Growth Through Loss & Change, Volume II: How to Grieve Without Undue Fear

By Clarice A. Schultz

Grief is an emotion that does not discriminateits anguish is felt just as keenly in the palace of the rich man as it is felt in the hovel of the poor. Growth through Loss & Change, Volume II shares the lectures developed and taught by nurse thanatologist Clarice Schultz for thirty years in a variety of settings. With a focus on the principles, theories, and intervention methods that underlie the care and support of the dying and bereaved, this resource guide also identifies the dynamics of loss and discovers practical means of support.

Clarice Schultz, one of the founders of the Fox Valley Hospice, relies on her seasoned interactions with the dying and grieving to encourage those who care for the terminally ill and their bereaved families to overcome their fears and learn what works and what does not work. Her focus includes: Different faces of grief Ways to support the grieving Signs of healing after loss Impact of grief Tailored for those who wish to develop a therapeutic presence for themselves as well as others, Growth through Loss & Change, Volume II provides compelling guidance for anyone in the midst of a grief journey.

• Language: English
• Publisher: Trafford Publishing
• Release date: Apr 29, 2010
• ISBN: 9781426945274

Clarice A. Schultz

Clarice Schultz has worked as a nurse thanatologist for thirty years and has taught numerous courses on grieving. She earned Bachelor of Science degrees in nursing and psychology as well as an AD in anthropology, and minored in theological studies.

Book preview

How to

Grieve

Without Undue Fear

Lectures by Clarice A. Schultz

RN, BSN, Psychology BS

A Resource Book

Put on Your Shelf for a Time of Need

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© Copyright 2010 Clarice A. Schultz.

Anyone who has purchased this book has my permission to make as many copies of needed portions as necessary for use solely for their own students for education purposes only, with the condition that they give full credit for authorship and copyrights in writing on each page of the handout, header or footer. They may charge sufficient money to cover copying cost but may not make a profit on any copy. Educators may make copies from which to teach.

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Contents Volume II

Dedication

Acknowledgments

Appreciation

Forward

Preface

Introduction

Chapter 10

The Scope of Grief

Consciousness Raising

Culturally Worthy & Unworthy Grief

Example of Losses

Betrayal of the Body

Fantasy Loss

Life Milestones

Peri-natal Loss

Grief for Someone You Don’t Like

Dislocation

Dreams of Future

Living Grief

Self Image Change

Grandparent Grief

Sibling Grief

Self Image Loss

Body Image Loss

Special Losses

Appendix A

Period of Interface

Interface - The Time

Before the After & After the Before

My Friend,

But Interface is Also a Gift Time

Chapter 11

Normal Dynamics Grief

Definition of Healing Grief

Healed Grief Looks Like

Living Grief

Characteristics of Grief

To Heal From Grief

Supporting the Grieving

Time Line

Characteristics of the Time Line

Two Distinct Phases of Grief

Physiology of Grief

Physiologically Dangerous

Many Physical Responses

What Helps Those Who Grieve

Summary

Appendix A

Mosaic Window

Beautiful Rose Window

Appendix B

Child in Brambles

Come to a Quiet Place

Appendix C

Self Care Plan

Appendix D

Corridors of Life

Chapter 12

Grieving Children

Need Adult Help

Introduction

Do Children Grieve?

How Is Death

Introduced To Children

How do People Relate to a Grieving Child

Working With the Child

The Atmosphere in the Home

Differentiate Between Work and Role

Funeral

Identifying the Grieving Child

School

Appendix A

Sibling Seminar Format

Chapter 13

Just For Teens

Grief is Real

Grief Overtakes You

What can Bring up these Feelings?

