Clinical Pastoral EducationCurriculum UUnniitt OOnnee

Clinical Pastoral Education Curriculum

UUnniitt OOnnee

This clinical pastoral education unit was written by several HCMA Chaplains and

edited by Jeffrey R. Funk, HCMA Executive Director. It is for the exclusive use of

HCMA Chaplains and Trainees. It is not to be altered in any way—no edits of

form or content. Permission for any other use must be obtained in writing from:

Healthcare Chaplains Ministry Association 101 S Kraemer Blvd, Suite 123A Placentia, California 92870-5094

Phone: (714) 572-3626 | Fax: (714) 572-0585 E-mail: [email protected] | Website: www.hcmachaplains.org

Copyright © 2016, HCMA. All rights reserved.

mailto:[email protected]

http://www.hcmachaplains.org/

HCMA Clinical Pastoral Education Curriculum Unit One, Chapter 7

2 Copyright © 2016, HCMA

Unit One Overview

Introduction Introduction to the HCMA Chaplaincy Training Program

A Word to the Trainee

Training Curriculum Overview

Educational Goals and Objectives: Unit One

Chaplain-Trainee Learning Goals

Daily Chaplaincy Training Activities Record

Verbatim Reports HCMA Policy Manual

Chapter 1 Biblical Foundation for Pastoral Care: Love and Compassion

Chapter 2 Spiritual Formation

Chapter 3 Hospital Visitation: Dos and Don’ts

Chapter 4 Active Listening

Chapter 5 Ministering to Patients/Residents

Chapter 6 Terminal Issues

Chapter 7 Death, Loss and Grief

Chapter 8 Handling Emergencies as a Chaplain

Evaluations Chaplaincy Training Evaluation and Trainee Evaluation

Supplement Developing Ministry Partners

Death, Loss and Grief


Clinical Pastoral Education Curriculum

Unit One — Chapter 7

DDeeaatthh,, LLoossss aanndd GGrriieeff

This clinical pastoral education curriculum was written by several HCMA

Chaplains and edited by Jeffrey R. Funk, HCMA Executive Director.

It is for the exclusive use of HCMA Chaplains and Trainees.

It is not to be altered in any way—no edits of form or content.

Permission for any other use must be obtained in writing from the:

Healthcare Chaplains Ministry Association 101 S Kraemer Blvd, Suite 123A Placentia, California 92870-5094

Phone: (714) 572-3626 | Fax: (714) 572-0585 E-mail: [email protected] | Website: www.hcmachaplains.org

mailto:[email protected]

http://www.hcmachaplains.org/



Unit One — Chapter 7 Death, Loss and Grief

Table of Contents

Death and Dying… ......................................................................................................... 5

Grief and Loss… ............................................................................................................ 7

Understanding the Grieving Process… ........................................................................ 8

Basic Insights on Grief….................................................................................... 8

The Cycles of Grief… ......................................................................................... 9

The Waves of Grief… ....................................................................................... 10

Four Tasks of Mourning… ............................................................................... 10

Four Key Facts about Grief…........................................................................... 11

Complicated (or Unhealthy) Grief… ................................................................ 12

Responding to Grieving Families…............................................................................ 13

Convey Caring… .............................................................................................. 13

Hurtful Clichés versus Healthy Comments… ................................................... 14

Offer Helpful Actions Instead of Empty Words… ........................................... 14

Chapter Assignments… ............................................................................................... 15

Chapter Resources… ................................................................................................... 17

Appendix A: The Mourner’s Bill of Rights… ........................................................... 29

Appendix B: The Journey Through Grief… ............................................................. 31

Appendix C: The Club No One Wants to Join… ...................................................... 34

Appendix D: Tangled Ball of Emotions… ................................................................. 38

Appendix E: Through the Valley of Grief… ............................................................. 40

Appendix F: Letter from Bereaved Mother… .......................................................... 42

Appendix G: After the Death… .................................................................................. 44



W


My grief lies all within, And these external manners of lament

Are merely shadows to the unseen grief That swells with silence in the tortured soul.

— William Shakespeare (1564-1616)

“God blesses those who mourn, for they will be comforted.”

— Jesus (Matthew 5:4, NLT)

Death and Dying

e live in a death-denying society. Everything around us is designed to keep death at bay. We

focus on looking young and being healthy in our lifestyles to avoid thinking about getting old

or sick or dying. We extol the virtues of those who are considered “old” yet are still active. We make-over

corpses to make them look like they’re only sleeping, hoping to hear, “He looks so natural” during the

viewing. Take time to go through the greeting cards at stationery stores and notice how many of them say

something like, “She is just away,” or “She is not dead, but only asleep.” Medical science is geared to

making us live longer. We see death as a failure, especially in the medical arena.

Why is denial of death so common in the American culture? Sociologists and other professionals have

suggested a number of reasons, but one factor seems to especially stand out: few people die at home.

Most people die in institutions: in acute care hospitals and nursing homes. Rarely does one hear of a

person dying in his or her own home. And, consequently, it is not unusual for family members not to be

present when their loved one dies.

Our culture’s changing view of what constitutes a family also contributes to the situation. Most

children do not live in the same community as their grandparents, let alone in the same house. So children

are often denied the experience of witnessing the dying process and rarely are present when a loved one

dies. If very young, they are often not even allowed to attend the funeral or memorial service. All of this

leads to a culture that increasingly attempts to avoid direct confrontation with death.

Death is no longer a natural part of life, but something to be feared. Yet the fear of death is nothing

new. Ever since the days following the fall, human beings have been in bondage to the fear of death. In

Psalm 55:4, David writes, “My heart is severely pained within me, and the terrors of death have fallen

upon me.”1



But what hope the Scriptures do offer! The writer of the letter to the Hebrews tells us that Jesus Christ

delivers us from that bondage: “Inasmuch then as the children have partaken of flesh and blood, He

Himself likewise shared in the same, that through death He might destroy him who had the power of

death, that is, the devil, and release those who through fear of death were all their lifetime subject to

bondage” (Hebrews 2:14-15).

In John 14:1-6, we read Jesus’ promise to go and prepare a place for believers. When we die, it is a

new experience for us personally. None of us can know what it will be like until it actually happens. How

meaningful and comforting to know that the Lord has already gone on ahead to prepare a place for

believers⎯and that they will not be alone there.

Yet a person’s fear of death does not mean s/he lacks faith. Fear of death motivates us to take care of

ourselves, to look both ways before we cross the street, and to see the doctor when we are sick. In fact,

the Scriptures encourage believers to take care of their bodies (cf. 1 Corinthians 6:19-20).

It is both normal and understandable that we would not want to face our own death, or the death of a

loved one. In the Garden of Gethsemane, the Lord Jesus prayed in agony for the cup of suffering to pass

from Him. On the cross He reassured the penitent thief of a place with Him in Paradise. Having faced

death Himself, Jesus understands a person’s fears and does not condemn someone for experiencing them,

although He wants believers to be aware that death has been swallowed up in victory (1 Corinthians

15:54-55).

As healthcare Chaplains, we have the great privilege and responsibility of sharing that hope with the

terminally ill and their families. It is important to be sensitive and alert when the patient/resident indicates

that s/he would like a religious leader to visit. Offer to phone his/her pastor, but do not insist upon it. The

patient/resident may be reluctant to have us phone, or s/he may wish to do it him/herself. Be willing to

help. Be available. But never be “pushy.” Demonstrate our genuine care and concern to the

patient/resident and we will probably be welcomed back often.2

As in any visit within a healthcare setting, there are a number of factors to consider, but we want to

explore them again here in terms of calling on the terminally ill. Because of this death-denying culture,

many dying patients/residents are acutely lonely. Their friends begin to stay away for a variety of reasons.

For example:

They cannot deal with their own loss in the face of the patient’s/resident’s impending death.

They are frightened by the things they see in the healthcare setting.

They are uncomfortable because the patient’s/resident’s condition confronts them with their own mortality and their own neediness.

As a result, patients/residents are lonely, in need of someone to listen to them, to help them work out

their feelings, and to face the very real spiritual crisis of death. As the healthcare Chaplain, we can make a

1 Unless otherwise noted, all Scripture references are from the New King James Version (Nashville: T. Nelson,

1982), emphasis added.

2 The previous chapter on “Terminal Issues” already dealt with the fears of the dying, the dying stages, and more

specifics on how to minister to them. Refer back to this chapter if review is needed on this information.



significant contribution to the patient/resident’s well-being at this time, especially if we know how to visit

effectively. This means understanding the grief process, as well as being in touch with our own feelings

about death and dying.

We may sometimes feel ill at ease when confronted with the totality of a person’s terminal illness.

Occasionally we may try to cover our uneasiness by being stiff, aloof, or too business-like. Yet giving in

to our uneasiness can be harmful to the patient/resident, who will certainly be sensitive to it. One way to

prevent this from happening is to prepare ourselves before going to see the patient/resident.

Pray for grace to be relaxed. The patient/resident will feel our warmth and kindness if we are at ease

and comfortable. Be willing to laugh and to chat if the patient/resident is so inclined. Remember that

Scripture says laughter does good like a medicine. This does not mean that we should be the clown of the

healthcare organization. Loudness, crudeness, and flippant behavior are unprofessional and unbecoming

to a minister. Our challenge and task is to behave in a professional manner, without appearing to be

merely professional.

Before visiting, we can prepare ourselves by imagining what the room will be like and how the

patient/resident will look. Will there be IV’s, heart monitors, and other equipment in use? Will there be

unpleasant odors? How ill will the patient/resident look? By thinking about what to expect, we will be

better able to confront many of our uncomfortable feelings while still in our office. Prepare a number of

things to say that will relate to what is going on in the outside world, so that we are not at a loss for words

when we first enter the patient’s or resident’s room.

If we call on a patient/resident whose family is present, step in and introduce ourselves, if we have

not done so already. Reassure everyone present that we are standing with them in prayer. This gives

comfort not only to the patient/resident but also to his/her family. Make our visit brief, but not rushed.

It is sometimes difficult to determine what the best time to visit is. This will often depend upon the

routine in our healthcare organization and the condition of the patient/resident. Each situation varies,

although many Chaplains feel that around 3:00 p.m. is best (and others feel that mornings are best).

Develop a pattern of the time of our visits, if possible. This gives the patient/resident something to look

forward to, assuming, of course, that our visits are helpful.

There are times when we should cut our visit short. For example, when we sense that the patient or

resident is in pain or uncomfortable, we should excuse ourselves and return at another time. The patient or

resident will appreciate our sensitivity and we will be welcomed and privileged to return for further

ministry later.

When visiting a patient/resident while other visitors are present, never discuss the patient/resident in

the third person. For example, don’t say, “He’s feeling better today,” or “She’s not eating anymore.” To

do so treats the patient/resident as though s/he were not even in the room. This conduct assumes that the

person cannot speak for him/herself. It tends to make the person feel that s/he is no longer in control of

his/her own life and adds to any feelings of victimization that s/he may be having.

Do not be the bearer of bad news. Information about train wrecks, airplane crashes, floods, fires, or

earthquakes are generally on television and the patient/resident may already be aware of them. If the

person has not already learned about them, s/he does not need to hear about them from us. Such

information offers nothing positive to the patient/resident.

By the same token, do not discuss our plans for a social evening or event, such as a big football game

we plan to see or a trip to the mountains. Since the patient/resident is unable to go and may never go

again, this can be depressing to the terminal person.



Grief and Loss

There are many ways to help those in grief. The primary emphasis should be on supporting them

through this difficult time. The importance of our ministry cannot be overstated, as the griever’s

emotional, mental, spiritual, and even physical well-being may hang in the balance. We need to “carry”

the grief-stricken person like the friends of the paralytic in Mark 2:1-5. Notice that Christ did not

emphasize the faith of the sick man, but the faith of his friends.

Our contribution may make a vital difference in their eventual recovery and re-adjustment into the

main stream of life. The following guidelines can help us express our concern and sympathy in a realistic

way as we become a CATALYST for healing:

C ⎯ Care given out of heart-felt concern.

A ⎯ Assessment of total needs of the grieving person that enables one to better anticipate the

needs of the bereaved.

T ⎯ Tact.

A ⎯ Attention to the little extras that make a grieving person feel good about self.

L ⎯ Listening love. This is listening for deeper levels of hurt and healing.

Y ⎯ Your own relationship with God that in turn influences your attitude and actions toward

others.

S ⎯ Skill in giving emotional support.

T ⎯ Time to be with the grieving person.

Understanding the Grieving Process3

If we are going to be helpful to those who are grieving the death of a loved one, it is important that we

have a basic understanding of the grieving process.

Basic Insights on Grief

It might be helpful to use some word pictures to describe a person’s grief reaction to a death. For

example, a loss is like a laceration. There is a difference between viewing grieving as merely being

“injured” rather than being “damaged.” Being damaged implies that something is severely broken (maybe

even beyond repair). And we usually require a professional to attempt to fix something that is damaged.

