Fragile Pieces

Eventually, all things merge into one, and a river runs through it. The river was cut by the world’s great flood and runs over rocks from the basement of time. On some of the rocks are timeless raindrops. Under the rocks are the words, and some of the words are theirs… Stories of bereavement, grief, anguish, and travel along the road of healing; including the cherished memory of loved and lost. We each choose what to remember and immortalized.

Unresolved Grief

Unresolved Grief The majority of bereaved people eventually manage to get their lives together, and find that life is again meaningful. They realize that even though there will be no-one to replace their loved one, they will have new and fulfilling relationships with others and will develop new interests and hobbies. But some people are either unable or unwilling to end the grieving process. They find themselves locked into a cycle of excessive and chronic despair, guilt and anger.

As you might imagine, given the varied nature of people’s circumstances, the process of grieving is not necessarily straightforward. Its normal progress can be disrupted by a variety of factors including the unspeakable nature of the death, the attitude of the people around the bereaved person, and a tendency, when people lose their partner, to distort the dead partner’s qualities.

In rare cases, the suddenness, and sometimes violence, of death can create a crisis of such enormity that it can take a great deal of time for grief to be resolved. Murder, being burned to death, dying in a car or plane crash, or as an innocent bystander or victim of terrorist attack are examples. The facts, and the magnitude, of what has happened may go so far beyond the experiences of those who are left that they cannot cope. Fear, incomprehension, vulnerability, and an intense anger at anyone (or a god) who may be responsible, are probable emotional outcomes. In addition, if your loved one was murdered, or killed themselves, the stigma can be so strong that it can lead to even more protracted grief. The questions commonly asked by neighbours or acquaintances, for example: ‘Why didn’t you do something?’ or ‘Didn’t you know they were going to kill themselves?’, can stir intense feelings of guilt and shame.

It doesn’t always end with only coming to terms with the death itself. The aftermath of such horrors in courtrooms, with officials, the police and the media can be as stressful and traumatic as the appalling events themselves. In these circumstances, it is likely that you would benefit from help by professionals who will provide an environment and support system for you to begin a full, healthy resolution to your grief. Refer to the Resources section at the back of this book for addresses of useful organizations.

Unsatisfactory Support

However, in more normal circumstances, one of the main reasons for an abnormally lengthy period of grieving is the lack of the right kind of support from friends and family. Some relatives and friends, with the best of intentions, don’t allow the bereaved person to talk about the death of their loved one. They fall silent when this ‘difficult’ subject is broached because they don’t want to risk ‘upsetting’ the bereaved. They forget that it is probably next to impossible to get more upset than the bereaved already is.

Other sets of family and friends go to the other extreme. They lavish excessive attention on the bereaved for an extended period that sometimes prevents them from starting work again or from renewing their old interests and friendships. They might insist: ‘Not yet. You’re not ready yet.’

This over-concern, while again undertaken with the interests of the bereaved at heart, unfortunately prevents the healthy and steady maturation of the grieving process. It goes against the advice of psychologists, who suggest that the most productive and supportive climate for the bereaved is one where they are able to acknowledge and express their feelings. During this process tears will fall, but this isn’t a case of getting more upset, it’s just a part of the process of recovery. And instead of smothering the bereaved with attention, it would be more appropriate for the bereaved to be encouraged to find practical solutions to the difficulties they face in returning to ‘ordinary’ everyday life.

Bereaved Partners

There are also issues that arise in the recovery period that relate specifically to bereaved partners. It sometimes happens that over time the image they have of their deceased partner becomes so distorted that it interferes with the successful formation of new relationships. In effect, the deceased partner is ’sanctified’ by the surviving partner. They habitually compare any new person they meet with an almost angelic figure who is all of the best aspects of their loved one, but without any of their less attractive features. More often than not, this comparison is conducted negatively: ‘Ah, but my wife/husband/partner would never have done this. She/he was so kind, thoughtful and giving. I’ll never meet anyone as good as her/him.’

While we would all like to remember our loved ones with the greatest of affection, it can be necessary, in order for the surviving partner to move on, for the ties with the first partner to be worked through and discussed in an objective manner by both parties in the early stages of a new relationship.

