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Mourning Resource Guide

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Introduction

 

Experiencing any loss can present many challenges, feelings, and unexpected realities. As we grow through life, we will continue to face various losses, some of which are expected and some that may not be expected. Most of us live during a time when we may face a higher prevalence of loss, whether physical or symbolic. (Rando, 1991, p. 12) Our current climate has led many people to experience the death of a loved one, loss of income or family home, or even loss of expected educational experiences or changes in relationship status. Some losses we welcome and expect, such as losing our student status once we graduate high school and move into the career world. In comparison, some losses happen outside our control, such as a failing marriage or our children growing up and moving out. Some people experience subsequent temporary upsurges of grief where the grief may feel afresh or secondary losses where a person experiences grief at a later point due to their initial loss. (Hadad, 2009, p. 60)

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Many feelings, emotions, and physiological reactions can occur with these losses. Some emotional reactions include relief, jealousy, despair, fear, guilt, sadness, longing, sorrow, loneliness, anxiety, and ambivalence. (Hadad, 2009, p. 60) Some cognitive reactions include confusion, decreased concentration and motivation, searching for meaning, pessimism, rumination, and disbelief. (Hadad, 2009, p. 60) Some physiological reactions include sleep and eating disturbances, fatigue, digestive problems, head and body pain, shortness of breath, and heart palpitations. (Hadad, 2009, p. 60) There may be behavioural changes such as self-destructive behaviours, social withdrawal, avoidance, and uncharacteristic changes in activity levels. (Hadad, 2009, p. 60) Not everyone will present with these changes as everyone's grief trajectory varies.

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Nowadays, it may seem harder to resolve our feelings of loss due to changes in family structure, decreased sense of community and spiritual involvement, working longer hours, and technological advancements. (Rando, 1991, p. 5) We are now faced with healthcare advancements where prolonging life through life-saving measures are readily available, allowing people to live longer. (Rando, 1991, p. 6) There are now more options in end-of-life planning, such as where a person will spend their final days and who will care for them. There are higher incidences of traumatic losses, including homicides, workplace accidents, and motor vehicle collisions. There is an increase in the types of illnesses a person may be diagnosed with and varying medical interventions and projected prognosis.

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There is no direct path in resolving the grief associated with loss, and no two losses are the same. It may take months or years to resolve grief, and not everyone will grieve the same way. (Rando, 1991, p. 7) There may be times that parents or children experience varying grief trajectories, and sometimes family members cannot be there for each other. (Rando, 1991, p. 7) Many theorists describe a grief trajectory that varies in phases or stages with no set order or time limit. Most models describe feelings of shock, denial, isolation, anger, numbness, searching, avoidance, disorganization, despair,  depression, conservation -withdrawal, bargaining, acceptance, recovery, reorganization, awareness of loss, healing, renewal, reinvestment, and restructuration. (Hadad, 2009, pp. 61-75)

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Whatever your path, circumstance, experience, or situation may be, there are resources out there to help you feel supported through your grief. The following is a resource guide in the hope that you can find the peace you need to assist through your grief.

 

Death and the Child

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Children can understand and sense changes within the family, especially emotional changes or when someone or something is absent. Children grieve the same way that an older child or an adult does, and they may express their grief differently, either through play or inquiry. (Hadad, 2009, p. 81) Research has shown that children who understand death understand the concepts of irreversibility, non-functionality, universality, causality, and personal mortality. (Hadad, 2009, p. 82)  Children will understand that there is no coming back from death because all life-sustaining functions end for a specific reason and that one day they too will die. (Hadad, 2009, p. 82) Factors affecting a child's concept of death include the ability to communicate and understand death circumstances, the concept of an afterlife, and their experiences with death and mortality either to their family or for themselves. (Hadad, 2009, pp. 83-84)  

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Children will vary in their grief expressions as it will depend on their age, their support system, the ability of their caregivers to care for them while managing their grief, and the ability of the family to restructure and create new roles and identities. (Hadad, 2009, p. 85) Common normal behaviours include crying, regression, changes in sleep and eating, sadness, magical thinking, nightmares, phobias, possessiveness, psychosomatic symptoms, anger, risk-taking, and suicidal ideation. (Hadad, 2009, p. 87)