Facets of Life Changed

Chapter 14

Gender Differences in Grief Response

Introduction

How Can I Help A Man Grieve

A Tribute to Men

Healthy Masculine Grief Expression

Culture

Matriarchal Society

Without Coping Patterns

Physiology of the Brain

Characteristics of Males

Appendix A

Meditation - Father’s Day

Come to a Quiet Place

Appendix B

Fathers Day

Fatherhood of all men

Appendix C

Feedback from Father’s Day Service

Chapter 15

The Pastoral Visitor in the Hospital From

A Nurse’s Perspective

Forward

Introduction

Communication Among

The Health Care Members

Concerns of Visitors

The Continuity Care Person

Different Views of The Minister Role

The Minister Nurse Team

How Nurses would like to be Related With

Special Situations

Faces of Prayer

Ministers in the Hospital

Chapter 16

Spiritual Handling of the Holidays

Gift from Your Grief Experience

Impediments to Healing

Loved One–Maybe Not

Holiday--A Time of Pain

Expect that Grief Will Surprise You

Name it & Proclaim it!

Examples of The Gift

People who Taught Me this Concept

**** Ceremonies ****

Closing

A Letter From Heaven

Gift Card

Gift Card

Appendix A

Remembrance Ceremony

Lighting the Candles

The Gift of Remembrance

Name It and Proclaim It!

Appendix B

Holiday Plan

Appendix C

Supply List

Handling the Holidays Spiritually

Afterward

Summary of the Course

You have Grown

Blessing

Growth Through Loss & Change

Volume I & II

Goals and Objectives

References

About The Author

Dedication

To my son

Officer Craig W. Schultz

Killed in the line of duty to his country and to the people of

Kansas City, Missouri on May 9, 2001.

Special Services Air Force, six years

Special Patrol Kansas City Police, eleven years

As a child and teen he came with me on my lecture tours. I saw him use these principles daily. Injury and Death was a constant in his professional life. He did not remember that he learned through my work. He commented that the other officers wondered how he could deliver the sad news and personal effects to families of the dead and work with them so well. He would say, It is just right and natural for me, Mom, to act and do these things at the time of pain and death. He thought he learned it all by himself.

Acknowledgments

To my students who taught me the majority of these interventions. They used them, adapted them, shaped them, and authenticated them. My part was to see what principles were being addressed and check them out with qualified personnel in the field for professional correctness.

With deep gratitude to the many professionals who so honestly shared their stories, feelings, and concerns.

Special thanks go to:

William Scheer

Bruce Conley

Donna Kruger

Rev. John Atherton

Rev. Steve Defor

Rev. Chuck Richardson

Rev. Gary McCann

And with deep gratitude to the many nurses who generously gave input to my interviews who declined my invitation to present this information saying:

"I am the clinician.

You are the mouthpiece.

If you do not present this information

It will stay on my unit with me.

You are the teacher

It is your responsibility to give it out

Unto those who can receive.

Appreciation

I appreciate the in-depth editorial and professional reviews of:

Bill Scheer, M. Div., MSW, Braidwood, IL

Bruce Conley, Funeral Director, Elburn, IL

Carter Crane, Editor, The Voice, Aurora, IL

William H. Schultz, BS, Plainfield, IL

John Atherton, M. Div., Hot Springs, AR

Jan Russell, RN, MSN, Pensacola, FL, Deceased 2009

Anita Scheer, MA, Educator, Coal City, IL

Ralph Kieffer, BA, My Brother, Oregon, WI

Marge Orchard, RN, MSN, Elgin, IL

Chuck Edwards, RN, PM, Batavia, IL Deceased 2001

I especially value the fact that the above professionals never ceased to pressure me to publish this manuscript.

Forward

William H. Scheer M. Div., MSW

Clarice has a profound effect on all who take her classes because she has touched us with kindness, knowledge and all the permissions necessary to embrace our loss, to accept it as our own, to grieve it while knowing that our ability to love is not diminished by our loss. She invites us to open our hearts to love once again as we slowly reorganize ourselves for our continued journey. Life is worth living and it continues to demand our participation. She prepares us to face the world again after bereavement and jump back into life.