Bereavement in Old Age

There can be severe emotional problems for older people after their partner dies. Some adjust very well to death, but in cases where partners have been together for many years, day-to-day living can be difficult. One reason, apart from loneliness, is that older couples are often mutually dependent, and the lack of support after a death can lead to chronic self-neglect. Why bother? time and life seem so pointless now. This reaction is common if one of a couple had to care for their partner for many months or years before they died. Tied to this is the burden of guilt at feelings of relief in seeing a partner’s misery coming to an end. This is not to say that most who wish their partner dead are motivated by hate - quite the opposite - but it’s characteristic of carers of the long-term ill to have such thoughts.

Practical Problems

There are many practical problems for someone who has been bereaved in old age. Perhaps chief among these is loneliness, but there are other anxieties including concerns about health, possible financial difficulties, and issues of security. Here are a few suggestions to deal with these particular issues:

  • Loneliness The loneliness after bereavement in old age can be intense. It doesn’t help that in Western society, where the extended family rarely lives together and may be quite widely scattered, widows and widowers almost invariably find themselves alone, and may become dangerously isolated. The sense of longing and loss is a feeling that some believe they can never get over. The only way to overcome loneliness is to work at it. Don’t expect it to be easy. It won’t be. Early on it may also seem as though to have fun is somehow disloyal to the memory of your partner, but there may come a time when instead of becoming distraught, and wistfully reflecting: ‘1 wish she/he was here’, you might begin to enjoy the activity itself without guilt and smile, and think: ‘Yes, she/he would have liked this too.’ Lack of money or mobility also can make things difficult, but if you have some extra cash to spare you could think about going to evening classes at a local college or joining one of the extracurricular classes at a university. Some local councils subsidize such courses, and so they can be fairly cheap. The range of studies is huge; there’s everything from learning how to upholster furniture to becoming computer literate or learning a new language. And, of course, it’s a very good way of meeting people. If you’re more mobile you could join a rambling club, a bowls club or a choir.
  • Health Some researchers have concluded that elderly widows and widowers are more likely to suffer illness or die soon after a bereavement. A few put this down to a loss of will to live, or more simply put, a broken heart. Others suggest that any increase in visits to doctors in the six months after a bereavement can be put down to tension or anxiety, or symptoms of illness that were ignored just prior to their partner’s death. Whatever the case, living by yourself is certainly difficult. Without a companion there doesn’t seem much reason to get up, eat properly and get out and about. There are potential health risks in this. Simple things can help: eat properly balanced meals; make sure you exercise regularly; keep warm.
  • Money Money doesn’t need to be tight for you to take advantage of any benefits that you might be entitled to. State grants or credit are not charity. If you are not very mobile or have medically-documented physical problems, you may be eligible for financial support. There is no shame in taking it. Similarly, if your partner served in any of the armed forces, you may be entitled to a sum of money as the widow of a war veteran.
  • Security It’s a fact that most elderly people who have lost a partner are women. Women tend to live longer than men, and also to marry older men. By the age of seventy-five two-thirds of women have lost their husbands. Many women in this position, probably quite rightly, feel threatened and physically at risk. If you haven’t already done so, install a chain on your door, and a fish-eye peephole, so that you can check on people who are calling. Put locks on all of the windows. Always ask to see the cards of any officials or workmen. If in doubt, call up their offices to be quite sure that they are legitimate. (Get the numbers from the telephone directory; any number you get from the person at the door might simply put you in touch with an accomplice.) Don’t be put off by people complaining that you’re being ‘difficult’; you’re just being safe. You could consider getting a dog. Get to know your neighbours, and let them know when you’re going away so they can keep an eye on your place. A telephone is an essential tool in keeping in touch with officials and friends. Think seriously about getting a phone/fax machine, or a computer with a modem and e-mail (if you haven’t got one already) as this makes communication easier.

Remember that your life still counts even though the death of your partner may have slightly shifted your perspective at present. You still have the right to make choices and decisions, to be treated decently and with respect, and to have control over what happens to you. Being older can make it a little more difficult, perhaps because in Western society the elderly aren’t valued as highly as they should be, but it is completely possible.