By contrast, being injured implies only a temporary hurt (a repairable wound that may leave a scar after it

heals). It usually involves a process of caring attention in order to promote healing. Grieving a loss is like

a laceration that, with time and special attention, will eventually heal. Grieving is a natural process of

healing a deep emotional wound. Sometimes the wound may become infected (which is called

complicated grief and we’ll discuss that later).

Another symbol for the grieving process might be a compost pile. Most people view a compost pile as

something gross, something to be avoided. However, with time and turning (special attention) the gross

pile can be transformed into something enriching and beneficial. Like a compost pile, mourning is a

natural process of adjusting to change that has the potential of enriching one’s life, even though it may

appear unpleasant for awhile.

Experiencing grief can be very stressful for the person going through it. But pressure can be

pernicious or productive. The Chinese have a character for the word “crisis.” It includes the Chinese

character wēi 危 (dangerous, perilous) plus the Chinese character jī 機 (incipient moment, crucial point, suitable occasion, opportunity). Within grief is the potential for embitterment (i.e., negative consequences—the danger) or increased sensitivity and depth (i.e., opportunity for positive growth—the

incipient moment). 3 The following grief information comes from seminar material presented by Chaplain Jeffrey R. Funk on

“Responding to Grieving Families.” Used by permission.



Events and circumstances do not determine the outcome. A person’s resources (those within and

those without) and reactions play a major role in his or her recovery. However, the initial intervention

during a crisis can make a significant difference. With this understanding, grief can become a stagnant

pond or a flourishing river; a dark, dead-end cave or a promising tunnel; or a place where we get stuck or

an adventurous journey.

Keep in mind that present losses link with past losses. Each loss asks its turn to be mourned. There

are no short cuts to grieving. All side roads eventually lead back to the main highway of doing personal

grief work. In fact, the losses of others may activate personal grief issues. There was a man whose wife

had a stillborn baby. Like many men, he moved on with his life and did not grieve the loss of his son.

Eight years later his sister had a stillbirth. The memory of his own loss came flooding back to him and he

wept intensely for the loss of both children.

Be aware that there is a difference between “grieving” and “mourning.” Grief is defined as “intense

emotional suffering caused by loss, disaster, misfortune, etc.; acute sorrow; deep sadness.” The word

derives from a Latin verb meaning “to burden.” Grief is the composite of thoughts and feelings about a

loss you experience within yourself ⎯ it is our private experience of the loss. Mourning is defined as “to

feel or express sorrow.” Mourning is when we take the grief on the inside and express it outside

ourselves⎯it is our public expression of our loss. The word derives from a Gothic verb meaning “to be

anxious,” and it comes ultimately from an Indo-European base meaning “to remember; to think of.”

Mourning involves remembering and thinking of the deceased and this may make us feel anxious or

uncomfortable.

Above all, always keep in mind that every person’s grief reaction and grieving process is unique. For

example, the nature of the loss will make each situation unique. Was the death anticipated or unexpected,

traumatic, witnessed, viewed as preventable, or one of several recent losses? The nature of the

relationship with the deceased will make each situation unique. Was the person very close to the

deceased, dependent on the other, ambivalent to or angry with the person (especially if there was any

abuse in the relationship), or was their unfinished business? The nature of the griever is unique. There are

distinctions in grief between gender, culture, age, health (both physical and mental), past experience with

loss, world view, resiliency, personality, and spirituality.

The Cycles of Grief (See Figure 1)

These are not well-defined steps, like going up

the rungs of a ladder one step at a time until we

reach the top⎯the end of our grieving. It is a

generalized process of healing that most everyone

experiences.

The first movement in the cycle is shock. The

grieving person might say something like, “I can’t

believe this is happening!” This is a cycle of

unreality, disbelief and/or numbness. It has been

compared to a shot of Novocain that numbs our

emotional system, or like a bad dream we hope to

wake up from soon and find it wasn’t real.

The second movement in the cycle is protest. The

grieving person might shout, “This isn’t fair!” This is a

cycle of reaction, which might include feelings of:

Figure 1

The Cycles of Grief

Guilt (saying, “If only...?”), having self-criticism and either real or imagined regrets.

SHOCK

REORGANIZATION PROTEST

DISORGANIZATION



Anger (saying, “Why me?”), which can be rational or irrational, turned inward or outward (e.g., frustration, fear, helplessness, blame, and resentment).

The third movement is disorganization. At this point the grieving person is exclaiming, “I’m falling

apart!” This is a cycle of emptiness, sadness and depression (with the person saying, “Poor me!”), which

are merely symptoms of a very painful wound. It is also a cycle of:

Confusion . Some have described it like being alone in the middle of a wild, rushing river with nothing to grab hold of, and others feel like they’re going crazy.

Yearning. This is a preoccupation with memories or a shift in perception, which might include hallucinations—having visions of the person who has died.

Anxiety. This might include pondering, “Am I going to be okay?”

The final movement is reorganization. At this point the person may say, “I’m finally enjoying living

again!” There is no timetable for this recovery. At some point along the journey through grief, the person

will eventually regain his/her ability to function as s/he once did. They will inevitably resolve and

integrate the loss into their life. This acceptance does not mean that they like the loss. It only means that

they have learned to live with it as they go on to reinvest their life in new relationships and new dreams.

The Waves of Grief (See Figure 2)

There is a pattern of emotional highs and

lows with grief⎯of jagged peaks and valleys.

The emotional pain is usually most intense the

first three to six months and then it gradually

subsides, but not in a steady manner. The

emotional response can fluctuate up and down

on a daily, even hourly, basis, like a wild roller

coaster ride. Around the one-year anniversary,

the intensity of the grief can come rushing in

with pain that almost rivals the initial feelings

of the loss.

Please do not make the mistake of telling a

grieving person who has had a significant loss

only a year or two ago, “You should be over it

by now!” Notice in Figure 2 that emotions

regarding the shock of the death don’t get back

to normal until about two years after the death

Figure 2

The Waves of Grief: Shock and Numbness

(on average).4 No timetable can be set for the person to reach acceptance of a death. Everyone moves

through the grieving process at his/her own pace. However, being stuck in a phase or with particular

emotions may indicate a blockage in the healing process and might be a signal that help is needed.

Four Tasks of Mourning5

4 This graph on the shock and numbness that follows the death of a loved one comes from Glen W. Davidson,

Understanding Mourning (Minneapolis: Augsburg, 1984). He also has graphs for disorientation and

searching/yearning that equally show the long-term (two years) ups and downs (waves) of adjusting to a significant

loss in one’s life.

5 Adapted from J. William Worden, Grief Counseling and Grief Therapy: A Handbook for the Mental Health

Practitioner (New York: Springer, 1982). For a deeper understanding of these tasks, read this excellent resource on

the subject.



1. Accept the reality of the loss. The first task of grieving is to face the reality that the person is

dead, that the person is gone and will not return, that reunion in this life is impossible.

Signs of an aborted task: Denial, i.e., not believing the person is truly dead, gone. Denying the facts

of the loss, the meaning of the loss, or the irreversibility of the loss only serves to prolong the grief

process. Though denial or hope for reunion is normal immediately after the loss, this illusion is usually

short-lived.

2. Experience the pain of our grief. We must allow ourselves to experience and express our normal

feelings that are a part of grieving, like anger, guilt, loneliness, anxiety, and depression. We need to recall

and relate both pleasant and unpleasant memories of the deceased.

Signs of an aborted task: Stoic, i.e., not allowing ourselves to feel or express our feelings openly.

Many people try to avoid the painful feelings by various ways such as “being strong”, moving away,

avoiding painful thoughts, “keeping busy”, etc. But there is no adaptive way of avoiding it. Be assured

that the memory of our loved one will continue, but the pain will lessen in time and will finally disappear.

3. Adjust to an environment in which the deceased is missing. In other words, be willing to do things

differently since our loved one will no longer be involved in any of these activities. Many survivors,

especially widowed persons, resent or fear having to develop new skills and to take on roles that were

formerly performed by the deceased. There may be many practical daily affairs we need help and advice

with, but there also will be a great sense of pride in being able to master these challenges.

Signs of an aborted task: Not adapting, not adjusting to new roles and a new identity. The emotions

involved in letting go are painful but necessary to experience. By not doing so, we will remain stuck in

the grief process and unable to resolve our loss.

4. Reinvest in living. The final task is for us to withdraw emotional energy from the deceased person

and reinvest it in continuing a productive life that involves relationships. This does not necessarily mean

finding a new spouse, surrogate mother, etc. It does mean re-entering the stream of life without our

deceased loved one. We must rebuild our own ways of satisfying our social, emotional, and practical

needs by developing new or changed activities or relationships. This is not dishonoring the memory of the

deceased and doesn’t mean that we love him or her any less. It simply recognizes that there are other

people and things to be loved and we are capable of loving.

Signs of an aborted task: Not loving, but continuing to “walk alone.”

Four Key Facts about Grief6

1. The way out of grief is through it. People heal best when they embrace their pain. Time will never

heal grief—it is what a person does with the time that matters. Everyone must deal with his or her own

grief and work through it.

2. The worst kind of grief is our own. Is it more difficult to say good-bye to a newborn or a teenager

or a grandparent? Is it worse to watch someone die “an inch at a time” from a crippling disease or to lose

our loved one suddenly and unexpectedly in a tragic accident? Pain is pain!

3. Grief is hard work. It’s hard to admit that a loved one has died. It’s hard work to vent our strong

feelings. And it’s hard work to release the one who has died.

4. Effective grief work is not done alone. It should not be kept to ourselves. We need to share our

grief with a personal confidant or in a grief support group.

6 Adapted from Bob Deits, Life After Loss: A Personal Guide Dealing with Death, Divorce, Job Change and

Relocation (Tucson, AZ: Fisher, 1992), 61-74. This excellent resource also includes guidelines for forming a grief

support group.



Complicated (or Unhealthy) Grief

When the grief process is significantly exaggerated, excessively prolonged and/or seriously interferes

with a person’s capacity to function in life roles, some degree of pathology may be assumed and

consultation with a professional therapist is earnestly advised.

The following symptoms should receive professional help if they occur:

Any self-destructive thoughts or behavior.

Inability to sleep at all.

Significant weight loss or gain.

Hallucinations and/or delusions.

Panic or anxiety attacks.

Unusual physical pain or symptoms.

Hyperactivity such as overworking, taking on major new responsibilities, compulsive shopping, gambling, sexual activity and/or traveling.

Feeling so completely overwhelmed they’re unable to get out of bed or be active.

Over usage of medications.

Excessive use of alcohol.

Use of illegal drugs.

The following symptoms should receive professional help if they are severe and persist for longer

than one month following the death:

Gross denial of reality of the loss.

Out of control anger or rage.

Intense shame.

Severe depression.

Severe anxiety and fears.

Alan Wolfelt, Director for Loss and Life Transition in Fort Collins, CO, explains unhealthy grief

responses that can be characterized through five avoidance patterns.7

1. The Postponer is the person who believes that if you delay the expression of your grief it will

hopefully go away over a period of time. But it doesn’t. It is through expression that healing comes.

Postponement only causes the grief to build up to volcanic proportions.

2. The Displacer is the person who takes the expression of grief away from the loss itself and

displaces the feelings in other directions. For example, the person may complain of difficulty at work or

in relationships with other people. Or the person may be chronically agitated and upset at even the most

minor of events. This places stress on personal relationships.

3. The Replacer. This is someone who takes the emotions that were invested in the relationship that

ended in death and reinvests these emotions prematurely in another relationship or in overworking.

7 Adapted from Alan D. Wolfelt, Death and Grief: A Guide for Clergy (New York: Brunner-Rutledge, 1988), 115-

119.



4. The Minimizer is someone who is aware of feelings of grief, but when the feelings are actually

felt, the person works to minimize the feelings, diluting them through a variety of rationalizations. This is

typically an intellectual process in which words substitute for the expression of authentic feelings in order

to avoid pain at all costs.

5. The Somatizer. This is the person who converts his/her feelings of grief into physical symptoms.

By taking on the “sick role,” people around the person legitimize his/her very real need to be nurtured and

comforted. The Somatizer often fears that if s/he was to express his/her true feelings of grief, people

would pull away and leave the person feeling abandoned.

Responding to Grieving Families

Before reading the rest of this section, first answer the following two questions: First, what’s hardest

about being with those who are grieving?

Once we have answered that question, we now need to ask ourselves: What do we think they

need/want from us?

Before we can help someone else deal with their grief, we must first experience fully and deal

adequately with our own grief issues. We need to do our own “grief work” so we can see and come

alongside someone else’s pain. Otherwise, their loss will function as a mirror of our own pain. In other

words, we will see our own grief instead of theirs, which will make it very difficult for us to effectively

come alongside them and comfort them.

