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Black Lives, Death, and Grief Matter

"I came face to face with a hospital system that, despite its diversity, equity, and inclusion initiatives still disregards black life, ignores black death, silences black grief, and shames the Black griever."

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"I came face to face with a hospital system that, despite its diversity, equity, and inclusion initiatives still disregards black life, ignores black death, silences black grief, and shames the Black griever."

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Book recommendation: First Aid for Broken Hearts

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Book recommendation: First Aid for Broken Hearts

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Brief content visible, double tap to read full content.

Full content visible, double tap to read brief content.

Dr. Alan D. Wolfelt is a noted author, educator, and grief counselor. Recipient of the Association for Death Education and Counseling's Death Educator Award, he serves as the Director of the Center for Loss and Life Transition in Fort Collins, Colorado. He is also a faculty member of the University of Colorado Medical School's Department of Family Medicine.

In addition to presenting dozens of keynotes and workshops across North America each year, Dr. Wolfelt facilitates four-day training seminars for bereavement caregivers in Fort Collins. Dr. Wolfelt is a popular media resource who regularly provides his expertise to many top-tier television shows, newspapers, and magazines.

He is the author of more than fifty bestselling book on grief and loss, including "Loving From the Outside in, Mourning From the Inside Out;" "Understanding Your Grief;""The Journey Through Grief;""Companioning the Bereaved:A Soulful Guide for Caregivers;""Healing a Spouse's Grieving Heart;""Companioning the Grieving Child;""Healing a Parent's Grieving Heart;" and "Creating Meaningful Funeral Ceremonies."

Dr. Wolfelt and his wife, Sue, a family physician, are parents to three children. They live in the foothills of the beautiful Rocky Mountains next door to the Center for Loss and Life Transition.

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First Aid for Broken Hearts [Wolfelt, Dr. Alan] on Amazon.com. *FREE* shipping on qualifying offers. First Aid for Broken Hearts

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The community resource directory information is up-to-date to the best of our knowledge. However, you should always call the provider to confirm this information and make an appointment. Be sure to confirm payment information with the provider, if payment is required. Pennsylvania 2-1-1 does not rate, recommend or endorse any agency. We simply provide information as a public service.

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﻿ The community resource directory information is up-to-date to the best of our knowledge. However, you should always call the provider to confirm this information and make an appointment. Be sure to confirm payment information with the provider, if payment is required. Pennsylvania 2-1-1 does not rate, recommend or endorse any agency.

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The loss of loved one or a significant family member is often a game changer for young families. The process of grieving is unique to each member of a family but has an overall impact on the functioning of the family unit. The losses are many and families often struggle with reconnecting to the world and each other.

The Grief Reach Program is targeted to young families who are on that journey of discovering the new "normal" for their family. The goal of program is to create a safe environment for families to share in activities that encourage re-connection and creating new memories as a family. It provides an environment to engage in creativity, adventure and fun, while remembering their loved one.

"It was very encouraging and uplifting to connect with other families and share our different experiences in the healing process." - Mother of a 15-year old

Participate in the Grief Reach Program

Grief Reach events are offered to grieving families throughout the year, free of charge. Families are encouraged to connect with each other while enjoying fun and unique shared experiences.
View our upcoming Grief Reach events
For more information or to participate in Grief Reach, please contact PMHChildBereavement@uphs.upenn.edu.

Volunteer with the Grief Reach Program

Volunteers are an integral part of the Grief Reach Program. They support at events, help in planning events, and fundraiser to make the events possible.
Submit your application to volunteer

"We've enjoyed everything. Most of the activities were new to us and thoroughly enjoyed. [Penn Medicine] Hospices' staff and volunteers were great. It is a great program. My kids and I appreciate all the work that Penn's program staff put into each event." - Mother of a 7 and 12-year old

Opportunities to Give
Donate to Grief Reach

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Grief Reach: Rediscovering Family, Rediscovering Fun - Penn Medicine

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The loss of loved one or a significant family member is often a game changer for young families. The process of grieving is unique to each member of a family but has an overall impact on the functioning of the family unit. The losses are many and families often struggle with reconnecting to the world and each other.

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Book recommendation: Dignity Therapy: Final words for final days

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Book recommendation: Dignity Therapy: Final words for final days

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"This is truly a remarkable book-- it simultaneously brings together the best we know of the science of palliative care with the essence and best of compassionate care." -- Jimmie C. Holland, Wayne E. Chapman Chair in Psychiatric Oncology and Attending Psychiatrist, Memorial Sloan-Kettering Cancer
Center

"For all health professionals who find themselves struggling to help patients face the complex process of dying, this book is both a detailed roadmap and an extraordinary guide that dispels the myth that 'there is nothing else they can do.' Embodying the essence of professionalism and caring, this
text describes an innovative, evidence-based, therapeutic intervention to address the psychological and existential distress of patients with serious life threatening illnesses. Most importantly, the book sets a high standard for creating an environment that enables patients' exploration of
personhood and suffering and enhances their dignity in the final days of their lives." -- Kathleen M. Foley, Attending Neurologist, Pain and Palliative Care Service, Memorial Sloan-Kettering Cancer Center

"People often ask how palliative care clinicians can do this work day in, day out. I struggle to articulate the profound experience of witnessing patients and families find meaning and transcendence through their illness, but now I will refer them to Dr. Chochinov's remarkable book. He not only
relays story after story of such healing, but he also gives us all clear guidance to help our patients and their families to make meaning of their lives in a consistent and standardized manner. Because it will help us to better help our patients and their families, his work is a gift to palliative
care clinicians everywhere." -- Diane E. Meier, Director, Center to Advance Palliative Care; Director, Hertzberg Palliative Care Institute; and Professor of Geriatrics and Internal Medicine, Mount Sinai School of Medicine

