Bereavement and grief

Also called Grief, Loss

Not an illness, and not a process with stages. What love costs when somebody dies.

What it is

Grief has been badly served by pop psychology. The five stages were never a map for the bereaved: Kübler-Ross described dying patients, not mourners, and she spent years saying so. People still get told they are doing it in the wrong order.

Grief is not linear and it does not finish. It changes shape. The early weeks are often strangely functional, because shock is an anaesthetic and there is a great deal of admin. Month four is frequently worse than week two, and nobody warns you about that.

It is a normal human response, not a disorder. But when it stays acute and disabling well past a year, doctors now recognise prolonged grief disorder as a real and treatable thing.

Signs you might notice

Exhaustion that sleep does not repair. Memory and concentration falling apart, which frightens people who think they are losing their minds.

Physical symptoms: chest tightness, appetite gone, a susceptibility to every bug going round.

Waves that arrive without warning, triggered by a smell or a song or a supermarket aisle.

Anger, often at the person who died, followed by guilt about the anger.

And in older people especially, a quiet withdrawal that gets mistaken for dementia or for depression.

How it can affect day-to-day life

The support usually stops around week three, which is roughly when it starts being needed. Cards stop arriving. People go back to work. And the bereaved person is left with a house that has gone quiet.

Practical grief is its own burden. Probate, banks, utilities, the DWP, all requiring the same person to explain the same death repeatedly to strangers.

For an older widow or widower, the risk after a bereavement is measurable: worse nutrition, missed medication, higher mortality in the first year. Isolation is doing much of that work.

Supporting someone well

Say the name of the person who died. The fear of upsetting somebody by mentioning them is almost always misplaced, and the silence is worse.

Do not say at least. At least they had a long life, at least it was quick. Every sentence beginning at least is an instruction to feel better, delivered to somebody who cannot.

Offer specifics rather than anything. "I'm coming Tuesday to do your washing" is help. "Let me know if you need anything" transfers the work to the person with the least capacity for it.

Diarise the second year. Anniversaries, birthdays, the first Christmas. Most people manage the first round because everyone is watching, and struggle with the second when nobody is.

In a care setting, remember the residents grieve too, and often for people staff never met. Fiducia Life holds a person's life story and their memories in The Library, which gives staff something better than a case file to sit down with.

Where to get help

Cruse Bereavement Support runs a free helpline on 0808 808 1677.

A GP is worth seeing if grief is stopping you eating, sleeping or functioning after several months, or if you are having thoughts of harming yourself.

For a child, Winston's Wish specialise in exactly this and are very good.