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Grief: When Two Loved Ones Die Days Apart

September 25, 2015

Recently, I heard of several stories of two members of the same family dying within days or weeks of each other. At the beginning of the summer my mother’s longtime friend of 47 years died the night of her husband’s funeral. The friend was unable to attend the funeral as she was in the ICU herself. During the funeral my mother sat holding hands with two girlfriends who made up their foursome. As children, we referred to them as the “couples club.” At the Shiva call, my mother noticed pictures of herself as a bridesmaid at her friend’s wedding. It was heart wrenching listening to the daughters first eulogize their father and then two days later, their mother.

A few weeks later one of my colleagues experienced the death of his sister who had suffered 37 years with a terminal illness. Two weeks later, his mother died of a different long term illness. Both he and his father were understandably devastated and overwhelmed with grief.

Sadly, there are many mind-boggling stories just like these. There are plane and automobile accidents and natural disasters where multiple family members die at once. How does one manage two or more devastating deaths so close together? How does one maintain a sense of self and a place in the world amidst so much loss?

Coping with multiple losses takes longer than coping with one loss. Each loss has a different level of significance based on the relationship with that person. It can take months to understand the role each loved one played in your life. You may feel closer with your neighbor that you have known only a few years than with your uncle who lives out of town. You may be estranged with one family member and extremely connected with another. Allow for differences and accept the varying grief reactions that occur with each death. You may experience deep pangs of grief. Give yourself permission to grieve, accept the pain and cry to your heart’s content.

Remember to:

  • Frequently check that you have balance in your life.
  • Be gentle with yourself. Although you may often feel overwhelmed, remind yourself that what you are going through is normal.
  • Educate yourself and become familiar with the normal experiences of grieving.
  • Remember that grieving takes time. Allow yourself to heal at your own pace.
  • Grieve each loss and talk about each death separately.
  • Be aware of the signs and symptoms of traumatic grief and post-traumatic stress disorder.

Grieving many losses concurrently can result in feeling overwhelmed or numb. You do not need to grieve alone. Reach out to family, friends or health care professionals or support groups to assist you on your grief journey.


Returning to School After the Sudden Death of a Loved One

August 25, 2015

The lazy days of summer are quickly coming to an end.  As we move into the routine of another school year filled with promise, death is typically the last thing on our minds. Unfortunately, sudden death can strike the lives of students and school communities without warning, leaving despair, uncertainty and pain in its wake.

Sudden death presents a unique set of circumstances that can impact children’s grieving process. Death may be due to illness (i.e. heart attack, stroke) or more traumatic circumstances such as accidents, natural disasters, suicide or even homicide. The sudden and overwhelming nature of this type of death can itself be traumatic. Young children are more vulnerable to sudden loss due to developmental limits which affect their ability to process such change. They may show regressive, clingy behaviors, or even seem unaffected by the loss.

Older children show distress more directly because they are more likely to grasp the meaning of the loss; they may act out feelings through play or attention-seeking behavior. Teens appear to grieve much like adults; however, deep, intense feelings may be expressed indirectly via self-destructive behavior or withdrawal. Behaviors specific to the school setting such as decreased concentration and memory, school avoidance or even flashbacks and intrusive memories may be observed. Grief reactions can affect students emotionally, physically, cognitively and even spiritually.

Thankfully, arming ourselves with knowledge and resources can help to offset feelings of panic and anxiety and aid us in supporting children.  Remember that children are intermittent grievers, that grief continues over time and grief responses change as the child ages.

Here are some suggestions to assist children after death:

