Chapter 1: Dying and grief Coping with grief and loss 1 What it takes to truly heal after a death in your life the right and

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1 Contents Chapter 1: Dying and grief Coping with grief and loss 1 What it takes to truly heal after a death in your life the right and 5 the wrong of grief Ten ways to remember people on special days 6 What is a Death Cafe? 7 Overcoming obstacles: why is death a taboo? 8 Religion, faith and philosophy 10 What are the top causes of death by age and gender? 11 Way to go: when will you die, how and with what support? 13 Activities 15 Chapter 2: After death Wills and probate 16 Organ donation 17 Attending a funeral 19 Reflecting personality prevalent in a modern-day funeral 21 How to afford a funeral 22 Your digital legacy what happens to your online data after 25 you die? Activities 27 Key facts 28 Glossary 28

2 Coping with grief and loss CHAPTER ONE: DYING AND GRIEF Understanding the grieving process. By Melinda Smith, M.A. and Jeanne Segal, Ph.D. Losing someone or something you love or care deeply about is very painful. You may experience all kinds of difficult emotions and it may feel like the pain and sadness you re experiencing will never end. These are normal reactions to a significant loss. But while there is no right or wrong way to grieve, there are healthy ways to cope with the pain that, in time, can permit you to move on. What is grief? Grief is a natural response to loss. It s the emotional suffering you feel when something or someone you love is taken away. You may associate grief with the death of a loved one which is often the cause of the most intense type of grief but any loss can cause grief, including: Divorce or relationship break-up Loss of health Losing a job A miscarriage Retirement Death of a pet Loss of a cherished dream A loved one s serious illness Loss of a friendship Loss of safety after a trauma Selling the family home. The more significant the loss, the more intense the grief. However, even subtle losses can lead to grief. For example, you might experience grief after moving away from home, graduating from college, changing jobs, selling your family home or retiring from a career you loved. Everyone grieves differently Grieving is a personal and highly individual experience. How you grieve depends on many factors, including your personality and coping style, your life experience, your faith and the nature of the loss. The grieving process takes time. Healing happens gradually; it can t be forced or hurried and there is no normal timetable for grieving. Some people start to feel better in weeks or months. For others, the grieving process is measured in years. Whatever your grief experience, it s important to be patient with yourself and allow the process to naturally unfold. Myths and facts about grief MYTH: The pain will go away faster if you ignore it. Fact: Trying to ignore your pain or keep it from surfacing will only make it worse in the long run. For real healing it is necessary to face your grief and actively deal with it. MYTH: It s important to be strong in the face of loss. Fact: Feeling sad, frightened or lonely is a normal reaction to loss. Crying doesn t mean you are weak. You don t need to protect your family or friends by putting on a brave front. Showing your true feelings can help them and you. MYTH: If you don t cry, it means you aren t sorry about the loss. Fact: Crying is a normal response to sadness, but it s not the only one. Those who don t cry may feel the pain just as deeply as others. They may simply have other ways of showing it. MYTH: Grief should last about a year. Fact: There is no right or wrong time frame for grieving. How long it takes can differ from person to person. Source: Center for Grief and Healing Are there stages of grief? In 1969, psychiatrist Elisabeth Kübler-Ross introduced what became known as the five stages of grief. These stages of grief were based on her studies of the feelings of patients facing terminal illness, but many people have generalised them to other types of negative life changes and losses, such as the death of a loved one or a breakup. The five stages of grief: Denial: This can t be happening to me. Anger: Why is this happening? Who is to blame? Bargaining: Make this not happen, and in return I will. Depression: I m too sad to do anything. Acceptance: I m at peace with what happened. ISSUES today: Death and Grief 1

3 CHAPTER ONE: DYING AND GRIEF If you are experiencing any of these emotions following a loss, it may help to know that your reaction is natural and that you ll heal in time. However, not everyone who grieves goes through all of these stages and that s OK. Contrary to popular belief, you do not have to go through each stage in order to heal. In fact, some people resolve their grief without going through any of these stages. And if you do go through these stages of grief, you probably won t experience them in a neat, continuous order, so don t worry about what you should be feeling or which stage you re supposed to be in. Kübler-Ross model: The five stages of grief Emotional response Active/ External Passive/ Internal Shock (event) Kübler-Ross herself never intended for these stages to be a rigid framework that applies to everyone who mourns. In her last book before her death in 2004, she said of the five stages of grief: They were never meant to help tuck messy emotions into neat packages. They are responses to loss that many people have, but there is not a typical response to loss, as there is no typical loss. Our grieving is as individual as our lives. Grief can be a roller coaster Instead of a series of stages, we might also think of the grieving process as a roller coaster, full of ups and downs, highs and lows. Like many roller coasters, the ride tends to be rougher in the beginning, the lows may be deeper and longer. The difficult periods should become less intense and shorter as time goes by, but it takes time to work through a loss. Even years after a loss, especially at special events such as a family wedding or the birth of a child, we may still experience a strong sense of grief. Source: Hospice Foundation of America Common symptoms of grief While loss affects people in different ways, many experience the following symptoms when they re grieving. Just remember that almost anything that you experience in the early stages of grief is normal including feeling like Who did this?! Who is to blame?! Anger Denial This isn t happening... Bargaining I d do anything... Depression Why even bother? Time* Acceptance I can t change what happened. *Grief is not a linear progression and any one of these five common experiences can occur in any order. Remember, there is no right or wrong way to grieve. Moving on Source: Changing Minds.org, you re going crazy, feeling like you re in a bad dream, or questioning your religious beliefs. Shock and disbelief Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened or even deny the truth. If someone you love has died, you may keep expecting him or her to show up, even though you know he or she is gone. Sadness Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning or deep loneliness. You may also cry a lot or feel emotionally unstable. Guilt You may regret or feel guilty about things you did or didn t say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done. Anger Even if the loss was nobody s fault, you may feel angry and resentful. If you lost a loved one, you may be angry with yourself, God, the doctors or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you. 2 ISSUES today: Death and Grief

