Sudden Loss: How to Help?

On April 16, my dear friend, Linda Frank, died in a traffic accident. I’ve gone through a wide range of emotions over the last month — numbness, sadness, humor (as we remember events like the time Linda tried to drive herself to the hospital after she stepped on a copperhead snake while wearing flip flops), confusion, emptiness, … But above and beyond my own grief, I’ve worried about her family. What do they need? How can I best be there for them?

I’ve also looked around and seen many people who want to do something. There are neighbors, members of Linda’s choir, her church, her yoga classes, her voice teacher, her language teachers, people she’d helped, her husband’s colleagues, people she visited. Many people ask, “What can I do?” or say, “I’ll do anything. Just ask.” Linda’s husband and daughter are ill equipped to ask.

So if you find yourself wanting to help others in a vortex of grief, here are some thoughts on using your strengths for their service and comfort.

What’s Going On?

Be aware that family members are experiencing a confusion of different thoughts, and their feelings may be changing from moment to moment. Nancy Hogan, now at the Marcella Niehoff School of Nursing, and colleagues came up with the following list for responses to sudden death:

• Finding out
  • Responding to the news
• Facing realities
  • Going through the motions
• Becoming engulfed with suffering
  • Missing, longing, and yearning
  • Enduring hopelessness
  • Existing in the present
  • Reliving the past
• Making sense
  • Aching with physical pain
  • Getting through the day
• Emerging from the suffering
  • Embracing hope
  • Getting on with life
  • Experiencing personal growth
  • Becoming

The bereaved may also need to modulate the dosage of grief, and back away from it periodically. So when you come by to talk, don’t be surprised if the conversation takes several turns, or if you find people laughing. Telling funny stories about the person who died can be an important part of healing.

One thing to remember following a sudden death is that the survivors haven’t had a chance to prepare. So they will need help drawing their network in. Another friend and I made a lot of calls letting people know. Just don’t leave the message on any answering machines!

Support through Your Strengths
I have a close friend who is always there with food and practical support. I’m more comfortable on the Web, so I took over setting up an online community where we could post pictures, people could write memories, and we could ask for help. We used LotsaHelpingHands, but there are other choices available. What are your most natural ways to contribute? Some people like to drive. There are trips to and from the airport to pick up family members coming in for the service.

We found that our friend needed company as much as food. So we started asking the people who brought meals to stay and eat with him.

Benkel and colleagues at Gothenburg University in Sweden found that people need a mixture of practical and psycho-social support. As an example of practical support, I printed out lists of things that need to be done following a death. But Benkel points out that good advice can sometimes be helpful but sometimes be seen as pressure to do things a particular way.

Psycho-social Support

Benkel and colleagues observed three things about the needs of the bereaved for conversation following the event:

1. They may discuss different things with different people to avoid burdening any particular individual or saying the same thing over and over to the same individual.
2. They may have certain people with whom they don’t talk about their grief at all, in order to have a zone of life that is free of grief.
3. They may find it relieving to speak to others who have gone through similar losses “in that such persons were able to understand their feelings without having to explain them in words.”

So if you have had similar losses, it may help if you identify your experience, so the person knows you understand without words. If you hear nothing about grief, you may be in a very needed grief-free zone. Who knows, you may be the person who can give a much needed hug, like the man Rodger and colleagues interviewed, who turned to a nurse that he knew slightly right after he learned of his wife’s death, “she felt there . . . was nothing I can do, but someone like her did something by being there, and you know, I couldn’t hug the bloody surgeon.”

Several sources mentioned that people need to know that their grief is normal, but that people go through grief differently. Being part of the network, you can make a difference. In their cluster studies of grieving spouses, Carol Ott at the College of Nursing at University of Wisconsin – Milwaukee and her colleagues found that 5 out of 6 older bereaved spouses come through suffering, including experiencing depressive symptoms, to adjustment over time. About a third of their sample had resilient responses.