Convey Caring

Remember: We can’t “fix it” (we can’t give them their loved one back and make it all better) but we

can imprint a memory of caring alongside their painful loss. How? Here are seven be-attitudes that will

help us convey caring to the grieving person. Be genuine. This is having our actions be consistent with our words. The truly genuine person is

unwavering in his/her values or attitudes, aware of his/her own emotions, and willing to share of himself/herself and his/her own feelings.

Be empathetic. Empathy is viewing and understanding the situation from their perspective, getting a feeling for what they are going through.

Be warm. This means showing friendliness and consideration through facial expression, tone of voice, gestures, a relaxed posture, and good eye contact.

Be available. Being available means being open to listen to them, to touch them appropriately, to sit with them, and to weep with them.

Be a sensitive listener. This involves trying to understand their feelings and hearing what they are really saying, without making judgmental or critical comments. Listening encourages the person to talk

Be an affirmer. Affirmation is encouraging them to feel what they feel. It is validating their loss by giving them permission to openly express their grief.

Be patient. It will take time. They won’t “snap out of it” quickly, so they need someone to persevere with them over the long haul.

Hurtful Clichés versus Healing Comments

When coming alongside grieving people we need to avoid saying hurtful clichés and, instead, offering

healing comments. (See Figure 3)



When the emotional wound of death is fresh and tender, clichés are simply too superficial. Instead,

those who are grieving need to hear reassurances that their suffering is genuine and that the life of their

loved one stood for something. Statements that validate a void has been made in their life, or that the

deceased person will be missed, are statements that are normally appreciated. Saying, “God needed

another angel,” is not usually soothing to most people. Making a comment like, “Be grateful for the time

you did have with him/her,” is seldom perceived as a positive statement at the moment of death.

Hurtful Clichés Healing Comments

▪ Time will heal.

▪ It’s a blessing in disguise.

▪ God never gives us more than we can handle.

▪ You must be strong.

▪ You’re holding up so well.

▪ This is God’s will (cf. Romans 8:28).

▪ I know how you feel.

▪ Let me know if I can do anything.

▪ This is a blessing in disguise (cf. Genesis 50:20).

▪ You need more faith (cf. Matthew 21:22).

▪ You need to get right with the Lord (cf. Isaiah

53:5).

▪ God showed me a verse for you.

▪ You shouldn’t feel this way.

▪ You need to accept what happened and get on with

your life.

▪ You should be glad it wasn’t worse…at least you

have insurance…other children…etc.

▪ You must feel as if the pain will never end.

▪ I’m sorry this had to happen

▪ This must seem overwhelming to you.

▪ Don’t feel you need to be strong for me.

▪ It’s normal to cry (be angry, etc.).

▪ Some things just don’t make any sense.

▪ I can only imagine how you must feel...Tell me

about it.

▪ I’ll come by tomorrow with groceries (or dinner),

what time is good for you?

▪ I’m sorry this had to happen.

▪ It must be hard to trust God right now.

▪ There are no words to express my sorrow for you.

▪ Tell me what you’re thinking/feeling.

▪ It’s normal to feel like this.

▪ God gives strength to get through each day…He

will be there for you…and so will I.

▪ What’s hardest for you about dealing with this?

Figure 3

Helpful Clichés versus Healing Comments

Offer Helpful Actions Instead of Empty Words

Begin where they are, not where you think they ought to be.

Listen to them. Encourage them to talk about their grief. Someone has said, “A joy shared seems to double it; a sorrow shared seems to half it.”

Give meaningful touch. When appropriate, this means holding a hand while they share painful memories, placing a hand on their shoulder while they cry, or giving them a hug. Few things heal wounded spirits better than the balm of supportive touch.

Pray for them and with them. This involves praying simply and specifically for the personal needs you are aware that they have.

Assess their needs. You might ask, “Who’s going to be there for you over the next two months?” Or you might inquire, “How do you normally cope with this kind of situation?”

Offer practical assistance. Like what? Offer to help them make some phone calls. Give them resources they can read that will help them understand the grieving process⎯a small booklet is best.



Refer them to a grief recovery support group. Refer them to a grief counselor (clergy, professional therapist). Give them a phone number for follow up support.

Chapter Assignments

1. Read a book on loss and grief and then write a one-page summary. Discuss your insights with

your Teaching Chaplain.

2. If possible, interview someone who has had a family member die. Ask about his or her grief

reactions and what support was most comforting to him/her. After spending several minutes in Bible

study, reflection and prayer on what you learned, write a two-page summary of your insights from this

conversation and discuss your insights with the Teaching Chaplain.

3. If possible, observe a grief recovery support group. After spending time in Bible study, reflection

and prayer on what you learned, write a two-page evaluation of your insights from this experience and

discuss it with your Teaching Chaplain.

4. After spending time in Bible study, reflection and prayer, write a sermon or Bible study outline

dealing with Biblical characters and their responses to grief. Discuss it with the Teaching Chaplain.

5. Watching a loved one die and then going through the grieving process is a very personal

experience. Spend time in reflection on the losses in your own life and how they have impacted your life

and influence your ministry to the grieving. Record your thoughts in a journal and discuss your insights

with the Teaching Chaplain.

6. After spending time in Bible study, reflection and prayer on the subject of grief, write a two-page

essay on “How to Minister to the Bereaved” (include Scripture to support your points). Discuss your

insights with the Teaching Chaplain.

7. Make rounds. Debrief regularly with the Teaching Chaplain.

8. Write a verbatim of a visit with a grieving person and present it to a peer group. Discuss your

learning issues with your Teaching Chaplain.

9. Study the “Respiratory System” section in the Medical Terminology Manual in order to become

familiar with these common medical terms and surgical procedures.

10. Interact with your Teaching Chaplain. Write out your response to each of the following and then

discuss each issue with your Teaching Chaplain.

a. Have you ever been seriously ill or injured? (If you have not yet had this experience, is there

someone close to you ⎯ a family member or family friend ⎯ who has? If so, answer these

questions in terms of how you reacted as a member of the family.)

Describe your feelings at the time. Were you afraid? Peaceful? Worried?

What was most helpful to you at the time?

What was least helpful?

b. What does death mean to you?

c. Describe the first time you had to deal with death. How did this experience with death affect

you? Were you angry? Frightened? Did you have feelings that you would think of as

negative? What took these feelings away?



d. If your doctor were to tell you that your illness was terminal, who would be the first person

you would want to talk with and why?

e. If you were a critically ill patient in the hospital, how would you expect your spouse to react?

What kind of support would you expect? What do you think you would do if you became

dissatisfied with your physician?

f. If your spouse had a terminal illness, would you want him/her to be told? Would s/he want to

be told? Explain why you answered the way you did. Have you discussed this issue with

him/her?

g. If you were dying, would you want a healthcare Chaplain to visit you? Explain why or why

not.

h. Write out your response to each question and then discuss them in depth with your Teaching

Chaplain:

Some people think we live in a death denying society. Do you agree or disagree with that? Please elaborate.

When you were a child or a young teenager, did your family ever discuss death? If so, did they discuss it openly and without fear, or was there some degree of discomfort? If death was never discussed in your family, why do you think that was so?

How has being a Christian played a role in developing your attitude about death and dying?

What do you think a Christian’s attitude about death should be? What role should fear play in a believer’s attitude?

For the Christian, is death an enemy or friend? Or is it neither?

Do you feel it is wise to discuss death with children? Why or why not?

How often do you think of dying: as often as once a week, not at all, or somewhere in between?

If you became gravely ill, what would you fear most: not being able to provide for your family, being kept alive by heroic efforts, or your family running into debt? Is there something else that would trouble you more?

i. Discuss the following questions in depth:

If someone you love knew s/he had a terminal illness, and if s/he wanted to talk with you about it, how would you feel about discussing death and dying? Would you be embarrassed, distressed, willing, and/or at ease?

What fatal illness do you fear most? Heart disease? Cancer? Multiple sclerosis? AIDS? Accident? Alzheimer’s? Other? Explain why this type of illness is so fearful to you

Do you find the sight of a dead body frightening, natural, or unsettling? Is there a difference between your feelings about a dead body that is still in a bed at home, in a hospital bed, or one that is in a casket?

j. What is hardest about being with those who are grieving? What do you think they want from

us?

k. To what degree does anger play a part in the grief process?

How do bereaved people show this anger?



What should you do if this anger is directed at you?

l. A small child in your healthcare facility has died unexpectedly from a sudden illness, and the

parents are distraught. After you identify yourself to the parents, the mother asks you to read

scripture to comfort her. What do you read? Do all babies and children go to heaven when

they die? Thoroughly discuss your views on this.

m. In 1 Thessalonians 4:13-18, Christians are admonished not to grieve as if we had no hope.

Explain what this means.

n. A terminally ill patient/resident, whose family supported her around the clock, dies after the

family stepped out of her room for only a short while. Upon their return, they become

hysterical and feel guilty because their loved one died alone. How would you seek to console

them?

o. A family member is running up and down the halls of your healthcare facility screaming and

totally out of control after learning that her mother had just died. The nurse manager pages

you and asks you to intervene. What would your intervention entail?

p. A young daughter is inconsolable in the ER because the doctors could not resuscitate her

mother. The mother had gone into a comma while her daughter slept in the bed next to her.

The mother was scheduled for heart surgery the very next day. The daughter feels that if she

had stayed awake, her mother would still be alive. What comfort could you offer her?

Chapter Resources

The following annotated bibliography is not intended to be exhaustive in its content, nor does it

contain all the latest resources. HCMA does not endorse all of the ideas expressed in all of the resources

listed here. Some of the sources are given simply to expose us to a variety of viewpoints on the subject. It

is expected that even in places of disagreement we will reflect upon and think critically regarding our own

views rather than simply dismissing views that may run counter to our own.

Grief Issues — Child

Berezin, N. After a Loss in Pregnancy: Help for Families Affected by a Miscarriage, a Stillbirth or the Loss

of a Newborn. New York: Simon & Schuster, 1982.

Borg, Susan, and Judith Lasker. When a Pregnancy Fails: Families Coping with Miscarriage, Stillbirth and

Infant Death. New York: Bantam, 1989. An excellent resource on the subject.

Church, M., Chazin, H., and Ewald, F. When a Baby Dies. Oak Brook, IL: Compassionate Friends, 1981.

Compassionate Friends. www.compassionatefriends.org. A national self-help organization, which assists families in the positive resolution of grief following the death of a

child of any age and provides information to help others be supportive.

Davidson, Glen W. Understanding Death of a Wished-For Child. Springfield, IL: OGR, 1979. Author Glen W. Davidson, Chief of Thanatology at Southern Illinois University School of Medicine, produced

a 28-minute documentary in 1977 that focused on an actual clinical case that Professor Davidson found typical

of those encountered during a five-year study of couples who had lost a baby. This publication, a 30-page

staple-bound pamphlet, essentially provides a transcript of that documentary, with additional commentary,

recommendations, and reference citations.

Davis, D., et al. “Perinatal Loss: Providing Emotional Support for Bereaved Parents.” Birth: Issues in

Perinatal Care and Education 15.4 (1988): 242-6.

Day, Sandy. Morning Will Come. Bemidji, MN: Focus, 2005.

http://www.compassionatefriends.org/



Doka, Kenneth J., ed. Living with Grief: Children, Adolescents, and Loss. Washington, DC: Hospice

Foundation of America, 2000. Features articles by leading educators and clinicians in the field of grief and bereavement. The chapters entitled

“Voices” are the writings of children and adolescents. The book includes a comprehensive resource list of

national organizations and a useful bibliography of age-appropriate literature for children and adolescents.

Fackler, Teale, and Gwen Kik. Threads of Hope, Pieces of Joy: A Pregnancy Loss Bible Study. A Bible study that has been designed to facilitate healing for those who have experienced an unintentional

pregnancy loss through miscarriage, stillbirth or any form of early infant death. You can download this study for

group or individual use by going to: http://www.scribd.com/doc/22465159/Threads-of-Hope-Pieces-of-Joy-A-

Pregnancy-Loss-Bible-Study.

Fitzgerald, Helen. The Grieving Child: A Parent's Guide. New York: Simon & Schuster, 1992.

Offers practical, compassionate advice for helping a child cope with the death of a parent or other loved one. Parents of children from preschool age to the teen years will find much-needed guidance, covering:

Helping a child visit the seriously ill or dying; Using language appropriate to a child's age level; Selecting

useful books about death; Handling especially difficult situations, including murder and suicide; Deciding

whether a child should attend a funeral.

