Coping with Death and Dying

Coping with Death and Dying

Summary

The loss of a loved one and the likelihood of impending death from a terminal illness are among life’s most traumatic events. When death occurs or is imminent, people generally experience grief.

Grief is a normal and natural emotional response. A person who is grieving can experience a wide range of emotions including numbness, denial, confusion, shock, sadness, yearning, anger, despair and guilt.

Other initial and ongoing reactions that can be part of the grieving process include sleep disturbances, loss of appetite, difficulty concentrating, headache, nausea, digestive problems, fatigue and/or avoiding people or places that remind one of the deceased. These emotions can occur both before a loved one’s death and afterward, even when the death is expected.

All of the emotional and behavioral reactions that typically accompany grief may continue for months. Some people may appear to move on in the grieving process, only to experience setbacks months later.

Coping with death or dying can be emotionally and physically draining. In addition, people may never fully recover after the loss of a loved one. Therefore, feelings such as sadness and yearning may linger for years. Nonetheless, there are various ways to cope with the extreme stress associated with death.

Tips for coping with death and dying include:

  • Accepting personal feelings and seeking support from caring relatives and friends.
  • Incorporating healthy lifestyle habits, such as eating a nutritious diet and getting adequate exercise and rest.
  • Joining a support group for people experiencing grief.
  • Being patient with oneself.

Individuals who experience grief that worsens over time –  especially if it interferes with daily activities, are urged to seek the care of a mental health professional. People who experience prolonged grief are at risk for mental illnesses (e.g., major depression). Treatment for these conditions generally involves psychotherapy and in some cases, medications such as antidepressants.

About death and dying

The loss of a loved one and the likelihood of impending death due to terminal illness are among life’s most traumatic events. When a loved one dies, or a person is made aware of their own impending death, a wide range of emotions may occur, including grief. Such emotions are natural and healthy, even when the death is expected.

Grief can affect people in many different ways, depending on the circumstances surrounding the death or illness. When a death is expected, the grief may not be as overwhelming as that of a sudden loss because the patient, family members and other loved ones have more time to come to terms with the loss. They may also be able to view death as an end to the patient’s suffering.

People may feel numb when initially learning of the death of a loved one. Other emotions include denial, confusion, shock, sadness, yearning, anger, despair and guilt.

Other initial and ongoing reactions that can be part of the grieving process include sleep disturbances, loss of appetite, difficulty concentrating, headache, nausea, digestive problems, fatigue or avoiding people or places that remind one of the deceased.

Regardless of the circumstances surrounding death, the process of grieving  generally takes time. It can be emotionally and physically draining, and because one may never fully recover after the loss of a loved one, feelings such as sadness and yearning may linger in some ways for years.

However, there is much that can be done to cope with death. The most important thing is not to ignore one’s feelings and to seek support and understanding from other relatives and friends. Avoiding the grieving process, such as by not thinking about it, is not an effective coping mechanism. It may only make things worse in the long run. In such cases, it can lead to emotional disorders such as major depression, substance abuse or dependence, and suicidal ideation. Physical ailments associated with prolonged grief include a weakened immune system and heart disease. People experiencing grief that worsens over a prolonged period of time, especially if it interferes with their daily life, are encouraged to seek the help of a mental health professional such as a psychologist or psychiatrist. Counseling can help individuals deal with intense grief because it allows one to talk about the deceased and express strong emotions that one may not have expressed before, either out of fear or guilt.

Tips for coping with death and dying

Grief is a natural process that affects everyone differently. Although grieving can be both physically and emotionally draining, the best way to deal with it is to allow oneself to experience it. There are various ways to cope with the extreme stress associated with death.

Tips for coping with death and dying include:

  • Accept personal feelings. Feelings of sadness, despair, anger, guilt and fear are normal following the loss of a loved one. It is important to take time to express these feelings and not repress them.
  • Talk with others. Seeking support from caring relatives, friends and other loved ones can help one feel less isolated when coping with the loss of a loved one or one’s own impending death.
  • Organize personal affairs (in the case of a loved one’s terminal illness or one’s own).
  • Take time to say goodbye to loved ones in a meaningful way, or to express feelings that were previously unsaid, such as “I love you” or “Please forgive me.” Such words can be especially important at this time.
  • Incorporate healthy lifestyle habits. Eating a well-balanced, nutritious diet and getting proper exercise and rest are important for coping with grief since it often takes a physical toll on one’s health.
  • Avoid unhealthy habits. Overeating or excessive food restriction, abusing drugs and/or alcohol, and smoking cigarettes are not healthy ways of coping with grief because these can potentially be hazardous to one’s health.
  • Postpone major life decisions. If possible, put off making major life changes, such as switching careers or moving to a new home, immediately following the death of a loved one. This can only add stress to an already challenging situation.
  • Join a support group for people experiencing grief. These groups, which may be in-person or internet-based, provide emotional support and practical coping skills and strategies for individuals experiencing loss. They can also be especially helpful for individuals with limited personal support systems.
  • Keep a diary or journal. Writing can be tremendously therapeutic for some people while dealing with loss.
  • Read uplifting articles or books and watch inspiring movies. Engaging in these activities can help relieve tension and improve a person’s mood.
  • Anticipate and take steps to deal with reminders. Holidays, birthdays, anniversaries and other special dates can bring up strong emotions of grief following the death of a loved one. Knowing that such reactions are normal and to be expected can make one understand them and perhaps even turn them into opportunities for emotional growth and healing. Planning distractions such as a weekend getaway or getting together with loved ones on such dates may help provide some relief.
  • Seek comfort from spiritual affiliations. People with religious or spiritual affiliations may experience healing through the rituals associated with their particular faith. Prayer may also provide solace for some people.
  • Be patient with oneself. Grieving takes time and it is important to be patient with changes in one’s emotional state, and not rush back into everyday activities. Individuals should also expect setbacks because some days or weeks may be better than others.