"Dr. Chochinov has pioneered the work of dignity therapy, and through his scholarship, the field of palliative care has been deeply influenced. Dignity Therapy is a rich blend of a deep understanding of the existential concerns of the seriously ill and dying, and an incredibly practical resource for
clinicians." -- Betty Ferrell, Professor and Research Scientist, City of Hope Medical Center

"Without careful characterization, concepts like dignity are ephemeral and profoundly difficult to address in a therapeutic paradigm. In Dignity Therapy: Final Words for Final Days, Harvey Chochinov brings clarity to the factors that influence the dignity of seriously and terminally ill persons. He
expounds upon a well-developed and pragmatic therapeutic approach that has already been of help to thousands of patients across the world. This is not your usual medical text-- it is written with profound sensitivity, humanity, and wisdom that is both inspiring and practical." -- Nathan I. Cherny,
Norman Levan Chair in Humanistic Medicine and Director of Cancer Pain and Palliative Care Service, Department of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel

"In this elegant book, Harvey Chochinov shows how the interrelatedness of one human being with another affects an individual's intrinsic sense of dignity, and he examines the implications of this on the care environment. Every palliative care service will find this book enriching and will look with
refreshed eyes on the work of providing care to others."
-- Baroness Ilora Finlay of Llandaff, Professor of Palliative Medicine, Cardiff University, and Member, House of Lords, UK

"As a clinical psychologist and hospice professional, I have always been an advocate of offering therapy and support to individuals as they face dying. The book Dignity Therapy offers unique insight into the process of psychological dying and the opportunity for growth. I recommend it to anyone who
is working in the helping professions and has the unique opportunity to be present as individuals create their own last chapter." -- J. Donald Schumacher, President and CEO, National Hospice and Palliative Care Organization

"Dying patients fear the loss of dignity at the end of their lives. Dr. Chochinov's book guides medical staff, patients, and families along a path where the patient is empowered, the family can be comforted, and the medical staff can truly provide for every aspect of its patient's needs." -- Sharon
Carstairs, Senator for Manitoba, Canada

"Dr. Chochinov is a pioneer of a new direction in psychiatry. Starting from first principles, he has defined dignity and developed an approach to its restoration in patients with far advanced disease. We have adopted it, clinically, in our own center. Our staff says it has added a new effective tool
in caring for patients and their families. There's no better accolade for a physician than to have moved the field forward in the eyes of its clinicians."
-- Charles F. von Gunten, Provost, Institute for Palliative Medicine at San Diego Hospice

"Harvey Chochinov is a world leading clinician scientist who has spent the last 20 years improving our understanding of the concerns of patients and their families dealing with life limiting illnesses and facing the end of life. Dignity is at the heart of all we do in health care. This book is
valuable to clinicians from all settings and fields, those involved in medical and nursing education, and those undertaking research to improve patient and family experience and care." -- Irene J. Higginson, Professor of Palliative Care, King's College, London

"Dr. Chochinov's Dignity Therapy provides a practical way to implement one of the essential elements of any healthcare system and any relationship between a clinician or caregiver and patient who is seriously ill-- honoring the dignity of each and every individual. His book provides practical,
evidence-based, yet sacred, interventions that allow for healing in the midst of suffering. Dr. Chochinov inspires all of us to transform our systems of care so that all people can find meaning, purpose, and value in their lives." -- Christina M. Puchalski, Professor of Medicine and Health Sciences,
and Director, The George Washington Institute for Spirituality and Health (GWish) , The George Washington University School of Medicine and Health Sciences

"Reading his latest book challenged me to look at his expanded work in Dignity Therapy to consider additional ways to engage with palliative care patients. Whether you are a professional who, like me, works in palliative care or in another setting, I recommend Chochinov's book as one to put on your
reading list for the coming year." -- Plain Views

"Dignity Therapy: Final Words for Final Days is an inspiring work that introduces the innovative work of Harvey Chochinov on maintaining dignity in individuals approaching death. It is an engaging read distinguished by its depth of insight and vibrant perspective.... On completing the book, I felt
that I had grown in the ability to help others find meaning and solace in the final chapter of life." -- Andrew R. Barnosky, DO, MPH, JAMA

"There is much of value in Chochinov's thoughtful and careful work... [O]ne of the unquestionable merits of this work is the sincerity, sensitivity, and authenticity with which the author grapples with the possible difficulties that might arrise in each step of the therapeutic process. Clearly, for
palliative care agencies and workers who are considering the possibility of utilizing dignitiy therapy with their patients, this is an essential text." --The National Catholic Bioethics Quarterly

"Dignity Therapy: Final Words for Final Days is a comprehensive, well-written, and engaging book, which provides a clear background and implementation guide for Dignity Therapy. It would probably be most useful for palliative care and hospice providers and for those of us in palliative care who are
in a position to either implement or advocate for the implementation of a Dignity Therapy program." -- Mercedes Pacheco, Journal of Palliative Medicine

"What I like about it particularly is that it presents a subtle and powerful argument against euthanasia without in any way being overtly religious." -- Francis Phillips, Catholic Herald

Dr. Harvey Max Chochinov is an international leader in palliative care. He is Distinguished Professor of Psychiatry at the University of Manitoba and Director of the Manitoba Palliative Care Research Unit at CancerCare Manitoba. His seminal publications on psychosocial issues in advanced illness
have helped define core competences and standards of palliative end-of-life care.
Dr. Chochinov has been a guest lecturer in many major academic institutions around the world. He has been lauded for his contributions to palliative care, with awards and recognitions coming from the Canadian Medical Association, the International Psycho-oncology Society, the Canadian Cancer
Society, the Canadian Association of Psychosocial Oncology, the Canadian Psychiatric Association, the Academy of Psychosomatic Medicine, and the American Association of Hospice and Palliative Medicine. He is Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences. In 2014
he was inducted as an Officer in the Order of Canada.