———. The Grieving Teen: A Guide for Teenagers and Their Friends. New York: Simon & Schuster,

2000. Adeptly covers the entire range of situations in which teens may find themselves grieving a death, whether the

cause was old age, terminal illness, school violence, or suicide. She helps teens address the gamut of strong and

difficult emotions they will experience and the new situations they will face, including family changes, issues

with friends, problems at school, and the courage needed to move forward with one's own life.

Friedman, R. and Gradstein, B. Surviving Pregnancy Loss. Revised ed. New York: Citadel, 1996. This sourcebook is designed for those women who have suffered the trauma of pregnancy loss, and is designed

to be both reassuring and insightful, offering clinical advice on how to deal with the pain of miscarriage,

stillbirth or ectopic pregnancy. This revised edition has been expanded to include information on invitro and

surviving a loss after amniocentesis, and is designed to be of interest to women suffering the effects of a

pregnancy loss and for those who care for and about them, providing practical approaches to coping with the

emotional problems associated with a pregnancy loss. The book includes personal accounts by women who

have undergone a pregnancy loss as well as a discussion of the physical and emotional consequences of loss and

a consideration of options for the future - trying again or considering adoption.

Grollman, Earl A. Bereaved Children and Teens: A Support Guide for Parents and Professionals. Boston:

Beacon, 1996. A comprehensive guide to helping children and adolescents cope with the emotional, religious, social, and

physical consequences of a loved one’s death.

———. Talking about Death: A Dialogue between Parent and Child, Fourth ed. Boston: Beacon, 2011. A classic guide for parents helping their children through the death of a loved one. With a helpful list of dos and

don'ts, an illustrated read-along dialogue, and a guide to explaining death, Grollman provides sensitive and

timely advice for families coping with loss.

Gryte, Marilyn. “Perinatal Loss: Interventions for Healing.” The Oregon Counseling Journal 10.2 (1988): 11-

15. The purpose of this article is to explore the concept of perinatal grief and evidence-based healing interventions

for it. The loss of a pregnancy or death of an infant causes profound grief, yet society has long minimized or

ignored this grief, which is among the most painful of bereavement experiences. Throughout the last century,

research on grief and the special needs of bereaved parents has changed the context of professional intervention

from protective to supportive. The central focus of bereavement interventions is to assist families in healing by

helping them make meaning of their losses. The use of symbols, spirituality, and rituals has been shown to help

bring meaning. Research has shown that memories are key to healing, and that gender, age, and relationships

bring different grief expressions and experiences. While children's understanding of loss and grief differs with

developmental age, they should also be given the opportunity to participate in grief rituals and practices.

Professionals who care for bereaved parents have a unique opportunity to offer support by validating their grief,

http://www.scribd.com/doc/22465159/Threads-of-Hope-Pieces-of-Joy-A-



facilitating rituals, providing mementos, and letting the bereaved tell their stories. While no intervention can

bring back their beloved children, appropriate intervention can promote healing.

Hanes, Mari, and Hayford, Jack W. Beyond Heartache. Wheaton, IL: Living, 1984.

Hughes, C., et al. “Fathers Experiencing a Perinatal Loss.” Death Studies 13.6 (1989): 537-56. Fifty-one fathers in the New Jersey-Pennsylvania area who experienced a perinatal loss were interviewed in

their homes for 1 to 3 hours for the purpose of describing the nature, intensity, and duration of the bereavement

experience.

Huntley, Theresa M. Helping Children Grieve: When Someone They Love Dies. Revised ed. Minneapolis:

Augsburg, 2002. This straightforward book helps adults talk to children in meaningful ways, nurturing their faith and building

their emotional strength during a time of crisis. The author explains common reactions (emotional, physical, and

behavioral) parents can expect from children of all ages, and offers adults the spiritual tools they need to help

children cope with a significant loss.

Hutti, M. “A Quick Reference Table of Interventions to Assist Families to Cope with Pregnancy Loss or

Neonatal Death.” Birth: Issues in Perinatal Care and Education 15.1 (1988): 33-5.

Ilse, Sherokee. Empty Arms: Coping with Miscarriage, Stillbirth and Infant Death. Revised ed. Maple Plain,

MN: Wintergreen, 2013 The book offers guidance and practical suggestions for the decision-making at the time (including why and how

one might see, hold, and memorialize one’s baby) and over time (such as how to handle such times as

anniversaries, holidays and the birth of other babies in the parents’ close circle.)

Ilse, Sherokee, and Linda Hammer Burns. Miscarriage: A Shattered Dream. Fourth ed. Maple Plain, MN:

Wintergreen, 2006. Offers a sensitive, comprehensive, and insightful perspective on possible causes, medical terminology, choices

and decisions, emotional aspects, coping suggestions, choices for the future, and resources for families

experiencing a miscarriage.

Johnson, Joy, and Marv Johnson. Children Die, Too. Omaha, NE: Centering Corporation, 1992. It is for newly bereaved parents needing general grief information. Includes: Feelings, Your Other Children,

Grandparents, Friends, Single Parents and Step-Parents, Taking Care of Yourself, and Searching.

———. Miscarriage: A Book for Parents, revised edition. Omaha, NE: Centering Corporation, 2013. This book covers: Feelings, Reaching Out, Dads, Your Baby, Single Moms, Other Children, Fears, The

Community, and Moving On.

———. Newborn Death: For Parents Experiencing the Death of a Very Small Infant. Omaha, NE: Centering

Corporation, 1982.

Kander, Jenny. So Will I Comfort You: Support for Bereaved Parents, Their Families, Friends and

Counselors. Omaha, NE: Centering Corporation, 1991.

Kolf, June Cerza. Grandma’s Tears: Comfort for Grieving Grandparents. Grand Rapids, MI: Baker, 1995. Grandparents are often overlooked when a grandchild dies, yet they carry a double burden--the loss of their

grandchild and the sorrow of their own grieving children. Author Kolf offers support and hope in brief chapters

that do not overwhelm the bereaved. She intertwines practical strategies for surviving grief with first-person

accounts from grandparents.

Komp, Diane M. Hope Springs from Mended Places: Images of Grace in the Shadows of Life. Grand

Rapids, MI: Zondervan, 1994. A unique tool to offer clients who want to see that they are not alone, and that hope can come to live again in

their heart and in their mind and in their spirit.

Kroen, William C. Helping Children Cope with the Loss of a Loved One: A Guide for Grownups.

Minneapolis: Free Spirit Pub., 1996.



Offers sound advice, comfort and compassion to any adult helping a child cope with death. Weaving in

anecdotes about real children and their families, he explains how children from infancy through age 18 perceive

and react to death and offers suggestions for how to respond to children at different ages and stages. Specific

strategies are offered to guide and support them through the grieving process.

Kuening, Delores. Helping People Through Grief. Minneapolis: Bethany, 1987. The book is designed to guide the reader in how to show care and concern—by what is said and done, by being

sensitive to the process, and by knowing when to do what. Each chapter is based on true experiences, and

caregivers are supplied with practical advice and insight, appropriate scripture for different needs, as well as a

list of recommended books.

Limbo, R., and Wheeler, S. When a Baby Dies: A Handbook for Healing and Helping. La Crosse, WI:

Resolve Through Sharing, 1986. Written to help families heal and provide support to healthcare professionals. Revised in 1998, the book covers

individual stories of pregnancy and perinatal loss. There are specific chapters on miscarriage, ectopic

pregnancy, stillbirth, newborn death and loss in a multiple gestation pregnancy.

Marshall, Sharon, with Jeff Johnson. Take My Hand: Guiding Your Child Through Grief. Grand Rapids, MI:

Zondervan, 2001. Contains practical suggestions for dealing with the common effects of grief on children, how to recognize and

respond to hidden grief in your child, and Biblical insights into the grief process.

McColgan, P. “Perinatal Loss—Helping Families Through Stillbirth and Neonatal Death.” Canada’s Mental

Health 37.1 (1989): 22-5.

Morrow, Judy Gordon, and Nancy Gordon DeHamer. Good Mourning: Help and Understanding in Time of

Pregnancy Loss. Dallas, TX: Word, 1989. According to one review: “No other book, no other counselor, no other family member offered the complete

understanding and first-person knowledge that this author did.”

Nussbaum, Kathy. Preparing the Children: Information and Ideas for Families Facing Terminal Illness

and Death. Gifts of Hope Trust, 1998. A useful book with very specific recomendations to help you talk with your kids about serious illnesses and

death.

O’Connor, Joey. Heaven’s Not a Crying Place: Teaching Your Child About Funerals, Death, and the Life

Beyond. Grand Rapids, MI: F. H. Revell, 1997. Writing with warmth and understanding, Joey O'Connor shows how to teach your child to trust God and

celebrate life and to deal with, learn from, and have hope in the face of death.

Panuthos, Claudia, and Catherine Romero. Ended Beginnings: Healing Childbearing Losses. New York:

Warner, 1986. Because of its wide scope (infertility, miscarriage, sudden infant death, abortion, release to adoption; emotional

disappointments including handicapped babies, cesareans, premature or traumatic birth; and help for grieving

children), this book will help parents and care-givers understand the great burden of all loss experienced.

Pizer, Hank, and Christine O’Brien Palinski. Coping with a Miscarriage: Why It Happens and How to Deal

With Its Impact. New York: New American Library, 1986.

Rando, Theresa A. Parental Loss of a Child. Champaign, IL: Research, 1986. A complete assessment of a parent having a child die.

Read-Sisti, D. “A Dream Dies. . .Tragic Death of a Newborn.” Maternal Child Nursing 15.4 (1990): 258.

Rothman, Juliet Cassuto. The Bereaved Parents’ Survival Guide. New York: Continuum Pub., 1997. Rothman addresses the issues bereaved parents are likely to face, from marriage break-ups, handling the grief

and guilt of siblings, dealing with well-meaning friends and relatives, to how to deal with the lost child's room

and belongings.

Schatz, William H. Healing a Father’s Grief. Redmond, WA: Medic Pub., 1984.



Self-help pamphlet about grief. The author lost his child to leukemia.

Schwiebert, Pat and Paul Kirk. When Hello Means Goodbye: A Guide For Parents Whose Child Dies Before

Birth, At Birth Or Shortly After Birth. Portland, OR: Perinatal Loss, 1985.

Schoeneck, Therese S. Hope For Bereaved: Understanding, Coping And Growing Through Grief. Syracuse,

NY: Hope For Bereaved, 1990. Written by bereaved people for bereaved people who have experienced the death of an infant, child, spouse,

parent, sibling, relative or friend by accident, illness including AIDS, murder and suicide. It contains realistic,

helpful articles.

Szgalsky, J. “Perinatal Death, the Family the Role of the Health Professional.” Neonatal Network 8.2 (1989):

15-19. In order to substantially assist a grieving family at the time of perinatal death, the health care team should have

sufficient knowledge of the grief reaction, including the duration, maternal/paternal differences, and perinatal

psychodynamics. Immediate support includes bereavement counseling. Predelivery care should be provided, if

appropriate. The health care team should be prepared for common questions and know about local cultural

traditions. Follow-up care after discharge, including anticipatory guidance, is important. The issues of repeat

pregnancies and holiday behavior should be addressed. Siblings must be taken into account. The health care

team should be able to detect unresolved grief and identify at-risk parents. A hospital protocol should be in

place. It should be kept in mind that parents remember the emotional care given to them rather than the

technical or medical care provided.

The Children’s Hospital – Denver (www.thechildrenshospital.org). The Children’s Hospital Bereavement Services has three films that are available for parents and professionals to better understand the experience of

bereaved parents and their surviving children: 1) Grieving and Hope: Living With the Death of Your Child was

made by bereaved parents for bereaved parents; 2) A Dad’s Journey Through Grief was made by bereaved

fathers for bereaved fathers; 3) Tender Healing: A Sibling’s Journey Through Grief is a film for children of all

ages who have suffered the loss of a sibling. These films are available at no cost to parents and a minimal cost

for professionals.

Vredevelt, Pam W. Empty Arms: Hope and Support for Those Who Have Suffered a Miscarriage, Stillbirth

or Tubal Pregnancy. Portland, OR: Multnomah, 2001. Offers sound answers, advice, and reassurance to the woman fighting to maintain faith in this heartbreaking

situation.

Wathen, N. “Perinatal Bereavement.” British Journal of Obstetric and Gynecology 97.9 (1990): 759-61.

Witzel, P., et al. “The Unrecognized Psychological Impact of Miscarriage.” Canada’s Mental Health 37.1

(1989): 17-21. The psychological impact of miscarriage is discussed as alife crisis. Miscarriage as death, obstacles to grieving,

and complicated grief are described. Grieving over a miscarriage is an experience that requires validation of the

woman’s grief over her loss, assistance in the expression of that grief, and help in establishing a sense of

meaning. Suggestions for caregivers include permitting and supporting the grieving process and oferring

therapeutic intervention that facilitates successful coping.

