Introduction

Coping with a bereavement

The death of a loved one can be devastating. This topic describes some of the feelings that can arise from losing someone, and where you can go for help and support.

Bereavement affects people in different ways. There's no right or wrong way to feel. You might feel a lot of emotions at once, or feel you’re having a good day, and then you wake up and feel worse again. Powerful feelings can come unexpectedly, like waves on a beach. You can be standing in water up to your knees and feel you can cope, then suddenly a big wave comes and knocks you off your feet.

Experts generally accept that there are four stages of bereavement:

  • accepting that your loss is real
  • experiencing the pain of grief
  • adjusting to life without the person who has died
  • putting less emotional energy into grieving and putting it into something new (in other words, moving on)

You'll probably go through all these stages, but you won’t necessarily move smoothly from one to the next. Your grief might feel chaotic and out of control, but these feelings will eventually become less intense. Give yourself time, as they will pass. You might feel:

  • shock and numbness (this is usually the first reaction to the death, and people often speak of being in a daze)
  • overwhelming sadness, with lots of crying
  • tiredness or exhaustion
  • anger, for example towards the person who died, their illness or your faith
  • guilt, for example guilt about feeling angry, about something you said or didn’t say, or about not being able to stop your loved one dying

Feelings like these are all perfectly normal. Negative feelings don’t make you a bad person. Lots of people feel guilty about their anger, but it’s OK to be angry and to question why.

Some people may become forgetful and less able to concentrate. You might lose things, such as your keys. This is because your mind is distracted by bereavement and grief. You're not losing your sanity.

The UK Gov website has information on what to do after someone dies, such as registering the death and planning a funeral.

Coping with grief

Talking and sharing your feelings with someone can help. Don’t go through this alone. For some people, relying on family and friends is the best way to cope. But if you don’t feel you can talk to them much (perhaps you aren't close, or they're grieving too), you can contact local bereavement services through your GP, local hospice, the national Cruse helpline on 0808 808 1677 or a local Cruse centre.

A bereavement counsellor can give you time and space to talk about your feelings, including the person who has died, your relationship, family, work, fears and the future. You can have access to a bereavement counsellor at any time, even if the person you lost died a long time ago.

Don't be afraid to talk about the person who has died. People in your life might not mention their name because they don't want to upset you. But if you feel you can't talk to them, it can make you feel isolated.

Anniversaries and special occasions can be hard - do whatever you need to do to get through the day. This might be taking a day off work or doing something that reminds you of that person, such as taking a favourite walk.

If you need help to move on

Each bereavement is unique, and you can’t tell how long it will last. In general, the death and the person might not constantly be at the forefront of your mind after around 18 months but this period may be shorter or longer for some people, which is normal.

Your GP or a bereavement counsellor can help if you feel that you're not coping. Some people also get support from an appropriate faith / religious minister. You might need help if:

  • you can’t get out of bed
  • you neglect yourself or your family, for example you don't eat properly
  • you feel you can’t go on without the person you’ve lost
  • the emotion is so intense it’s affecting the rest of your life, for example you can’t face going to work or you’re taking your anger out on someone else

These feelings are normal as long as they don’t last for a long time. The time to get help depends on you.  If these things last for a period that you feel is too long, or your family say they’re worried, that’s the time to seek help. Your GP can refer you, and they can monitor your general health.

Some people turn to alcohol or drugs during difficult times. Get help cutting down on alcohol, talk to someone on  the free phone  24 hour Drug and Alcohol helpline DAN 08088 082234 or see the Frank website for information on drugs.

Pre-bereavement care

If someone has an incurable illness, they and their loved ones can prepare for bereavement. Practical things can help, such as discussing funeral arrangements together and making a will.

Bereavement counsellors also offer pre-bereavement care, helping patients and their family cope with their feelings. This can be especially important for children, Children’s stress levels are at their highest before their family member dies, so support during this time is important.

Find out more about children and bereavement on the Child Bereavement Charity website.

Children and bereavement

The following information could help if your child has lost a loved one or if a loved one is dying.

If your child has a loved one who's dying

If a child has a loved one who is going to die, they can benefit from special support.

Hospices offer pre-bereavement care to help patients and their family in the run-up to the end of life. This is especially encouraged for children because children’s stress levels are at their highest before bereavement because of fear and the unknown.