One way of starting to take control is to get organized. Arrange what you’re going to do the next day each evening. This could be a part of a regular (possibly weekly) routine involving getting out for a walk every day with a purpose other than getting some fresh air, such as getting your pension, going to a class or an exhibition, or posting letters. Get some exercise, be curious and active. If you aren’t so mobile, ask relatives and friends to help with things you can’t do yourself. Alternatively, contact an association that represents elderly people for information and assistance.

Child Bereavement & Helpful Concepts

Of course, there is a great deal that you can do to help your child yourself. Apart from answering questions as honestly and as fully as you can, you can help by explaining the following concepts:

  • Death is inevitable All living things must die. It’s a natural process. People don’t die because they’ve done, thought or said something wrong and are being punished for it.
  • Death is irreversible It’s important to make sure that the child isn’t suffering the delusion that if they wish the person back enough they will return. Sometimes children can be confused by the permanence of death and feel bewilderment, hurt or intense anger when, for example, their parent doesn’t reappear as they used to after a business trip.
  • Death is for a reason. Some children find it difficult to accept that illness, accidents or old age are straightforward reasons to die. It needs to be emphasized that the illness or accident didn’t happen because that person wasn’t ‘good’ enough to live. Similarly, though it may seem almost callous to even consider it, violent death through murder is a reason to die. It’s important for children to realize this because they often feel that they caused the death because they thought ‘bad’ things.
  • Death means that all functions of life cease A child’s world is a very sensory one, full of movement and activity. Some children, who do not understand that all the sensory functions of life and all thought processes end with death, become worried that the person may feel cold, hungry or have undergone great pain if the body was cremated, or not have enough air to breathe if it was buried.

Perhaps the most important thing is for you to be patient and be available to talk to the child and to share your own feelings of grief with them. This can encourage them to talk, understand and accept death. It’s also a good idea to have a talk with the child’s teachers at school. After all, teachers are significant adults in a child’s life and can be a great help. They should be asked to make sure that while they should be flexible with the child as regards their school work, they should expect and encourage the child to do the work. Keeping busy is an essential strategy in preventing depression from taking too great a hold.

There are a number of other strategies that can encourage children to grieve in an inclusive, positive way. Together you can plant a tree or a bed of flowers in remembrance of the person who has died. Alternatively, you could help them create an album of photographs or paintings of your loved one; let the children have some input into the writing of any captions underneath the pictures. It can also help if you encourage the child to write down their feelings as a journal, poem or a story. Take some time not only with what is written, but also with the way it’s presented. You could bind all of it into book form, with covers and, perhaps, a photograph of the person on the front.

Grieving and Children - Losing a Parent

All too often children are cosseted instead of being brought into the grieving process. The justification for this decision is outwardly entirely rational: ‘Don’t upset the child.’ But, of course, the death of a family member or friend has short- and long-term effects for a child just as it has for an adult. There may be emotional difficulties for them at school and later, as young adults, it’s possible that they will suffer a loss of self-esteem and a profound sense of aloneness.

Losing a Parent

Instead of being shut out by the surviving parent, it is important for the child to be included in the grieving process from the start. High on the list of priorities for the surviving parent is the need to assure the child that he or she will be looked after, cared for and loved. This in itself might be problematic since a surviving parent may feel ill-equipped, as far as having all the skills necessary to care for and support the child or children, and, at the same time, to hold down a job. However, don’t be afraid to take your children into your confidence. Make time each day to sit with your children and talk over what has happened.

On a more practical level, even if the children are small, you might have to ask them to take on some more household responsibilities. This will not only give you all the chance to understand that you are still working together as part of a family, but also give you a framework to talk about the significant, though less serious, events that are part of everyday life. But remember that if you do ask your children to shoulder more of the day-to-day chores, it’s best if you are consistent in the demands you make of them. In other words, don’t impose extra work on them just because you may be busy at the time.