Wolfelt, Alan D. A Child’s View of Grief. Fort Collins, CO: Center for Loss and Life Transition, 1991. This concise resource for parents of grieving kids explores several key principles for helping children cope with

grief and offers ways to create an emotional environment filled with love and acceptance. It answers common

questions such as “What should I say to children when someone they love dies?” and “Should young children

attend funerals?” This guide also identifies and explains typical behaviors, thoughts, and feelings of grieving

kids and offers adults tips for responding to them.

———. Healing a Child’s Grieving Heart: 100 Practical Ideas for Families, Friends and Caregivers. Fort Collins, CO: Companion, 2001. Presenting simple yet highly effective methods for coping and healing, this book provides answers and relief to

parents trying to deal with the loss of a child.



———. Healing Your Grieving Heart for Teens: 100 Practical Ideas. Fort Collins, CO: Companion,

2001. With sensitivity and insight, this series offers suggestions for healing activities that can help survivors learn to

express their grief and mourn naturally.

Grief Issues — General

American Academy of Bereavement. www.cmieducation.org. CMI Education Institute, Inc. is a non-profit organization committed to providing high-quality education and

training for health care professionals, counseling professionals and the general public on topics related to

palliative care, mental health, grief and bereavement, serious illness, loss and/or other subjects of interest to

healthcare and mental health professionals.

Association for Death Education and Counseling (ADEC), The Thanatology Association. www.adec.org. This Association is a professional organization dedicated to promoting excellence and recognizing diversity in

death education, care of the dying, grief counseling and research in thanatology. Based on quality research and

theory, the association provides information, support and resources to its international, multicultural,

multidisciplinary membership and through it, to the public.

Atchison, Liam, and Precious Atchison. Grief. Colorado Springs, CO: NavPress, 1994.

Attig, Thomas. How We Grieve: Relearning the World. Second ed. New York: Oxford UP, 2010. It shows how through grieving we overcome challenges, make choices, and reshape our lives. These intimate

treatments of coping with loss address the needs of grieving people and those who hope to support and comfort

them. The accounts promote understanding of grieving itself, encourage respect for individuality and the

uniqueness of loss experiences, show how to deal with helplessness in the face of “choiceless” events, and offer

guidance for caregivers.

Auz, Martin M., and Maureen Lyons Andrews. Handbook for Those Who Grieve: What You Should Know

and What You Can Do During Times of Loss. Chicago: Loyola, 2002. This valuable resource guide provides practical information for people who are grieving and the people who

support them. Material is presented in an easy-to-read format for quick reference and features: Tips for planning

funerals and wakes; Sample sympathy letters appropriate for a variety of grief situations; “Do” and “don’t” lists

for family and friends of the grieving; Helpful lists of pertinent planning details; Information on helping

children grieve; A comprehensive list of publications and organizations that provide grief support.

Bailey, Robert W. The Minister and Grief. New York: Hawthorn, 1976. A Baptist pastor shares his observations and his very sensitive manner of leading parishioners through a grief

experience. Drawing on Scripture and research on death and dying, the author blends a practicality with

recognized concepts for grief counseling.

Baxter, J. Sidlow. The Other Side of Death: What the Bible Teaches about Heaven and Hell. Grand

Rapids, MI: Kregel, 1997. A study of heaven, hell, and life beyond death. Specific topics include marriage in heaven, infant death,

purgatory, and the location of heaven.

Baugher, Robert, and Marc Calija. A Guide for the Bereaved Survivor: A List of Reactions, Suggestions,

and Steps for Coping with Grief. New Castle, WA: Robert Baugher, 1999. If you are looking for a basic Grief 101 book, this 58-page guide is for you. On each even-numbered page is a

brief description of a grief reaction (denial, shock, guilt, anger). On each facing page is a list of suggestions for

that reaction.

Bayly, Joseph. The Last Thing We Talk About: Help and Hope for Those Who Grieve (formerly called The View From a Hearse).Elgin, IL: LifeJourney, 1992. Offers help and hope for the dying and the grieving. An excellent resource for pastors and those working with

the terminally ill.

Bowman, George W., III. Dying, Grieving, Faith, and Family: A Pastoral Care Approach, New York:

Haworth Pastoral, 1998.

http://www.cmieducation.org/

http://www.adec.org/



Helps bring an understanding of faith development, family systems, and gender and ethnic differences into your

professional practice as you work with dying and grieving persons.

Bregman, Lucy. Death in the Midst of Life: Perspectives on Death from Christianity and Depth

Psychology. Grand Rapids, MI: Baker, 1992.

Briggs, Lauren. What You Can Say When You Don’t Know What to Say: Reaching Out to Those Who

Hurt. Eugene, OR: Harvest, 1985.

Center for Loss & Transition. Fort Collins, CO. www.centerforloss.com. The Center for Loss is dedicated to “companioning” grieving people as they mourn transitions and losses that

transform their lives. They help mourners, by walking with them in their unique life journeys, and both

professional caregivers and lay people, by serving as an educational resource and professional forum.

Centering Corporation. Omaha, NE. www.centering.org. This catalogue lists over 600 resources for the bereaved. They are very helpful if you call them with what you

need.

Chesser, Barbara Russell. Because You Care: Practical Ideas for Helping Those Who Grieve. Waco,

Texas: Word, 1987.

Churchill, Larry R. “The Human Experience of Dying: The Moral Primacy of Stories Over Stages.”

Soundings 62 (1979):35-36.

Compassion Books. Burnsville, NC. www.compassionbooks.com. They have over 400 mail-order books, audios and videos on death and dying, bereavement and change, comfort,

healing, inspiration and hope.

Davidson, Glen W. Understanding Mourning: A Guide to Those Who Grieve. Minneapolis: Augsburg, 1984. Dr. Davidson offers the latest findings and most helpful guidelines for healthy mourning and return to a

reorganized life.

Deits, Bob. Life After Loss: A Personal Guide Dealing with Death, Divorce, Job Change and Relocation.

Tucson, AZ: Fisher, 1992. The go-to resource for anyone who has suffered a significant life change.

Doka, Kenneth J., ed. Disenfranchised Grief: Recognizing Hidden Sorrow. Lexington, MA: Lexington,

1989. A rich and full exploration of the myriad of instances where a mourner is deprived of the catharsis shared grief

brings. Provides numerous interventions designed to help patients recognize and explore their loss, and find

meaningful and appropriate ways to resolve their grief.

———, ed. Living With Grief After Sudden Loss: Suicide, Homicide, Accident, Heart Attack, Stroke. Washington, DC: Hospice Foundation of America, 1996. Brings the reader into the world of the survivor.

Doka, Kenneth J., and Joyce D. Davidson, eds. Living With Grief: Who We Are, How We Grieve. Washington DC: Hospice Foundation of America, 1999. Examines how key aspects of identity affect how individuals grieve. Variables explored include culture,

spirituality, age and development level, class and gender.

D’Arcy, Paula. When Your Friend Is Grieving: Building a Bridge of Love (Heart and Hand Series). Wheaton, IL: H. Shaw, 2000. Useful and practical material.

Giunta, Ray. Grief Recovery Workbook: Helping You Weather the Storms of Death, Divorce, and

Overwhelming Disappointment. Nashville: Integrity, 2002. New material in this edition includes guidance for dealing with: Loss of faith, Loss of career and financial

issues, Loss of health.

Graham, Billy. Facing Death and the Life After. Waco, TX: Word, 1987.

http://www.centerforloss.com/

http://www.centering.org/

http://www.compassionbooks.com/



He calls for Christians to confront the sobering face of death--realistically, but with the confidence that through

Christ the final enemy can be conquered.

Grief Recovery. www.grief-recovery.com. They have Certification Training, Articles and a Personal Workshop.

Grief Share. www.griefshare.org. They offer support groups and resources.

Holmes, Marjorie. To Help You Through the Hurting: A Loving Guide to Faith, Hope and Healing. New

York: Bantam, 1984. This book was written after the death of Marjorie Holmes first husband of 47 years in an effort to help others.

Irish, Donald P., Kathleen F. Lundquist, and Vivian Jenkins Nelson, eds. Ethnic Variations in Dying,

Death and Grief: Diversity in Universality. Philadelphia, PA: Taylor & Francis, 1993. The strength of the book is that contributors write about their own traditions rather than reporting on studies

about traditions... the reader gains a respect for the varied ways racial, ethnic, and cultural groups have learned

to try to make sense of death.

Johnson, Christopher Jay, and Marsha G. McGee, eds. How Different Religious View Death and After Life.

Second ed. Philadelphia, PA: Charles, 1991. This book presents an objective, thoughtful and practical explanation of the often-complicated subjects of death

and afterlife. It offers a clear, concise and comparative overview of the teachings and the death beliefs of 19

different religions.

Justice, William C. When Death Comes. Nashville: Broadman, 1982.

Kinnamen, Gary. My Companion Through Grief. Ann Arbor, MI: Servant, 1996. This book is meant to be a tender companion, a source of comfort through life's deepest sorrow - the death of a

loved one.

Kolf, June Cerza. How Can I Help? Reaching Out to Someone Who Is Grieving. Grand Rapids, MI:

Baker, 1989. Listen to real-life stories that are easy to relate to, and benefit from concrete ideas to help others in each stage of

grief.

———. When Will I Stop Hurting? Dealing with a Recent Death. Second ed. Grand Rapids, MI: Baker,

2002. Readers have found in Kolf a gentle guide to lead them through the stages of grief and eventually the healing

process. This new edition of her book is revised and updated and includes a study guide ideal for bereavement

groups.

Kubler-Ross, Elisabeth, and David Kessler. On Grief and Grieving: Finding the Meaning of Grief

Through the Five Stages of Loss. New York: Scribners, 2005. Applies the stages to the grieving process and weaves together theory, inspiration, and practical advice,

including sections on sadness, hauntings, dreams, isolation, and healing.

Kuenning, Delores. Helping People Through Grief. Minneapolis: Bethany, 1987. The book is designed to guide the reader in how to show care and concern—by what is said and done, by being

sensitive to the process, and by knowing when to do what. Each chapter is based on true experiences, and

caregivers are supplied with practical advice and insight, appropriate scripture for different needs, as well as a

list of recommended books.

Larson, Dale G. The Helper’s Journey: Working With People Facing Grief, Loss, and Life-Threatening

Illness. Champaign, IL: Research, 1993. A must have for those who deal in end of life issues.

Lewis, C. S. A Grief Observed. San Francisco: HarperSanFrancisco, 1961. Written after his wife's tragic death as a way of surviving the “mad midnight moment,” A Grief Observed is

C.S. Lewis's honest reflection on the fundamental issues of life, death, and faith in the midst of loss. This is a

http://www.grief-recovery.com/

http://www.griefshare.org/



beautiful and unflinchingly honest record of how even a stalwart believer can lose all sense of meaning in the

universe, and how he can gradually regain his bearings.

Linn, Eric. I Know Just How You Feel: Avoiding the Clichés of Grief. Cary, IL: The Publisher’s Mark,

1986. This book is written in an easy to read style and gives insights into the better things to say to those who are

hurting.

Living with Loss Magazine: Hope and Healing for the Body, Mind, and Spirit. Formerly Bereavement

Magazine. Published by Bereavement Publications. www.bereavementmag.com. This is an excellent magazine (2 to 4 issues per year). They also publish some very good booklets at a

reasonable cost.

Manning, Doug. Don’t Take My Grief Away: What to Do When You Lose a Loved One. San Francisco:

Harper & Row, 2005. Doug writes like a long-time friend who is sitting in the room with you sharing your experiences and your hurt.

Means, James E. A Tearful Celebration: Finding God in the Midst of Loss. Portland, OR: Multnomah,

2006. This new edition of a 1986 Gold Medallion finalist will lead you to the place you most truly long to be: right

with God and secure in Him again.

Meyer, Charles. Surviving Death: A Practical Guide to Caring for the Dying & Bereaved. Mystic, CT:

Twenty-Third Publications, 1991. Written by a priest who was the chaplain in an oncology ward for years, it pulls no punches. Meyer examines

myths about dying, inaccurate Biblical quotes about death, taboos, cultural misconceptions about the grief

process, and the change of status that accompanies widowhood.

Miller, James E. How Can I Help? Twelve Things to Do When Someone You Know Suffers a Loss / What

Will Help Me? 12 Things To Remember When You Have Suffered a Loss. Second ed. Fort Wayne, IN:

Willowgreen, 2000. Held one way, this book is for those who are grieving. In 12 brief, easy-to-read chapters, it offers helpful

suggestions for how one can move through one's grief in a healthy, healing way. Held the opposite way (so the

back cover becomes the front cover), it’s a book for those who want to help someone who is grieving. Its 12

succinct chapters offer positive, practical advice.

