High Bereavement Risk

If somebody is at a high risk for complications related to bereavement one or more of the following factors are present:

• client perceives social support as very limited or nonexistent
• history or immediate evidence of ineffective coping
• multiple stressors (e.g. financial distress, loss of role, job or health)
• ambivalent or conflicted relationship with the deceased
• psychiatric symptoms of major depression or personality disorder
• inability to acknowledge the death or the death is unexplained
• very high degree of dependence on the deceased
• suicidal ideation
• danger to self or others

Journal of Hospice and Palliative Care (1990)

Threatening behavior toward self or others requires immediate intervention, perhaps involving police or legal ramifications.  People who are at a high risk are encouraged to seek professional help.  Mourners who score moderate or low on the risk scales usually find support groups helpful.
When thinking about yourself or loved ones and their bereavement risk, is there anything you would be concerned about?  Is there anything you can do proactively?

Moderate Bereavement Risk

What constitutes a moderate level of risk for adjustment after a loss? Grief professionals look for two or more of the following factors present in the lives of the bereaved:

• limited social support or perception of limited support by the bereaved
• difficulty coping with current or past stressors
• stressors, in addition to the loss, are present such as financial, housing, relationship difficulties
• poor health or somatic symptoms lasting more than a month (after the death)
• guilt or ambivalence about the loved ones death or the care provided prior to the death
• unresolved previous losses
• unexpected death
• younger age (of the deceased) or young children at home

Journal of Hospice and Palliative Care

Again, as in the previous entry about low bereavement risk, we can be proactive in bolstering our internal and external resources to help us weather the inevitability of various losses inherent in life...develop a quality network of friends and family, learn how to manage stress better, maintain physical and financial health, resolve unfinished business with loved ones, attend to our own hurts, and perhaps ultimately, continually examine the existential nature of death and what that means to each of us.

What is a Low Risk for Bereavement Adjustment Difficulties?

Generally, people who exhibit the following factors are expected to manage their grief and cope well with a loss:

• Self perception of adequate social support.
• Effective coping with past losses and /or crisis.
• Adequate financial resources.
• Positive relationship with the deceased or resolved separation.
• Belief that care provided prior to death was adequate.

(Journal of Hospice and Palliative Care [1990])

An important factor is what one believes-self perception- in all of these areas. Others, professionals included, often have preconceived ideas of how and what people need, should have or be in order to grieve well (another area that is best left to each individual to evaluate for themselves). But, in the end, how well we cope is directly related to how well we expect to cope and our self-perceived meaning of loss and recovery.

 As you evaluate yourself against these criteria, is there room for improvement?  Perhaps focusing time and energy on developing a strong social network of supportive friends, learning about and practicing skills such as relaxation and meditation, cognitive restructuring, enhancing your spiritual base, etc., becoming financially sound (even consider long-term care insurance), mending and deepening relationships with important people in your life and learning about and getting comfortable with end-of-life issues and the wishes of your loved ones will not only be a boon to you now, but also in times of loss and grief.

Grief, Mourning and Bereavement

What exactly is the difference between grief, mourning and bereavement?
Although the words are often used together, they have three different meaning. Grief is the emotional experience resulting  from the loss.  It's the inner, personal feelings of an individual.  Sometimes we can observe these feelings; other times they are locked tightly inside the person.  Feelings might include anger, frustration, loneliness, relief, regret, peace, sadness and guilt.  Mourning is the outward, social expression of the loss.  Often the mourning process is dictated by religious and cultural norms, rituals and traditions.  Bereavement is the state of having suffered a loss.  Usually we associate the loss with death, but it can be for many reasons such as divorce, empty-nest, job elimination, or a move to a new city.

No matter what you call it, getting support for loss in a group can be helpful, enriching, and feel less lonely.

  See a schedule of groups and workshops here-http://www.beaconhospice.com/ or click on the support group tab at the top of the page.