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Caregivers and parents play an influential role in a child's grief trajectory. Children who feel supported with minimal disruption to their routines may be able to adjust to the loss. It will be up to the surviving parent to take on additional roles and emotionally encourage physical and emotional caring. (Hadad, 2009, p. 88) Children who have lost a sibling will rely on their parents to communicate and share details to prevent cognitive distortions such as feelings of guilt or responsibility. (Hadad, 2009, p. 89) They will also be greatly affected by their parent's ability to cope and may feel that their parents are not caring enough or caring too much by being overbearing or protective. Children may also feel a diminished sense of worth or a need to overachieve to make up for their lost sibling. (Hadad, 2009, p. 90)

Children who are terminally ill may have an advanced understanding of death and mortality depending on their age and capacity. (Hadad, 2009, p. 95) It will be essential for them to communicate with their medical providers and parents regarding their diagnosis, medical interventions, and progression. Children will need to understand that a death has occurred or may occur depending on the circumstance. They should be informed, allowed to express and communicate their feelings, be involved in the process, and decide if they wish to attend the final rituals.

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While there is no clear path, the following are resources to assist through the grieving process for a child. Please refer to the next page.

 

Children and Death Resources

Kids Help Phone:

  • Helping children and adolescents navigate various challenges and issues, including grief, loss, suicide, and anxiety

  • Website:  https://kidshelpphone.ca/

  • Toll-free: 1-800-668-6868

  • Text 686868

 

KidsGrief.ca

  • Supports children, parents, and educators in navigating serious illness, dying, and death

  • Website: https://kidsgrief.ca/

  • Email: info@virtualhospice

 

Rainbows, Guiding Kids Through Life's Storms

 

My Good Grief Journal App for Apple iPad

  • App created for children and can be used by adults and children during grief, allowing children and parents to create safe-space conversations and create a treasure chest of memories, thoughts, and feelings

  • https://www.mygoodgriefjournalforkids.com/

 

SickKids Recommendations

 

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Death and the Adult

 

Adults face various challenges and changes when navigating death and grief, whether they have experienced the loss of a parent, sibling, life partner, or child. Adults may experience changes in their role identity when losing a parent, whether it is their first parental death or second. Adults may experience challenges when caring for an ailing parent and planning final rituals while feeling sorrow, remorse, guilt, and additional responsibilities in caring for surviving family members. (Hadad, 2009, p. 105) Losing a life partner will bring feelings of losing identity and needing to relearn roles, which may vary depending on gender roles. (Hadad, 2009, p. 102) Losing a child may bring various challenges, as the death of a child goes against the natural progression of life. (Hadad, 2009, p. 100) Most parents will feel despair, confusion, guilt, anger, and even marital problems. (Hadad, 2009, pp. 100-101)

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Adults can face challenges when navigating the loss of a sibling, friend, or close relative, and it will depend on the type of relationship, complexity, and closeness. (Hadad, 2009, p. 106) Adults who experience miscarriage, abortion, and stillbirth will also experience mourning. Various emotions are felt, especially regarding guilt and responsibility or even inability to mourn in elective abortions. (Hadad, 2009, p. 107) Terminally ill adults will also face challenges relating to their diagnosis, unfinished business, providing support for surviving family members, prognosis and treatment options, and achieving relief. (Hadad, 2009, pp. 109-111) Adults may also face challenges in the death of a pet either through natural causes or euthanization.

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The following are resources that may provide support for those adults experiencing grief.

 

Adult and Death Resources

 

SickKids Pathways Grief Support Program

 

Sunnbybook Pregnancy and Infant loss Network

 

Ontario Pet Loss Support

  • Providing individual and online grief support for anyone coping with the loss of an animal companion.