Mitchell, Kenneth R., and Herbert Anderson. All Our Losses All Our Greifs: Resources for Pastoral

Care. Philadelphia: Westminster, 1983. Grief as a lifelong human experience is the scope of this absorbing book. The authors explore the multiple

dimensions of the problem, including the origins and dynamics of grief, loss throughout life, caring for those

who grieve, and the theology of grieving. This examination is enriched by vivid illustrations and case histories

of individuals whose experiences the authors have shared.

Mitsch, Raymond R. and Lynn Brookside. Grieving the Loss of Someone You Love: Daily Meditations to

Help You through the Grieving Process. Ann Arbor, MI: Servant, 1993. The authors can help you endure the anguish; understand the stages of grief; sort through the emotions of anger,

guilt, fear and depression; and face the God who allowed you to lose the one you love.

New England Center for Loss & Transition. www.neclt.org. They list several resources.

O’Toole, Donna. Healing and Growing through Grief. Burnsville, NC: Compassion Books, 1993. It helps us understand grief as a natural healing process and how to find help and support. An excellent resource

for support groups and as a handout for hospice and counseling purposes.

Pine, Vanderlyn R., ed. Unrecognized and Unsanctioned Grief: The Nature and Counseling of

Unacknowledged Grief. Springfield, IL: Charles C. Thomas, 1990.

http://www.bereavementmag.com/

http://www.neclt.org/



Price, Eugenia. Getting Through the Night: Finding Your Way Through Grief. New York: Harper, 1991. She offers this simply written yet profoundly valuable book for anyone struggling through the loss of a loved

one.

Rando, Therese A. Grief, Dying, and Death: Clinical Interventions for Caregivers. Champaign, IL:

Research, 1983. Early chapters of this book address the issue of bereavement, why it is necessary and how to work with

individuals and families who are hurting from a loss. The latter half of the book looks at the issue of terminal

illness care.

———. How To Go On Living When Someone You Love Dies. New York: Bantam, 1991. Whether the death was sudden of expected, from accident, illness, suicide, homicide, or natural causes,

Dr. Rando will help you learn to: Understand and resolve your grief; Talk to children about death; Resolve

unfinished business; Take care of yourself; Accept the help and support of others; Get through holidays and

other difficult times of the year; Plan funerals and personal bereavement rituals.

———. Treatment of Complicated Mourning. Champaign, IL: Research, 1993. Teaches you how to recognize complicated mourning and how to help the bereaved. Her research is impeccable

and helps you understand the therapeutic relationship between client and counselor.

Richards, Larry, and Paul Johnson. Death and the Caring Community: Ministering to the terminally Ill (A

Critical Concern Book). Portland, OR: Multnomah, 1980. The book takes a careful look at how the community can express God's love to the dying. He shows how not

only medical professionals and the clergy, but families and members of local congregations can communicate

Christ's love to the terminally ill.

Robinson, Haddon W. Grief: Comfort for Those Who Grieve and Those Who Want Help. Grand

Rapids. MI: Discovery House, 1996. This new, 48-page gift edition, filled with warm and inviting full-color pages and photographs,

continues to draw on the wellspring of Scripture with consolation and strength to go on with life.

Shepherd, Martin. Dying: A Guide for Helping and Coping. Sag Harbor, NY: Permanent, 2000. A guide to not only dealing with the death of loved ones, but an exploration of facing one's own death. It is a

book designed to amplify and challenge one's own perception of both the dying process and death itself, in

order to allay fears, help one find a more loving and rewarding experience, and to build a richer spiritual

foundation.

Staudacher, Carol. Men and Grief: A Guide for Men Surviving the Death of a Loved One. Oakland, CA: New

Harbinger, 1991. An insightful and thought-provoking look at the problems men face as they experience the emotionally painful

times of their lives.

Westberg, Granger E. Good Grief: A Constructive Approach to the Problem of Loss. Philadelphia:

Fortress, 1971. This book is an excellent resource to address the various issues and emotions often experienced by loss in

particular by death.

Wiersbe, Warren W., and David W. Wiersbe. Comforting the Bereaved. Chicago, IL: Moody, 1985. It deals with death and grief from a biblical and psychological perspective and also offers practical advice to

ministers on how to handle the grief situation and the funeral service.

Williams, Donna Reilly, and JoAnn Sturzl. Grief Ministry: Helping Others Mourn. San Jose, CA:

Resource Publications, 1990. This book is a great place to begin to learn how to be helpful to every person at some time.

Williams, Robert A. Journey Through Grief. Nashville: T. Nelson, 1991. The mental, physical, emotional and spiritual journey and experiences of grief.

Wolfelt, Alan D. Death and Grief: A Guide for Clergy. New York: Brunner-Rutledge, 1988.



Wolfelt gives the reader the permission to not have the right words to say when helping a grieving person. His

advice is "mouths closed; ears open; presence available." Marvelous advice!

———. Understanding Grief: Helping Yourself Heal. Muncie, IN: Accelerated Development, 1992. This classic resource helps guide the bereaved person through the loss of a loved one, and provides an

opportunity to learn to live with and work through the personal grief process.

Wright, H. Norman. Recovering from the Losses of Life. Tarrytown, NY: F. H. Revell, 2006. Writing from his own experience, Wright covers such issues as the meaning of grief, blaming God, and learning

how to express and share in times of loss. Now repackaged and updated with additional material, this book will

help readers find hope in difficult times. Study questions included.

Zonnebelt-Smeenge, Susan J. and Robert C. De Vries. Getting to the Other Side of Grief: Overcoming the

Loss of a Spouse. Grand Rapids, MI: Baker, 1998. This sensitive and biblically oriented book offers a roadmap for bereaved spouses on the journey through grief

to resolution. Excellent for pastors, too.

Grief Issues — Suicide

Berkley, James D, ed. Called into Crisis: The Nine Greatest Challenges of Pastoral Care. Carol Stream,

IL: Word, 1989.

Offers helpers the crisis counsel they crave. Resourced by those who have been there to help

transform a crisis into an opportunity to grow.

Biebel, David B., and Suzanne L. Foster. Finding Your Way after the Suicide of Someone You Love.

Grand Rapids, MI: Zondervan, 2005. A compassionate and practical guide that addresses the intensely personal issues of survivors of suicide (SOS).

This gentle and faith-affirming resource helps survivors know what to expect, especially during the first year

following a suicide. It includes personal stories of survivors and suggestions on how to move beyond survival to

live life again.

Blocher, Henri. Suicide. Downer’s Grove, IL: InterVarsity, 1976.

Chesser, E. Living With Suicide. London: Hutchison, 1967.

Christian, Randy. “After a Suicide: What is the best way to serve those left behind?” Leadership (1997):

84-89.

Clemons, James T., ed. Perspectives on Suicide. Louisville, KY: Westminster/J. Knox, 1990. Seven authorities deal with questions about suicide from various perspectives, including medical,

psychological, sociological, biblical, ethical and pastoral.

Collins, Gary. How to Be a People Helper. Santa Ana, CA: Vision House, 1976. This is a step by step informative instruction manual.

Danto, Bruce L., and Austin H. Kutschen. Suicide & Bereavement. Salem, NH: Ayer, 1977.

Demy, Timothy J., and Gary P. Stewart, eds. Suicide: A Christian Response. Grand Rapids, MI: Kregel,

1998. This contemporary resource presents the medical, ethical, legal, pastoral, and personal arguments for choosing

life rather than death.

Hewitt, John H., and Wayne E. Oates, eds. After Suicide. Louisville, KY: Westminster/J. Knox, 1980. This constructive guide offers much-needed information and clinically-tested advice for those struggling to

cope in the aftermath of a suicide. Written in clear language, this book presents the facts and demonstrates how

to deal with feelings of guilt, anger, bewilderment, and shame. Also included is an anniversary memorial

service that enables family members to recommit themselves to life.

Hsu, Albert Y. Grieving a Suicide: A Loved One's Search for Comfort, Answers and Hope. Downers

Grove, IL: InterVarsity, 2002.



Hsu draws on the resources of the Christian faith to point suicide survivors to the God who offers comfort in our

grief and hope for the future. If you have lost a loved one to suicide or provide chaplaincy care to those left

behind, this book is an essential companion for the journey toward healing.

Kaplan, Kalman J., and Matthew B. Schwartz. A Psychology of Hope: A Biblical Response to Tragedy

and Suicide. Revised ed. Grand Rapids, MI: Wm. B. Eerdmans, 2008.

Kuenning, Delores. Helping People Through Grief. Minneapolis: Bethany House, 1987. The book is designed to guide the reader in how to show care and concern—by what is said and done, by being

sensitive to the process, and by knowing when to do what.

Lum, Doman. Responding to Suicidal Crisis: For the Church and Community. Grand Rapids, MI: Wm.

B. Eerdmans, 1974.

Townsend, Loren L., edited by Daniel G. Bagby. Suicide: Pastoral Responses. Nashville: Abingdon,

2006. This book will help ministers identify particular markers and give steps for pastoral intervention and suicide

prevention.

Welter, Paul. How to Help a Friend. Wheaton, IL: Tyndale, 1990. It offers information relevant to practicing counselors or to the common person that wants to be a good friend.

Wolfelt, Alan D. Understanding Your Suicide Grief: Ten Essential Touchstones for Finding Hope and

Healing Your Heart. Fort Collins, CO: Companion, 2009. Using the metaphor of the wilderness, the book introduces 10 touchstones to assist the survivor in this naturally

complicated and particularly painful journey. The touchstones include opening to the presence of loss,

embracing the uniqueness of grief, understanding the six needs of mourning, reaching out for help, and seeking

reconciliation over resolution. Learning to identify and rely on each of these touchstones will bring about hope

and healing.

Wright, H. Norman. Crisis Counseling. San Bernardino, CA: Here’s Life Publishers, 1991. Here are practical solution to specific problems as well as biblically based strategies that will equip you to face

life’s emergencies.



Appendix A

The Mourner’s Bill of Rights8 By Alan D. Wolfelt, Ph.D.

Though you should reach out to others as you do the work of mourning, you should not feel obligated

to accept the unhelpful responses you may receive from some people. You are the one who is grieving,

and as such, you have certain “rights” no one should try to take away from you.

The following list is intended both to empower you to heal and to decide how others can and cannot

help. This is not to discourage you from reaching out to others for help, but rather to assist you in

distinguishing useful responses from hurtful ones.

1. You have the right to experience your own unique grief.

No one else will grieve in exactly the same way you do. So, when you turn to others for help, don’t

allow them to tell what you should or should not be feeling.

2. You have the right to talk about your grief.

Talking about your grief will help you heal. Seek out others who will allow you to talk as much as

you want, as often as you want, about your grief. If at times you don’t feel like talking, you also have the

right to be silent.

3. You have the right to feel a multitude of emotions.

Confusion, disorientation, fear, guilt and relief are just a few of the emotions you might feel as part of

your grief journey. Others may try to tell you that feeling angry, for example, is wrong. Don’t take these

judgmental responses to heart. Instead, find listeners who will accept your feelings without condition.

4. You have the right to be tolerant of your physical and emotional limits.

Your feelings of loss and sadness will probably leave you feeling fatigued. Respect what your body

and mind are telling you. Get daily rest. Eat balanced meals. And don’t allow others to push you into

doing things you don’t feel ready to do.

8 Copyright 2007, Center for Loss and Life Transition. Used with permission. Alan D. Wolfelt, Ph.D., C.T. is an

internationally noted author, educator and grief counselor. He serves as Director of the Center for Loss and Life

Transition and is on the faculty at the University of Colorado Medical School's Department of Family Medicine.



5. You have the right to experience “griefbursts”.

Sometimes, out of nowhere, a powerful surge of grief may overcome you. This can be frightening,

but is normal and natural. Find someone who understands and will let you talk it out.

6. You have the right to make use of ritual.

The funeral ritual does more than acknowledge the death of someone loved. It helps provide you with

the support of caring people. More importantly, the funeral is a way for you to mourn. If others tell you

the funeral or other healing rituals such as these are silly or unnecessary, don’t listen.

7. You have the right to embrace your spirituality.

If faith is a part of your life, express it in ways that seem appropriate to you. Allow yourself to be

around people who understand and support your religious beliefs. If you feel angry at God, find someone

to talk with who won’t be critical of your feelings of hurt and abandonment.

8. You have the right to search for meaning.

You may find yourself asking, “Why did he or she die? Why this way? Why now?” Some of your

questions may have answers, but some may not. And watch out for the clichéd responses some people

may give you. Comments like, “It was God’s will” or “Think of what you have to be thankful for” are not

helpful and you do not have to accept them.

9. You have the right to treasure your memories.

Memories are one of the best legacies that exist after the death of someone loved. You will always

remember. Instead of ignoring your memories, find others with whom you can share them.

10. You have the right to move toward your grief and heal.

Reconciling your grief will not happen quickly. Remember, grief is a process, not an event. Be patient

and tolerant with yourself and avoid people who are impatient and intolerant with you. Neither you nor

those around you must forget that the death of someone loved changes your life forever.