Pre-bereavement care gives the child a chance to think and talk about their feelings, and to share their worries.

If you're a parent and you know you're going to die think about making a memory box to give to your child, or making one together. This is a box containing things that remind you both of your time together. It can provide an important link between you and your child once you've gone.

If a child has lost a loved one

During bereavement, it can help a child to talk about the person who has died, whether it was a grandparent, parent, brother, sister or friend. Sharing and talking about emotions and about the person is important, especially for children. If they have lost a loved one, it’s important to have someone with whom they can talk about that person. It could be through photos, games, memory boxes or stories.

If the person who has died didn’t leave a memory box you could make one with your child. It can include gifts, shells collected on the beach, memories written on a card or anything that makes the child feel connected to that person.

You can find out more about children and bereavement on the Child Bereavement Charity website.

Bereavement and young people

Losing someone important to you is one of the hardest things to experience in life and if you’re young, bereavement can be even more difficult. But support and advice are available to help you get through it.

Your teenage years can be a lot of fun, but they are also often an emotional time. If someone close to you dies, it can be incredibly hard. Your world may feel as though it has crashed around you. It can make you feel very alone, especially as a young person, because you might find that none of your friends have gone through anything similar and don’t understand or know what to say.

Your emotions

Grieving is a natural part of recovering from a bereavement, and everyone’s experience of grief is different. There are no rules about what we should feel, and for how long. But many people find that they feel a mixture of the following:

  • sadness
  • shock, particularly if the death was unexpected
  • relief, if the death followed a long period of illness
  • guilt and regret
  • anger
  • anxiety
  • despair and helplessness
  • depression

These feelings may be very intense, particularly in the early days and weeks. Time eventually helps these intense emotions to subside and there's no need to feel guilty about starting to feel better. It doesn’t mean that you’re not respecting the person’s memory or forgetting about them.

There are several things that can help you start to feel better. Looking after your health and talking to someone will help you to get through this difficult time.

Finding support

Talking about your grief is an important part of getting through a bereavement. Choosing who to talk to about your feelings is a very personal decision. Sometimes the most unlikely person can actually offer the most support. If you’ve lost a family member, someone else in your family may also be good to open up to because they’re likely to understand how you’re feeling.

A close friend can be a good listener and a source of comfort and support, even if they haven’t gone through this themselves.

There are lots of other sources of advice and support available, including:

  • Helplines: such as the Cruse young people’s free helpline (0808 808 1677), where trained volunteers offer advice.
  • Your GP: especially if you’re concerned that you’re not coping, might be depressed, have trouble eating or sleeping, are thinking about hurting yourself or you're not starting to feel better after a few months. Your GP may suggest you have counselling.
  • A teacher or tutor: you may be distracted or find it hard to concentrate at school or college for a while. So talking to a teacher you feel comfortable with can help them understand what you’re going through, and take a bit of pressure off you. Special circumstances, such as bereavement, can sometimes be taken into account if you’re having trouble with coursework or exams.

Looking after yourself

During a time of grief you may not feel like looking after yourself, but it is important to help you cope with the extreme emotions that come with bereavement. Some of the following quite simple things can make a big difference, such as:

  • Eating: you may lose your appetite, but try to keep eating as normally as possible. Your body needs food even if you don’t want it. Ideally, go for healthy well-balanced meals.
  • Sleeping: it can be hard to sleep when you’re very upset, but there are some things that can help. See the Insomnia topic self-help section for more information.
  • Socialising: seeing your friends and keeping up your normal social life may help to take your mind off things and allow you to talk about how you’re doing if you want to. Don’t feel guilty about not thinking about the person you’ve lost or having a good laugh with friends.
  • Exercising: regular exercise can make you feel good and help you sleep (but avoid doing vigorous exercise close to bedtime). It can also be a relief to focus on something physical when you’re going through an emotional time.
  • Avoiding smoking, drinking and taking drugs: you may feel like smoking or drinking because you feel down, but your body has to work hard to deal with substances such as nicotine, alcohol or illegal drugs, especially when you’re young, and they’ll end up making you feel worse.

Sudden death at home

When someone dies suddenly at home often it will be  ambulance clinicians that arrive at the scene first. An ambulance clinician cannot confirm the cause of death so they will attempt to contact the deceased person's GP.

