Bereavement: Managing Loss and Grief

Death is probably the most difficult separation in life. And yet every one of us has to face it sooner or later. Even though our deceased loved ones are like kites that fly away from us, the strings of the kites are not broken. The connection with our loved ones will not end after their death. Through the strings of the kites, let us tell our loved ones that we are learning to adapt to the separation and coping with grief, and send our memories and blessings to them from afar.

When our loved one is in his/her last days

Medical arrangements
  • Discuss among the patient, family members, and health care professionals to come up with a treatment and end-of-life care plan together.
  • Ask the patient about his/her wish regarding arrangements for funeral, organ/body donation etc.
Taking care of the body
  • Keep the patient clean and warm.
  • Help to ease the discomfort caused by pain, breathlessness, dry mouth, and other physical conditions.
Taking care of the mind
  • Facilitate the patient to review his/her life in search of meaning.
  • Fulfill his/her unfinished wishes to avoid unnecessary regrets.
  • Keep the patient company and show your care through body language or by means of massage and physical touch etc.
Saying goodbye to loved one
  • Upon the patient’s agreement, inform friends and family to visit so that they can bid farewell to him/her.
  • Encourage the patient to share his/her joy, happiness, sadness and worries if physical condition allows.
  • Family members may also share their feelings with the patient by expressing thankfulness and love, asking for forgiveness, and saying goodbyes.  

After our loved one passed away

There are many practical issues that need to be handled after the death of a loved one. One can handle these issues according to their significance and seek help from family members, friends, or organizations when necessary.

Breaking bad news
  • Keeping bad news from family members may have negative impacts on their physical and mental health. It may damage family relationships and even instill regrets in life.
  • Elders will handle the news better if it is disclosed at an appropriate time and place, and in the presence of close relatives. 
Attending funeral
  • Attending a funeral can facilitate acceptance of the death and provide a space to release emotions.
  • Seek advice from health care professionals beforehand to see if the elder is physically fit to attend the funeral.
  • Inform the elder about the procedures of the funeral and arrange family and friends for support during the process when necessary.
Housing arrangement
  • Upon discussion with the elder, family members can consider letting the elder stay at friends’ or relatives’ places temporarily. They can also sleep over at the elder’s home to help him/her adjust to the changes gradually.  
Handling belongings of the deceased
  • Elders may experience fluctuation in emotion during the process. Family members may help safekeep nostalgic items, discard or donate those that are not useful or important, and put aside those that are yet to be decided and review after a period of time.

Grief reactions

Emotional
  • Sadness
  • Loneliness
  • Anger
  • Guilt
  • Anxiety
  • Helplessness
  • Shock
  • Yearning
  • Relief
  • Numbness
Behavioural
  • Crying
  • Insomnia
  • Sighing
  • Poor appetite
  • Restlessness
  • Absent-mindedness
  • Dreaming
    of the deceased
  • Calling out the name of the deceased
  • Social withdrawal
  • Keeping or
    carrying objects
    of the deceased
  • Avoiding people or objects that remind  him/her of the deceased
Cognitive
  • Disbelief
  • Confusion
  • Preoccupation
    with the
    deceased
  • Sense of
    presence of
    the deceased
  • Hallucinations
Physical
  • Stomach discomfort
  • Heaviness in the chest
  • Tightness in the throat
  • Oversensitivity
    to noise
  • Breathlessness
  • Muscle weakness
  • Lack of energy
  • Dry mouth

Grief is a normal reaction after the loss of a loved one. The intensity and duration may vary across individuals. Grief reactions may also fluctuate over time, with stronger intensity on special occasions such as birthday, death anniversary, other anniversaries, or festivals. Everyone grieves in his/her own way. There is no need to compare with others. Just follow your own pace in the grieving process.

Coping with grief

Sharing experiences and feelings One can truly accept and transform the pain of grief only if he/she is willing to face and experience it honestly. Talking to trusted friends, relatives, or professionals about your grief will help you come to terms with the death.
Attending funeral or mourning ritual Bidding farewell to your deceased loved one at a funeral, saying things that you did not have a chance to say, or sending your final blessings will help you accept the death and process your emotions.
Letting out grief Choose your own ways to express your feelings, such as crying, talking to your friends, writing letters to the deceased, practising calligraphy, drawing, dancing, singing, etc.
Resuming daily routines A structured daily routine such as regular sleep, balanced diet, appropriate level of physical exercise, social interaction, etc. can help you adjust to the changes after the death of a loved one.
Adjusting to new roles in life You can adjust to new roles by learning new skills, developing hobbies, and redefining your view about self and life in general.
Maintaining connection with the deceased Your connection with a loved one will not end after his/her death. It can be maintained by other means such as looking through photo albums, visiting graves, or continuing life with his/her values.
Nurturing existing and building new relationships While maintaining connection with the deceased, you can put effort to nurture existing relationships with friends and relatives. You may also try expanding your social network by meeting new friends with an open heart.

When grief becomes unbearable

Persistent yearning/longing
with intense sorrow
Preoccupation with
the deceased/ death
Difficulty accepting the death
of a loved one even after
a long period of time
Excessive numbness,
bitterness,
anger or guilt
Preoccupation with
negative memories
of the deceased
Excessive avoidance of
reminders of the loss

Difficulty trusting others
Feeling alone or detached
most of the time
Emptiness or
meaninglessness
Confusion about new roles
in life

Loss of interest or motivation
Thoughts of suicide
as a way to reunite
with the deceased

If the symptoms above cause significant distress or impairment in daily functioning, you should seek help from doctors or health care professionals immediately.

Community resources

Hospital Authority Mental Health Direct ( 24 hours)
Tel： 2466 7350 Website： https://www.ha.org.hk/
Social Welfare Department
Tel： 2343 2255 Website： http://www.swd.gov.hk/
Society for the Promotion of Hospice Care
Tel： 2331 7000 Website： http://www.hospicecare.org.hk/
The Comfort Care Concern Group
Tel： 2361 6606 Website： http://www.cccg.org.hk/
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