I remember the comment of a group participant in one of our grief workshops. The woman lost her husband of many years and two grandsons. She had been stuck in grief for four years. She hadn’t baked Christmas cookies or given presents since her husband died. She just couldn’t bring herself to do it. Life offered her no joy and crying was her sorrowful lifestyle. After taking Clarice’s class she was able to celebrate the holidays, decorate, and hang remembrances on the Christmas tree that honored those whom she loved and lost. She was able to step back into life while respecting the memory of her departed loved ones. It was okay for her to feel joy again!

This is what Clarice has done all her adult life. She has set people who were lost in grief free; free to experience the joy of living and loving once again. Her two volume set is full of information about the many dimensions of grief with insights that have been tested and refined over the years. These two volumes are an invaluable source of information for anyone working in the caring professions including nursing, ministry, teaching, psychology and social work. May you have good reading, and welcome to Clarice’s world!

Twenty-seven years ago I was suffering the effects of a recent divorce. I spent many lonely weekends in my apartment hoping to find someone to fill my life with joy. I was standing in my living room one Saturday with nothing to look forward to. I said to myself, You’re not going to meet anyone sitting here in this apartment! I decided that I needed to get involved in a community activity. I had seen several advertisements for volunteers for Fox Valley Hospice. I volunteered as a public relations speaker traveling to churches and fraternities educating the public about the importance and value of this new service in our community. By early fall I decided to volunteer as a direct worker visiting and supporting the dying patient and their family. I was informed by the director that I would have to take a ten week course.

This was my first meeting with the instructor, Clarice Schultz. Little did I know then that she would change my life in some very dramatic ways. There were twelve of us in the class. We were all profoundly affected by Clarice and her teaching style. Once you have taken one of her Grief and Loss classes she is indelibly etched on your heart, never to be forgotten.

Clarice introduced me to my wife in the form of a blind date. She gave me Anita’s phone number as she reminded me, Remember she comes in a package of four. I met my wife to be and her three children on March 19, 1983. We were married in April of 1984. Her children embraced me and we legalized the adoptions at the courthouse. We now have a fourth child. I invested in life and love again. That is healing grief.

Preface

How it Began

The door burst open to the Recovery room where I was nursing two critical patients. This was a quiet room with the lights dimmed and movement quick; but subdued, so as not to agitate the recovering patients coming out of anesthesia. The energy coming in from the nurse at the door was electric. She was saying, I will take your patients, Clarice, I can do it. You go to the emergency department where a man is writhing on the floor, completely overcome with grief at the death of his wife. You are good at that! You can do it! He needs you! I was scared. Death is always scary. I protested; but, she was already taking care of my patients.

At the emergency department I saw bewildered, kind folks, encouraging a young man on the floor. He was inconsolable and could not hear them. They had only been married a year. Swiftly I walked to him and went down onto the floor beside him. I locked in on his energy stream and reflected, reflected, coo-ed, reflected, comforted, and reflected.

That is how this all began. From then on I was often called to any part of the hospital.

I had just graduated from nursing school a couple of months before, so when the administration offered me an opportunity to attend Dr. Kubler-Ross’s seminars in Chicago, I was amazed and honored. The only requirement was that I turn in a summary of her presentations and develop nursing recommendations upon my return to the hospital. I did; and I was done.

A week later I met the Nursing Administrator in the hallway. She asked me to make an appointment with her to arrange teaching times for all the head nurses in the hospital. I said, Thanks, but no thanks. I don’t teach. She answered Yes, you can teach. I replied that it was a conscious decision of mine to choose nursing over teaching; therefore, someone else would have to teach the material because I would not be doing it. I was going to nurse patients. As I walked down the hall I heard her voice say, Yes, nurses do teach."

About two weeks later I met her in the hall again. Her mood was different. Sounding authoritative, she said, I asked you to make an appointment to come in to talk about teaching. I responded, And I told you, no. I would not teach. I cannot teach. I don’t know how, and I choose not to teach. Squinting her eyes, she asked in a steel voice, Ms. Schultz, do you like working here at this hospital? If you do, you will make that appointment with my secretary. And that is how my teaching career began.