Appendix B

The Journey Through Grief: The Mourner’s Six “Reconciliation Needs”9

By Alan D. Wolfelt, Ph.D.

The death of someone loved changes our lives forever. And the movement from the “before” to the

“after” is almost always a long, painful journey. From my own experiences with loss as well as those of

the thousands of grieving people I have worked with over the years, I have learned that if we are to heal

we cannot skirt the outside edges of our grief. Instead, we must journey all through it, sometimes

meandering the side roads, sometimes plowing directly into its raw center.

I have also learned that the journey requires mourning. There is an important difference, you see.

Grief is what you think and feel on the inside after someone you love dies. Mourning is the outward

expression of those thoughts and feelings. To mourn is to be an active participant in our grief journeys.

We all grieve when someone we love dies, but if we are to heal, we must also mourn.

There are six “yield signs” you are likely to encounter on your journey through grief - what I call the

“reconciliation needs of mourning.” For while your grief journey will be an intensely personal, unique

experience, all mourners must yield to this set of basic human needs if they are to heal.

Need 1: Acknowledging the reality of the death

This first need of mourning involves gently confronting the reality that someone you care about will

never physically come back into your life again.

Whether the death was sudden or anticipated, acknowledging the full reality of the loss may occur

over weeks and months. To survive, you may try to push away the reality of the death at times. You may

discover yourself replaying events surrounding the death and confronting memories, both good and bad.

This replay is a vital part of this need of mourning. It’s as if each time you talk it out, the event is a little

more real.

Remember – this first need of mourning, like the other five that follow, may intermittently require

your attention for months. Be patient and compassionate with yourself as you work on each of them.

9 Copyright 2007, Center for Loss and Life Transition. Used with permission. Alan D. Wolfelt, Ph.D., C.T. is an

internationally noted author, educator and grief counselor. He serves as Director of the Center for Loss and Life

Transition and is on the faculty at the University of Colorado Medical School's Department of Family Medicine.



Need 2: Embracing the pain of the loss

This need of mourning requires us to embrace the pain of our loss – something we naturally don’t

want to do. It is easier to avoid, repress or deny the pain of grief than it is to confront it, yet it is in

confronting our pain that we learn to reconcile ourselves to it.

You will probably discover that you need to “dose” yourself in embracing your pain. In other words,

you cannot (nor should you try to) overload yourself with the hurt all at one time. Sometimes you may

need to distract yourself from the pain of death, while at other times you will need to create a safe place to

move toward it.

Unfortunately, our culture tends to encourage the denial of pain. If you openly express your feelings

of grief, misinformed friends may advise you to “carry on” or “keep your chin up.” If, on the other hand,

you remain “strong” and “in control,” you may be congratulated for “doing well” with your grief.

Actually, doing well with your grief means becoming well acquainted with your pain.

Need 3: Remembering the person who died

Do you have any kind of relationship with someone when they die? Of course. You have a

relationship of memory. Precious memories, dreams reflecting the significance of the relationship and

objects that link you to the person who died (such as photos, souvenirs etc.) are examples of some of the

things that give testimony to a different form of a continued relationship. This need of mourning involves

allowing and encouraging yourself to pursue this relationship.

But some people may try to take your memories away. Trying to be helpful, they encourage you to

take down all the photos of the person who died. They tell you to keep busy or even to move out of your

house. But in my experience, remembering the past makes hoping for the future possible. Your future will

become open to new experiences only to the extent that you embrace the past.

Need 4: Developing a new self-identity

Part of your self-identity comes from the relationships you have with other people. When someone

with whom you have a relationship dies, your self-identity, or the way you see yourself, naturally

changes.

You may have gone from being a “wife” or “husband” to a “widow” or “widower.” You may have

gone from being a “parent” to a “bereaved parent.” The way you define yourself and the way society

defines you is changed.

A death often requires you to take on new roles that had been filled by the person who died. After all,

someone still has to take out the garbage, someone still has to buy the groceries. You confront your

changed identity every time you do something that used to be done by the person who died. This can be

very hard work and can leave you feeling very drained.

You may occasionally feel child-like as you struggle with your changing identity. You may feel a

temporarily heightened dependence on others as well as feelings of helplessness, frustration, inadequacy

and fear.

Many people discover that as they work on this need, they ultimately discover some positive aspects

of their changed self-identity. You may develop a renewed confidence in yourself, for example. You may

develop a more caring, kind and sensitive part of yourself. You may develop an assertive part of your

identity that empowers you to go on living even though you continue to feel a sense of loss.

Need 5: Searching for meaning

When someone you love dies, you naturally question the meaning and purpose of life. You probably

will question your philosophy of life and explore religious and spiritual values as you work on this need.



You may discover yourself searching for meaning in your continued living as you ask “How?” and

“Why” questions.

“How could God let this happen?” “Why did this happen now, in this way?” The death reminds you

of your lack of control. It can leave you feeling powerless.

The person who died was a part of you. This death means you mourn a loss not only outside of

yourself, but inside of yourself as well. At times, overwhelming sadness and loneliness may be your

constant companions. You may feel that when this person died, part of you died with him or her. And

now you are faced with finding some meaning in going on with your life even though you may often feel

so empty.

This death also calls for you to confront your own spirituality. You may doubt your faith and have

spiritual conflicts and questions racing through your head and heart. This is normal and part of your

journey toward renewed living.

Need 6: Receiving ongoing support from others

The quality and quantity of understanding support you get during your grief journey will have a major

influence on your capacity to heal. You cannot - nor should you try to - do this alone. Drawing on the

experiences and encouragement of friends, fellow mourners or professional counselors is not a weakness

but a healthy human need. And because mourning is a process that takes place over time, this support

must be available months and even years after the death of someone in your life.

Unfortunately, because our society places so much value on the ability to “carry on,” “keep your chin

up” and “keep busy,” many mourners are abandoned shortly after the event of the death. “It’s over and

done with” and “It’s time to get on with your life” are the types of messages directed at mourners that still

dominate. Obviously, these messages encourage you to deny or repress your grief rather than express it.

To be truly helpful, the people in your support system must appreciate the impact this death has had

on you. They must understand that in order to heal, you must be allowed - even encouraged – to mourn

long after the death. And they must encourage you to see mourning not as an enemy to be vanquished but

as a necessity to be experienced as a result of having loved.

Reconciling your grief

You may have heard – indeed you may believe – that your grief journey’s end will come when you

resolve, or recover from, your grief. But your journey will never end. People do not “get over” grief.

Reconciliation is a term I find more appropriate for what occurs as the mourner works to integrate the

new reality of moving forward in life without the physical presence of the person who died. With

reconciliation comes a renewed sense of energy and confidence, an ability to fully acknowledge the

reality of the death and a capacity to become reinvolved in the activities of living.

In reconciliation, the sharp, ever-present pain of grief gives rise to a renewed sense of meaning and

purpose. Your feeling of loss will not completely disappear, yet they will soften, and the intense pangs of

grief will become less frequent. Hope for a continued life will emerge as you are able to make

commitments to the future, realizing that the person who died will never be forgotten, yet knowing that

your life can and will move forward.

Related Resources

The Journey Through Grief: Reflections on Healing (New York: Routledge, 1997).



Appendix C

The Club No One Wants to Join: A Dozen Lessons I’ve Learned from Grieving

Children and Adolescents10 By Donna L. Schuurman, Ed.D.

I’m frequently introduced as an “expert” in the field of children and death, referencing my

involvement over the last sixteen years at The Dougy Center, The National Center for Grieving Children

& Families. Over these years, more than 12,000 children and teens, and their parents or adult care givers

have shared their journeys through grief with each other, our staff, and volunteer facilitators. All shared

membership in a club no one wants to join with the common denominator of the death of a family

member or close friend.

Through them I have, I suppose, earned a dictionary definition of expert, “one who has a high degree

of skill or knowledge of a certain subject.” This expert status is perhaps enhanced by a doctorate in

counseling, despite the fact that my entire studies included just one hour on the topic of death and dying,

and only a brief acknowledgment that children too were affected. Expert indeed!

The real experts, I believe, are the children and families who’ve thrashed around in the mysterious

and chaotic experience we call grief, mourning, and bereavement. I prefer to think of myself as an

emissary, “an agent sent on a mission to represent or advance the interests of another.” Toward that end,

given the topic of “the grief of children and adolescents,” I have chosen not to review the literature,

discuss developmental challenges, theories or texts (though they all provide helpful information), but to

reflect on what I have learned from the three-year-olds through 18-year-olds whose stories I’ve been

privileged to share over these last sixteen years.

1. Children know and understand much more than we give them credit for

I can’t even guess how many times over the years parents have conspiratorially confided that their

child or adolescent doesn’t know the full details of dad’s (or mom’s or whomever’s) death, that perhaps

it’s best that way, and that they aren’t certain how much the child is affected by the loss. In a blaring

example, 9-year-old Joshua was told that his father, who’d suicided, died in a car accident. In his first

group with other parentally bereaved six to 12-year-olds, he quietly shared that his father had died by

suicide. “But don’t tell my mom,” he instructed the group, “she thinks he died in a car accident!” Children

10 Published in: Grief Matters, The Centre for Grief Education, Australia (August 2002). Donna is National Director

of The Dougy Center for Grieving Children & Families, Portland, OR.



know, hear, listen, observe, and incorporate much more than adults realize. Their antennas are fined tuned

to picking up cues from those around them. They want to protect adults from further pain just as we have

that natural inclination to protect them. Just because they’re not verbalizing what’s going on inside

doesn’t mean nothing’s going on in there.

2. One of the biggest impediments to children’s healing after a death is...adults!

Years ago in the U.S., Art Linkletter had a television show, “Kids Say the Darndest Things,”

highlighting the funny, outrageous and ingenious statements of children. Grieving kids could produce

their own version of “Adults Say the Stupidest Things!” While the topics of missing the deceased, regrets

from the past, unfilled dreams and wishes certainly emerge in their group and individual conversations,

the unhelpful, non-supportive and downright hurtful responses of (presumably) well-meaning adults in

their lives adds unnecessary fuel to the fire of grieving, further complicating an already complex and

confusing experience. I don’t think adults intend to make matters worse. I think three barriers interfere.

One is our own fear of death and the resulting avoidance of uncomfortable realities. A second is a lack of

understanding of what words to use, how to act, and what children need. The third, and perhaps most

insidious, is the troubling truth that it is demanding and difficult to “be with” a child whose pain we can’t

fix or take away.

3. Grieving children don’t need to be fixed

Grief is not an illness that needs to be cured. It’s not a task with definable, sequential steps. It’s not a

bridge to cross, a burden to bear, or an experience to “recover” from. It is a normal, healthy and

predictable response to loss. Its symptoms are normal reactions and may include changes in appetite,

sleep, motivation, and energy. Their duration and intensity will vary from individual to individual based

on the interface of multiple issues including personality, support systems, the child’s relationship to the

deceased, and the meaning he or she derives from the loss. Not all grieving children or adolescents need

therapy, support groups, counseling or professional help. Some do. But in either case, our roles as parents,

therapists, counselors and friends are to support and assist, not to help them “get over,” or “move

beyond.”

4. Grieving children don’t need to be “taught” how to grieve as much as be “allowed” to grieve, and to

make their own meaning

I believe working with grieving children with the attitude they need to be taught how to grieve is a

mis-placed effort based on an erroneous attitude about the nature of children and grieving. It presumes we

(no matter who “we” are) can or should teach a child how to grieve. I believe they’ll do it naturally, and

in healthy ways, if we let them, and if we provide the safety, atmosphere, permission, and example. We

can get caught up in fixing and instructing, when the skills of evoking and listening better suit the need.

Additionally, even the youngest children share with adults the insatiable desire to understand, and to

make meaning from experience. Why me? and Why did this happen? are questions three-year-olds ask as

they try to make sense of their world. How we assist them in finding their own answers to these critical

questions will shape their lives for years.

5. Children are resilient, but not in a vacuum

Resiliency is not an accident. The word, from the Latin “resilire,” means to leap back, to bounce back

to one’s original shape, to recover. It’s something that has received increasing and well-earned attention

from researchers and practitioners, and about which we know more and more. We know, for example,

that among the personality traits resilient children display are positive self-esteem, and an internal locus

of control. (Werner & Smith, 1992). We also have strong evidence that parentally bereaved children show

(citing just two of seven susceptibilities) (Schuurman, 2003) significantly lower self-esteem compared to

their non-bereaved counterparts, as well as a higher external locus of control. (Lutzke, Ayers, Sandler, &



Barr, 1997). What we know about resilient children has tremendous applicability to how we can help

children following death and other traumatic losses.