The child will have a lot of questions about the death that will probably be disturbingly frank: When? Where? How? and Why? These should be answered as openly and as honestly as possible. Perhaps most important of all, the distinction between the temporary and permanent absence of the parent should be made evident. This can be difficult with the very young. Children under the age of five have a poor understanding of the permanence of death and are likely to think of it as extended sleep. As a result they may even worry about sleeping themselves. Often the very young believe that death is a planned act for which someone is responsible. They may even feel that they are responsible in some way.

Those who are a little older realize that death is final.

However, they may seem morbidly interested in the process of the body’s decay rather than simply wanting to grieve. This may be because they tend to view death in very impersonal terms; it’s something that happens to other (and older) people. For this reason they find it interesting, but in what can seem to be a cold and heartless way. It’s possible that their impressions of death may be distorted by what they experience through television or the snippets of adults’ discussions about death they overhear.

Children of about 9-11 begin to realize that death is not only permanent, but also irreversible. They also have an understanding that it’s something that could happen to them. However, it’s not their death that worries them so much as the possibility that one or both of their parents will die - and soon. Some children attempt to hide their fears by joking about death or pretending to be perfectly indifferent to it.

Like adults, children experience similar stages of the grieving process, but can react differently. This is because they have limited experience of life and find it difficult to express the confused jumble of emotions they feel. Extremes of behaviour are common. They may at turns seem very upset and then totally disinterested in what has happened. They may want to talk about the person who’s died all the time or conversely not at all. There may be similar reactions in their attitudes to schoolwork. Almost inevitably there will be some children who constantly want attention or complain of minor illnesses such as headaches or stomach upsets.

Sometimes these extreme reactions can persist and deepen.

Some children may exhibit a constant and unreasonable anger towards everyone and everything. This may be manifested in shouting or screaming or in physical attacks on siblings or friends. Sadly, animals are often the victim of a child’s confused state; they can feel that it’s acceptable to take out their anger on a family’s pet or to shoot at birds with a catapult or air gun. Depression for children can be a real problem. They may isolate themselves from all their friends and family, develop an extreme fear of going to school, and threaten suicide. If you feel your child’s behaviour goes beyond a normal expression of grief then consider outside help.

Strategies for Coping with Suicide Grief

Given these stresses, it is immensely difficult for those left behind to pick up the pieces of their lives, and start to recover. It’s quite possible that specialist help will be necessary to overcome the barriers of silence inside the family, and feelings of public isolation. However, regardless of whether a specialist is brought in, there are a number of strategies that you can use to help cope with your loss:

  • Talk Make sure that the family talks about what has happened. It’s important for everyone to show each other constructive support at this time. This is especially true in the first few days following the death since this is a time when feelings of guilt, and bitter accusations of blame, are likely to surface and stifle and ensnare a family in a cycle of unhealthy recrimination.
  • Be objective It is common for survivors of an adult suicide to view the death, and the person, in extreme terms. This can result in seeing your loved one as having had an almost saintlike personality. In addition, survivors often assume total responsibility for not having foreseen the act itself, and blame themselves for not having ‘done enough’ to prevent it. While sadly there is sometimes good reason for such guilt, it is important to realize that suicide is not necessarily motivated by a feeling of not being supported by others, but can be a result of an unseen accumulation of stresses, or by psychiatric disorders and personality factors that probably could not have been influenced by immediate family members. It is essential to correct distorted guilt patterns and reassess attitudes so that the fact of suicide, and objective feelings of guilt, can be accepted as soon as possible. With acceptance and understanding, it is more likely that a sense of peace will follow.
  • Allow yourself to be angry In tandem with a sense of wanting to idealize your loved one, it is likely that you will find yourself becoming intensely angry with them. You may be furious at your son for not having tried to communicate his problems and needs before he took his life. If your partner was a suicide, you may feel rage within you that she left you (or your relatives) with children to bring up, a mess of legal and financial issues to deal with. You may simply feel rage at the seeming waste of life itself. It is perfectly normal for suicide survivors to experience an almost terrifying anger. Permit yourself this emotion.