  • Use honesty and simplicity. Children are concrete thinkers and are often confused by metaphors such as “your grandpa is sleeping”, euphemisms and complicated stories.
  • Be available to listen and initiate conversations. Children need you to normalize their grief reactions to feel safe expressing them.
  • Describe the big feelings of grief. Share ways that you have manage these feelings. Reassure them by letting them know what you are doing to keep them safe and healthy.
  • Be aware of magical thinking. Children believe their thoughts can cause things to happen-they may believe that things they wished, or said, or did caused the person to die. They may also believe that the person is coming back. It is important to help children understand the finality of death so that they can grieve the loss.
  • Model healthy coping. Let your children know that it is healthy to cry and that it may make them feel better. Offer creative and safe ways for children to express feelings.
  • Maintain daily routines. Routine provides safety and security.
  • Encourage involvement in memorializing activities. Remembrance activities, such as collecting photos, retelling their stories or creating a memory box, provide children safe and constructive ways to express their grief.
  • Do not lose hope. Help your child carve out a special place in their heart for their loved one while helping them integrate this death into their lives. As they grow and mature, they may feel sadness with each milestone – graduations, family events, holidays, and other special times. Your openness and understanding through these times will be comforting.

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Continuing Bonds

July 28, 2015

Many grieving people wonder how they can maintain the bond they had with their deceased loved one as they move on with their lives. Many can’t even imagine moving on.

Developing a continuing bond happens over time. It shifts and changes for the mourner as different meanings in the loss are discovered. Continuing bonds provides solace, support and helps ease the transition from the past to the present.

Finding a way to carry the love for the deceased in our hearts is a great comfort. Some folks make major life changes. They go back to school, get new jobs, advocate for new laws or start fundraising. Others engage in their heritage and cultural activities to find meaning and connection.

Often we hear mourners remark, he would have loved this. I often think how my dad would react to certain news events. I know he would have loved when all of his children would get together.  He would have loved my newest granddaughter. The truth is that we can honor and remember our loved one in the context of things they haven’t experienced but would have loved.

Finding consolation in simple things can also help grievers find meaning in the relationship with the deceased and with the death. It helps create a bridge to a lasting, enduring, loving connection.

Remember your beloved when ….

…that person’s favorite song or artist comes on the radio.

…you wear a certain piece of jewelry or clothing.

…savoring a favorite food or dining in a preferred restaurant.

…watching the news, television or a movie.

…you meet someone that resembles or acts similar.

…you do something new and adventurous that he or she would have loved doing.

When we remember our deceased loved one, we frequently remember what they loved doing and various experiences. Continuing bonds allows us to carry our memories forward into how we live and what we love today. May your memories be a blessing.

Creations from Special Belongings

June 22, 2015


When someone you love dmosaic tableies, being surrounded by their belongings can be both a treasure and a stressor. What is the best thing to do with all that stuff?

Do you toss it in a dumpster, donate to your local charity, save it for other people, save it for yourself or sell it?!  And how do you decide what to keep? And if you do keep it, what do you do with it?

Our loved one’s belongings often hold special memories.  Repurposing those items by turning them into artwork can help us honor and celebrate their lives as well as keep our memories alive.  While it may be difficult to cut, snip and refashion these precious items, with patience and a little creativity they can be turned into a lasting keepsake.

Here are some suggestions to get you started:

China – Mosaics are the art of assemblage of colored stone, glass and other items to create artwork.  Use china, tea cups and decorative plates to decorate the top of a teddy bears joanmemory box, tray or table.

Clothing – Old neckties, jeans, hats, sweaters, and other items can be used to make quilts, blankets, teddy bears, hats, and purses. Pockets from shirts and jeans can be included for holding personal notes.

Jewelry – Create new jewelry. Silver and gold can be melted down by a jeweler and used to create something new for you or for several people in your family. Gems and semi-precious stones can be shared amongst everyone in new designs. Cufflinks can become charms on a bracelet or necklace. Costume jewelry can adorn anything from a Christmas tree to a candle. Old pins can be turned into vinshadow boxtage magnets. Belt buckles can become necklaces. Be creative!

Table Cloths – Skirts, blouses and shawls can be fashioned from the beautiful fabric of a cherished table cloth. They can also be turned placemats or pillows.

Wall Art – Tools, jewelry, clothing and dishes can be used to create interesting and memory filled displays. Create a special wall hanging area for hats and/or purses that belonged to your loved. You can have items framed or buy and decorate a shadow box for these mementos.