    However, most mental health experts recommend not withdrawing from daily life for an extended period of time because doing so may put individuals at risk for developing depression or experiencing an increase in depressive symptoms.
  • Honor the deceased. This can be done by creating a memorial or engaging in a special ritual, such as planting a tree, making a scrapbook or having a remembrance party with family and other loved ones in memory of the deceased. Doing so can help bring closure and ensure that the deceased loved one is not forgotten.
  • Enjoy life once again. It is important to realize that it is acceptable to find laughter in life after a period of grieving. This can be achieved by pursuing hobbies or socializing and having fun with friends. Engaging in such activities is not disloyal or disrespectful to a loved one’s memory. Instead, these are signs of healthy emotional healing.

Individuals who experience grief that worsens over time, especially if it interferes with daily activities, are urged to seek the care of a mental health professional. People experiencing severe grief are at risk for mental illnesses such as post traumatic stress disorder, major depression or suicidal ideation. These conditions may be treated with some form of psychotherapy and in some cases, medications such as antidepressants.

Helping a loved one cope with death and dying

Everyone handles the grieving process differently. When friends or family members experience a death, they may be in denial or may want to be left alone. Although it is important to respect their wishes to a certain extent, there are several ways to help a loved cope with their loss and grief.

Tips for helping a loved one cope with death and dying can include:

  • Let them know they can talk. Encouraging a loved one to talk about their feelings of loss and share memories of the deceased can help the healing process.
  • Do not minimize their loss. It offers no consolation to a person experiencing grief to hear “It was for the best” or “You will get over it in time.” Instead, offering one’s sincere condolences and just listening to the individual  express their grief are better ways of showing compassion and understanding.
  • Offer practical help. Assisting a grieving loved one with their daily chores, such as by babysitting, cooking or helping make funeral arrangements can be extremely helpful.
  • Be patient with them. It is important to remember that everyone experiences loss in their own way. Some people may take a long time coming to terms with the death of a loved one. In such cases, one can show support by being available whenever needed.
  • Encourage them to seek physical and/or mental health treatment when necessary. This is extremely important because individuals experiencing grief may be so overcome with their emotions that they may not realize they need professional help.

Children who experience the loss of a loved one, such as a parent, may grieve differently than adults. Because it can affect their sense of security, younger children may even revert to earlier behaviors such as bedwetting or temper tantrums. At this time, it is important to help youngsters deal with their grief by offering them consolation, love, support and assurances.

Sometimes grieving adults may be too affected by their own emotions to initially know how to respond to children’s questions. Nonetheless, parents or other caregivers should discuss death openly with children and try to answer all questions to the best of their ability. Death should be discussed in a language that can be understood by children, depending on their age or stage of development. Children under age 6 may not understand that death is permanent and may ask the same questions repeatedly. Children older than 6 may understand the concept of death, but may feel at fault.

Vague or inaccurate explanations or avoidance of the subject will not protect children from death. Rather, children may experience feelings of anxiety, confusion, mistrust and unresolved issues later in adulthood.

In most cases, no matter how young they are, children often sense a change in their environment following the death of a loved one. Adults should include children in their own grief and reassure them that their feelings are normal.

Caring adults should also be alert and recognize if children are experiencing symptoms of worsening grief – especially if prolonged – such as depression, inability to sleep or eat, fear of being alone, reverting to infantile behavior (e.g., thumb-sucking), withdrawal from friends and daily activities, difficulty in school and suicidal ideation. In such cases, a child and adolescent psychiatrist or other mental health professional can help children effectively cope with the death of a loved one.

Because death is a difficult concept for children to understand, it is important to let children know that death is a normal part of life early on when they are first able to begin to comprehend it. This can be done by visiting elderly relatives or friends and talking to them about aging and death. The death of a family pet – usually the first experience children have with death – can be another opportunity to teach children about dying. Burying and saying goodbye to a pet can help children understand death. Encouraging children to ask questions is always important. It can teach children that death is not a forbidden subject and is acceptable to discuss, which in turn may help them cope better with the loss of a loved one when the situation arises.

Resources available

A variety of local health and social services can provide assistance and support for individuals who have lost a loved one or who are faced with their own impending death due to a terminal illness.

These services typically educate individuals about grief and how to cope with death as well as ways to help prevent conditions such as major depression andpost traumatic stress disorder(PTSD) following the death of a loved one. Health care professionals, such as physicians, nurses, social workers and psychologists may be able to provide coping tips and/or referrals for such resources.

Counseling or mental health centers are another helpful option because in addition to reliable information, they also provide treatment for psychological trauma (e.g., major depression). Churches and synagogues frequently have grief support groups that meet regularly. Many services and organizations are available for specific types of grief, including the loss of a child or the loss of a pet. Many organizations and support groups also have resources available on the internet.

Questions for your doctor

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions regarding coping with death and dying:

  1. I thought I was feeling better about the loss of my loved one, but there are times when I have sudden crying spells. Is this normal or do I need professional help?
  2. Since my loss, I just don’t seem to have any interest or enthusiasm for anything anymore. When will these feelings pass?
  3. I’ve been diagnosed with a terminal illness and I want to talk about it with my family, but they’re very uncomfortable and try to change the subject. How can I get them to open up to me?
  4. Why would it be a mistake for me to tell my child that his grandpa has gone to sleep, rather than say he died?
  5. Is it normal for me to feel so angry all the time?
  6. Do you think that I or members of my family would benefit from mental health counseling?
  7. What help would a support group provide me?
  8. Can you recommend a support group for me?
  9. Since the loss of my loved one, I have been having difficulty sleeping. Would you recommend the use of a sleep aid?
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