    Euthanasia

    It must be pointed out, however, that not all forms of suicide are necessarily incomprehensible or hugely traumatic. The arguments in favour of active euthanasia, or ‘assisted suicide’ as it seems to be becoming more widely known, are fairly straightforward. Under circumstances of advanced terminal illness that causes intolerable pain and suffering to an individual, or when physical handicap is deemed too restrictive by an individual, despite lengthy consideration, counselling, physiotherapy and other intervention, then it is the right of a mature, rational adult in the face of hopelessness to take their own life. Supporters do not believe euthanasia should be used as a first resort when the knowledge of certain death from illness becomes apparent.

    Perhaps because of the voluntary and rational nature of euthanasia the emotions of shame, guilt and fear may be lessened for those left behind, knowing that their loved one’s life ended under their own control, and without undue suffering. This would be especially true if your loved one made a Living Will indicating that they accepted the notion of taking their own life in a calm and orderly fashion. A Living Will is a document that outlines the circumstances in which the person who draws it up wishes medical intervention to be limited or stopped altogether.

    Opponents of euthanasia see this form of suicide as being unjustifiable from a number of different perspectives. Perhaps chief among these is that the practice of pain management and relief available in hospices is excellent. There are also those who reject euthanasia on ethical and theological grounds. They would suggest that it is the duty of doctors not to take life, but to preserve it, and to leave the matters of life and death to a god.

  • Facing Grief after a Suicide

    Coping with a death that was self-inflicted is extremely difficult. It seems to be beyond question that the stresses on a family where a death is a result of suicide are greater than those imposed by most other forms of death. A great deal depends on the age of the person who takes their life, but in all cases the reactions of family members and friends are likely to be harsh and complex.

    Stresses

    In addition to dealing with the range of emotions that all the bereaved have to cope with, the families of a suicide face other extreme stresses. Typically they include:

    • Denial In common with those who have become bereaved under less tragic circumstances, the families of suicides find it difficult to accept that their loved one has died. Yet, more than this, it’s not unusual for them to deny that the death was due to suicide at all. If the suicide was a teenager or young adult, his or her father tends to take it very badly. Of all of the family members it’s fathers who typically deny the fact of suicide the most. Even when they become more accepting, they commonly rationalize the act of suicide. Instead of recognizing in the tragedy any internal family problem or other unreleased pressures, outside factors such as drugs in society, the company that the suicide kept, and the breakdown of society as a whole are blamed.
    • Shame There is such stigma attached to suicide that one of the most powerful emotional reactions to an act of suicide within the family is shame. Registrars are routinely asked to falsify death certificates by grieving family members who don’t want the truth to emerge publicly. Even within the family there is often a conspiracy of silence to keep the dread secret. To neighbours and acquaintances, the death is passed off as an ‘accident’.
    • Guilt The guilt in the aftermath of a suicide is unlike the regrets and guilt associated with other forms of death. Instead of bitter regrets over a catalogue of actions or arguments, you might feel almost overpowering guilt not only for what you feel you should have done to prevent the suicide, but also for what you might have done that contributed to its happening. The guilt of parents whose children have taken their own lives may be extreme. Western society holds that they are responsible for the upbringing of children, and with the suicide they are deemed to have failed as stable, nurturing parents. Similarly, adult children may feel overwhelming guilt if their elderly, recently widowed parent died by suicide. They will inevitably feel they should have visited them more often. Partners of suicides may feel a peculiarly acute form of guilt since they more than anyone should have ’seen the signs’.
    • Fear A darker, and perhaps more disturbing, reaction to suicide is the fear that it can unleash. Primarily, this is the fear of self and of an individual’s impulse to self-destruct, but in addition it is the fear that someone else in the family might take their own life.

    Perhaps more tragic, and very real, is the constant fear that people outside the family will discover the fact of the suicide and almost inevitably interpret it in such a way as to negatively affect the family’s social standing. There seems little doubt that someone who dies as a result of an accident, illness, old age or even violence is more likely to be viewed with sympathy than someone who takes their own life. The act is often interpreted by others as a shocking and violent end to a tragic story of rejection or abuse by (usually) the suicide’s father, and is symptomatic of a dysfunctional family.

