Bereavement

Grief

The death of a loved one can be devastating and loss is something we will all experience at some point in our lives.  However, it can be difficult to know what is “normal” in the grieving process. 

Bereavement affects people in different ways.  There’s no right or wrong way to feel.  You might feel a lot of emotion at once, or feel you’re having a good day, then you wake up and feel worse again.  Powerful feelings can come unexpectedly.

Experts generally accept that there are four stages of bereavement.

• Accepting that your loss is real.
• Experiencing the pain of grief.
• Adjusting to life without the person who has died.
• Putting less emotional energy into grieving and putting it into something new (in other words, moving on).

You’ll probably go through all these stages, but you won’t necessarily move smoothly from one to the next.  Your grief might feel chaotic and out of control, but these feelings will eventually become less intense.  Give yourself time, as they will pass.

You might feel:  

• Shock and numbness (this is usually the first reaction to the death, and people often speak of being in a daze).
• Overwhelming sadness with lots of crying.
• Tiredness or exhaustion.
• Anger, for example towards the person who died, their illness or God.
• Guilt, for example, guilt about feeling angry, about something you said or didn’t say, or about not being able to stop your loved one dying.

All of these feelings are all perfectly normal.   The negative feelings don’t make you a bad person. Lots of people feel guilty about their anger but it’s OK to be angry and to question why.  Some people become forgetful and less able to concentrate.  You might lose things such as your keys.  This is because your mind is distracted by bereavement and grief not because you are losing your sanity.

The early hours and days:

People often describe shock soon after a death of a close friend or relative.  You may feel numb, panicky, very weepy or find that you are unable to cry at all.  You may find it difficult to sleep.  Some people may have physical symptoms such as heart palpitations.  However, some people find that they calmly go through the practical tasks surrounding the death and worry that they may be seen as uncaring.  This is just one sign of shock and it is most likely that the impact of the death will follow at a later stage.  Some people find that they are completely unable to cope and will need a lot of practical and emotional support from those around them.

You may wonder “what is the point of carrying on?”  You may experience periods of guilt and constantly find you are reviewing the circumstances of the death.  You may wonder if things could have been done differently and therefore helped the situation.  This is also common when there has been relief at someone’s death following a painful and prolonged illness.  It is worth remembering that many people feel relief when suffering ends. 

In the hours or days following a death you may feel anger.  This can be directed at the person who has died or at those around you.

Other people’s reaction to a death may be difficult for you to understand.  You may find that people may be clumsy in what they say to you or that people avoid contact with you.  These reactions are usually because people do not know what to do or say in the face of someone’s grief.  Sometimes other people do not realise that it can take a long time to begin to recover from a death.

Recovery from bereavement:

Coming to terms with a death is a very individual process.  You may find that the process takes considerable time to deal with.  After a period of time people usually find that they are able to get on with their lives and think a little less about the person they have lost.  Most people begin to feel like this within one or two years of the death of someone close to them but this will vary from person to person.  You may find that you are able to accept the death of a loved one but impossible to move on with your life in spite of this.

It is important not to feel guilty if you are beginning to build a life for yourself following a death.  It is quite normal to begin to recover and start to rebuild your life, and it is not in any way disloyal to the memory of the person who has died.

What you can do to help yourself cope with bereavement

Bereavement is always a difficult time but there are things you can do to help yourself through it.

Where possible, try to prepare yourself for a death of someone you are close to.  It is important emotionally and practically to talk things over.  Discuss with them the things which will need sorting out such as finances, make a Will, and funeral arrangements.  Make sure you say all of the things you want to say. 

Following the death carefully consider whether you wish to view the body.  Some people may find this too distressing and can regret it later whilst others find it helps.  Follow your own feelings.  There is no right or wrong thing to do – just make sure it is your decision.

Funeral arrangements should be considered carefully and may have already been arranged by the person you have lost.  If you are arranging funeral arrangements then try to make sure someone is with you and don’t feel pressured into a funeral that  you are not really looking for or one that is too over budget.

Don’t make major changes in your life such as moving home or job for example until you have had time to adjust to the death of your loved one.  The bereavement period is a time where people can make changes that they later regret.

Do make sure that you look after you own health.  This may be a time where you become prone to illnesses.  Ensure that you try and rest and eat well. 

Keep in contact with friends and family.  Accept invitations and invite people to visit.  When you feel ready find out about local events/clubs and classes.

Most importantly talk to people about how you are feeling.  You mustn’t bottle things up.  Visit your doctor if you feel you don’t have anyone to talk to.  They may suggest speaking to a counsellor. 

How friends and family can help:

• You can help by spending time with the bereaved person who will need comfort more than words and to know you will be with them during this time of pain and distress. A sympathetic arm around the shoulders expresses care and support when words are not enough.
• It is important that, if they want to, bereaved people can cry with somebody and talk about their feelings of pain and distress without being told to pull themselves together. In time, they will come to terms with it, but first they need to talk and to cry.
• Others may find it hard to understand why the bereaved person has to keep talking about the same things again and again, but this is part of the process of resolving grief and should be encouraged. If you don't know what to say, or don't even know whether to talk about it or not, be honest and say so. This gives the bereaved person a chance to tell you what he or she wants. People often avoid mentioning the name of the person who has died for fear that it will be upsetting. However, to the bereaved person it may seem as though others have forgotten their loss, adding a sense of isolation to their painful feelings of grief.
• Remember that festive occasions and anniversaries (not only of the death, but also birthdays and weddings) are particularly painful times. Friends and relatives can make a special effort to be around.
• Practical help with cleaning, shopping or looking after children can ease the burden of being alone. Elderly bereaved partners may need help with the chores that the deceased partner used to handle - coping with bills, cooking, housework, getting the car serviced and so on.
• It is important to allow people enough time to grieve. Some can seem to get over the loss quickly, but others take longer. So don't expect too much too soon from a bereaved relative or friend - they need the time to grieve properly, and this will help to avoid problems in the future.