I taught two series of eight sessions at the hospital, at the local college the next semester, the following semester I spoke nine hours in the superdome in New Orleans to an international convention of emergency physicians and nurses. Decades later, it is still going on. I am still teaching.

Donna Kruger RN

It was a few years later when I heard that a nurse from a nearby hospital was at a Catholic school in Aurora, Illinois, presenting a session on meeting the needs of the dying and their families. I attended and introduced myself. The custodian locked the school but Donna Kruger and I were still in the school parking lot at 3am. It was so exciting! She had been approached by Illinois Senator Grotberg to begin a new emerging model of care for the dying and their families, called Hospice. Donna Kruger, Bruce Conley, and I founded the Fox Valley Hospice.

We divided the duties, she took the development of the administration and I developed the hospice educational component. There was no end to the growth of that knowledge. I spent days at Rush Medical College Library doing research. I loved it! I taught the hospice training course for eleven years, at which time I left Illinois and moved to Houston, Texas. I continued to teach and develop this course continuously in Texas and now again in Illinois.

Certified

The entirety of this material has received full continuation education credit for all the helping professions in numerous states on the Regional and National lecture circuits. I have taught it for graduate as well as undergraduate credit. All of it has been clinically tested in the classroom and professional institutions of hospitals, nursing homes, hospices, schools, home health and palliative care facilities.

Most years I lectured or taught on the average about four times a week during the semester. The course was designed as a 2 ½ hour session by the original college for whom I taught. It consisted of 1 hour lecture and the other hour as facilitated sharing time. The college observers quickly saw that the one hour format did not do the students justice. Grief is so intense that when the student opened up they needed time to debrief. I still keep that format for classroom situations.

Introduction

My intention is to publish these unedited versions of my lectures so that others may use parts of them to augment their own presentations. It is my desire that readers find the material helpful in their personal as well as professional lives. It is a body of work that has proved useful throughout many years.

If something were to happen to me these lecture manuscripts will die in my file cabinets. It is to avoid this fate that I put them on the internet for the use of anyone. That is what they were developed for, that is what I devoted my life to, and may the ministry to the suffering continue.

The manuscripts were developed by request of the sponsoring agency for presentations at professional regional and national conventions. Therefore they are meant to stand alone. To achieve this, I often cut and pasted from existing manuscripts to provide the proper introduction and background for the material.

They went together nicely for the college courses that I taught. You may use them as you wish to best serve your audience.

Course Name:

Many versions depending on the institution sponsoring the program or course.

Sensitivity to Loss

Death & Dying

Grief & Grieving

It is an assumption of this course that all who are bereaved,

Are also placed in the role of helper

This role occurs both in a present loss situation as well as in future losses, so that any healthy coping patterns learned in this loss event will be available with adaptation for future losses.

Course Description:

This course focuses on the principles, theories and intervention methods that underlie the care and support of the dying and bereaved. Emphasis is on identifying the dynamics of loss and discovering practical means of support in the personal and institutional setting.

Content Includes:

Dynamics of grief for the adult and child, tasks of the dying person, the grief impact on family and institutions, and the role of the community in support of mourners.

Intervention methods are taught which are related to the cultural and emotional aspects of, dying, grieving, sudden death, grieving children, and caregiving.

Target Population:

All persons in the helping professional and paraprofessional fields, e.g. nurses, physicians, teachers, counselors, ministers, funeral directors, EMT’s, respiratory therapist, police, fire, hospice volunteers, grief support facilitators, church visitors, and all lay persons who are sensitized to death and grief. Continuation education credit for this material has been granted to each of the above groups.

History of Course:

Content of this course has been DEVELOPED and taught by CLARICE SCHULTZ for 30 years in a variety of settings, colleges, hospitals, hospices, churches, workshops, seminars, and inservice programs around the USA. Ms. Schultz published some of the content in professional journals.