    These perceptions are increased if the suicide act of your loved one required some determination and energy, such as hanging, as opposed to a more passive end through taking an overdose of pills. Furthermore, even if there are mitigating factors, such as the proven psychological instability of the suicide, these tend not to alter an outsider’s interpretation of events.

    Friends and Family Grief

    Of course, not all of the difficulties of terminal illness relate solely to the patient. Friends and family are also affected. If you have been aware of the nature of your loved one’s illness, you will have been anticipating their death. It’s only natural, but it makes an already distressing ordeal all the more demanding. This is because in anticipating the death it’s likely that you will have been feeling guilty at thinking about the practical issues of how you will live your life after they are dead even while they are still alive. It seems as though you’re being disloyal in letting go before you’re supposed to.

    But, again, this is to be expected. There is an inevitable conflict between looking after someone who is dying, and the need to reorder your life. It’s a pre-death reshuffling of roles that happens when people recognize that someone they love is dying that is similar to post-death grief. However, the two processes shouldn’t be confused, in the sense that in anticipating what happens after the death you will somehow subsequently grieve less. There isn’t a fixed amount of grieving that takes place when someone dies. You’ll just grieve differently, that’s all.

    Terminally Ill Children

    Younger children tend to have a very clear notion of causation, and commonly believe that since no-one else is to blame for their illness, they somehow are responsible for bad things happening to them. They may not openly say this, but it’s likely that these thoughts will be deeply troubling them. Questions like: ‘Why am I ill?’ or ‘What’s happening to me?’ can be coded messages from children, inviting reassurance rather than a straightforward explanation of what’s happening to their bodies. One way of gently opening up these thoughts, and resolving these fears, is to turn questions like these on their head and ask your child why they think they’re ill or what could be happening to them. Thus they have the opportunity to express what is really worrying them.

    This doesn’t mean, of course, that children don’t worry about what’s happening to their bodies. They do. In cases where there are multiple treatments, constant side-effects, and occasional relapses and failures, it can feel to the child that their body no longer belongs to them, but somehow is the property of the doctors and nurses. Very young children can become extremely upset when medical staff have to take blood samples, not understanding that their bodies can replace any blood that’s taken from them.

    Furthermore, children also may be aware that they will die.

    They will be anxious about this even though they might not openly say so.

    All of these constitute delicate subjects that should be treated according to your child’s age and understanding, and in a spirit of honesty, reassurance and supportiveness. Children aren’t incapable of understanding what’s happening, and, like an adult, can feel very alone and fearful. They need to be listened to, by you and by professionals, and be given guidance on how to face their illness, and to live optimistically despite it.

    Terminal Illness

    Perhaps the most important factor in relation to terminal illness is for you and your loved one to maintain a belief and dignity in life until death comes, despite possible increasing pain, and decreasing autonomy. For some people for whose illness there is no cure, the needs of security and support are not necessarily provided by a conventional hospital. Hospital staff don’t have the luxury of time to devote to dying patients or their loved ones. The primary aim of a hospital is medical and physical intervention, without necessarily taking into account the emotional needs of the patient or those closest to them.

    An alternative is hospice care. The approach of a hospice is to alleviate suffering through medical intervention, and to maintain the dignity of the person who is dying while giving support to their family. A collaborative programme of care is developed, and the family is consulted and included in providing support for their loved one. The intention is to allow the patient to die with dignity, and in an atmosphere of humanity.

    However, regardless of whether your loved one is in a hospital, a hospice, or at home, they will probably exhibit the fears and needs common to those in their position. It’s possible to identify these, and, with the assistance of professional carers, offer them some help in coping with a whole range of issues. Apart from the illness itself, these can include the sometimes painful diagnostic procedures, treatments such as radiation or chemotherapy, and turbulent emotional states including a sense of worthlessness, aloneness and a need to tidy up the loose ends of life.