“The resilient cluster had the highest scores on self esteem (i.e., comparison of self to others) and advice/appraisal (i.e., having someone to talk to about one’s problems). … Findings from this study are supportive of other research that has demonstrated social support may buffer individuals from the deleterious effects of stressful life events.”

Martin Rodger and colleagues at the Edith Cowan University in Australia observed that the time required to incorporate the change in the survivor’s life may be greatly underestimated by friends or even the professional community.

Practical Support
Here are some suggestions from Zoe Ulshen, the bereavement coordinator at Linda’s church, based on her experiences receiving care from a friends and neighbors after a major accident:

• When I was receiving care from a support team, I really appreciated it when folks would call or email to confirm what they were going to do the next day (e.g., “Just confirming that I’ll pick you up at 9:30 for a 10:00 appointment”).

• I also really appreciated it when people offered something concrete, rather than “just let me know what you want.” For example, Cindy said, “I’ve got Friday afternoon free. I can come over and we can decide then what you’d like to do with that time. We can shop, go for coffee, whatever you feel like doing.” Another friend said she was going to the store the next day, so what did I need?

• The other “lesson” I learned from receiving care was how important cards were, especially cards that came weeks after my accident. You get tons of cards and support immediately after an event, but then people necessarily go back to their own routines and you’re left in a life that is anything but normal. Cards I got two, four, seven weeks later were so precious, because healing takes a long, long time, and I needed tangible reminders that people recognized my need for ongoing support.So my message to people ever since then has been: if you forgot to write, not to worry! Go ahead and send the card, but do go ahead and send the card!

• Same goes with checking in with the person periodically for the following year, by phone and in person whenever you see them. Just a simple, “How are things going?” is all that’s needed, along with the willingness to listen to the response. That kind of open-ended question let me chose how much or little I wanted to talk at that particular moment.

My friend talks about 3 time frames: Up to and including the memorial service, short-term, and long-term. The memorial service was last Saturday, with many people attending, 2 choirs and a soloist, and several people talking about memories. Short-term means creating a new routine, getting through the days without Linda’s help and company. Long-term means recreating life direction, creating new images of the future. I hope we, his social network, can find the right ways to help him reach a resilient response!
 

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References
Benkel, I., Wijk, H., & Molander, U. (2009). Family and friends provide most social support for the bereaved. Palliative Medicine, 23, 141-149.

Bozarth, A. L. (1994). Life Is Goodbye Life Is Hello: Grieving Well Through All Kinds Of Loss. Hazelden Publishing.

I haven’t read this book, but it was recommended to me by Zoe Ulshen.

Hogan, N., Morse, J., & Tason, M. C. (1996). Toward an experiential theory of bereavement.
Omega: Journal of Death and Dying, 31(1), 43-65.

Ott, C. H., Lueger, R. J., Kelber, S. T., & Prigerson, H. G. (2007). Spousal bereavement in older adults: Common, resilient, and chronic grief with defining characteristics. The Journal of Nervous and Mental Disease, 195(4), 332-341.

Rodger, M. L., Sherwood, P., O’Connor, M., & Leslie, G. (2006-2007). Living beyond the unanticipated sudden death of a partner: A phenomenological study. Omega, 54(2), 107-133.

Walsh, T., Foreman, M., Curry, P., O’Driscoll, S., & McCormack, M. (2008). Bereavement support in an acute hospital: An Irish model. Death Studies, 32, 768-786.

Bonanno, G. (2009). The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After Loss. Basic Books. (added later)

Images
All images used here were posted to the Lotsahelpinghands network for the Frank family by Linda’s friends. Mike Kalt took the picture of Linda pointing to the snakebite site, Ed Britton took the picture of Linda following her concert, Tony Armer provided the picture of Linda in Anything You Can Do, I Can Do Better, and Christopher Frank provided the picture of Linda walking with a friend in the rain.

Grandma brings her casseroles courtesy of szlea