Goal:

To enable the students to: develop a therapeutic presence that they can offer to themselves and others coping with a loss, in family, community, and institution.

Chapter 10

The Scope of Grief

Consciousness Raising

Multiple losses are the norm. You need to know that the loss you are cognizant of may not be the issue that is sapping the emotional and spiritual strength of the mourner. A grief rarely comes alone. At a loss there is a domino effect of many subsequent losses such as, the death of a wage earner brings loss of income, inability to pay mortgage, loss of home, loss of neighbors, church members, clubs and more. There are more subsequent losses for children than for adults. Usually these are not identified. When I present in schools youngsters identify about 60 losses within 10 minutes. Students refer to this exercise as a real eye opener. They say it is a key to understanding where and why their grief is stuck. Remember, grief is cumulative and each loss must be processed individually.

The new grief never comes alone. It brings up all the losses in one’s present life as well as all the losses of the past, necessitating the rerunning of past losses to integrate them into the new self-image of, Who am I now that this has happened to me?

Hours and hours must be spent in integrating the meaning of all these losses in their lives. One is impelled to do this or the time and emotional energy will be spent stuffing the grief with illness or compulsive behaviors such as, overeating, sexual stimuli, drugs, alcohol, and ruminating.

Many Losses

At this time I invite the reader to look at how many types of losses you can name that bring about the grief response. For the sake of consciousness raising lets run as many losses as come to mind. Then consider how families or persons with these multiple losses are supported by society. Often the issue the mourner is dealing with is not the precipitating event such as death, but losses that are consequences of that death.

Everyone has many losses that are influencing their thinking and confidence level. This is determining the energy that is available for daily life. It is good to identify past losses. It validates struggles and successes. As you do this, you see strengths and trust that those coping patterns will be there for you again. Most of your former coping patterns will work again with adaptation to your present age and circumstance. Healing grief is all about coping patterns. By identifying those that worked well in the past you can choose to adjust them and use them again.

At a time of stress and crisis it is sometimes difficult to identify what got you through in previous tough times, or how that strength might adapt to the present day crisis. It often takes the insight of others to assure you that you do have what it takes to adjust to love and life again. In the absence of friends such as, after a move, a socially unsupported grief, or when everyone in your milieu is also grieving, it is good to ask a therapist or other helping professional to assist you,. This is also how you support others as they process their grief. You do not tell them what to do, but you can help them to identify their strengths and goals.

Culturally Worthy & Unworthy Grief

Let’s do an exercise for the purpose of opening the doors to the corridors of our mind. We will walk down those corridors later in discussions, readings, and by listening to others. You will find that thoughts and insights will come to you in the weeks and months following this reading. At this time we only want to look at how many changes can bring about the grief response.

As you raise awareness to these losses it is valuable to identify what supports are available or absent to the mourner. Therefore, before we begin it is important to identify dynamics of high status loss, low status loss, culturally worthy of support loss, culturally unworthy of support loss.

How to Identify

As helping persons we do not want to operate on status systems to comfort others. All losses must be processed. Our desire is to support those who need our help regardless of the cause of the grief. When they have guilt to process, part of the support we give is to help them process this issue. However they may have a socially unworthy grief without guilt. That is alright. It is not up to us to judge. If a loss is culturally unsupported or it results from a positive loss such as graduation or a promotion, it often remains unidentified which causes the mourner to repress strong feelings.

A grief support person must identify the low and the high status losses. In the high status losses, our part is to connect the support of the community to the persons who are going through the loss. In the low status losses, the same adjustments need to be made but there is virtually no support for us to mobilize. Then we need to approach individuals and institutions for the help that is needed. Often the griever is so shamed that secrecy is important to them. In that case, what is done for them is done only by you and the few persons you can mobilize in a professional manner.

Unworthy loss is often unidentified. Yet, the grief healing process must be gone through or the grief wounds will affect their life in dysfunctional and disabling ways. In stuck grief, energy is tied up to repress the pain. Our goal is to free up that energy so the mourner can be open to receiving beauty and love again.

