“Dealing with Death and Dying: Providing Emotional Support for the Bereaved or Terminally Ill,” Ensign, Feb. 1976, 45
Dealing with Death and Dying:
Providing Emotional Support for the Bereaved or Terminally Ill
Late one summer afternoon while I was studying in my college dormitory room, I received a phone call from my best friend, Dave, and his new wife, Peggy. They were about to conclude their honeymoon and wanted to take me to a movie.
Dave and Peggy were probably my closest friends. I had introduced them to each other. We’d served together for a year on the same stake MIA board. Dave and I had corresponded during our missions, and we came back to the same school. I was a witness when Dave and Peggy were married in the temple.
“Only one catch,” Peggy explained over the phone. “I get to choose your date. There is someone very special I want you to meet; she’s my cousin, Marsha. …”
I had been so close to this couple for such a long time, and we had shared so many wonderful times together that I readily consented to date the attractive young lady she had in mind, whom I had known for most of my life but with whom I had never become involved socially. Ten months later they accompanied us to the temple when we were married.
All four of us were overjoyed when Peggy became pregnant. Then tragedy struck. One week before their first wedding anniversary, Dave was rushed to the hospital and in a few days passed away because of a brain tumor.
Marsha and I felt the loss very deeply. In fact, this was the first time in my life that I felt real grief and bereavement. I wanted very much to be able to comfort Peggy, but I simply didn’t know how. I felt helpless when confronted with her pain and her questions.
Now, many years later, I have seen death and dying in my family, as a bishop, and as a doctor. I find that most members react as I did at Dave’s death. We sincerely want to help but are hesitant because we are uncomfortable in our own inexperience. Each time I assist the bereaved and dying I feel that same hesitancy. Yet there are ways to help, and the value that comes from the very substantial support and strength of a sincerely concerned family member, priesthood leader, or friend cannot be measured.
Let me share with you some of the understanding I have gained about bereavement—understanding that could have made me of infinitely more assistance to Peggy, understanding that we all need in order to provide effective, compassionate service.
It is important to remember that we feel a loss at every death. We long for the touch, the sight, the presence of the one we lost, and even a secure knowledge of the plan of salvation doesn’t take away the longing.
Although each loss is different, there are consistent stages of bereavement that each widow or widower seems to feel. The family member, priesthood leader, or visiting teacher can be a genuine source of help by providing the sensitive support necessary during each stage.
The first stage of grief is merciful: a numbness that comes with shock. “The numbness was a blessing,” said Peggy in retrospect. “Everything inside you stops. Even after the funeral I tried to fill my life with as many activities as I could because it was a security blanket. Yet, subconsciously, I felt the loss, and my grandmother says I cried in my sleep every night during this time.”
The bereaved individual goes through the daily routine like a robot. A widow takes the children to the park, cleans house, and irons clothes; a widower works, eats, and sleeps. Both are in a daze.
It may take a few days or several months, but eventually the numbness wears off and sorrow sets in. Peggy expressed it this way: “I was overwhelmed by a sorrow that filled my whole being. The realization that Dave was gone and I was alone, really alone, deeply hurt me. With the sorrow came a flood of anxieties—the responsibility of raising an unborn child by myself, my financial situation. I felt intense sorrow and loneliness.”
It is natural to feel anger accompanying the grief. Often a widow will feel that she has been cheated because her husband’s influence is no longer felt in her and her family’s lives. As Peggy said, bitterly, “It’s not fair, when I’ll have a child to raise.” Occasionally, anger is even expressed against the person who is being mourned, that he “left me in this situation,” as if he had a choice.
It is also natural to sometimes feel angry with God: “I really wanted to die. I wanted to go with him. I was very bitter against the Lord, even though my testimony was strong. He had taken Dave and then refused to let me go with him. I felt a very deep bitterness against the Lord.”
Anger is very difficult for most comforters to deal with, but in most cases it is best to neither encourage nor discourage it. Those who mourn honestly feel angry and bitter, and to respond, “You don’t know what you’re saying” or “You don’t really mean that” is pointless and unhelpful. It seems best not to agree with their anger or aggressively oppose it either, for it is a natural stage of bereavement.