If the person had not been seen by a doctor during the past 2 weeks HM Coroner will need to be informed as it may not be possible to establish the cause of death immediatley. Under these circumstances the police, who act as agents of the coroner will be contacted and attend.

When the ambulance clinicians have left, the body of the deceased will be left at home until a doctor, the police or an undertaker arrives.

In some instances the deceased will have to be moved to a mortuary, which will be carried out by the chosen undertaker. It may be necessary to hold an inquest. The police will explain this procedure if it is needed.

Things to consider

Things that you may wish to consider include which funeral director/home do you want to use. Funeral Directors can be found in the yellow pages and local newspapers.

You also need to consider who to contact about the death, for example close relatives, friends or care services.

A minister of the deceased's religion may already have been in attendance and may be of support to family and friends during this period. They will discuss your preferences and advise on details of planning the funeral service. If there has been no recent contact with a religious group and you wish to contact a religious group, your GP or funeral director can advise on someone of appropriate faith in your area who will be happy to carry out the required duties. Your funeral director will also be able to advise you on contact details and locations for humanist (non-religious) funerals.

Remember that you can speak to your own GP if you are finding it hard to cope with bereavement.

Losing someone close through suicide

The loss of someone you’ve been close to, whatever the cause of their death, can bring intense feelings of grief.

But losing someone through suicide can cause reactions and emotions that are different to those felt after death from illness, an accident or natural causes. The fact that a person’s death involved an element of choice raises painful questions.

Shock, social isolation and feelings of guilt can be greater when bereavement is caused by suicide than when it's caused by other types of death.

It’s not uncommon to have recurring images of the death or nightmares, even if you didn’t see it happen.

The grieving process is characterised by questioning and a search for an explanation. Talking to other people is crucial. Sharing your feelings with other people can be extremely therapeutic. Going through the details of what happened can be helpful. Some people get trapped at the stage at which they have recurring images or nightmares for other reasons, perhaps due to guilt. But talking can help them move on.

If the images persist and you find they interfere with your life, ask your GP if they can refer you to a specialist who can help. There is also a dedicated resource developed for people who have lost someone by suicide called Help is at Hand Cymru. See link below

Looking for answers

Many newly bereaved people will ask, "Why?" but there isn’t always a straightforward answer.

People will have different explanations. There’s a tendency to think about a single cause for each death, but that’s rarely the case. Cases are often complex. There may be a trigger for the event but studies show there are often several factors. These may be historical, family and genetic, for example.

Finding answers isn’t easy because all the information is not always at hand. Nonetheless, searching for an explanation is useful and essential. People get to a point where the death makes more sense to them and that’s part of the healing process.

Going over what could have been done to save someone from suicide is a natural reaction. Everything can seem painfully obvious with the benefit of hindsight, and the "What ifs?" may seem endless.

Changes in behaviour that lead to suicide can be gradual. Even mental health professionals find it hard to know when a person is particularly at risk. A person who has decided to take their life can go to great lengths to cover up their plans.

Self-blame

When someone commits suicide, their family and friends may feel intense guilt, self-blame and self-questioning. There is often a considerable sense of guilt and shame. Suicide is still a stigmatised topic, although, thankfully, attitudes are changing.

People often avoid talking to someone who has lost a loved one by suicide because they don’t want to cause offence. This can reinforce feelings of shame and stigma in the bereaved. This reticence makes the bereaved person feel worse and more isolated.

This can lead the bereaved person to cut themselves off from people who could help them because they feel worthless or fear further rejection.

It may help to talk about your feelings with someone you trust. Talking about your feelings will help you to get a realistic perspective on them. If your feelings of guilt persist, you might find it helpful to discuss them with a support group or talk to a counsellor.

Suicidal fears

People bereaved by suicide sometimes worry that suicidal tendencies are inherited and they may become more vulnerable to suicidal thoughts of their own.

If you have feelings like this, it may help to discuss them with a support group, call the Samaritans, or speak to your GP. Such thoughts usually pass with time, but it’s vital to seek professional help if they become very strong.

You may feel isolated and as though you haven't been able to talk about, remember and celebrate all aspects of the life of the person you've lost. Joining a support group for people bereaved by suicide can help reduce the sense of stigma and isolation.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 23/05/2017 08:42:00