WHAT NEEDS TO BE DONE FOLLOWING A DEATH

If someone dies at home:

Call the family doctor and nearest relative immediately. If the death was expected, the doctor will give you a medical certificate showing the cause of death. They’ll also give you a formal notice saying they’ve signed the medical certificate and telling you how to register the death. If the person is to be cremated, you’ll need two certificates signed by different doctors.

If someone dies in hospital:

The hospital will usually issue a medical certificate and formal notice. The body will usually be kept in the hospital mortuary until the funeral directors or relatives arrange a chapel of rest, or for the body to be taken home.

Unexpected death:

If someone dies unexpectedly, or the family doctor hasn’t seen them in the last 14 days, the death is reported to a coroner. A coroner is a doctor or lawyer responsible for investigating unexpected deaths. They may call for a post-mortem or inquest. This may take some time, so the funeral may need to be delayed.

Death abroad:

If someone dies abroad, register the death according to the regulations of the country and get a consulate death certificate. Register it with the British Consul in the country too, so a record can be kept in the UK.

Community Nurses/Palliative Care Nurses:

If community (district) nurses have been involved in the care of the young person who has died, you should let them know about the death.  Your community nurse can advise you about the safe disposal of any pieces of equipment to be moved from the home.

Funeral Director:

Choosing a funeral director can be a difficult and stressful, particularly if the death of your loved one was unexpected or you have to make a quick decision. Here are a few tips to help you choose the right funeral director to assist you in time of bereavement.

1 – If possible ask for a recommendation from friends or relatives who have used a funeral director’s services or have heard positive comments about a firm. If this is not possible you can look in the yellow pages for names of local funeral directors.  They can be contacted 24 hours a day.  It is important to choose a funeral director with whom you feel comfortable with. 

2 – Always choose a funeral director that is a member of the National Association of Funeral Directors (NAFD), as this is your guarantee of a quality service. 

3 – Contact at least two funeral directors in your area to get an estimate for funeral costs so you can make comparisons because not all funeral directors charge the same prices. This will help to ensure that you get the best value possible for the funeral services you need.

4 – Many people assume that you can only contact a funeral director once you have registered a death. But this is not the case; you can contact the funeral director before then, perhaps while you are waiting for a post-mortem to be completed. The sooner a funeral director becomes involved in the process, the sooner they will be able to discuss your requirements and act on your behalf so the funeral will not be delayed unnecessarily once the death has been registered.

How do I register a death?

Once you have the medical certificate you must take it to the registration office and register the death within five days.   The registrar will issue a death certificate and notification of disposal which should be given to the funeral director. 

Who can register a death?

• A relative
• Someone present at the death
• An administrator from the hospital
• The person making the arrangements with the funeral directors

When you register the death you must take with you the:

• Medical certificate of cause of death – this is essential.
• The deceased’s persons medical card, if available.
• The deceased’s persons birth certificate, marriage or civil partnership certificate, if available.
• There is no need to take the birth certificate or marriage certificate when registering, providing the informant knows the date and place of the deceased. 

 You should tell the register:

• The date and place of death.
• The deceased’s last (usual) address.
• The person’s full name at date of death and any previous names including a maiden name.
• The deceased’s date and place of birth.
• Their occupation and the name of their spouse or civil partner.  Whether the deceased was receiving any pension or other social security benefits.

The Registrar will give you:

• The death certificate.
• A green certificate i.e. the certificate for burial or cremation to hand to the funeral director so that the funeral can be held.  If the death was referred to the coroner other procedures may apply.
• It is important to make some copies of the death certificate as proof of death as you will need this for bank accounts, insurance purposes and anyone else who had dealings with the deceased.

Support following a bereavement

Cruse Bereavement:  Cruse Bereavement Care is the leading national charity for bereaved people in England, Wales and Northern Ireland. We offer support, advice and information to children, young people and adults when someone dies and work to enhance society’s care of bereaved people.

Cruse offers face-to-face, telephone, email and website support. We have a Freephone national helpline and local services, and a website (hopeagain.org.uk) specifically for children and young people. Our services are provided by our network of 5,000 trained volunteers and are confidential and free. Cruse also provides training and consultancy for external organisations and for those who may encounter bereaved people in the course of their work.

For further information please visit www.cruse.org.uk

Child Bereavement:  Child Bereavement UK is a national charity that supports families and educates professionals when a baby or child of any age dies or is dying, or when a child is facing bereavement.  They provide confidential support, information and guidance to families.  Professionally trained bereavement support workers are available via telephone or email. 

For further information, please telephone 0800 02 888 40 or visit www.childbereavementuk.org 

Balloons Bereavement is a local charity working with children and they can be contacted on 01392 826064