One of the most difficult adjustments the widow or widower has to make is the change in people’s attitudes. They discover that our society and the Church are, to a large extent, couple and family oriented. Peggy yearned for comfort and companionship and turned to the world of families where she used to belong so naturally, only to find that she was excluded from most of the intimacies of her old friendships. She was encouraged to seek special friends in what is now called the Special Interest group, where she had had no previous experience and had no intimate relationships. These adjustments can be difficult indeed. The word widow itself, which originated in the Sanskrit and means “separate” or “empty,” can become harsh and painful.
In the next stage, the widow or widower wants to begin to live a normal life and not be consumed with the past. Peggy said, “It was a hard decision to make. I wanted to fulfill my existence, my patriarchal blessing. I always knew I would have to face reality, and finally I did. There is a loneliness that never goes away, but you have to live.”
During each of the foregoing stages, but more particularly during the stages of grief and anger, Peggy needed to know that people sincerely cared: “I appreciated anything that anyone did. After the numbness wore off there was nothing. No one invited me anywhere. I really felt like I was not being invited because they felt uncomfortable. But that is when I needed it most. Not words, but activity, love, and involvement.”
This is the time to invite the widow or widower over for dinner, to join with your family in the park for a home evening activity, or to go to a play or movie. If a baby-sitter is needed, you make the arrangements. Don’t talk about death unless the bereaved brings it up. Be normal, act natural.
And finally comes acceptance and peace of mind. The bereaved person, realizing his or her strength, becomes independent. There is more understanding and stability, and the poignant memories find their place and perspective. As new problems approach, successful resolutions become easier; life becomes happier, richer, and more enjoyable. But though the widow or widower has accepted reality, the true nature of his or her love for the departed partner has not diminished.
Recently Peggy told me, “I felt his presence for several months after he died, as if he had not gone spiritually. Then, when I began to face reality, I accepted the fact that he needed to be working at whatever he was called to do, and he left.”
An equally painful situation for most of us is when a friend or family member is terminally ill.
We need to understand that the critically ill individual also experiences several distinct stages as death approaches. Such an understanding can provide a basis from which substantial support can be given in each of these stages, and which will help maintain close, eternal relationships.
Initially, the individual denies that he is critically ill: “There has been a mix-up in the records” or “The doctor has made a wrong diagnosis; I’m not sick.” Often this denial persists for some time, even after several physicians have corroborated the original diagnosis. This temporary defense is usually replaced sooner or later by partial acceptance, and less radical defense mechanisms are adopted.
When the individual is no longer able to maintain his fantasy of health, he may experience feelings of anger, envy, and resentment. The individual now asks himself, “Why me?” or “Brother Jones is old; his family is all grown up. I still have much of life ahead of me. Why not him?”
This stage is one of the most difficult for the family and ward to cope with, because his anger is irrational and displaced at random. Family and friends feel his resentment and anger, and then respond either with grief and tears, or guilt and shame. It is natural to avoid future visits, but this only increases the person’s discomfort and anger. It is important that the individual be respected and understood. He must be treated as a valuable human being who will be visited and listened to with pleasure, not merely from duty or assignment. If he expresses anger against Deity, the visitor should not be alarmed. These feelings are temporary, and contradicting them has no positive effect.
In the next stage, the individual hopes that God will postpone the inevitable happening. He might say, “If Heavenly Father has decided to take me from this earth and he didn’t respond to my angry pleas, he may be more favorable if I am humble.”
About the same time, he becomes aware of how his situation is affecting others and feels sincerely concerned about his imposition. Since extensive treatment and hospitalization usually bring heavy financial burdens, the individual usually feels sad and even guilty. If the father is ill, he sees the family income dwindle. The mother may have to work. If the mother is ill, the small children have to be given to relatives or friends for their daytime care. Family members, or Church leaders if no adult relatives are available, should do all they can to help reorganize the household, since the individual’s depression lifts quickly when he or she sees that these vital issues have been taken care of.
