Grief and Loss

Overview of the grieving process

Grief is a natural human response to the loss of a loved one. It can show itself in many ways. Grief moves in and out of stages from disbelief and denial, to anger and guilt, to finding a source of comfort, to eventually adjusting to the loss.

It's normal for both the dying person and the survivors to experience grief. For survivors, the grieving process can take many years. The challenge of accepting death and dying as the end stage of life is what the grieving process is all about.

What is anticipatory grief vs. sudden loss?

  • Anticipatory grief. This happens when someone has a prolonged illness, and the patient as well as the family anticipates death. Anticipating the loss of a loved one can be just as painful and stressful as the actual act of losing that person. Anticipatory grief allows the family to prepare for the inevitable death. This can be a time to resolve issues and concerns, and seek the support of spiritual leaders, family, and friends. It's also a time to clarify the loved one's wishes for funeral and burial arrangements and other end-of-life issues.

  • Sudden loss. This is a death that happens unexpectedly and suddenly, like a fatal accident or heart attack. Such tragedies can leave survivors feeling shocked and confused. Loved ones are often left with many questions, unresolved issues, and a range of emotions, including anger, guilt, and pain. Support from family, friends, and clergy is important to people experiencing sudden loss.

What may happen in the case of anticipated death?

Many, although not all, people facing their own death are willing to discuss issues of death and dying. This can be a time to discuss spiritual issues, resolve family concerns, reflect on a loved one's life and accomplishments, and express gratitude. It also provides an opportunity to put practical matters in order, including the following:

  • Can funeral expenses be prepaid?

  • Which funeral home would the person prefer to handle arrangements?

  • Can the person help with obituary information to make sure it's accurate and complete?

  • What are their specific funeral wishes?

  • If a church service is planned, can the person facing death help plan favorite Scripture passages or hymns?

  • Is cremation or burial preferred?

  • Has a cemetery plot been purchased?

  • Does the person wish for memorial contributions to be made to a particular charity or benevolent organization?

  • Can the person direct others regarding important practical issues, like wills, bank accounts, lawyer's name, pension plans, retirement funds, and life insurance policies?

What are the symptoms of grief?

For both the person facing death and survivors after the death of a loved one, it's natural to have many symptoms of grief. These can include:

Physical symptoms:

  • Lack of energy or fatigue

  • Headaches and upset stomach

  • Excessive sleeping or overworking and excessive activity

Emotional symptoms:

  • Memory lapses, distraction, and preoccupation

  • Irritability

  • Depression and feelings of euphoria

  • Extreme anger or feelings of being resigned to the situation

Spiritual symptoms:

  • Feelings of being closer to God or feelings of anger and outrage at God

  • Strengthening of faith or questioning of faith

What are the different stages of grief?

It's natural for people who are facing death, as well as those they leave behind, to move through many stages of grief. For survivors, the grieving process can last for several months or for 2 to 3 years or more. The stages of grief don't necessarily fall into a set order, and vary greatly from one person to another. People may move in and out of these stages at different times throughout the grieving process. These stages include:

  • Shock

  • Depression

  • Physical symptoms, such as headaches, body aches, or stomach distress

  • Feelings of panic

  • Guilt

  • Anger

  • Inability to return to daily routine

  • Return of feelings of hopefulness

  • Acceptance

If you or a loved one is grieving longer than you feel is normal, you may want to seek professional counseling to help you through the process. Your healthcare provider may be a good referral source, or you may want to speak with your spiritual leader (like priest, rabbi, and minister) for advice.

When providing support for the bereaved

There are many things you can do to help a bereaved person. These include:

  • Sending cards or flowers

  • Preparing food

  • Providing child care

  • Doing household chores

  • Contributing to a cause which is meaningful to the family

  • Offering transportation

You may also consider the following when providing for the bereaved:

  • Be available. Sometimes, when people are grieving, they don't want to talk or listen. They simply want you to be there for them.

  • Let the grieving person the full range of his or her emotions, including anger and bitterness, which may sometimes be expressed against the healthcare providers, God, or even the loved one who has died.

  • Be patient and understanding, but not patronizing. Don't claim to know how the other person is feeling. Don't force the person to talk or share feelings.

  • Don't be concerned about mentioning the deceased person's name or sharing a fond memory of the person while in the company of the bereaved. They, too, are thinking about their loved one, so it's acceptable and natural to bring the name into conversation.

  • Remember that grieving takes time and is a natural human process. No matter how much you want to "stop the hurt," the bereaved must endure the grieving process. Allow them time and care for them as they move through it.

  • A person who is grieving for over a year should be evaluated by a healthcare provider.

Abnormal bereavement

The primary healthcare provider can help the bereaved person adapt to his or her loss. Even though they may experience ill health, people with abnormal bereavement are less likely to use health services. Outreach efforts are important to help those in need of these services.  Depression, suicide, anxiety, and complicated grief are the most common negative psychological traits associated with loss. 

Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Raymond Turley Jr PA-C
Online Medical Reviewer: Steven Buslovich MD
Date Last Reviewed: 5/1/2021
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