How Support is Given

When a loss is culturally worthy our culture reaches out. People make the parental caring sounds such as: Awe, that is difficult, let me help you. They lean forward, listen and ask caring questions. Support information and support groups are readily available. Money is provided by the community for insurance benefits, hot lines, crisis lines, information, self help groups, research, and relays.

How can we tell whether a loss is culturally worthy or unworthy of support? The clue is in the answer to these questions: What is the culture’s response to the announcement of this change in an individual’s life? What are the platitudes we say? What mores do we introduce? What are grief stoppers, such as, I never get angry, All things turn out for good, God never gives you more than you can handle, what goes around comes around, you made your bed, now lie in it. Be glad to be rid of the bum. Don’t talk about it. Close the chapter. Start a new life. These comments stop the grieving process.

The question to ask, "Is the pain still there in socially unworthy grief? Is the loss still there? Has the self-image shattered? Does the former image of self have to be grieved and an image of self redesigned with this new information in it? Will they cry alone in their beds and put on a happy face to the outside world? Does this take its toll on the human being?

Listen Non-judgmentally

If you can bear to listen non-judgmentally to those who are processing low status losses you are doing a wonderful thing. You are probably the only person they can be honest with and cry with. We want to be non-judgmental. We leave judgment to a Higher Power and the legal system. We need to acknowledge that our culture mores do punish. We need to be aware that each of us is a product of our own culture and that we also respond subconsciously to punish others. Therefore we need to work intentionally at being non-judgmental.

Example of Losses

In preparing the material for this chapter I am aware that I have great discrepancy in the amount of comment under the title of each loss. Some of the subjects have many insights given to me by students that are not readily available in printed form. Some losses are not readily identified out loud in verbal conversation. I would like to include these insights for the reader’s perusal. Some of the subjects are listed simply as subject headings for the purpose of opening the mind to its existence. Information may be readily available from other sources or simply not the area that this document delves into deeply. Many of these losses are represented by specialty areas of grief, such as suicide, peri-natal death, and divorce.

Let us begin the consciousness raising exercise. Call out quickly the name of a loss, identify whether it is culturally supported or culturally unsupported, and whether it is a high status loss or low status loss.

Betrayal of the Body

Disease

My nursing instructor said to us, If you must have a disease choose it carefully. There are high status diseases and low status diseases. How do you know which diseases are worthy of community assets? A clue is to look at where the culture spends its resources.

Research

Literature

Medication

Support group

Emergency phone line

Hospice and Palliative Care

Specialty hospitals

Specialty Home Health Services

How about Cancer? Is that culturally supported? Are there support groups, literature, call pack, money appropriated for prosthesis, relays to raise public awareness, and hospice care? Do people who lose a leg from other sources such as a motorcycle accident or infections receive an equal amount of community resources? That would give a more accurate picture of grief support.

How about support given in long term dying versus unpredictable death such as multi-system failure, sudden death, liver sclerosis, congested heart failure, and infection.

How do others tolerate conversation about the illness? For instance heart disease is often seen and spoken about as a badge of honor. Many talk about it all the time, au-nausea-um. How does this compare to the need to converse about sexually transmitted diseases such as HIV, AIDs, herpes, genital warts, gonorrhea, and syphilis?

If we look at the number and percentages of socially unacceptable and therefore culturally unsupported diseases we realize that in our church, work, neighborhood and recreational milieu we are relating to many persons who are making these adjustments. They would benefit as much as a cancer patient benefits from conversation and support. They die without it.

Pelvic Inflammatory Disease

As an example, let us look at a case of two women at a church social. Both of them are suffering from pelvic inflammatory disease, one as a result of cancer and the other as a result of sexual activity.

If the first lady were to say, These chairs hurt the ulceration from radiation treatments, how might others respond? Would she likely get help with padding, adjusting the chair, and comforting words?