6. Theories are well and good, but as Carl Jung said, “Learn your theories well, but lay them aside when

you touch the reality of the living soul”

Sometimes I think we try too hard to pound and bend and push what we see into a theory, rather than

having our theories evolve from what we see. Theories are helpful efforts to make sense of and categorize

processes, events and phenomenons, but the theory should never be mistaken for the thing itself. The

word itself derives from the Greek word theoros, meaning “spectator,” and we should never confuse the

spectator’s role and 20/20 hindsight with the action of the players on the field. Our theories can cloud the

ability to truly be available to a grieving child if we’re clicking through them and missing “the reality of

the living soul” before us. Each child is a teacher, and best approached by adults willing to be taught.

7. Labels work for cans and bottles and boxes, but aren’t so good for children

The diagnosis du jour seems to be “attention deficit disorder,” with all the attending medications and

labels associated with it. Not to deny such a disorder exists, but I believe it’s over- and mis-diagnosed

(and therefore, mis-treated). Some of our labels pathologize and pigeonhole kids, patronizing them with

band-aids of superficial self-esteem building, rather than focusing on strengths and competency building.

I shudder when I hear adults dismiss children or adults who are “acting out,” as if their attention-getting

behavior is best ignored. Of course they’re acting out; they’re acting out their pain, fear, confusion,

uncertainty, questioning, anger. If we choose to disregard their behavior or are too quick to label, they

may need to “act out” in more attention-getting ways. I remember a child whose diagnosis was discussed

by a team of psychologists and their consulting psychiatrist: was it “defiant personality disorder” or

“borderline behavior” with the possibility of “psychic splitting”? The wise professional who’d been

working with this child wisely chimed in with her hypothesis: “scared kid.” I don’t mean to suggest that

DSM-IV categories and serious mental health issues don’t exist, only that we ought not forget that behind

every label is a scared kid.

8. Expressions of grief assist in the healing process, but the form that expression takes varies greatly.

What matters most is feeling understood

The role of emotional health and expression has received increasing attention from researchers over

the last decade. Psychologist James Pennebaker, (1990) one of the foremost authorities in this area, has

conducted and cited dozens of research studies illustrating the interplay between emotional expression

and physical and mental health. Two aspects of this are frequently misunderstood, however. One is the

subtle difference between feeling and expressing emotion, and rumination. The word rumination derives

from the Latin root, “ruminare,” meaning throat. A “ruminant” is a classification of hoofed mammals

including sheep, goats and deer, who “chew cud” (ruminate). Cud is literally regurgitated, partially

digested food. Healthy expression is not just endless emotional cud chewing, regurgitating partially

digested feelings. What gets tricky is distinguishing between healthy and unhealthy digestion. A second

misunderstanding revolves around the nature of helpful expression. It appears that it’s not just expressing

that helps, but in believing we’re understood. Pennebaker asserts that “early childhood traumas that are

not disclosed may be bad for your health as an adult.” (1990: 19-20). But we shouldn’t assume that the

person who chooses not to disclose in ways we deem acceptable is unhealthy, isn’t grieving, or isn’t

doing it right.

9. We’d be better off reframing emotions as messages from our souls to be embraced rather than enemies

to escape from

“Depression is inspiration without form,” a wise therapist once told me, and it was the first time I’d

conceptualized uncomfortable emotions as positive signals rather than enemies. But we live in cultures



where we’ve institutionalized escape routes at the onset of discomfort: pharmaceuticals and other legal

drugs (alcohol, nicotine), compulsive shopping, eating, TV watching, (name your poison). After loss of

any kind, it’s normal, natural and healthy to have feelings that, well, don’t feel so good! When we try to

push them out of our consciousness, they don’t go away...they simply simmer on back burners. I don’t

mean to suggest that medication is never warranted, or that we should sink into despair from emotional

storms. But I’ve noticed that we encourage our children and adolescents to run from, bury, or ignore their

emotions much more than model healthy expression. Often it’s because we don’t like the form the

emotion displays itself in. Anger is a great example. Rather than finding healthy modes of expressing

justified anger, we tend to stifle it because we don’t like how it looks. Instead of saying, you’re angry

because your father died, and I would be too, and finding healthy ways to vent that anger, we say I don’t

like what you’re doing with that anger, so stop it. Then they have even more to be angry about!

10. Shakespeare got it partially right when he advocated to “give sorrow words...”

...But he was, after all, a writer. A fellow writer, the poet William Wordsworth, was said to suffer

such shock after his brother’s death by drowning that he didn’t speak for two months. When he regained

his voice, he wrote: “A deep distress hath humanized my soul.” Picasso may have advocated to “give

sorrow paint...” and Beethoven to “give sorrow song...” and none of them are wrong. Sorrow needs

expression, but it’s not always with words. The more tools and permission we provide for children and

adolescents, the more likely they will find their own forms of expression rather than the narrow options

we might offer. Give sorrow words, yes, but also paint and glue and hammers and nails and long walks

and quiet and music and play and all other possible forms of expression, including silence.

11. Children need, want, and deserve honesty, truth, and choices

Allowing children informed choice and multiple options rather than making decisions for them helps

them regain a sense of stability after their worlds have been rocked by the realization they can’t control

everything that happens. None of us can, of course: all we can control is how we respond.

12. The best thing adults – parents, counselors, therapists, teachers, youth workers, aunts, uncles,

neighbors – can do for grieving children is to listen

To listen, that is, not just with our ears, but with our eyes, our hearts, our souls. To not presume we

have (or have to have) answers.



Appendix D

Tangled Ball of Emotions11

This Ball of Grief describes the normal array of feelings anyone might experience when grieving. You may

want to make a copy of this, laminate it, and keep it with you to bring out and show folks who are grieving. You can

ask them, “Do you experience any of these feelings?” Then after they point to a few of them, you can tell them,

“That’s normal. Grieving people have these normal feelings.”

As people express their emotions of grief, they need to remember the following:

11 This “Tangled Ball” was presented during a class at Talbot School of Theology (1977) by H. Norman Wright.

Used by permission.



There’s no way to predict how each person will or should feel. The reactions of grief are not like recipes, with

specific, prescribed ingredients and certain (predictable) results. Each person mourns in a different way. Some may

cry hysterically or they might remain outwardly controlled, showing little emotion. They might lash out in anger

against family and friends, or they might express gratitude for their dedication. They might be calm one moment and

then in utter turmoil the next. Reactions are varied and even contradictory.

Though grief is universal, at the same time it can be extremely personal. Allow each person to heal in his/her

own way.



Yea, though I walk through the valley of the shadow of death, I will fear no evil; For You are with me… (Psalm 23:4)

Appendix E

Through the Valley of Grief12

12 This graph was presented in a class at Talbot School of Theology (1977) by H. Norman Wright. Used by

permission.



You can show people who are going through grief this graph so that they will know what to expect and discover

where they might be at this moment in their grief journey.

They will experience the following in varying degrees depending on the severity of the loss. Remember that

there is no set timetable for how fats a person should move through these stages of grief.

Shock and numbness can last a few seconds or even hours.

Denial is refusing to face what has happened and refusing to deal with the grief. It’s normal and even a

necessary part of coping, but it’s important for a person not to become stuck in this stage.

Emotional outbursts (including anger and fear) are a normal part of grieving.

The searching includes looking for help and support, but it’s mostly focused on what we have lost. It often

takes the form of reminiscing about who or what we have lost.

During times of disorganization, feelings will range from overwhelming panic to deep depression. It will

include moments of loneliness and guilt and isolation. These feelings will come and go.

There will be times of depression, where the person is so downhearted it will be hard to function. This is

normal.

Getting back into life will involve some “re-entry” troubles. It will often look like two steps forward and one

step back. It may involve a pattern of trial and error, with one day going well and another day not so good. That’s

normal. Feelings and experiences will fluctuate. The person may talk about investing in new relationship,

demonstrating new strengths, and exploring new patterns of doing things. Encourage them in this process and

remind them not to make any major decisions during their down times.

Eventually they will come to a place where they can hope again. Paul identifies several reasons for hope in

Romans 8:18-25, 31-39. Real hope will allow the person to see beyond the pain to a deeper perspective that will

reinterpret the loss. Often that comes through an eternal rather than temporal viewpoint. Hope can trust in God’s

goodness in the midst of the dark night.

Eventually the person will come to a place where they will be able to take what they have learned through their

journey of grief in helping others work through their journey.



Appendix F

Letter from Bereaved Mother

The following letter was sent to the HCMA Office years ago. It is from a mother who was informed

that her son had been in an accident and how she was treated by the Chaplain when she called the

hospital. It reminds us, as Chaplains, how important it is concerning our response with grieving people.

After reading it, take some time to reflect on your own death notification protocol.

Dear Chaplain,

I am writing this letter to express my confusion and pain concerning the way you informed

me of my son's death. I have spoken with other officials concerning this matter, but I felt it was

only appropriate for me to contact you personally on this matter.

Most confusing to me concerning this matter is why did you inform me of my son's death

without first knowing who I was? When I called the hospital for information concerning my son,

my conversation with you quickly moved from your initially appropriate "Please take your time,"

to telling me that "Yes" my son was dead. In addition, when I called back after the initial call,

you repeatedly made me feel like you didn't want me at the hospital. My desire to come in, to see

and identify my precious son was only met by your resistance of “You don't need to do that—he's

a mess and all bloody.” Chaplain, he's my son. You didn't even know I was his mom, let alone tell

me how to address my need to come in and wrap myself around him and begin grieving for the

deepest loss a mom can go through. Your responses came across abrupt and condescending. Why

was I not simply told, "Yes we do have David. Please be careful in getting here. We will take you

to David as soon as you get here." In such a context I would have been in the presence of a

supportive pastoral staff; I would have been physically near my son and I could have gone to him

and begin the process of healing in a less traumatic way. But because you informed me the way

you did, I was left shell-shocked, forty minutes removed from my beloved son. You didn't know if I

had people around to support me, or driving if I was driving by myself down the road or in

any situation in which I would have been even more vulnerable—not to mention the additional

risk it is to drive forty minutes to a hospital in complete shock. That alone is it's own risk.

Chaplain, I don't know what your intentions were with me that day. Maybe you weren't

trained properly on such crisis situations. But the way you handled my situation increased my

trauma. But now, of importance to me, is how can I possibly tell my story so that others do not

have to suffer additional trauma when they are informed of their loved ones death. In the future,

please consider making it your personal policy to follow the response as mentioned above. Those

from HCMA and the APC reported to me that my situation was mismanaged. They have

encouraged me to keep telling my story so as to possibly help shape policy so that such situations

are handled in a more professional and sensitive manner. Please consider this mom's heart cry.

It still hurts that I have not heard an acknowledgment of your mistake or mishandling from

either you or the hospital. A sincere apology would be helpful in my healing process. Either way,

however, I am committed to taking my painful situation and using it for a positive gain.

Sincerely,

Bereaved Mother



Appendix G

After the Death…

There are over fifty separate and usually urgent things that must be done and decisions that must be

made within days and even hours after a death in a family. This will involve some or all of the following.

We may need to notify:

1. Doctor or coroner (if death at residence)

2. Funeral Director

3. Cemetery 4. All relatives

5. All friends

6. Minister and church

7. Employer for possible benefits plus time off

8. Organist and soloist

9. Pallbearers 10. Life insurance agent

11. Union or fraternal organization

12. Newspapers to place an obituary

13. Attorney and/or accountant (regarding will/trust, changing auto and property titles, bank

accounts, credit cards, loans, etc.) 14. Social Security

15. Veteran’s Administration (if applicable)

We may need to select:

16. A casket

17. A grave 18. A memorial marker (headstone)

19. An outer burial container (vault)

20. If cremation, an urn and final disposition

21. Burial clothing

22. Pictures/mementoes for the service (Collage Board and/or DVD) 23. A minister

24. Flowers

25. Music

26. Scripture

27. Food for the reception

28. A time for the service 29. A place for the service

30. A time and place for the reception after the service

31. Transportation to/from the service

32. Memorial folders

33. A register book

34. Thank you/acknowledgement cards



In addition, you may need to:

35. Provide personal background about the deceased for the obituary

36. Provide vital statistics for the completion of the death certificate

37. Prepare and sign necessary papers 38. Provide address and directions for all interested people

39. Answer innumerable sympathetic phone calls, messages, and letters

40. Meet and talk with everyone about all the service details

41. Go through family pictures

42. Greet all friends and family who visit you at home 43. Provide lodging for out-of-town guests

44. Clean the house

45. Plan the transportation

You may need to pay some or all of the following:

46. Doctor bills 47. Hospital bills

48. Medicine and drugs

49. Funeral costs

50. Cemetery costs

51. Minister honorarium

52. Organist/Soloist honorariums

53. Obituary notices

54. Florist

55. Clothing

56. Transportation

57. Telephone bill

58. Reception food

59. Grief counseling

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