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Dignity Therapy: Final Words for Final Days

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Dignity Therapy: Final Words for Final Days: Chochinov, Harvey Max: 9780195176216: Books: Amazon.com

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Vet Centers (Readjustment Counseling)

Bereavement Counseling

What is Bereavement Counseling?

Bereavement counseling is assistance and support to people with emotional and psychological stress after the death of a loved one.  Bereavement counseling includes a broad range of transition services, including outreach, counseling, and referral services to family members.

Does VA Have Bereavement Counseling for Surviving Family Members?

The Department of Veteran Affairs (VA) offers bereavement counseling to family members of Armed Forces personnel who died in the service of their country.  Also eligible are family members of Reservists and National Guardsmen who die while on duty.

Where Is Counseling Offered?

VA's bereavement counseling is provided at community-based Vet Centers located near the families.  There is no cost for VA bereavement counseling.

How Can You Obtain These Services?

Vet Centers (Readjustment Counseling) provide free and confidential bereavement counseling at our 300 Vet Centers across the Country to families who have lost Service members while serving on active duty. Also eligible are family members of Reservists and National Guardsmen who die while on duty. You can schedule an appointment by calling your nearest Vet Center. Often counseling can be made available in the family's home or where the family feels most comfortable.

You may use the Location Finder (please omit apartment or unit numbers in the search bar) to find the nearest Vet Center, or you may call our Vet Center Call Center at 1-877-WAR-VETS (927-8387) available 24 hours a day, 7 days a week.

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Apply for and manage the VA benefits and services you’ve earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more.

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City of Philadelphia bereavement resource

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City of Philadelphia bereavement resource

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Fetal and infant deaths

First Candle - Online resources for parents after the death of an infant or toddler.

UNITE, Inc. - Local support groups and online resources for parents after miscarriage, stillbirth, and infant deaths.

Glow in the Woods - Online community and resources for parents after fetal and infant deaths.

Death of a child of any age

Compassionate Friends - Support groups and online resources for parents, grandparents, and siblings after the death of a child of any age.

Bereaved Parents USA - Support groups and online resources for parents after the death of their child.

Drug-related deaths

Broken No More - Online community that provides support and guidance to those who have lost a loved one to substance use.

GRASP - Online community of support and healing for those who have lost a loved one to substance use; includes listing of area peer support groups.

Suicide deaths
Homicide deaths

Resources and camps for grieving children

Uplift Center for Grieving Children - Local, free, support groups and other grief support services for children, teens, young adults, and their caregivers.

Peter's Place - Local area support groups and other grief resources for children and teens (4-17) and their caregivers and for young adults ages 18-25 (located in Radnor, PA).

The Dougy Center - Online resources for grieving children, teens, young adults, and their caregivers.

Highmark Caring Place - Free brochures for families and professionals that address some basic concepts of grief.

Camp Erin Philadelphia - A free weekend bereavement camp for youth ages 6-17 who are grieving the death of a significant person in their lives.

Camp Kesem - Online resources and free summer camps for children who have been impacted by a parent's cancer; local camps sponsored by chapters at UPenn and Temple.

Camp Mariposa - A national addiction prevention and mentoring program that offers free weekend camps for children ages 9-12 who have been affected by substance abuse in their families.

A Haven (in Exton, PA) - offers free individual/family sessions and support groups for kids ages 3-18 and their caretakers, including a group for teens and groups for kids who have lost a parent or a sibling

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Fetal and infant deaths First Candle - Online resources for parents after the death of an infant or toddler. UNITE, Inc. - Local support groups and online resources for parents after miscarriage, stillbirth, and infant deaths. Glow in the Woods - Online community and resources for parents after fetal and infant deaths.

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Need Help Dealing with Grief? - GriefShare

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GriefShare is a grief recovery support group where you can find help and healing for the hurt of losing a loved one.

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Elegy: Lament in the 20th Century, exhibit at the Philadelphia Museum of Art

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Elegy: Lament in the 20th Century, exhibit at the Philadelphia Museum of Art

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Buy Tickets

Need help? View our

Search for an artist by first name, last name, or both first and last name: Claude, Monet, Claude Monet

Search for an object by the title, object id, type, or accession number: Japanese Footbridge, 59194, Painting, #1963-116-11 (must include hash sign, #, before full or partial accession number)

Search for amenities: Parking, Tickets, Hours

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Philadelphia Museum of Art - Grief Resources

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The exhibition Elegy: Lament in the 20th Century explores how artists have used their work to convey sorrow and commemorate those who have passed. This page includes resources for those who have experienced loss and/or are looking for support.

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COVID 19 Death and Grief Resources for Caregivers

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COVID 19 Death and Grief Resources for Caregivers

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Place of death and correlations with QoL

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Neuroendocrine mechanisms of grief systematic review

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Hospital Bereavement intervention after childhood death

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Family members perceived needs for bereavement follow up

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Effect of bereavement groups on grief anxiety and depression

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Dying in acute hospitals voices of bereaved relatives

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Note: This guidance is general only, and may be affected by COVID-19 rules at the time, prohibiting people from viewing a body.