Managing Anticipatory Grief

May 27, 2015

ThinkstockPhotos-482256089Many of us are aware that grief is a normal part of every loss we experience, but grief does not only appear after the loss.  Anticipatory grief is the form of grief that occurs when one is confronted with a chronic or life threatening illness or when one anticipates the death of a loved one (or oneself). Anticipatory grief does not substitute, or necessarily lessen, grief that follows death. It is not simply grief pushed ahead in time.

Anticipatory grief is not a way to complete your grief prior to the death of the individual. Rather, it is a response to losses of both the person who is ill as well as caregivers and others who are close to him or her. Each experiences anticipatory grief from their own unique frame of reference.

Many times when we think of a loss we think about the death of a person, but there are many other losses. These include tangible losses such as physical limitations and intangible losses such as the loss of hopes, dreams, dignity, motivation and many others. With life limiting and chronic illnesses, both the patient and the caregiver experience anticipatory grief. Anticipatory grief not only includes future losses but also past and present losses.

Tips on managing anticipatory grief:

  • Accept that anticipatory grief is normal. Acknowledge the loss.
  • Stay connected with a support system that you can trust and rely on. Talk to those who have experienced the same journey you are traveling.
  • Exercise, eat right, and get enough sleep.
  • Prioritize your life, attending to those things that need to be done and letting go of the rest.
  • Say the things you need to say and experience the things you need to experience.
  • Create memories while you can.

Remember there are no rules to grieving. Grief is a result of loving someone. Be kind to yourself and in doing so you will be better able to help others.

Five Tips for Dating After the Death of a Partner or Spouse

April 27, 2015

The depth of grief after the death of a partner or spouse can be overwhelming. There is a void – a hole in your heart that your beloved once filled and the aloneness is vast.  Just the idea of beginning a new  relationship can be scary.

Each person grieves in his or her own way and not everyone is interested in dating or resuming a social life after the death partner or spouse. However, you may find that starting a relationship and finding this aspect of meaning in life can be part of the healing process.

How will you know when you are ready to date? Here are some things to consider:

  1. Time – While there is no calendar for grief, you want to make sure that enough time has passed for you to work through the tasks of grief. Some people need more time to grieve than others and some want to date fairly soon into their grief.  There is no right or wrong, good or bad way to grieve.
  2. It is important to experience and process the feelings of grief and loss. Moving into a relationship too soon may be a way of avoiding or escaping this crucial task of grief.  Also, many people feel guilty when starting new relationships. If the guilty feelings are too strong, it may be an indication of moving too quickly.
  3. Have you adjusted to your new role? Can you take care of yourself?  Have you assumed all the roles around the house that you used to share with your partner or spouse?  You want to be careful that  you are not looking for a “caregiver ”or replacement or someone to take out the garbage or cook a good meal. Think about what you miss about your partner or spouse.
  4. Have you gone through your partner’s possessions? Many people quickly remove any and everything that reminds them of their beloved.  Some people hang on to belongings for a very long time.  Before you begin dating, sort through your loved one’s possessions.  Decide what you want to donate, toss, store or leave on display. This can also be very healing.
  5. Inform your children, family and friends. This is not a request for permission or a blessing, but letting them know is a courtesy. No one wants to be surprised when you show up with your date at an event. Some may be upset at first, but talk to them. Let them that you wish to start dating again. They want you to be happy.  Reassure them that you will be safe and remind that no one will ever replace the person who died.

The death of your partner or spouse has become part of your life story and who you are.  Your relationship with the deceased does not end, but a new relationship is created based on memory, spirit and love.   Meeting someone new and developing a connection creates new memories and meaning.

Diane Snyder Cowan, Hospice of the Western Reserve ©2015


Death From an Overdose: Managing the Grief

March 26, 2015

heroin overdose


According to the Centers for Disease Control and Prevention, death rates from drug poisoning have tripled since 2012. The researchers found an average increase in heroin-related drug poisoning deaths of 6% per year from 2000 through 2010. The increase from 2010 through 2013 was an astonishing 37%. Deaths have shifted from middle and older-aged men to younger white men from Middle America.

It’s tragic and impacts the bereaved on many levels.

Grief reactions are often intricate and complex. When you add that the person died from an overdose, accidental or not, it complicates matters. There is a myriad of emotions that occur when someone dies and when someone dies from an overdose, the most difficult ones rise to the surface.

