As a physician, I have seen acute grief in the hospital and treated the symptoms associated with grief in my office practice. However, nothing has taught me more about how to support a person through grief than the recent experience of a close family member. I share these lessons with you so you might be better prepared to help someone close to you who is in grief.
Observing the one-year anniversary of her husband's death, a close family member shared with me a touching essay she wrote for her grief counselor about her husband, her grief, how her life has changed and how she has made it through the past year. Her essay made me realize how her grief has permeated every part of her life, and how little others understood her pain. Throughout this past year, she often shared her thoughts with me on what things have helped her get through a day and what things were less effective in helping her deal with her grief.
The most important thing I learned was that, while we often feel the need to say something to help lessen someone's pain, comfort comes not from what you say but from how you listen. You cannot truly understand the sense of loss unless you have also lost a husband or life partner. Avoid making statements like, "At least, he didn't suffer." "He lived a long life." or "It will only get better." As much as we all want to offer solutions and encourage our friends or loved ones, these statements might serve to create distance rather than promote a supportive environment.
Instead, listen and make reflective statements, echoing back what you hear to show that you are listening. For example, "It sounds like you're feeling frustrated with your family's attempts to get you out of the house before you're ready." Also, don't expect her to seek your company or "move on with her life." Realize how much her world has changed and that everything she does may be a reminder of those changes. Take the initiative in easing her back into the world. Don't wait for an invitation but invite her to a restaurant or movie.
Watch for signs of physical and mental health problems. It is common for people who are grieving to experience loss of appetite, stomach upset, weight loss, depression, sleep disturbance, loss of energy and physical symptoms of anxiety, such as palpitations or aches and pains. Remind her that her health care professional can be an important resource during this difficult time, and encourage her to seek help when she experiences any of these symptoms. While it might be common for people to experience these symptoms during grief, there are still ways to make her feel better. Even if depression is a reaction to grief, it can still respond to antidepressant medications with or without counseling.
Financial stress can be particularly hard to deal with while you are grieving. In my practice, I have often seen that grief symptoms begin to clear only after the finances have been settled. If your friend or loved one has experienced a loss, you might offer to help her to sort out her finances. For example, join her on trips to the bank, or help in refinancing a mortgage. Contacting insurance companies and paying the taxes alone for the first time can also be stressful. Your company and participation can be extremely helpful.
For maintaining health after the loss of a loved one, three important things to focus on include:
- Regular exercise — Walking is probably the easiest way to get moving. It will be especially helpful if she can get a neighbor or friend to join her. Simply taking a walk around the block for 15 minutes can help to increase her energy. You could also go to a nearby mall and walk together during the day when it is quiet.
- Eating well — Cooking for one is not easy, and when your appetite is poor, it is easy to settle for fast food and other unhealthy options. It may also be hard to sit down to a meal at home when you are alone. It may help your loved one to prepare meals, freeze them or share them with friends and family. Shopping with her can also help to avoid waste and get her eating right.
- Sleep — Adequate sleep is one of the toughest challenges when you're grieving. Although many people try medications or alcohol to sleep, those can paradoxically impair your ability to sleep in the long run. Although no one should let himself or herself become sleep deprived, urge your loved one to make every effort to sleep without the use of medications. Here are the first steps for her to try:
- Follow a regular sleep schedule — try to go to bed and wake up at roughly the same hour. Nap if you are tired, but avoid sleeping during the day as a routine, as it may make it difficult to fall asleep at night.
- Eliminate disturbing noises or bright lights that prevent or disrupt sleep.
- Optimize your sleeping environment by having the room at a comfortable temperature and wearing loose, comfortable clothing.
- Cut down on beverages containing caffeine during the day. The stimulating effects of caffeine can last for many hours.
- Avoid heavy meals and alcohol before bedtime.
- Exercise daily, but do not exercise within a few hours of going to sleep.
Although nothing can replace the part of her life that she has lost, a woman survives the loss of her partner with the help of time and the people and friends around her. I know now that there are better ways to help a loved one deal with grief than simply saying, "It will get easier."
Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.