Seeing a body immediately

Some people who are suddenly bereaved have no choice over whether they ever see the body or not, because they see the body at a very early stage due to circumstance.

Some witness the death. For example, people who witness the death of someone close to them in a road crash or a drowning or a sudden medically-caused death.

Other people arrive at the scene of the death just after that death. For example, someone discovers a loved one’s suicide, or is alerted by someone else to the death of a loved one nearby that has only just happened.

When recounting this experience later to researchers of sudden bereavement, suddenly bereaved people who witnessed a death or arrived at the scene shortly afterwards said they had an overwhelming desire to be beside the dead person; to hug and touch them and comfort them. They did not want the dead person to be alone and they wanted the dead person to be with someone who loves them. In other words, the bereaved person still felt their dead loved one had a “social identity” and needed nurturing [1]. Often suddenly bereaved people at this time will resist strongly any attempt by professionals or other carers to keep them away from their loved one’s body.

The bereaved person’s experience of seeing their loved one’s body at this time will be different to seeing their loved one’s body later. There will be no control at this early stage over whether or not they see any visible injuries or physical damage to their dead loved one’s body. There will be no ability to prepare for the situation they find themselves in. In the case of violent disasters, it is often a chaotic, fast moving experience.

Seeing a body later

After a sudden death there are usually opportunities to see the body in a more formal and usually much calmer setting, such as when it is laid out in a mortuary or funeral parlour. There are often many people who were close to the person who died, including children, who may wish to consider seeing the body at this stage, and who did not see the body at the time of the death.

The decision to view the body of a loved one is a big decision. It results in a suddenly bereaved person experiencing something that usually creates a strong memory, central to the experience of the bereavement. This can be a memory viewed positively or negatively, or both. However, the feelings that result from that memory may change over time.

The decision not to view a body is also a big decision. It can result in feelings of regret at not seeing the reality of the death with “my own eyes”. Arguably this is something that may be felt more often in cases of sudden death, due to the unexpected and unanticipated nature of the death, and therefore the feeling of unreality often associated with it.

Research by Oxford University published in the British Medical Journal [1] interviewed people suddenly bereaved about their experience of viewing or not viewing the body of their loved one.

It concluded:

Many people bereaved by a sudden and traumatic death think it is important to see the body of their loved one.

However, within a family there will be different attitudes; some bereaved relatives may want to view, but others will not, and some will find viewing helpful, but others may find it distressing.

Seeing a damaged body is inevitably distressing, but in the research was often not regretted. Clinicians should not assume that relatives will be harmed by seeing a bruised or damaged body.

Those who had mixed feelings or regretted seeing the body felt they had lacked choice or preparation.

The way that relatives refer to the body can be a strong indication for professionals about whether the person who died retains a social identity for the bereaved.

Therefore, while many suddenly bereaved people may find the experience helpful, it is inadvisable to encourage a suddenly bereaved person to view a body. To enable a bereaved person to make the choice that is best for them, you can help by asking them relevant questions and providing them with relevant information. The below guidance helps you to do this.

A body may be different in death than in life

Some people who have been suddenly bereaved may want to view the body of their loved one because they have had a positive experience of viewing a body previously, for example a grandparent who died in old age. If someone dies of old age then their body in death often looks fairly similar to their body in life. However, when someone dies suddenly in childhood or in mid life their body may look very different to how the person looked when alive. This is particularly the case if their death was violent, or they had urgent medical intervention such as a major operation prior to death.

A body may be different in death to life because:

injuries or surgical procedures have damaged the body. For example, skin has changed colour due to internal bleeding, or the body’s facial appearance has changed due to a broken jaw, or cuts, etc.

a mortician or funeral director has changed a body’s appearance through clothing, or hair arrangement, or cosmetics. Such “dressing” of the body may be very different to how the person in life would have done it.

the body smells different. For example, due to embalming processes, or antiseptics used during an operation.

Maggie says: “I had seen the body of my grandmother so I wasn’t worried about seeing my husband’s body. I knew that seeing my grandmother’s body had helped me come to terms with her death so I thought it would be the same when I saw Gary’s body. I just didn’t think how different it would be. Gary’s body was destroyed by the car crash. When he was in the Intensive Care Unit of the hospital the staff had wired up his broken jaw and not bothered to tell me it was broken because he had so many internal injuries and other broken bones so they felt his jaw was unimportant information; a minor detail. But when he died and I went to see the body I was utterly shocked that his face looked so collapsed. I thought he would look about the same in death as he had when he was on the life support machine. I remember screaming “That’s not my husband” and running out. It was horrible. I felt terrible, and I felt I had behaved terribly, with no self control. This left me with feelings of misery and some embarrassment.”

As someone helping a bereaved person, it is therefore useful to know what changes have occurred to a body, and, firstly, to tell a bereaved person that there have been changes, then, secondly, ask the bereaved person if they wish to know the details of those changes in order to assist them to make the decision to view a body or not.

Some bereaved people may not want to be told about any changes to the body and may not want to view the body. They may wish to remember the person how they were in life, and not have this memory intruded upon in any way, either by being told what the body looks like or by seeing the body.

Some bereaved people may want to be told the changes, but then choose not to see the body.

Some bereaved people may want to be told the changes and then choose to see the body.

Some bereaved people may want to discover the changes for themselves and not be receptive to being given information second hand.

