Written by Dorothy E. Deremo, Hospice of Michigan

DEATH CHANGES EVERYTHING, especially when it's the death of your spouse. You may experience confusion, doubt, fear, abandonment, insecurity, anger, sorrow and a host of other feelings. The ground is shaking and everything seems to be in flux, including your finances, your social life and even your own health.

Suddenly there is no plan or pattern in place. All of your images of the past are displaced by the fuzzy realization that fate has dealt you a blow that has changed your life. Waves of strong emotion threaten to engulf your ability to think, make decisions and properly care for yourself. Strong, even overpowering emotions are a normal and expected consequence of your loss. Once you come to accept that your primary source of love, happiness and security is gone, the grieving process can begin. We are much more knowledgeable about physical injuries than injuries of the spirit. If we have a physical injury like a cut, we bleed, and a scab forms over the wound. We protect the area from infection by keeping it clean and shielding it from re-injury. The scab may break open delaying the healing process, but eventually the tenderness lessens, the wound heals and normal function returns. We know with time our cut will heal and we will be restored to health.

The same healing principles apply to injuries of the spirit. Losing a spouse can be an emotional assault that hurts deeply. If you're scared, confused and hurting, you are not crazy. You would not be human if you were not struggling to cope. Your emotional and physical reactions are part of the normal grieving process that follows a profound loss.

Grieving is a normal process that contributes to emotional healing. With time, your wounds will mend and your life, though changed, will continue. It is important that you not deny your grief, but feel it fully. Enlist the help of those around you. Don't be alone. As Thomas Lynch says in "Tract," reproduced in Chapter Thirteen, "The only way around these things is through them."

The stories of the surviving spouses that we share in this chapter illustrate how people react differently to the loss of a spouse and how their reactions can contribute to, or hinder the healing process. We will make specific recommendations to help you on your journey of healing and discovery. Those of us who have made this journey can attest to the fact that there is hope, and you will again experience joy.

The death of a spouse propels us on a difficult journey that is unique to each. During life, we experience many kinds of loss. Some are small and relatively easy to bear, like losing a favorite piece of jewelry or misplacing your driver's license. Others cause us to question our abilities and our self-worth, like the loss of a job or the failure of a business. Some force us to accept that life changes, such as when our children leave for college or when we divorce. Loss is a part of life.

Because you share so much of your life with your spouse, it is only natural that his or her death shakes you to the core. Together, you may have raised a family, laughed, cried and celebrated every special event you can remember. You may have been married so long that the time before you were married seems like someone else's life. You expect your spouse to be at your side. Losing your spouse is like losing a part of you.

You may feel buffeted about and may lose confidence in yourself. You may feel confused, unable to make even minor decisions or feel as though you lack the strength to carry on. Many widows and widowers alike find it difficult to make important decisions without the advice or direction of their spouse. As a result, they often fail to make time sensitive decisions.

To complicate matters, you may not know how to act while grieving. We learn how to behave in school, at the movies and work, but not how to act while grieving. You may worry that friends and family will think you are not grieving enough, trapping yourself in the grieving stage just to prove your love for your spouse. Healing and moving on with your life neither proves nor disproves your love for your spouse. Being "okay" simply means that you choose to live in spite of fate's blow. It is your right to be happy, live your life and even remarry. Some survivors emerge from their late spouse's shadow to resume a career, become a family leader or a public crusader.

It has been said that we never get over the loss of a loved one, but instead we slowly integrate the loss into our lives. In his book, "The Journey Through Grief," author and grief counselor Alan Wolfelt, Ph.D. identifies six stages of grieving.

1. Acknowledging the reality of the death - it can take weeks or months to accept that our loved one is really gone.
2. Embracing the pain of the loss - although we may rather hide our pain, we need to confront it and express it with caring people.
3. Remembering the person who died - our loved one might have died but our relationship continues. We need to remember and cherish our time together.
4. Developing a new self-identity - discovering who we are without our loved one. We are changed by love and by grief. Reinvesting in life—developing a new life plan.
5. Searching for meaning - we ask "why" and we look for new meaning to life.
6. Receiving ongoing support from others - seeking out people who will allow us to mourn, to cry, to remember and to realize our own value. It helps to share our burden.