There is at this time a second type of depression, a silent type. The individual realizes his impending separation from his loved ones and mourns in much the same way as the living do after the death of a family member. All of the same human courtesies should be afforded him that we give anyone who has suffered a family loss. He should be allowed to express his sorrow, and interference from visitors who try too hard to cheer him up are inappropriate. He may silently turn to sincere, meaningful prayer and begin to think of things ahead rather than behind. He will be grateful to those who can sit with him quietly without constantly telling him not to be sad.
If the individual has had enough time and support in the initial stages of adjustment, he will enter the final stage of being neither angry nor depressed.
He becomes neither happy nor sad, but is in a peaceful mood of acceptance. This is the time when the family usually needs more help and support than the person, for often they have not yet come to grips with reality.
Death is a part of God’s plan and provides an opportunity for faith to overcome fear. It is a time when free agency does not allow us the option of whether or not we will face the trial, only how we will face it.
When the bereaved or terminally ill individual asks my assistance in explaining or justifying their problem, I counsel them that their primary task is not to find explanations but to accept death and dying. Every mourner and every terminally ill individual has to face this reality, and each comes to the task with unique spiritual and emotional characteristics and needs. Yet there are general stages, any or all of which may be observable, and the sensitive family member, priesthood leader, visiting teacher, or friend who is aware of these emotional stages is better equipped to help the individual face death and dying successfully.
The sensitive companion will not avoid discussing the person’s questions, for this can be an important assistance to those who are bereaved or dying; however, he will be a listener primarily, not a preacher indulging in speculation. Receptive to the infinite experience and wisdom available through the Holy Ghost, he will quietly help the individual resolve his complex, searching questions and to come to an understanding of the importance of faith in God as a vital step in coming to acceptance.
Recently in our ward an elderly sister suffered the loss of her husband. Again I observed how members who have suffered a loss and who have a secure knowledge of the plan of salvation find their testimonies to be a substantial source of comfort and peace of mind. She did ask several of the questions that are often asked by the bereaved or dying, but she already knew the answers to most of them. The presence of a family member and friends with the same knowledge provided adequate emotional support, and this sister quickly came to understand that her husband had lived a long and fruitful life and that he was going to prepare a place for her.
On the other hand, some time ago I counseled a young Latter-day Saint widow who seemed to have an insatiable desire to know what the spirit world and life after death are like. She had to feel that her husband was personally needed in the spirit world for a specific mission. She searched the scriptures, studied Church history, and read several books that included a discussion of the spirit world. After several weeks of concentrated study, she had satisfied her need and progressed very smoothly toward acceptance. She had not found the answers to all of her questions, but she had resolved enough of them to discontinue the grieving process.
The answers the person ultimately decides upon are perhaps not critically important in and of themselves so long as they are within the gospel context. What is important in a situation where death has occurred or is inevitable is that questions are resolved to the individual’s satisfaction so that he or she can continue to grow toward the stage of acceptance.
Providing service and comfort to those who have suffered a loss or who are terminally ill should not be approached with reluctance. The strength we can offer to such people in need is immeasurable, and is greatly appreciated.
If we will become educated to the needs and the moods of the bereaved and terminally ill and will allow ourselves to be receptive to the promptings of the Holy Ghost, we will not be hesitant because of our inexperience, and there will be very few situations in which we cannot be of significant help.
Bibliography
Epstein, Charlotte. Nursing the Dying Patient. Reston, Virginia: Reston Publishing Co., 1975.
Kubler-Ross, Elizabeth. Death, The Final Stage of Growth. Englewood Cliffs, New Jersey: Prentice-Hall, 1975.
Lee, Harold B. From the Valley of Despair to the Mountain Peaks of Hope. Memorial Service Address delivered May 31, 1974. Deseret News Press. Stock Number JC-0041, Form Number 2404–6, 71.
Richards, LeGrand. A Marvelous Work and a Wonder. Salt Lake City: Deseret Book Company, 1966, pp. 282–341.
Photography by Royce Bair
A person who is terminally ill experiences several stages in learning to accept his illness. If you recognize these stages, your support can be more meaningful and helpful.