4 CHAPTER TWO: AFTER DEATH ensure they are compatible. The better the match, the greater the chance of a successful outcome. People from the same ethnic group are more likely to be a close match. Those with rare tissue types may only be able to accept an organ from someone of the same ethnic origin. This is why it is important that people from all ethnic backgrounds register to donate their organs. Types of donation There are three different ways of donating an organ. These are known as: donation after brain stem death donation after cardiac death live organ donation These are described below. Donation after brain stem death Most organ donations are from brain stem dead donors. This means the donor has been confirmed brain stem dead following a severe brain injury. The circulation is supported by artificial ventilation until the donated organs have been removed. Heartbeating donations have a high success rate because the organs are supported by oxygenated blood until they are removed. Donation after cardiac death Organs and tissue can also be donated after cardiac death. In the UK, almost all donors of this type are people who have died in intensive care from severe brain injuries, but who are not quite brain stem dead. In these cases, the organs must be removed within a few minutes of the heart stopping to prevent them being damaged by a lack of oxygenated blood. Live organ donation A live organ donation usually involves one family member donating an organ to another family member. The relative is usually blood-related, most commonly a parent, although it could be a partner. Following changes in the law, it is now possible to be an altruistic donor. Altruistic donors are unrelated to the patient but become donors as an act of personal generosity. Kidney donations are often made from living donors, as a healthy person can lead a normal life with only one working kidney. 19 October 2012 Transplants save lives: statistics In the UK between 1 April 2013 and 31 March 2014: 3,500 Organ transplants carried out in the UK between 1 April 2013 and 31 March 2014 Kidney 3,257 1,328 lives were saved through a heart, lung, liver or combined heart/lungs, liver/kidney or heart/kidney transplant 4,655 organ transplants were carried out, thanks to the generosity of 2,466 donors 3,724 people had their sight restored through a cornea transplant Number of orangs transplanted Source: Statistics: Transplants save lives, July 2014, NHS Blood and Transplant. 3,000 2,500 2,000 1,500 1, Pancreas 261 Heart 206 As of March 2014, 239,715 people have pledged to help others after their death by registering their wishes on the NHS Organ Donor Register Lung 218 Organ type transplanted* Liver 924 Bowel 26 *Multi-organ transplants are counted once in each organ, e.g. Heart/Lung transplants are counted in Heart and in Lung. The above information is reprinted with kind permission from NHS Choices. NHS Choices ISSUES today: Death and Grief

5 CHAPTER TWO: AFTER DEATH Reflecting personality prevalent in a modern-day funeral A new YouGov report shows that funeral planning in the UK is becoming increasingly personalised and tailored to the individual involved, as more and more people consider the service they would like after death. By Ben Tobin Two thirds (66%) of UK adults have had some thoughts about the kind of funeral ceremony they would like. This rises to nearly three quarters (73%) for those aged 55+. An even larger percentage have thought about whether they would like to be buried or cremated, with 91% of the same age group having given this dilemma some consideration. Women are more likely than men to have started to think about their own funeral service. In the age group, 55% of men have thought about their funeral plans, as compared to 70% of women. This is important for marketers to recognise, as women may also be able to persuade men to think about their own plans. The modern nature of funeral services is underlined in one instance by the use of music. Increasingly, songs such as My Way (Frank Sinatra) and Monty Python s Always Look on the Bright Side of Life, are being chosen over traditional, sombre church music to reflect the personality of the deceased. Six in ten (58%) chose to have recorded music at a ceremony, with just a third (33%) opting for a musician such as an organist. Almost all (96%) those who organised a funeral in the past five years used a funeral director; however, 44% chose one that they were already familiar with, indicating how vital it is for funeral directors to build strong trusting relationships with families as they may well be called upon again in the future. James McCoy, Research Director at YouGov said, The study shows that families and friends are often looking to move away from an overly morose and sombre atmosphere at funerals, by reflecting the deceased s personality and interests in the ceremony. Of course, funeral planning occurs at an upsetting and stressful time; it is therefore important for funeral directors to continue to forge relationships with families and friends in order to establish ways in which the specific wishes of the deceased and family can be honoured and translated into the service. 21 March 2014 The above information is reprinted with kind permission from YouGov YouGov plc Mini glossary Morose gloomy. Sombre sad and serious. ISSUES today: Death and Grief 21

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