  • Website: https://ontariopetloss.org/       Telephone: 905-272-4040

 

Wellspring Cancer Support

 

Circle of Care Sinai Health

  • Providing bereavement support for adults experiencing the death of a spouse, family member, or friend. At this time, they are not providing support for child or infant loss

  • Registration for individual support or group sessions, contact Charlotte Koven case manager Telephone: 416-635-2860 ext 271 Email: ckoven@circleofcare.com

 

Life in Harmony Grief Counselling

 

 

Death and The Senior Adult

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Senior adults face various challenges and concerns towards death and dying, including health factors, illnesses, disease progressions, treatments options, surviving family members, and type of care and facilities available. Their attitudes towards death will vary depending on their capacity, life experiences, and feelings, including fear, personal choices, cultural and religious backgrounds and beliefs, and expected outcomes relating to fear and type of death. (Hadad, 2009, p. 117) Care settings and support staff or family members can play a role in their attitudes. They may either be in a hospital, palliative care setting, or home and cared for by support healthcare workers or family members. (Hadad, 2009, p. 117) Seniors may have less fear and anxiety in death if they feel satisfied with their life accomplishments, feel they lived a good life, found meaning while living and through an internal spiritual belief system. (Hadad, 2009, pp. 118-119) Seniors who feel connected to others and something larger than themselves or self-transcendence may also feel peace towards dying. (Hadad, 2009, p. 119)

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Seniors often wish for a good death, including little to no pain, autonomy, capacity to make informed decisions, control over the location, and connections to spiritual leaders and loved ones. (Hadad, 2009, p. 120) They would like to feel as if they are living while dying with a sense of normalcy while clearing up unfinished business, making peace with the past, or leaving letters to their loved ones. (Hadad, 2009, p. 121) Some seniors may experience losing loved ones, their living situation, and their physical and mental abilities. These losses can present challenges in feeling alone or unable to function or live independently. (Hadad, 2009, p. 125) They may lose social relationships and community support. Seniors should have clear directives for their end-of-life wishes, including funeral arrangements, power of attorney, and a legal will. The following resources can provide support in end-of-life planning and grief support.

 

Seniors and Death Resources

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Arbor Memorial

 

Circle of Care Sinai Health

 

Carefirst Seniors and Community Services Association

  • Providing community support through education, seminars and workshops relating to death, dying, funeral service, will arrangements, counselling, pension and financial assistance, and bereavement support

  • Website: www.carefirstontario.ca

  • Telephone: 416-502-2323

  • Email: info@carefirstonatio.care

 

Woodgreen Toronto Seniors Helpline

  • Providing seniors and caregivers with community, homecare and crisis services

  • Telephone: 416-217-2077       Toll-free: 1-877-621-2077

  • Webchat: https://torontoseniorshelpline.ca/

 

Sisterhood of Widows

 

Acclaim Health Widowed Friends

 

 

Suicide

* If you or someone you know needs help, please call 1-833-456-4566*

 

What you need to know: (Canada, 2019)

  • Approximately eleven people die by suicide each day

  • Approximately 4000 deaths by suicide per year.

  • Suicide is the second leading cause of death for people aged 15-34

  • One-third of death by suicide is by those 45-59

  • Male suicide rates are three times higher compared to women

  • Canadians are three times more likely than an immigrant to attempt suicide

  • 11.8% have thought about suicide in their life

  • 2.5% have thought about suicide in the past year

  • 4% have made suicide plans in their life

  • 3.1% have attempted suicide

  • For every death by suicide, at least 7-10 survivors are significantly impacted

 

For comprehensive information on Suicide in Canada, please visit https://www.canada.ca/en/public-health/services/suicide-prevention/suicide-canada.html#a3

 

The act of suicide is emotionally charged as it is complicated, confusing, and full of questions and regrets. It can impact any person and is free of bias and discrimination. It can happen in any way and at any point in a person's life. Research has shown that those with psychological disorders such as depression, panic disorders, and personality disorders may be at a higher risk. (Hadad, 2009, p. 133) Marginalized populations such as the LGBTQ2+S, Transgender, and Indigenous communities also have a higher risk. (Canada, Suicide in Canada, 2021) Other factors include suicidal idealization, cognitive factors, environmental stress, substance and process addictions, physical illness, and previous suicide attempts. (Hadad, 2009, pp. 133-134) Educational awareness and mental health support are available to help anyone experiencing suicidal idealization and crisis intervention.

