Supporting a grieving loved one

In her many years of working with bereaved people, occupational therapist Sandy Ayre has repeatedly seen that grief doesn’t follow an orderly path through different stages.

The well-known five stages of grief — denial, anger, bargaining, depression and acceptance — have done much to raise awareness about the process of loss, but Sandy says society’s desire to place it in an ordered list was never the intention and does an injustice to grieving people. Grief is messy, complicated and unpredictable.

“I think that the ‘stages’ concept barely scratches the surface of just how much human beings feel when they’re grieving,” she explains. “There are physical, mental, emotional, social and spiritual dimensions to grief, as well as changes in world view and life purpose.

“None of this fits neatly into stages, and our grief-phobic society has a really difficult time with this.”

An occupational therapist since 2000, Sandy says her life changed in 2006 with the sudden death of her partner. Her bereavement journey led her to pursue certification in death and grief studies, setting her on her current career path. A member of Covenant Health’s tertiary palliative care unit at the Grey Nuns Community Hospital since 2013, Sandy is also a certified yoga instructor who has been providing Yoga for Grief Support in Edmonton since 2010.

Sandy’s work as both a clinical practitioner and a yoga teacher centres on the “companioning” model of grief support. The key to this grief support approach, she explains, is removing all sense of timeline and urgency and being available to listen and observe while trying to create a safe and non-judgmental sanctuary in which the grieving person can express themselves.

“There is no way to ‘fix’ grief,” she says.

“A lot of people try to be solution focused when consoling a grieving person. This really doesn’t help. Instead, stay where the person is at emotionally. Don’t try to make it ‘better.’ Listen and refrain from offering advice. Avoid all ‘shoulds.’ Allow the grieving person to teach you about their experience. Getting them to talk about it and express it is helpful. You don’t need to fix it. You are helpful in your helplessness.”

Sandy explains that the loss of a loved one can impact every facet of a person’s life — their sense of security and identity, income, life roles and social support network — and that being a companion gives the grieving person a safe space to explore this transformation.

Being a companion to the bereaved means, above all, being a good listener rather than handing out advice.

“Companioning is about curiosity, not expertise,” she notes. “Spiritual clichés like ‘God needed another angel’ or ‘Everything happens for a reason’ don’t help, nor do rational ones like ‘He/she (the deceased) wouldn’t want you to be sad.’ Statements like these pull the person out of their emotion, and while the intention might be good, it conveys the message that it’s not OK to talk about their pain or loss. If they can’t talk about the pain, they can’t uphold the love, and then the griever doesn’t have a safe space to express their loss and their love.”

Prolonged grief disorder

With the globe still reeling from a “grief pandemic” resulting from COVID-19, the American Psychiatric Association has recently added a new disorder to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Prolonged grief disorder (PGD) is diagnosed no sooner than one year after the death of a loved one and is characterized by intense daily yearning for a deceased person or preoccupation with thoughts or memories of them at least a year after their death.

Additional symptoms — three of which are required for a diagnosis — include identity confusion, disbelief, avoidance of reminders of the loss, intense emotional pain, difficulty engaging with others and with life, emotional numbness, feeling that life is meaningless and intense loneliness. Seeking support for prolonged grief is essential.

Sandy acknowledges the importance of understanding PGD while also cautioning against a broader “medicalization” of normal grief.

“Thankfully, most people do well with genuine, compassionate, non-judgmental support with no timeline tied to it,” she says. “Unfortunately, we still have a long way to go as a society when it comes to providing this.”

November 16 marks National Grief and Bereavement Day. On this day, Canadians are encouraged to engage in a national dialogue to identify and support access to necessary resources for those living with grief and bereavement.

For Sandy, this mission is a daily labour of love centred on accompanying people along their own path of grieving and helping others become better companions to the bereaved.

“Grief and love are two sides of the same coin — it’s integral to who we are,” she says.

“I don’t think we ever really get ‘closure’ on a personal loss. Even now, I’m reminded of my own losses in my work. There’s no road map, no timeline. Being a companion is about being present to another person’s pain rather than taking it away. I think the COVID experience has shown us, above all, how essential this role is, how much we need each other — especially in times of loss.”

Edmonton area community grief resources

The greater Edmonton area has many resources available to people who are grieving. Contact one of our chaplains to help find a local resource or visit Inform Alberta to find the service you need. Additionally, many employers provide employee and family assistance programs as part of benefits packages that include grief support professionals.

• BriarPatch Centre for Grieving Families
• Grieving Parents Society of Edmonton
• Parent Care
• Pilgrims Hospice
• Victims of Homicide Support Society of Edmonton
• Edmonton Healing Center for Grief and Loss
• Suicide Grief Support Services Canadian Mental Health

Online grief resources

There are many resources available online. Here are some good ones we recommend.

• Inform Alberta
• My Grief
• Center for Loss and Life Transition
• Refuge in Grief
• Association for Death Education and Counseling
• Kids Grief