We do not march through the stages of grief in a linear fashion as was previously thought by experts. Rather, each person has his or her own way of moving through the stages, often cycling back and forth among them. With time, emotions become less intense, shorter in duration and the time between grief cycles lengthens.

My mother, with whom I was very close, died several years ago. As a professional nurse and CEO of a hospice company, I "knew" intellectually about grieving. But, "knowing" intellectually about grieving and experiencing the loss of a loved one first hand are different. Early on, I was consumed with the memory of her last days. I thought of things that I could have done or said. I cried a great deal. Eventually, I found peace and acceptance of her passing. One morning while showering, I remembered being at her bedside just before her death. I burst into tears and sobbed for several minutes. I was caught off guard by the intensity of my feelings, but unlike previous months I quickly recovered to go on and enjoy the day. My grieving period was slowly coming to an end.

Acknowledging the death of your spouse can be the most difficult step in the grieving process. Your spouse's passing may seem unreal or temporary and you may have the lingering sense that he will appear at any moment. You may even look for him at the time that he normally came home, or you may expect him to be there when you return. Gradually, you will accept that your spouse's passing is real and permanent.

COMMON REACTIONS TO GRIEF

Grieving, like all feelings and emotions, is also physical. You may feel sick, tired or listless. You may not have the energy to get out of bed or get dressed. You may lose your appetite. All of these physical reactions are normal. Expect to experience any number of the common reactions to grief described below.

IT IS HEALTHY TO GRIEVE

Allow yourself to grieve fully and openly. Do not fear the painful emotions that seem to be rocking your foundation. You may cry, moan or even yell in anger. Crying is nature's way of soothing you when you are in distress. Crying releases proteins and hormones, such as prolactin, that comfort the body and purge toxins.

If you are lost in your grief, confused by the cacophony of competing feelings, emotions and physical manifestations of your loss, get help! Individual therapy and grief support groups have helped many grieving spouses. Help is available through your local hospice, your funeral home, your priest, minister or rabbi. You would not hesitate getting professional help if you were in a car accident. Don't be ashamed to seek professional help if you are bleeding emotionally.

Failing to attend to your real emotional and psychological needs will only result in continued emotional and physical dysfunction. This advice is most true for men, who would often rather "gut it out" than admit that they are hurting. The following stories in the next few pages about Beth, Norman, Susan, and John illustrate how various surviving spouses grieved the loss of their spouse.

Brian went to the emergency room when his headache did not respond to his normal course of aspirin and bed rest. Physically fit at 63, Brian adhered to a fitness plan that included daily five-mile runs. He was rarely ill, so he considered the Saturday evening visit to the hospital an inconvenience. In fact, Brian and his wife, Beth had plans later that evening.

Brian soon realized that he and Beth would not make either dinner or their movie. When the doctor entered the room, Brian was not prepared for what he was about to hear. He listened to the news calmly while intently watching Beth’s face. Beth sat perfectly still as the doctors delivered the news: Brian had a brain tumor.

As they talked about their medical options, the need for a second opinion and further tests, Beth drifted off. She remembered their home on the lake, and kayak paddling along the shore. As if looking through a scrapbook, she pictured their children setting the table for Brian's birthday dinner, wrapping presents, and packing for holidays at the cottage. As she listened to the doctor, Beth slumped into the chair next to her husband. The room and voices grew hazy. Her hands felt clammy and she could hear her heart beating loudly. Beth’s grieving had begun.

When your spouse is terminally ill, the first noticeable loss is the cadence of your former life. Before the impossible news sinks in that death is a possibility, you begin to grieve the life you had as two healthy people. The sense of loss becomes part of the fabric of your life with each visit to the doctor, each prescription, each sleepless night spent caring for the person that shares your life. In a way, your changing life helps prepare you for the more staggering reality of your spouse’s death.