    • Fear of being alone One of the greatest fears of people who have been told, or believe, that they are dying is that they may die alone. Sometimes they feel that any physical deterioration may turn people away; they fear that they might become too repulsive, or ugly, or too much of a burden. In a sense this is true. Often, when death is inevitable or draws near, friends and relatives outside the immediate family tend to disengage themselves, and draw away from the dying person on the assumption that they would want to be alone in order to prepare themselves for death. There may be additional factors that influence whether or not people visit the dying person. For example, the continuing stigma of a disease such as AIDS might keep potential visitors away from a dying AIDS patient. But a person who is dying needs the love and support of their closest and dearest. It’s a very human need. They need you to be there to appreciate them, to reminisce, to cry and to laugh.
    • Feelings of worthlessness Up until the time they started to become ill, people who are dying had a more positive selfimage, and a greater sense of worth as members of their family and society. However, their illness may have led to a gradual physical deterioration to the point that they are unable to go to work or even live at home. Whereas previously they may have had important jobs, or contributed to the household as a decisionmaker or bread-winner, these roles are gone. With these, all too easily, goes their positive self-image. It won’t help their feelings of uselessness to say: ‘Don’t waste your time thinking about these little things. You just concentrate on conserving your energy. Don’t waste it.’ You can help restore their spirits and feelings of selfworth by finding ways to fully involve them in making many of the important everyday decisions that involve family members and finances. You could draw up a list of decisions that need to be made, or an account of expenses that need to be sorted out, and find a regular time to discuss them. Naturally, they should be fully consulted in all the medical decisions made on their behalf.
    • A need to ‘tidy up’ For those adults who recognize that they are dying, there is usually a need to put their affairs in order. This can take the form of writing a will, planning the funeral or making sure that the family is financially secure or employed. It can also involve a desire to release old resentments, and to resolve any outstanding personal or family feuds that may exist. These issues can be painful, not only because of what might be said, but also because this might seem as though they are somehow ‘giving in’ to death or abandoning hope. This probably isn’t the case; when people feel they are near death they can feel an extreme need to tie up the loose ends of their life. Their attitude may be rather businesslike, but that’s only because they know that there’s so little time left. You’ll help in being similarly pragmatic in order to bring them towards a sense of closure and inner peace.

    The Grief of Siblings

    In the despair following a child’s death, the grief of the surviving children can easily be overlooked, since friends and relatives generally pay their respects to the parents first, and only afterwards to the children. If the surviving child or children are teenagers or younger, they may hardly be acknowledged at all except with a passing ‘Are the children coping?’

    Perhaps, if it was pointed out to someone that this attitude was slightly thoughtless, they might dispute it, saying that the parent-child relationship is the most significant - a sibling is someone who’s ‘just’ lost a brother or sister. The received wisdom appears to be that the grief of a parent who has lost a child is greater than the grief of a sibling of that child.

    But a sibling’s grief is not ‘greater’ or ‘lesser’ than a parent’s; it’s simply different. And, regardless of whether they got on with their brother or sister when they were alive, it’s very real. They have lost someone who shared a common bond and background. Despite this, many surviving children feel they can’t express their feelings to the rest of the family, which in turn increases their sense of frustration, anger and resentment at being left alone to deal with their grief.

    In many cases they are expected to help their parents grieve, and this can be a heavy burden because they feel that they always have to be upbeat for their parents’ sake while keeping their own grief private. Don’t forget that children can experience acute feelings of guilt as well, especially if they fostered long-term ill will against their brother or sister. For other siblings, who have lost a close companion who shared a special bond during childhood and adult life, there can be intense and long-term feelings of regret. These feelings often emerge at significant points in the surviving sibling’s life when it’s apparent that their brother or sister is not there to share in the joy, say, of a marriage, birth of a child, or even moving to a new place and starting an exciting new job.

    Surviving siblings also tend to believe that the favourite or ‘wrong’ child died. So, if your other (particularly younger) children begin to adopt the personality and habits of their dead brother or sister, it may be an attempt to lessen your pain as parents. To the same end, other surviving children temporarily assume parental roles when adults cannot cope. This may happen particularly at significant family occasions such as birthdays and family reunions.

    So, remember to include your children, and talk with them when they need it, but remember that they also need space. Allow them to grieve.

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