Dealing with Loss & Bereavement
A Guide for Caseworkers
B Simpson
April 2010
Introduction
Caseworkers will often attend interviews where there has been a loss or bereavement. This could have been a recent event, or an event which has not been resolved but is still of concern to the client.
An experienced Caseworker must be aware of the signs and symptoms and be prepared to deal with these issues with sympathy and sensitivity.
Grief can be experienced in many different ways and is all too often expressed as pain, anxiety and anger it can also be accompanied by periods of physical distress). The reality of loss can trigger a wide range of emotional feelings as grieving people may withdraw from normal social contacts becoming lonely and isolated. The normal grieving process takes time and can vary from person to person.
Caseworkers should be aware of the symptoms often associated with grief. If this process is seen to be excessive, prolonged or complicated, then professional help should be suggested to the bereaved person through your CWO or and organisations like CRUSE.
Coming to terms with grief can involve behaviour, thoughts and emotions and the changes that occur in a person’s behaviour can sometimes be seen to have an adverse effect on the healing process. Some of us come to terms with loss, but others need considerable help and perhaps, more time.
1. Caseworker Skills
Coping with feelings
- Empathic understanding
- Active listening
- Open questions
- Paraphrasing
- Reflecting feelings
- Clarification
- Identifying problem areas
2. Knowledge Needed To Recognise Grieving Process
- Recognising the symptoms of the bereaved
- Understanding the 4 stages of loss
- Appreciation of the feelings and emotions associated with loss
- Understanding the boundaries
3. Attitudes to Grief
Following a death there is a brief period of numbness and shock this can last from a few hours to a few weeks. Grieving people can feel tremendous pain, anxiety, and anger. This is often accompanied with waves of physical distress such as shortness of breath, dizziness, weakness and fatigue. They could also experience uncontrollable sobbing and outbursts of tears.
Their frequent thoughts of the deceased result in intense pining and yearning for the lost relationship. They may direct their anger at themselves, or at the person who has died or in some cases others around them.
As the reality of the loss sets in, the emotional reaction shifts. The anger irritability, pain, anxiety and intense longing for the lost person become more subdued and less intense. Life seems meaningless, without purpose and disorganised. Depression along with feelings of hopelessness and helplessness can all be very intense.
Grieving people may withdraw from normal social contacts because they are now accepting the loss and tolerating the pain resulting from that loss. It is painful acknowledgement that leaves the bereaved person feeling lonely, isolated and in despair. This stage is recognised as a one of transition from living with the lost person to living without that person.
As time passes, most bereaved people gradually adapt to the loss. Their emotional energies can be reinvested in both new and old relationships. They begin to feel more active and involved again. Memories of the deceased can still bring about painful experiences, particularly on birthdays and anniversaries. Life of course will never be the same and the pain related to the loss does not go away, but now in some cases the bereaved person can have more control and are able to detach him or herself from the experience.
The normal grieving process takes time and this can vary from person to person. For purposes of description, the stages of grief can be broken down but in reality they can overlap. In most cases the period of numbness can last from a few hours to a few days. The denial stage can also last from two to four weeks. Feelings of despair can also last up to a year and beyond.
4. Symptoms Often Associated With Grief
Sadness
Despair
Loss of energy, interest and motivation
Changes in eating or sleeping habits
Feelings of hopelessness and helplessness
Irritability and anger
Tearfulness
Fatigue
If the grieving process is seen to be excessively prolonged then professional help should be suggested to the bereaved person.
Grief is a personal reaction to loss. It is a process, not a state.
The stages of grief are:
- Numbness
- Pining
- Depression
- Recovery
5. Living Through Grief
Coming to terms with loss involves our whole selves and can involve our behaviour, thoughts and emotions. A primary emotion associated with grief is sadness. Grieving clients will also probably experience anger from the sense of frustration and helplessness. Many people experience guilt and self-reproach. There can also be feelings of insecurity when there is a realisation that not all things in life are permanent and that at some stage we all have to face death.
In addition to our emotions many people are preoccupied with the loss and become obsessed with thoughts about the person who has died and how that loss might have been prevented. Many bereaved people often experience flashbacks and these can be so strong that they can really believe they have been talking to and seeing there loved one’s.
Change in behaviour may be noticed; the most common is sleep disturbance. Most lose their appetite and in some cases overeating can be a problem. Many people also withdraw socially in the early stages. Restlessness and agitation can be very common. Overworking can also be noticed as a way of dealing with loss.
Adjusting to loss requires time yet there are actions we can encourage people to take in helping with the process. It is important to acknowledge the loss so that it can be dealt with. One of the most helpful ways is simply talking to the bereaved person about it. For some people it isn’t easy to talk. For them, writing about their experience can be very beneficial.
When someone dies it is very common to feel angry. This anger is real and must be expressed. Many people take their anger out through exercise or walking. Feelings of guilt can also be experienced, and in most cases is often irrational and excessive. A realistic look at their relationship prior to the death can be of great value particularly in taking responsibility of their part, in that relationship. It is also important to be able to express our sadness and at times it is helpful to cry.
Some people feel that crying openly will not look dignified, or that it will embarrass others. In a lot of cases it gives the opportunity for others to share and also to give their support.
Strengthening existing relationships and establishing new ones are also essential tasks in dealing with loss. Frequently people can feel they are dishonouring the person who has died if they engage in new friends and relationships.
Remember to give people time to grieve. This is vital, as in many instances the grieving process can last for a considerable period of time.
- What Is Loss
- Loss of a significant person – Partner, child or parent
- Loss of part of ones self – Disablement of injury
- Loss of material objects – Divorce, separation, retirement
- Developmental loss – Loss of innocence, rape, prison
Examples of incidents which trigger the process of grief and a sense of loss:
Death; stillbirth; miscarriage; child for adoption; ending of a significant relationship; rape; blindness; deafness; divorce; loss of a pet; accident; amputation; mastectomy; hysterectomy; ageing; retirement; redundancy, unemployment; broken treasure; failure; house move; children leaving home; leaving service life; infertility; imprisonment; emigration.
7. Helpful Organisations
Cruse Bereavement Care
Cruse House
126 Sheen Road
Richmond
Surrey TW9 1UR
Telephone 0208 940 4818
Cruse Bereavement Care offers support to all bereaved people by providing counselling, advice and information on practical problems and opportunities for social contact via nearly 200 branches throughout the United Kingdom.
National Association of Bereavement Services
20 Norton Folgate
London E1 6DB
Telephone 0207 247 1080
The association acts as a resource for bereavement related organisations. It offers a referral service for people seeking a local or specialist bereavement ervice.
Dealing With Loss And Bereavement
The 4 main stages of bereavement:
Time can be a great healer possibly 2 years or more …
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Bereavement & Loss - April 2010 – B. Simpson