The viewing experience

Charlotte arrived to view the body of her sister. She was taken into an empty room with no explanation. With no warning, a curtain was swept back and she found herself within a metre of her sister’s body, on a table behind the curtain

Charlotte says: “It was like a magician’s trick and a terrible shock. It made me want to run out of there straight away. I burst into tears and only stayed a few minutes. I really regret the way this made me feel and the whole experience.”

John went to view the body of his son in a hospital mortuary. He was taken into a small intimate room containing only his son’s body. While he was in the room a member of the mortuary staff stood solemnly in the corner. “It was very strange. I had been anticipating this time with my son’s body and wanted it to be special and private. Yet this man was in the corner the whole time. I remember it made me feel very self-conscious and left me feeling like he was a prison warden; there to check I didn’t do anything silly, such as run off with the body. It didn’t give me a good feeling. It was such a vivid experience that I remember every single detail. I remember that the man was wearing a white coat with a small enamel badge on it of a steam engine. I have no idea why; I presume he was a train enthusiast. But I remember thinking “Why are you interfering with my private experience of grief by being there and making me think about steam trains when I want to be thinking about my son?” It made me feel unreasonably angry towards the man at a very difficult time.”

Every detail about the viewing experience matters and every detail can be explained to a person who is going to view a body, before they view a body. As someone caring for the suddenly bereaved person, you can help by:

Talking to the bereaved person about what they want the experience to be like. Do they have any requests, for example they may want to be left alone, or only see the body at a distance or through glass.

Talking to the mortuary staff about what the experience will be like. For example, will it be possible for a bereaved person to touch the body? Sometimes this is not possible for forensic reasons. Will parts of the body be covered because they are too damaged? Are there any parts that the bereaved person is not advised to touch because they are fragile? What will the room look like and will anyone else be there?

Every word matters

Jane was only five when her father died. Her mother told her that “Daddy isn’t here anymore. His body is here, but the rest of him had gone away to heaven.” Jane, who is now an adult, remembers being shocked when she saw her dad’s body because it had a head, arms and legs. She had thought the word “body” meant his torso, so she thought she was only going to see his chest and stomach areas and that his head and limbs had gone up “into the sky to another planet”.

If you are giving information to someone who is considering whether to view a body it is important to ensure that your information is understood. This is particularly important to check when talking to children, or people who are communicating in a second language or have hearing difficulties.

Concentration is difficult when suddenly bereaved so important details may need repeating.

One way to ensure your information is understood is to seek consideration through continued conversation and repetition. For example, “I’ve told you a few things that I’m just going to list again now. I’ve told you that you won’t be able to touch your dad’s chest area, and that only his head and hands will be exposed, and that his eyes will be shut and his skin colour will be purple due to internal bleeding. I’ve told you that a mortician will be present. Do you have any thoughts about what this experience may be like for you if you decide to see him?”

Managing the experience

If more than one person wants to view the same body, have conversations with these people about whether they want to do the viewing on their own or together. Sometimes viewing rooms may be small and get crowded easily, reducing the quality of the experience. Children’s experiences have to be managed with particular care, ensuring they are accompanied by an adult helper who will assist them appropriately to understand what they are seeing.

It is also important for bereaved people to consider what they are going to do after viewing a body. Will they be able to sit somewhere safe and quiet and have a few minutes to themselves and an offer of a hot drink before facing the world again? What will their plans be for the rest of the day; will it be possible to do something relaxing, with people they trust and know, that doesn’t require extensive travel?

Religious rules and rituals

When managing the experience, it is important to be aware of, and consider the implications, of any religious rules or rituals that wish to be followed by a person viewing the body, such as touching and preparing a body through procedures such as washing and wrapping, or only allowing certain people to visit at certain times.

The importance of such rules or rituals to loved ones should be considered sensitively alongside any needs for post-mortem examination by pathologists and forensic scientists. Some families may object to the touching of the body by a non-faith member, but there is no rule for this in Hinduism, Islam or Sikhism in emergency situations. In Islam an invasive post-mortem examination (involving cutting open the body) is forbidden and it may, in some circumstances and in some countries, be possible to agree a non-invasive post mortem examination.

It is important to be receptive to cultural and religious differences and consult with the family to identify their particular needs. Although there are some general rules, it is important not to make assumptions based on a religious or cultural background. However, knowledge of other backgrounds may make communication and understanding easier.

Identification

Often, the police require identification of a body; however sometimes no-one wants to view the body. In this case, some countries allow identification through a photograph, or through glass.

Author note

This information was prepared by Mary Williams OBE, chief executive of Sudden and Brake, the road safety charity, with advice on religious rules and rituals by Yunus Dudhwala, Head of Chaplaincy & Bereavement Services, Newham University Hospital NHS Trust, UK

Reference

1. Viewing the body after bereavement due to a traumatic death: qualitative study in the UK, A Chapple, S Ziebland, 2010, BMJ

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American Cancer Society Grief and Loss Supports

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American Cancer Society Grief and Loss Supports

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The importance of support during the grief process

During the time of bereavement and throughout the grief process, a grieving person needs a lot of emotional support. You can read more in Grief and Bereavement. Finding support can be the key to a person's recovery and acceptance of the loss. Family members, friends, support groups, community organizations, or mental health professionals (therapists or counselors) can all help.

The grieving person must travel through the grief process, and should be allowed to move through it at their own pace. For some people, the grieving process can go on for a long time. This happens more often when a person was very close to the deceased. Sometimes this leads to what is known as complicated grief.