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Nishnawbe-Aski Nation program on Improving Mental Health: (Hadad, 2009, p. 145)

  • Instill a sense of value in individuals and communities

  • Enable youths to feel purpose and direction

  • Restore a sense of wellbeing and pride to individuals and communities

  • Motivate youths to be productive and constructive

  • Provide life skills training that can be used in a real-time application

  • Help individuals develop good coping skills

  • Address mental health issues

 

How Can You Help (Hadad, 2009, p. 145)

  • Be aware of the warning signs, especially if a person mentions suicide

  • Stay calm and listen. Let them know that you are listening, you are here for them, and they are in a safe space with you

  • Ask directly: are you thinking about suicide? Do you have a plan to kill yourself?

  • Do not be judgemental or attempt to solve their problems

  • Remind them of reasons to continue living

  • Encourage them to seek counselling, with the hope to resolve some of their feelings

  • Pay attention to your wellbeing after the incident or event, seek help for yourself

  • Call 911 if suicide seems imminent

 

The following resources are available for those thinking about suicide or who have been affected by suicide. There is help available, and it is strongly encouraged to seek help.

 

Suicide Resources

Canada Suicide Prevention Service

  • Responders are available 24 hours a day, seven days a week, and year-round

  • Toll-Free: 1-833-456-4566

  • Text messaging is available between 4 pm to midnight

  • Text: 45645

  • Website: https://www.crisisservicescanada.ca/en/

 

Canadian Association for Suicide Prevention

 

Distress Centre Durham Crisis and Suicide Support

 

Distress Centre Durham LGBTQ2+S Prideline

 

Life Voice

 

Strong Hearts Native Helpline

 

 

Death and Trauma

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Grieving traumatic death can directly impact us through the death of a loved one and through social media and print production. (Hadad, 2009, p. 151) Traumatic death occurs when death is unexpected, sudden, and violent and can shock a person's reality and world lens. (Hadad, 2009, p. 151) Survivors face the difficult task of mourning the loss of their loved ones, and in some instances, coping with the trauma, which can lead to posttraumatic stress disorder. (Hadad, 2009, p. 151) World views change to reflect an unjust, cruel, insensitive, and malevolent world. (Hadad, 2009, p. 152) Research has shown that violent, unexpected deaths can pose challenges in the grief process because there are often strong emotions tied to the reasons or the person/people responsible for the death. (Hadad, 2009, p. 152)

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Traumatic death carries the heavy burden of grieving that, by way of circumstance, may be challenging to resolve, as compared to death that is accompanied by illness. Traumatic death can turn into complicated grief, which prevents the griever from resolving their feelings or reestablishing a new relationship with the deceased. (Hadad, 2009, p. 154) Complicated mourning can be seen through heightened sensitivity, hyperactivity, restlessness, fear anxiety, over concern, inaccurate memories, impaired daily functioning, rumination, lack of normal emotional reactions, inability to talk about the loss or feelings, social withdrawal, self-destructive behaviour, and long-standing feelings of numbness, alienation, anger, intolerance, and aggressiveness. (Hadad, 2009, pp. 154-155)

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Disenfranchised grief occurs when a person cannot grieve or mourn because society does not recognize the individual's right to mourn because social order and expectations are prioritized over the griever's feelings. (Hadad, 2009, p. 159) This type of grief may result in complicated grief and can occur in various conditions and circumstances. (Hadad, 2009, p. 159)

