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High-profile deaths of public figures or celebrities capture a lot of attention, especially when they are local. Consider the automobile dealer and the hospital administrator who lost teen-aged sons, and respectively fought drunk driving and established a charity golf tournament; the well-known physician whose daughter was murdered and who became a high-profile spokesperson for endangered young women; the public grief of a local TV anchor whose reporter/fiancé was murdered on camera; the local newspaper columnist who wrote about his wife’s suicide and a few years later died a public death after a stroke.
Most deaths and most grief are not like that.
The vast majority of us face the death of members of our family or our friends quietly and with the dignity of privacy. Death is a personal part of life, perhaps the most personal. It is the final phase and one for which Elisabeth Kubler-Ross developed a “stage theory” of the adjustment to death in the 1960s, one that remains generally accepted. It is: denial, anger, bargaining, depression and acceptance.
A recent Dana-Farber Cancer Institute study shows “that disbelief was highest initially, yearning for the deceased peaked at four months …, anger at five months …, and depression at six months … Acceptance of the person’s death was high and grew over the two-year study period.”
The death of a loved one can be slow and tediously painful or it can be as sudden and final as a lightning strike. Regardless, it is memorable in ways that tend to be permanent.
Sue Ranson, CEO of Good Samaritan Hospice in Roanoke, puts it into perspective: “When a loved one is dying, everyone—patient, family, friends—experiences what we call ‘anticipatory grief.’ That’s because grief is an emotional, physical, spiritual, and social response to a loss or the perception/anticipation of a loss. So when someone dies, there is grief, and when someone is dying, there is grief.”
But there is no grief template. “Everybody does it differently,” she says. “Just as our fingerprints are unique, so are our grief journeys.”
Trying to anticipate grief reactions can be frustrating because “there are at least 30 or more factors that determine how someone reacts to a particular loss,” says Ranson. In controlled settings, however, “Grief may be experienced differently than say a sudden loss.” Still, death is final and those experiencing it are often “still not prepared for the person’s death and their grief afterward.”
Ranson says you cannot prepare for sudden, unexpected death, but when death is inevitable and hospice is the choice for the families, “patients and families learn to live with (if not accept) the reality of loss.” Hospice tends to focus on what is most important for the family and the patient and that isn’t usually the disease. Professionals “teach and coach and affirm and encourage.”
A 2014 Columbia University study concluded that the “death of a loved one roughly doubled the risk for new-onset mania in people 30 and older.” It was a five-fold increase for those 50 to 70. Additionally, the sudden death increased the risk of “major depression, excessive use of alcohol, and anxiety disorders, including panic disorder, post-traumatic stress disorder (PTSD), and phobias … [with the largest risk increase] for PTSD, which was seen across age groups with an increased risk as high as 30-fold.”
The older the survivor, the more intense the grief in most cases.
Sandra Phillips, bereavement coordinator at Good Sam, believes there “are as many different ways [to grieve] as there are people and no way is wrong, as long as it does not hurt them or someone else.”
We talked with those who have survived especially difficult deaths of family and friends recently to see if there was a common thread. The thread we found is the pain and the inevitability of loss.