Complicated grief

If what's considered to be "normal grieving" does not occur, or if the grieving goes on for a long time without any progress, it's called "complicated grief" or "unresolved grief." Symptoms of complicated grief might include:

Continued disbelief in the death of the loved one, or emotional numbness over the loss

Inability to accept the death

Feeling preoccupied with the loved one or how they died

Intense sorrow and emotional pain, sometimes including bitterness or anger

Unable to enjoy good memories about the loved one

Blaming oneself for the death

Wishing to die to be with the loved one

Excessively avoiding reminders of their loss

Continuous yearning and longing for the deceased

Feeling alone, detached from others, or distrustful of others since the death

Trouble pursuing interests or planning for the future after the death of the loved one

Feeling that life is meaningless or empty without the loved one

Loss of identity or purpose in life, feeling like part of themselves died with the loved one

For some people who are taking care of a loved one with a long-term illness, complicated grief can actually start while their loved one is still alive. Caregivers under severe stress, especially if the outlook is bleak, may be at higher risk of having abnormal grief even before the death.

If you or anyone close to the deceased has any of the above symptoms of complicated grief, talk with a health care provider or mental health professional. Certain kinds of mental health treatment have been shown to help people with complicated grief. Treatment is important, since people with complicated grief are at risk of their emotional illness getting worse, and are at higher risk of committing suicide.

Coping with loss

Ideally, a bereaved person will be able to work through the process of grieving. With time and support, they'll accept and make sense of the loss, work through the pain, and adjust to a life without their loved one physically being present.

If you or someone you know has lost a loved one, the following tips may help you cope with the loss:

Let yourself feel the pain and all the other emotions, too. Don't tell yourself how to feel or let others tell you how you should feel.

Be patient with the process. Don't pressure yourself with expectations. Accept that you need to experience your pain, your emotions, and your own way of healing − all in your own time. Don't judge your emotions or compare yourself to others. Remember that no one else can tell you how you should mourn or when to stop.

Acknowledge your feelings, even the ones you don't like. Let yourself cry. You need to do both for healing.

Get support. Talk about your loss, your memories, and your experience of the life and death of your loved one. Don't think you are protecting your family and friends by not expressing your sadness. Ask others for what you need. Find and talk to others who have lost a loved one.

Try to maintain your normal lifestyle. Don't make any major life changes (for example, moving, changing jobs, changing important relationships) during the first year of bereavement. This will let you keep your roots and some sense of security.

Take care of yourself. Eat well and exercise. Physical activity is a good way to release tension. Allow yourself physical pleasures that help you renew yourself, like hot baths, naps, and favorite foods.

Avoid drinking too much alcohol or using other drugs. This can harm your body as well as dull your emotions. It's also likely to slow your recovery and may cause new problems.

Forgive yourself for all the things you did or didn't say or do. Compassion and forgiveness for yourself and others is important in healing.

Give yourself a break from grief. You must work through it, but you don't need to focus on grief all the time. Find distractions like going to a movie, dinner, or a ball game; reading a good book; listening to music; or getting a massage or manicure.

Prepare for holidays, birthdays, and anniversaries knowing that strong feelings may come back. Decide if you want to keep certain traditions or create new ones. Plan in advance how you want to spend your time and with whom. Do something to honor the memory of your loved one.

Join a bereavement support group. Other people can encourage, guide, and comfort you. They can also offer practical advice and information, and help you feel less alone. If you can't find a group near you, online groups may be helpful.

When you feel ready, do something creative. Some options include:

Write a letter to the person who died to say everything you wish you could say to them.

Start keeping a journal.

Make a scrapbook.

Paint pictures.

Plant flowers or trees.

Involve yourself in a cause or activity that the deceased loved.

Family changes after a loss

When a loved one dies, it affects all their family members and loved ones. Each family finds its own ways of coping with death.A family's attitudes and reactions are shaped by cultural and spiritual values as well as by the relationships among family members. It takes time for a bereaved family to regain its balance.

It's important that each family member be able to grieve with one another to help the family cope. Each person will experience the loss differently and have different needs. As hard as it may be, it's important for family members to be open and honest when talking with each other. This is not the time for family members to hide their emotions to try and protect one another.

The loss of one person in a family means that roles in the family will change. Family members will need to talk about the effects of this change and work out the shift in responsibilities. This time of change is stressful for everyone. This is a time to be even more gentle and patient with each other.

Losing a child

Facing the death of a child may be the hardest thing a parent ever has to do. People who have lost a child have stronger grief reactions. They often have more anger, guilt, physical symptoms, greater depression, and a loss of meaning and purpose in life. A loss is tragic at any age, but the sense of unfairness of a life unfulfilled magnifies the anger and rage parents feel.

A longer and slower bereavement and recovery should be expected when someone loses a child. The grief may get worse with time as the parents see others going through the milestones they expected to pass with their child.

Bereaved parents especially may be helped by a grief support group. These groups may be available in the local community. You can ask your child's cancer care team for referral to counseling or local groups.

Getting professional help

Bereavement counseling is a special type of professional help. You may be able to find it through hospice services or a referral from a health care provider. This type of counseling has been shown to reduce the level of distress that mourners go through after the death of their loved one. It can help them move through the phases of grief. Bereavement counseling can also help them adjust to their new lives without the deceased.

Helping someone who is grieving

It's common to feel awkward when trying to comfort someone who is grieving. Many people don't know what to say or do. Use the following tips as a guide.

What to say

Acknowledge the situation. Example: "I heard that your_____ died." Use the word "died." This shows that you are more open to talk about how the person really feels.

Express your concern. Example: "I'm sorry to hear that this happened to you."