Right beside her is another lady who has pelvic inflammatory disease as a result of a sexually transmitted disease. If she were to say, These chairs hurt my herpes blisters, would people help or add to her misery? What reaction is she likely to get? Might someone say, You deserve it. It is God’s punishment. Would she even complain out loud? Do you think she would mention it in a group? Not usually. Would she suffer in silence? Is her pain less painful than the first woman’s? Perhaps she has never told anyone about it.

The point is that both have to learn to live with the pain, both have to go through the self-image adjustment. Both have to live with the sense of body betrayal and undependability, but there is a great deal of difference in the community support and comfort available to each of them.

If losses are not processed, the emotion is stuck and needs releasing. In stuck grief, energy is tied up to repress the pain. Our goal is to free up energy so that the mourner may be open to receiving beauty and love again.

The culturally worthy losses are the ones we speak about in public and receive compassionate comments, encouragement, and comfort. Look at the culture and identify how we continuous talk about, certain surgeries, physical pain, and medications.

Culturally unworthy losses are often the ones never brought up. When they are brought up in conversation the listeners respond with a culture mores to shut them up or to punish. The grieving person usually gets silent immediately and leaves the scene to cry alone.

Sometimes the culturally unworthy grief is made public, perhaps by a newspaper story. Even so, the shame of the griever will keep them from bringing it up. As a society we are supposed to take shameful losses in stride. However, there is no difference in grief tasks.

Those experiencing a culturally unsupported grief are as worthy of your love, compassion and outreach as those who are suffering a culturally worthy loss.

Losses that are culturally supported or culturally punished are different from one culture to another. We may think it awful that a tribal woman on another continent, whose mate dies, is punished by banishment and social isolation, yet in the United States we do exactly that to many grieving persons.

Fantasy Loss

Fantasy may be the most difficult loss from which to heal. Most people deny they are fantasizing. Fantasy is real. Part of the creative life is to fantasize. Denying this inhibits the grief healing.

Fantasy must be grieved. Identify each fantasy when it comes up and then grieve each fantasy separately, by acknowledging it, grieving its deadness, its never-to-be-ness. The mourner must accept that reality and then do the tasks of looking at reality as it is now.

The grief task is to answer the question, What are the pieces of my life? And What can I, or what does God wish me to build with these real pieces that do exist? After reality testing the answers one must just do it. Just live positively in reality. Too hard? Yes, at first it is too hard. Be gentle with yourself.

From here on, I will refer to death of a person but you will understand mourning must be a necessary process after the perceived loss of any object, be that: person, place, ideal, or fantasy.

Baby Blues

Grieving for the children that never were. It is the ticking clock syndrome. This phenomenon is increasing rapidly in our society. Many couples choose to marry later, to have their education, profession established, and money saved first, only to find they are now ready and health fails, or for some reason conception is not possible. Often they are ready but there is no mate in their lives. Then what? They think of options, choose single parenting, artificial insemination, surrogate Mother, or choose a biological mate to co-parent without marriage. These are lonely and difficult decisions. In some cases their partner chooses not to have children. The partner has changed their minds and the mate needs to decide to either give up their biological urge to reproduce or divorce someone who in other respects has been a wonderful partner. This is a very difficult time.

Marriage Blues

Another increasing loss in our society is the marriage blues. Persons who always assumed the right mate would appear and they would have a home with children and grandchildren but it just never happened.

Dreams of Old Age and Retirement

Some times none of the fantasies come to fruition, perhaps there are no grandchildren, or the mate is incompetent. There are no holiday celebrations when the older generation becomes feeble, no traveling, or golf outings in retirement. There is no one to comfort at the major loses in life such as moving to a retirement community, disablement, or dying. Some times there is no one to inherit one’s special objects, photos, money, or family treasurers. These must go to charity, Goodwill and the dumpster.

Sometimes the dream is unrealized because it arrives when the person is too old to take advantage of it. For example becoming a grandparent at such a late age it precludes active participation in grandchildren’s activities. This is happening in greater numbers because child bearing is delayed until late thirties and early forties. There is a trade off on both ends of the age spectrum. The new child’s grandparents are aged and the new parents will be aged when it is their time to become grandparents.