Up to the moment that Brian took his last breath, one year after his visit to the emergency room, Beth believed and desperately hoped that he would recover. Her denial allowed her to forestall acceptance of his pending death and gave her enough hope to be an effective caregiver. Perhaps nature knows that we cannot endure the pain of complete acceptance all at once. Denial is a slow-drip acceptance of death, preventing a jarring downpour of grief.

Complete denial, on the other hand, would prevent you from experiencing the loving intimacy of your spouse’s last days. Knowing that the end is near and accepting death allows you and your spouse to have meaningful conversations, reunite with distant relatives, make peace with God and make final plans. One of the roles of hospice is to facilitate such end of life involvement with family, friends and clergy. Although painful, saying goodbye and making peace with loved ones allows for a level of intimacy that you may have never before experienced.

Beth deeply grieved the loss of her husband. She replayed their life together in her mind like an old movie. During their thirty-six years of marriage, they had idealized each other and rarely disagreed. His income provided a comfortable lifestyle. She raised four children and relied on Brian to handle their finances.

In the months following the funeral Beth walked around their big house like a lost child, looking for signs of Brian. Her heart leapt every time the phone rang, hoping to hear his voice. At 5:30 in the evening, she anticipated his arrival from work, her body aching with loss. Her best friend was gone forever. She thought she would never feel secure again without him.

To help her cope with her loss, Beth relied on grief support services offered by the hospice that had provided care to Brian in the last few months of his life. Like many hospices, her hospice offered bereavement support for thirteen months following the death of a loved one. Beth joined a grief group with others like her. At first she cried each time she told her story, but as time went on her grief diminished. Talking openly with other widows and widowers made her feel less alone. In fact, over time she found herself mentoring newly widowed group members, adding to her growing sense of balance and competence.

At first, Beth was intimidated making decisions without Brian. She had little or no experience filing tax returns, managing investments or administering an estate such as Brian’s. She felt a fresh stab of grief with each decision she faced as it reminded her of the calm, matter-of-fact way Brian had managed their affairs.

Gradually, Beth tackled her responsibilities with growing competence and strength. Through her efforts and the passage of time, she was able to accept her new life without Brian. By acknowledging the loss of her husband and openly addressing her grief she was free to take control of her life.

Norman was in his late 70’s when his wife, Edie, died. When Edie was alive, she and Norman enjoyed taking long, leisurely Sunday afternoon drives. They would embark with neither a plan nor a particular destination in mind. During the summer months, they stopped at roadside stands to purchase vegetables, fruits and fresh-baked pies. For Halloween, they bought pumpkins and corn stalks to decorate their porch. In the spring they filled their trunk with annuals to be planted in the large clay pots of their garden.

They stopped for dinner on each return trip. After forty years of Sunday drives, they had a favorite restaurant in every direction. Their Sunday ritual was one of the things that Norman most missed after Edie’s death. To keep her near, Norman had Edie cremated and kept her ashes with him saying: “I keep her with me, I’m comforted by that.”

Norman reeled when Edie died. Her death plunged him into a confused and listless state. He felt that his life had no meaning. Norman was the financial provider while Edie took care of hearth and home. Months after her death, Norman revealed: “Now I understand what my wife did; everything.”

As a couple, they had a small, but active social circle. They had one child, a son, Michael. Edie was the family’s social director. She organized dinners, get-togethers and holiday celebrations. She was also Norman’s link to his son, calling him weekly to invite him and his family for dinner. Norman was a stoic working man typical of his era. He enthusiastically took part in everything his wife arranged and was grateful for her making their house a home.

The dinner parties stopped at Edie’s death. Norman struggled to make phone calls and maintain contact with friends and family. While Edie was dying, Norman often talked to the hospice workers about his connection to his son, and how awkward he felt phoning him. He said, “Edie always did that, so it feels strange, even though I love my son. I’d better call him or I may never see him again.”

