mental history, support systems, and the person’s social and financial status.
The terms grief, bereavement, and mourning are often used in place of each other, but they have different meanings.
Grief is the normal process of reacting to the loss. Grief reactions may be felt in response to physical losses (for example, a death) or in response to symbolic or social losses (for example, divorce or loss of a job). Each type of loss means the person has had something taken away. As a family goes through a cancer illness, many losses are experienced, and each triggers its own grief reaction. Grief may be experienced as a mental, physical, social, or emotional reaction. Mental reactions can include anger, guilt, anxiety, sadness, and despair. Physical reactions can include sleeping problems, changes in appetite, physical problems, or illness. Social reactions can include feelings about taking care of others in the family, seeing family or friends, or returning to work. As with bereavement, grief processes depend on the relationship with the person who died, the situation surrounding the death, and the person’s attachment to the person who died. Grief may be described as the presence of physical problems, constant thoughts of the person who died, guilt, hostility, and a change in the way one normally acts.
Bereavement is the period after a loss during which grief is experienced and mourning occurs. The time spent in a period of bereavement depends on how attached the person was to the person who died, and how much time was spent anticipating the loss.
Mourning is the process by which people adapt to a loss. Mourning is also influenced by cultural customs, rituals, and society’s rules for coping with loss.
People who are grieving often feel extremely tired because the process of grieving usually requires physical and emotional energy. The grief they are feeling is not just for the person who died, but also for the unfulfilled wishes and plans for the relationship with the person. Death often reminds people of past losses or separations. Mourning may be described as having the following 3 phases:
- The urge to bring back the person who died.
- Disorganization and sadness.
- Reorganization.
Understanding how other people cope with a life-threatening illness may help the patient and his or her family prepare to cope with their own illness. A life-threatening illness may be described as having the following 4 phases:
- Phase before the diagnosis.
- The acute phase.
- The chronic phase.
- Recovery or death.
The acute phase occurs at the time of the diagnosis when a person is forced to understand the diagnosis and make decisions about his or her medical care.
The chronic phase is the period of time between the diagnosis and the result of treatment. It is the period when a patient tries to cope with the demands of life while also undergoing treatment and coping with the side effects of treatment. In the past, the period between a cancer diagnosis and death usually lasted only a few months, and this time was usually spent in the hospital. Today, people can live for years after being diagnosed with cancer.
In the recovery phase, people cope with the mental, social, physical, religious, and financial effects of cancer.
The final (terminal) phase of a life-threatening illness occurs when death is likely. The focus changes from curing the illness or prolonging life, to providing comfort and relief from pain. Religious concerns are often the focus during this time.
Phases of Grief
The process of bereavement may be described as having 4 phases:
- Shock and numbness: Family members find it difficult to believe the death; they feel stunned and numb.
- Yearning and searching: Survivors experience separation anxiety and cannot accept the reality of the loss. They try to find and bring back the lost person and feel ongoing frustration and disappointment when this is not possible.
- Disorganization and despair: Family members feel depressed and find it difficult to plan for the future. They are easily distracted and have difficulty concentrating and focusing.
- Reorganization.
Grief counseling helps mourners with normal grief reactions work through the tasks of grieving. Grief counseling can be provided by professionally trained people, or in self-help groups where bereaved people help other bereaved people. All of these services may be available in individual or group settings.
The goals of grief counseling include:
- Helping the bereaved to accept the loss by helping him or her to talk about the loss.
- Helping the bereaved to identify and express feelings related to the loss (for example, anger, guilt, anxiety, helplessness, and sadness).
- Helping the bereaved to live without the person who died and to make decisions alone.
- Helping the bereaved to separate emotionally from the person who died and to begin new relationships.
- Providing support and time to focus on grieving at important times such as birthdays and anniversaries.
- Describing normal grieving and the differences in grieving among individuals.
- Providing continuous support.
- Helping the bereaved to understand his or her methods of coping.
- Identifying coping problems the bereaved may have and making recommendations for professional grief therapy.
Information obtained from National Institute of Health