Shame, blame, guilt, stigma, isolation, loneliness, fear and anxiety are prevalent.

Sometimes the bereaved feel guilty. They relive over and over the “should haves, could haves” and “if onlys.”  The bereaved often blame themselves and they blame others. Shame is a common reaction. Some feel judged for loving someone with an addiction or for having an addiction themselves. Unfortunately, the shame makes people hesitant to share. Consequently, they don’t reach out but rather become isolated and lonely. It is a sad, downward spiral.

Fear and anxiety are also prevalent grief reactions with a substance abuse death. There is the fear that other family members or friends will overdose or that people who are currently using might die. And, there is the fear of relapse for people in recovery.

The stigma society imposes for substance abuse loss is overwhelming and there is an overlap between intentional overdose and unintentional overdose. Unfortunately, people deeply misunderstand addiction and mental illness. suggests the following to help manage grief after a substance abuse death:

  1. Accept the role substances played in the death.
  2. Find a way to work through and express emotions. This could be through talking, writing, making art or music, hiking, etc. Do whatever works for you.
  3. Educate yourself and understand addiction. Understanding addiction can help put to rest feelings of guilt and blame. One thing to learn is that we are powerless and we don’t have control over someone else’s addiction.
  4. Surround yourself with the right support system. Avoid those who disenfranchise your grief. You might find comfort with a counselor or a support group with others who are also experiencing grief of an overdose death.

Grief includes all kinds of feelings. If you feel overwhelmed with emotion, trust the grief process and give yourself permission to be with all your feelings. Know that there are others out there who feel the same. And, there are counselors and support groups that will welcome and support you. You do not have to grieve alone.

Diane Snyder Cowan, Hospice of the Western Reserve ©2015

LGBTQ, Art Therapy and Grief

February 25, 2015

OGrieving the loss of a loved one is difficult enough, but when the relationship is non-traditional it can become even more complicated. When an LGBTQ person cannot openly mourn the death of a loved one or when society at large disenfranchises this grief, heartache is turned inward and the healing process suffers. Sadly, sometimes folks disenfranchise their own grief. Secrecy, shame and guilt are a few of the grief reactions commonly expressed in the LGBTQ community. Turning grief inward can result in isolation, use of unhealthy coping strategies and feelings of depression.

Members of the LGBTQ community who have experienced the death of a loved one, especially of their significant other, may not have the support from family and friends that heterosexuals come to expect when a loved one dies. Family and friends may not understand the relationship or may be angry at their loved one and partner. Some family and friends may not have known about these relationships as couples could have kept them hidden for years. This all complicates the mourning process and impacts mourning rituals.

LGBTQ art therapy workshops offer this community the opportunity to come together in a safe environment to creatively work through their grief as well as to create art in honor of their loved one.

Michael created this beautiful rose Suncatcher (dyes on silk) to honor his late partner. His partner loved roses and had a beautiful rose garden. Unable to get support from his family and friends, Michael relied on his deceased partner’s family to comfort him on his grief journey.


Maggie’s grief was also disenfranchised by her partner’s family. In fact, shortly after the death, her partner’s children arrived at her home to take out their mother’s bedroom set. Maggie was assertive and didn’t allow this to happen. Sadly though, Maggie’s loss was complicated because her partner was the breadwinner. In addition to her death, Maggie lost her home and had to move to a smaller community away from her supports. The art therapy workshops allowed her to work through her feelings of grief and come to some acceptance. The groups provided a safe place for her to come, create and meet other members of her community who were grieving. Her piece, Door to Tomorrow, shows her feeling alone but hopeful.

OMembers of the LGBTQ community need to know that they have the right to grieve and that support is available.  Please consider attending one of our LGBTQ art therapy events. For more information, contact the bereavement center at 216.486.6838.

Click here to see our Spring Support Groups 2015.


Diane Snyder Cowan, Director, The Elisabeth Severance Prentiss Bereavement Center ©2015

Food and the Grief Connection

February 2, 2015

95168617After the death of a loved one, many newly bereaved lose their appetite and interest in food. However food can play an important role in grief work. Food is a harbinger of memories.  Aromas often transport us to the past, providing comfort and joy in treasured remembrances.