Norman’s daughter-in-law, Ann, tried to help father and son stay in touch. She made weekly calls to Norman to see how he was doing and often invited him to their home for dinner. Michael visited his father on his way home from work once a week to help him with home repairs and to chat. While Norman loved his son, and admired Ann, he didn’t want them to feel responsible for him. He believed he was still able to take care of himself.

Norman was in pain. Michael and Ann, realizing that Norman was too private to accept their help, suggested that he participate in a grief support group. They told him that it would be good for him to get out of the house and talk to other people who were also grieving. At first, Norman felt uncomfortable in a group of strangers and questioned how the group could help him cope with his loss. It was especially hard in the beginning because he was the only man in the group.

Unfortunately, men commonly shun help from others and actively avoid participating in support groups. They are often embarrassed to talk about their feelings or to openly admit their grief. Norman also suffered from this misguided belief, but was surprised when he began to find comfort in talking with others about his experience.

After six months in a support group, Norman no longer felt the need to keep Edie’s ashes. He called his son to discuss the best place for Edie and agreed to spread her remains at a beautiful, unspoiled place that Norman and Edie passed on their Sunday drives. On the agreed upon day, Norman, with Michael and Ann spread Edie’s ashes in a green field beneath a lovely tree.

Susan was conflicted by Joe’s death. A handsome, outgoing man, Joe was the life of the party. But out of the sight of friends, Joe drank and was abusive. After years of being deeply unhappy in her marriage, Susan began seeing a counselor. It took her months to muster the courage to leave Joe, but she steadfastly made her plans. She heard Joe crying as she gathered the children and left him. Joe was devastated. After Joe pleaded for months for her to come back, she agreed to see him provided he got help with his drinking. He was angry at Susan, but realized that complying with her demands was the only way to keep his family. He joined Alcoholics Anonymous, found a therapist and began to change his life.

Joe found a new job and stopped drinking. Susan moved back home and together they began seeing a marriage counselor. They committed to repair the damage to their marriage and move on. There were many happy days after they got back together. Rather than attending parties and group gatherings, Susan and Joe focused on family outings with their children.

Four years later Joe was diagnosed with terminal cancer. That night Susan cried in Joe’s arms. She noted with irony that he was finally being strong for her as they were facing the end. Because they needed the emotional and physical support Susan and Joe decided that they would ask for hospice care.

Despite her love for Joe, Susan was also angry at him for getting sick when things were finally going right for them. She loved her husband and he loved her. Their financial problems were behind them and he had just celebrated four years of sobriety. His illness was a violent blow that neither of them was prepared to handle. As Susan overcame the initial shock of the news, she became increasingly preoccupied with life’s unfairness, blaming Joe for how difficult things had become.

A hospice social worker suggested that Susan keep a daily journal. Susan doubted that writing would help, but began writing about her thoughts and feelings of sorrow and rage. Before long, she found comfort in writing and began to make room for her love, anger and guilt. She decided to talk with a therapist to help her work through her feelings.

With the help of the social worker, her therapist and Joe, Susan made a conscious decision to put her anger aside and enjoy the limited time she and Joe had left to them. They spent Joe’s final weeks together. Susan stroked Joe’s forehead and promised him that their children would grow up to be adults that would make him proud. Joe began to plan his funeral, selecting songs, readings from the Bible and some favorite poems. They cherished their family time talking to the kids about what was ahead.

When Joe died Susan was lost. After devoting so much of her energy to caring for Joe, she now had a difficult time focusing on everyday tasks. Susan’s family became alarmed when, months after Joe’s death she had not regained her appetite. She ate only chicken broth and tea, and had dropped to 100 pounds on her 5’ 5” frame. She had stopped seeing her therapist and appeared to have given up.

One night she was awakened to the sound of her daughter crying. Susan tried to get up but was dizzy and disoriented. She was unable to discern whether her daughter was truly crying or if she was imagining the noise. She climbed into bed with her, and held her daughter’s sobbing body, as she cried for daddy. Susan had fallen so deeply into her own grief that she could not see her children’s suffering. In the morning, Susan called her doctor and her therapist. She was confused and barely functioning, but knew something had to be done.