Be genuine and don't hide your feelings. Example: "I'm not sure what to say, but I want you to know I care."

Offer your support. Example: "Tell me what I can do for you."

Ask how the bereaved person feels and listen to the answer. Don't assume you know how they will feel on any given day.

What to do

Be there. Even if you don't know what to say, just having someone near can be very comforting.

Listen and give support. But don't try to force someone if they're not ready to talk.

Be a good listener. Accept whatever feelings the person expresses. Even if you can't imagine feeling like they do, never tell them how they should or shouldn't feel.

Give reassurance without minimizing the loss. Try to have empathy with the person without assuming you know how they feel.

Offer to help with errands, shopping, housework, cooking, driving, or yard work. Sometimes people want help and sometimes they don't. They may not take you up on your offer, so remember they're not rejecting you or your friendship.

Avoid telling the person "You're so strong." This puts pressure on the person to hold in feelings and keep acting "strong."

Continue to offer support even after the first shock wears off. Recovery takes a long time.

It may help to check in with the bereaved on anniversaries of the death, marriage, and birthday of the deceased, since those can be especially difficult.

If the grieving person begins to abuse alcohol or drugs, neglects personal hygiene, develops physical problems, or talks about suicide, it may be a sign of complicated grief or depression. Talk to them about getting professional help.

If you believe someone is thinking about suicide, don't leave them alone. Try to get the person to get help from their doctor or the nearest hospital emergency room right away. If that's not possible, call 911. If you can safely do so, remove firearms and other tools for suicide.

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Seeking Help and Support for Grief and Loss

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During the time of bereavement and throughout the grief process, a grieving person needs a lot of emotional support. You can read more in Grief and Bereavement. Finding support can be the key to a person's recovery and acceptance of the loss.

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Bereavement is the situation in which a loved one has died, and grief is the response to this loss [ 1]. Typical acute grief reactions are often characterized by emotional and somatic distress and impaired functioning, but should not be diagnosed as a psychiatric disorder and generally do not require treatment [ 2,3]. However, bereavement is also a stressor that can precipitate or worsen psychiatric disorders (eg, unipolar major depression). In addition, acute grief may progress to prolonged grief disorder, which is a unique and identifiable syndrome marked by intense, unrelenting, and functionally debilitating symptoms that require specific treatment [ 4,5].

Psychotherapy or pharmacotherapy are typically not necessary for acute grief because most bereaved individuals are resilient, and grief is usually transformed and integrated during a natural adaptive process that typically occurs with the support and encouragement of close family and friends, as well as clergy and clinicians.

This topic discusses the management of bereavement and grief. The clinical features of bereavement and grief are discussed separately, as are prolonged grief disorder, palliative care, and hospice:

●(See "Bereavement and grief in adults: Clinical features".)

●(See "Prolonged grief disorder in adults: Epidemiology, clinical features, assessment, and diagnosis".)

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider's examination and assessment of a patient's specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms ©2022 UpToDate, Inc. and its affiliates and/or licensors. All rights reserved.

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Bereavement and grief in adults: Management - UpToDate

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Bereavement is the situation in which a loved one has died, and grief is the response to this loss [ 1]. Typical acute grief reactions are often characterized by emotional and somatic distress and impaired functioning, but should not be diagnosed as a psychiatric disorder and generally do not require treatment [ 2,3].

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The Recovery Village Drug and Alcohol Rehab

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Most people grieve after certain events, such as the loss of a loved one. This usually causes symptoms of depression and anxiety for months afterward. Grief statistics show just how many people are affected in the U.S.

Statistics on grief and loss show that a large part of the U.S. population grieves each year. While some mourn the loss of close friends or relatives, others face the loss of jobs, pets and relationships. Grief is a complex and painful experience unique to each individual, but nearly everyone goes through it.

Grief Prevalence

It is unclear what the exact prevalence of grief is in the U.S. However, these facts and figures shed some light on this relatable experience.

Older adults experience grief at a higher rate than younger adults or children. Spousal loss is common in older adults as well as the death of friends, siblings and cousins.

About 2.5 million people die in the United States annually, each leaving an average of five grieving people behind.

It's estimated that 1.5 million children (5% of children in the United States) have lost one or both parents by age 15.

Complicated Grief in Adults

When grief is overwhelming and powerful, it can seem to have no end. Grief this extensive is called complicated grief, which affects between 10% to 20% of grievers.

For many people, the most difficult time is the first several days or weeks. After that time, these individuals gradually return to their daily routine and normal activity. This is a common experience for adults grieving the death of a parent.

For an adult with complicated grief, emotions become overwhelming and difficulty with daily functioning goes on for much longer. These individuals need additional guidance and support to process their loss.

Childhood Grief and Bereavement

Childhood grief is often a memorable experience, commonly marked by the death of a grandparent or older relative. Childhood grief statistics state that 1.5 million children live in a single-parent home because of the loss of one parent and nearly 2 million children under 18 have lost both parents.

The way grief in children is processed can be positively or negatively affected by others around them. Bereavement during childhood can also cause issues such as bedwetting, digestive problems and trouble sleeping.

Causes of Grief

Grief is the process an individual goes through after losing a significant person or element from their life. While grief is usually associated with the loss of human life, that is not the only cause of grief. Any significant loss can be emotionally difficult and disruptive for an individual, and it can also cause complicated grief in some people.

There are a few common causes of grief, including:

Death of a loved one: Losing a person you are close to is the most commonly recognized cause of grief. Coping with the death of a loved one in the family is one of the most common human experiences.

Suicide loss: When a person loses someone to suicide, grief can be more challenging and complicated to process.