A Lifetime Preparing

A 76 year old lady came into my nurse’s office, closed the door, and wept. She explained she was about to become a Grandmother. As a young nurse I rejoiced. To my shock she did not. She talked about her lifelong dream to have children and be an involved grandmother. How dear her own grandmother was to her and how she had so many gifts of wisdom, insight, encouragement, and love to share with her grandchildren to be. All three of her children delayed parenting until now the first child was conceived. Her health prevented her from acting out any of her fantasies for which she spent a lifetime preparing.

Loss of Pension

Pension loss or annuity loss is increasing each year. It used to be that one third of the retirees actually got the retirement benefits they planned on receiving. That was sad but now that percentage is growing smaller and smaller. Companies no longer provide pensions and people are using their personal retirement money before they get to retirement age.

Retirement

Retirement is often a gain of freedom but a loss of the productive years. There is a need to feel of value at any age. In reality most persons want a two-year sabbatical from work. They do not want be done forever. When the sabbatical is over they wonder how they can be valued. That is the task of the aged. When illness sets in post retirement there are unfilled dreams that people spent a life time working to get. Depression is high in the retirement communities of Florida, Arizona, Texas, and Alaska.

Estrangement from Adult Child

Nothing in my life is as I dreamed it would be. This is truly a Living Grief. The child is thought about and the heart breaks many times each day. One learns not to mention it very often. This is more common than anyone acknowledges.

When I nursed in a retirement community I was often surprised to discover that there were children of the diseased at the funeral. Children were not listed on my records and even though I gave them bedside care, they never mentioned having a child. Later I found that rather than explain, many older persons just do not mention an estranged child. They say that mentioning them only brings up pain, and when they do mention that they are estranged it becomes a conversation stopper, so rather than ruin the atmosphere at the gathering they just say they have no family near.

Loss of Heirs

Who will receive my precious things? Who will care about the contributions of my life? Who will ever want to know my life story such as the adversities I overcame and the personal growth I accomplished? Who will come to my funeral? Who will tell their children about the examples of goodness that were mine? Who will honor my memory? No one. This is the sad reality of many elderly.

Failure to Attract a Friend

Feeling rejection; failure to attract a friend you want. Have you ever heard others around you talk about a party, get excited about going to it, and then hear that it was last week? Does that hurt?

Or have you had the experience of gathering up your things to go to lunch with the gang and then realize they planned to leave without you? These events happen to each of us, yet we are ashamed and think we are the only ones who suffer this indignity. We think there must be something radically wrong with us.

Loved One Waste Away

Watching someone you love waste away in grief is difficult. Witnessing the life of someone you love change as a result of death or breakup with a significant other, feels so helpless. Sometimes the hardest grief to bear is watching loved ones grieve and seeing the effects of grief on their lives. There seems to be so little one can do, only stand by. One of the girls in my class told of watching her twenty two year old brother mourn the accidental death of his girl friend. She observed his grades fail, watched as he dropped out of college, and lose his job as he grieved inconsolably. She did not know the girl personally but grieved deeply for her because she knew how it affected her brother.

Many a mate has told how sad they were when their partner wept and mourned the death of a parent, brother, or sister. They could be near and comfort but they could not take away the pain. Can you identify the loss for the one that stands by? The mourner is a different person now. They no longer laugh and play freely. Grief affects the family atmosphere. Often there are major changes in the life of the mourner that affect everyone near to him. It is not a simple matter of supporting a grieving family member but one of living with the consequences of living with and working with a grieving person. Often you see their life changed. They are no longer the same person they were before the grief occurred.

Life Milestones

Place Someone in a Facility

Often one hears this lament after a death, I promised her I would never leave her, that I would never put her in a nursing home. I panicked and called 911, I failed. These individuals need to understand they did keep the promise. The dying took place