Susan’s initial reaction to Joe’s death was normal. After the repair of their marriage, she was angry at the unfairness of Joe’s illness. Remembering from their separation what life had been like without him she was afraid to continue alone. Unfortunately, Susan became lost in her sorrow neglecting herself physically, leaving her children confused and alone. Startled into reality by her daughter’s night terrors, Susan was able to solve her self-destructive behavior and provide the necessary support and comfort to her children.

Twice a week John played tennis with the guys from work. He loved his work and the camaraderie of his co-workers. No matter how crazy the workload, he made sure that tennis was on his calendar. But in the two years since his wife, Julia felt the lump in her breast he found no joy in either tennis or his friendships.

John and Julia had been married 10 years when she was diagnosed with terminal breast cancer throwing them into what became a frantic and failed medical journey. They had a two-year-old daughter, a beautiful new home and a happy life built on love.

Julia loved Christmas and passionately decorated for the holiday. They hosted numerous holiday parties inviting his co-workers, family and friends. Julia, an architect, liked to create beautiful environments and Christmas was the holiday that most inspired her. They enjoyed shopping for their daughter. John was proud of his wife, her beauty and quick mind. He liked to buy her one special gift at Christmas, usually a piece of jewelry or something for the house. John shopped with a heavy heart the Christmas Julie was ill knowing that he could not buy her the only gift she wanted; life.

When they talked about their daughter, tears streamed down Julia’s face. John wanted to save Julia, and he wanted their life to be like it was before the illness. Chemotherapy treatments made party planning, decorating and shopping impossible tasks for Julia. John could not muster the energy to do it for her. He hired someone to decorate their tree and hang lights. Even if it did not feel like Christmas, it would look like Christmas at their house.

When Julia died, one year after her diagnosis, John felt that he had also died. Routine chores like going to the grocery store or making dinner became burdensome. While his sister and mother helped, he lay in bed and stared at the ceiling. Oddly, he was relieved by Julia’s death. It pained him to watch her suffer, to see her sadness when she held their daughter and to watch her beauty fade. John was learning that the anguish of grief could be as intense as the joy of love.

John did not return to work for a month after her death. He avoided all conversations about his wife and their ordeal. Although he tried hard to focus, John found it difficult to concentrate on work.

His employer and his clients were understanding, and temporarily shifted his responsibilities.

After several months, he began to play tennis once a week. He didn’t play well, but it felt good to use his muscles. One day in the locker room after a match, his friend Mike asked about Julia. John found it too painful to talk about her. He hurried to pack his things and left the club. Alone, John cried in the car.

The first Christmas after Julia’s death, John thought that decorating their tree would be too painful. His mother and sister insisted that he celebrate the holiday for his daughter’s sake. Relenting, John agreed to let them decorate their tree. Although the lovely tree and festive room evoked painful memories of Julia’s passion for the season, he was buoyed by his daughter’s joy.

HELPING OTHERS HELP YOU GRIEVE

Death can make the most socially skilled among us feel awkward and uncertain. We often don’t know how to adequately express our condolences.You can help your friends and family by telling them how they can help. For example, you might tell them that you look forward to their phone calls, or that they should stop by regularly to check on you. In the beginning, you may feel reluctant to express your needs, but it will get easier. Friends and family want to help you through this time, but don’t want to interfere. Give them direction. Accept their love and kindness. All will benefit.

THE IMPORTANCE OF SELF-CARE

Caring for yourself is neither selfish nor self-indulgent. Neglecting your physical or mental health is harmful to you and your family. The death of a spouse is a significant risk factor for developing serious illness. Proper rest, healthy meals and light exercise will nurture your body and mind. Deep breathing and relaxation techniques will calm you and create a place for healthy thoughts.

If the people that love you are worried about you, hear them. Although it may seem that they are interfering, they mean well. They may be more objective about your health than you are during this period. Seek help and advice from your family and friends, grief support professionals or from your minister. If it is difficult to share your feelings with those closest to you, seek out a neutral counselor.