Divorce: While divorce is not the same as a person's death, it can cause both parties to grieve. Divorce represents a complex change that can impact many parts of life.

Loss of job: The loss of a job can be a devastating and life-changing event. Job loss grief reflects the lack of financial security and can affect personal identity.

Death of pet: For some people, the death of a pet can be as significant as the loss of a human life. This is especially true when grieving the loss of pets who are viewed as family members.

Rates of Grief and Co-Occurring Conditions

There are a few different effects of grief on overall health and daily function. The normal reactions of grief overlap several symptoms of depression and anxiety disorders. Crying, low mood, disrupted sleep and loss of appetite are common during the early stages of grief. Anxiety and depression disorders show similar symptoms for several weeks at a time.

According to an article from Psychiatric Times, 40% of grievers meet the criteria for major depression one month after their loss, and 24% still meet the criteria after two months. Because of these similarities, a bereaved person cannot be diagnosed with depression until two months have passed since their loss.

Additionally, some individuals may turn to substance use as a way to self-medicate and numb their symptoms. Therefore grief and substance use disorder often co-occur.

Cost of Grief in the Workplace

The true cost of grief in the workplace is often underestimated. Employees going through the grieving process need support and schedule flexibility. However, many workplaces do not address these needs openly or thoroughly.

Employees experiencing grief process higher levels of daily stress than normal. This can lead to poor decision making, substance misuse and increased risk of injury. Because of these issues, employers in the United States lost up to $75 billion annually, according to a 2003 study by the Grief Recovery Institute.

Grief Research and Trends

Some recent grief research studies are transforming the way people understand grieving. Current trends in grief counseling involve using new technologies, but each person handles grief differently. Generational differences, social media and the severity of grief all affect how the experience is handled. For example:

Millennials have grown up with increased divorce rates, frequent job changes and constantly changing technology. For this reason, it's possible millennials are able to adapt more easily to loss and manage grief more effectively.

Facebook, Twitter and other social media outlets allow a grieving person to connect with others easily and quickly. This access makes it easier to find support and connection in a timely manner.

Complicated grief is not yet an official mental health diagnosis. However, mental health professionals are learning more about this condition through research and experience.

Statistics on Grief Treatment and Recovery

How long does grief last? While most people usually show symptoms for a month or two, some can develop complicated grief. When this occurs, treatment providers and online counseling can offer additional support and guidance. A 2005 study showed that grief treatments that resembled trauma therapy seemed to promote an approximately 25% better response rate than typical interpersonal therapy.

Related Topic: How long does depression last?

If you or someone you care about is having a difficult time with a major loss, they may be going through a period of grief. Because people with grief may develop deeper mental health issues or turn to substance use, it's important to reach out for help. Contact The Recovery Village today if you are experiencing grief and a co-occurring substance disorder. We can discuss treatment plans and teletherapy to find a solution that will work well with your situation.

If you're looking for other ways to help you navigate your way through grief, the Nobu app can help. It is free and for anyone that is looking to reduce anxiety, work through depression, build self-esteem, get aftercare following treatment, attend teletherapy sessions and so much more. Download the Nobu app today!

Erika Krull has a master's degree in mental health counseling and has been a freelance writer since 2006. Read more

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By - Nanci Stockwell, LCSW, MBA

A dynamic leader and award-winning business strategist, Nanci Stockwell brings years of industry experience in behavioral health care to her role at Advanced Recovery Systems. Read more

Crowe, Justin. " These 3 Trends Might Make Millennials Better at Grieving Than Baby Boomers. " Connecting Directors, March 7, 2018. Accessed June 16, 2019.

DocuVital. " The Hidden Costs of Grief in the Workplace. " January 5, 2017. Accessed June 16, 2019.

Experience Camps. " Statistics on Childhood Bereavement. " Accessed June 16, 2019.

Miller, Mark D. " Complicated Grief in Late Life. " Dialogues in Clinical Neuroscience, June 2012. Accessed June 16,2019.

Osterweis M, et al. " Chapter 5: Bereavement During Childhood and Adolescence. " Bereavement: Reactions, Consequences, and Care; National Academies Press, 1984. Accessed June 21, 2019.

Rauch, Joseph. " How Social Media has Changed the Way We Grieve. " Talkspace, August 29, 2017. Accessed June 16, 2019.

Shear, K., Frank, E., Houck, P., Reynolds, C. " Treatment of Complicated Grief: A Randomized Controlled Trial. " JAMA Network, June 1, 2005. Accessed June 16, 2019.

Shear, M. Katherine, et al. " Bereavement and Complicated Grief. " Current Psychiatry Reports, November, 2013. Accessed June 16, 2019.

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

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Grief By The Numbers: Facts and Statistics - The Recovery Village Drug and Alcohol Rehab

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Most people grieve after certain events, such as the loss of a loved one. This usually causes symptoms of depression and anxiety for months afterward. Grief statistics show just how many people are affected in the U.S. Statistics on grief and loss show that a large part of the U.S.

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What to do when someone dies in the hospital?

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What to do when someone dies in the hospital?

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What to do when someone dies in hospital

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Bereavement Advice Centre | What to Do When Someone Dies in Hospital

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If the deceased has died in a hospital and you are the named next of kin, the hospital staff will inform you. For bereavement advice call 0800 634 9494

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How to overcome grief’s health-damaging effects - Harvard Health

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Grieving over the death of a spouse, friend, or family member exposes people to constant stress that can lead to anxiety, depression, trouble sleeping, and more. Strategies to lower and manage stre...