Two Faces of Grief

 My work this week led me to two individuals who are grieving; one of them is grieving her husband and her sense of purpose; the other is grieving the loss of health and the security of his relationships.  Both reminded me that grief manifests itself in highly individualized ways.

Marilyn called me the other day, frustrated with herself and her current situation.    She had been the sole caregiver for Jack, her husband of more than 30 years during the last years of his life.  He had suffered from a slowly progressive disease that over the last year had left him unable to do anything for himself.  Marilyn carried the burden selflessly; her days were busy and totally focused on Jack’s needs.  There was no time to feel sorry for the situation they were in.  Jack died several months ago.  With his death, her life as she had lived it for several years was suddenly gone; she had lost her reason for being.

Marilyn found her days empty, so she filled them with food.  Her favorite comfort foods did just that – and added 20 pounds to her frame.  The physical activity of being a caregiver had also ceased; no more turning and lifting of her beloved or racing up and down the steps with load after load of laundry and supplies.  The lack of a daily workload had made her a bit lazy.  She only had to care for herself, so it didn’t matter if the laundry waited another day or if she didn’t change the bed for a few more days.  She didn’t recognize this lethargy as a profound form of grief.

She was self-aware enough to realize that these habits were not healthy for her well-being but she didn’t recognize her symptoms were also a part of depression that can accompany grief.  She requested an appointment to come in to see me and discuss what she could do to lose the additional pounds and get motivated again.

It was easy to recognize that Marilyn was an outgoing person.  She needed some instruction about changing her current behaviors, but most of all she needed to renew her contact with other people.   Far too often, caregivers become isolated in the world of caregiving, closing the doors to other relationships for several reasons.  Sometimes, the doors reopen after the caregiving experience ends, but all too often they remain shut unless and until the caregiver takes action to reach out.   

Marilyn was receptive to suggested changes in her diet, but exercise options were a bit more challenging.  She liked to walk but her arthritic knees weren’t as enthusiastic and she wasn’t excited about walking alone.  We discussed water exercise classes at a nearby YMCA.  Marilyn had enjoyed this type of class in the past and it would not create additional stress on her knees.  The additional benefit of this type of class was that is would get her out of her house and her favorite chair.  It would also reintroduce her to other women in her own age group and physical condition. 

                                    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 

Mel had been discharged from the hospital a month ago.  He had been ill for weeks before finally collapsing.  When he was admitted to the hospital, his condition was critical and his recovery was slow and included several weeks in rehab.  The diagnosis he and his wife received was shattering:  he had AIDS.  There were many troubling questions left unanswered as his body healed. 

This week, he arrived at my office looking much healthier than he had when I first met him a month ago. Mel was also much more open with me during our chat.  Physically he had improved, but emotionally he was a wreck.  He didn’t know where to begin; he did not have the answers everyone wanted from him and the doctors had told him his exposure may have occurred as long as 15 years before.  He was focusing most of his energy on this confusion and uncertainty.  His grief for life as he had known it only a month before was palpable.

We discussed what happens when we cannot change things in our lives.  Our focus must inevitably shift to accepting a new way of life – even when we resist this, and even if we are not ready.   In this case, Mel would have to work on his physical and emotional well-being in order to stay healthy.   

His wife had begun sessions with a therapist but had closed the door on their relationship.  Mel described it as living two separate lives.  He was hoping time, therapy and the love and family they shared could close the gap that had formed between them.

Mel realized he needed help, but wasn’t ready for one-on-one counseling.  He agreed to meet with a support group of individuals with similar circumstances.  Although computer literate, he could not bring himself to look online for community resources.  He was very grateful when I did the research and was willing to make the outreach calls on his own.

                                    ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Grief is defined as an emotion of great sadness associated with a loss.  We all grieve and no one should ever dictate what, when or how another grieves.  Each relationship and situation is different.

Grieving is often more of a roller coaster ride rather than an orderly progression of stages with clear time frames.  It is complicated by rapidly changing emotions and the challenges of learning new skills, and it is made harder by fatigue, loneliness, anxiety, and the necessity of renegotiating existing relationships and building new ones.  For most, the ride becomes more manageable with time, and the challenges and changes become fewer. 

Similar to riding a roller coaster, the experience can be better when shared.  Family and friends may be involved but caregivers should also be encouraged to contact their health care practitioner and their insurance provider for assistance with identifying therapists and community resources available to them.