Think about the food that connects you with your deceased loved one. Was it a special meal? Was it the meal where he or she proposed? Was it associated with a holiday? Was it a late-night snack at the kitchen table or a picnic on a beach? Take a minute and you will most likely come up with many dishes. One or two will stand out.

Of all the special dishes my mother-in-law prepared, my husband’s childhood favorite was apple pancakes. With his eyes lit and mouth-watering, he is able to describe how his mother and grandmother would carefully core an apple, thinly peel the outer layer and slice it into circles. After the batter was on the griddle his mom would place one apple slice on it and then flip it over.

A master baker recently described a simple cheesy potato recipe that her mother used to make. With tears in her eyes she recalled how this dish, more than any fancy meal or celebration, connected her with her mother.

After my dad died, I could not look at a lemon bar without tearing up. Now I smile and take a bite on his behalf.

Many bereaved share stories about duplicating their deceased loved one’s recipes. One routinely makes her aunt’s cranberry relish for Thanksgiving despite the fact that no one eats it. For her, this ritual connects her with her aunt.

In grief work, continuing bonds are the objects or events that connect us to the deceased.  Continuing bonds are dynamic. They shift and change over time. Preparing your deceased loved one’s recipe can be one way to make and find meaning in your relationship. If you’re not into cooking, simply having that tasty treat or going to a restaurant that you both frequented will provide that bond.

Appetizers, entrées and desserts that transport us to special memories can provide meaning and comfort during the grief journey.

Please visit our on-line grief discussion groups.

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When the Unthinkable Happens: Homicide and Grief

January 9, 2015

It seems as if the news is filled with senseless murders and of inexplicable interactions between the police and the community. The inconceivable happens – a special person dies in a sudden and unexpected way. When a loved one is murdered, family and friends often experience traumatic symptoms along with grief reactions.

Homicide is so sudden and unanticipated. It falls outside the usual experience of what one expects life to be like.  Abruptly losing a person in this manner can shatter one’s sense of well-being. Strong reactions are common, including fear, helplessness, shock, anger and even horror. These trauma reactions are normal responses to an extremely difficult time in our lives. But when you mix these reactions with grief, the results can be overwhelming.

Grieving parents of murdered children and grandchildren often mention that they feel like they are in “another world,” but the world around them doesn’t stop. It’s common to feel a sense of numbness, of “being in a fog.”

You may also feel:

  • Disbelief at what happened
  • Intense rage at the guilty party
  • Guilty as if somehow you could have prevented this tragedy
  • Preoccupied with visual images or sounds
  • Fear, distrust, helplessness, and hypervigilance
  • Blame, isolation, exploitation
  • Anger

The signs and symptoms of a stress reaction may last a few days, a few weeks, a few months, or longer, depending on the severity of the traumatic death.  The understanding and support of family and friends can help the stress reactions pass more quickly.  Here are a number of tips that can help during this very difficult time:

  • Maintain as normal a schedule as possible (as impossible as it seems); structure your time
  • Follow the basics for good health (even when you don’t feel like it) – rest, eat well, exercise
  • Reduce other stressors as much as possible – make to do lists, be patient with yourself when you can’t find your keys, limit distractions that might interfere with concentration
  • Be aware of numbing the pain with overuse of drugs or alcohol; go easy on caffeine
  • Talk to people – reach out, spend time with others
  • Do things that feel good to you – take a walk, listen to music, keep a feelings journal, etc.
  • Set boundaries with law enforcement officials, news media and friends and family
  • Give yourself permission to feel the pain and share these feelings with others
  • Don’t feel the need to fight reoccurring thoughts, dreams or flashbacks; they are normal and will decrease overtime and become less painful

Above all, know that you’re not going crazy. Your reactions are normal. However, there are times when a traumatic death is so painful that professional assistance may be helpful. Seek professional help if anger, anxiety and depression persist, worsen or begin to interfere with your life, job or relationships. Be kind and gentle with yourself and remember that there is no right or wrong way to grieve.

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