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Complicated grief can be seen as mourning that is absent, delayed, inhibited, distorted, conflicted, chronic, and unanticipated. Absent mourning is seen as extremely rare, and mourners must have the powerful ability to block out reality, suppress their emotions, and may appear to be in denial or shock. (Hadad, 2009, p. 155)  Delayed mourning occurs through complicated grief and when a mourner is triggered much later and experiences the full mourning process in an effort to avoid pain and fear. (Hadad, 2009, pp. 155-156) Inhibited mourning occurs when the mourner concentrates on the positive aspects or idealizes their relationship with the deceased. (Hadad, 2009, p. 156) The grief becomes buried deep under their feelings of guilt in an effort to avoid conflicted or negative emotions. (Hadad, 2009, p. 156)

 

Distorted mourning occurs when the mourner has intense feelings of anger or guilt in their grief response, which impairs their daily activities. (Hadad, 2009, p. 156) Conflicted mourning occurs when the mourner has intense feelings of guilt and remorse stemming from an ambivalent, troubled, or conflicted relationship with the deceased. (Hadad, 2009, p. 157) Chronic mourning occurs when the mourner cannot progress through their grief, and the death seems as if it recently occurred, even though significant time could have passed. (Hadad, 2009, p. 158) Chronic mourning can happen in individuals who have a dependent relationship with the deceased and have a decreased ability and self-confidence to function independently. (Hadad, 2009, p. 158) Unanticipated mourning occurs when the mourner experiences reactions to a great deal of shock and trauma. (Hadad, 2009, p. 158) They may not have time to prepare for the death, correct mistakes, or complete unfinished business leading to feeling shocked for a longer time. (Hadad, 2009, p. 158) It can occur in unexpected to sudden death, and the mourner will have a harder time adjusting to their new and challenged reality leading to biopsychosocial problems.

 

Traumatic Death Resources

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SAMHSA, Tips for Survivors:

 

MADD, Trauma, Loss and Bereavement

 

How To Go On Living When Someone You Love Dies

 

Trauma Survivors Network

 

What's Your Grief

 

Dr. Jay Children's Grief Center

 

Grief Journal:

 

 

Additional Resources

Grief Yoga

 

Grief Art Therapy

 

Grief Meditation

 

Additional Reading

  • The Five People You Meet in Heaven by Mitch Albom

  • The Mourning Handbook by Helen Fitzgerald

  • On Grief and Grieving by Elisabeth Kubler Ross and David Kessler

  • The Memory Tree by Britta Teckentrup

  • Trauma Bonding: how to stop feeling stuck, overcome heartache, anxiety, and PTSD by Dr. Annely Alexander

  • Mindfulness-Based Cognitive Therapy with People at Risk of Suicide by Mark Williams, Melanie Fennell, Thorsten Barnhofer, Rebecca Crane, and Sarah Silverton

  • Comfort for the grieving adult child's heart: hope and healing after losing your parent by Gary Roe

 

Movies

  • The Fault in Our Stars

  • A Walk to Remember

  • Stepmom

  • PS I Love You

  • Dear Evan Hansen

  • The Sterling

  • Marley and Me

  • The Descendants

  • The Bucket List

  • My Sister's Keeper

  • My Girl

  • Coco

  • Soul

 

Conclusion

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Experiencing grief, death, and dying is an unavoidable part of living. Much like life, there is no direct path in the process of resolving grief. Grieving is indeed a unique process, with no right or wrong ways. What will work for one person may not work for another, and vice versa. The conversations surrounding death and dying may seem awkward and uncomfortable and naturally so, as it brings about feelings and emotions that most prefer to avoid. It will be essential to keep in mind that there is no direct timeline and the best support is when it is welcomed or when a person is ready. Do not feel rushed or pressured to act or be a certain way based on societal expectations or internal pressures.

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The grief journey will come in waves as there will be good and bad days. Some days will feel easy and peaceful, and some will feel overwhelming and stressful. It will be helpful to pay attention to your thoughts, feelings, and physical reactions. Paying attention to the here and now can assist in creating a present focus. Take the time that is needed to listen to thoughts and bodily reactions. Rest and breathe. There are various resources out there that are online or in-person and can be in a group or individual setting. Take the time to choose and access support when it feels right or when it is the right time.

 

I wish you the best of luck in your journey of grief.

Kashri C Bhookmohan   

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