BEGINNING A NEW LIFE

If you are like most married couples, your spouse was an integral part of your identity. You were seen as a “couple” by your friends and neighbors. Your hobbies, vacations and entertainment choices were influenced by things your spouse liked doing or you enjoyed doing together. Without your spouse you may feel like a “fish out of water.”

You begin a new life the day your spouse dies. Assess your hobbies, friendships, where you live. Are they right for you? If not, replace them with new activities and rituals. Perhaps you want to get your college degree, write a book, make jewelry or travel? Make a plan now for the rest of your life. On the other hand, avoid rash decisions. Often, strong emotions interfere with clear thinking. Carefully consider major changes. Seek the advice of others.

HOLIDAYS AND SPECIAL OCCASIONS

Holidays and special occasions may be especially difficult for you. We expect special occasions to be a time of joy and togetherness. Your spouse’s absence at such times is a painful reminder of your loss. You may dread the approaching month of your spouse’s birthday, your wedding anniversary or your first Thanksgiving alone. The first year can be especially difficult, filled with “firsts” without your loved one. As time passes, your grief, even at holidays and special occasions, will subside.

Give yourself the freedom to change or replace your old traditions. You may decide to forego mailing holiday cards in favor of writing a few intimate letters to special friends or family. Plan a special outing with a friend or relative, like going to a movie, visiting an art museum or trying a new restaurant. Once you decide what is best for you, communicate your wishes to your friends and family.

KEEPING THE MEMORY OF YOUR SPOUSE ALIVE

John didn’t remember exactly when the pain began to lift. Soon he was playing tennis regularly at or near his former level of play. John was reluctant to talk openly about Julia believing that it would make his friends uncomfortable. However, in the locker room one day John told his friend Mike that he had decided to wear a small gold medal that he had given Julia. “She really liked this medal and it reminds me of her,” he said.

Despite bringing tears to his eyes, John also began talking to his daughter about Julia. He told her, “Mommy would love the way you look in this dress. I wish she could see you.” But as time went by, Julia became a normal part of their conversation and this was a way of keeping her spirit alive.

He placed a picture of Julia in his daughter’s room. They talked about her in the quiet moments before she went to bed. He was careful to recall specific memories of Julia’s laugh or her favorite sayings so that his daughter would never forget her.

He was shocked the first time someone mentioned dating. John thought: “Are you kidding? No way!” Yet, as time passed, John longed for the intimacy he shared with Julia. One day he noticed a pretty woman at the grocery store. He stopped short, feeling disloyal to Julia. To avoid eye contact, he focused his attention on his groceries and picked up a magazine to avoid eye contact. John felt awkward. It was the first time that he had noticed another woman since Julia’s death. At that moment he realized that he did not want to continue his life alone. One day, when the time was right, he would meet someone to share a laugh, his love and his life.

You need not forsake your love for your spouse. You couldn’t if you tried. Your spouse is a part of your life’s fabric, woven into your soul by years of living and loving. Cherish the memory of your spouse. Maintain the memory of your spouse as an integral part of your history. Don’t allow mention of your spouse to disappear from conversation. Share a story, a laugh about a funny incident and display photos where you will see them during the day.

Allow yourself to grieve fully.

Surround yourself with friends and family who love you. Talk to them and let them help. Become involved in the bereavement program of your local church, hospice or funeral home. Take time to nourish your body and spirit. Eat well, get adequate sleep and exercise. If you are stuck in unhealthy grief that jeopardizes your long-term physical or emotional health seek the help of a professional therapist. You may not recognize that you are in physical or emotional danger. Rely on the “eyes” of family and friends who may be better able to objectively assess your coping skills.

Gradually, the intensity of your grief will subside. Holidays, a song on the radio or special occasions may trigger unexpected tears or feelings. With time, you will recover more quickly from these episodes.

We are never the same after the death of a loved one. As we grieve our loss, we are also reminded of our own mortality. We may wonder and reflect about how we will use the balance of our time on this earth. Nothing defines life more than death. It is a time to examine our relationships and our personal, professional, financial and spiritual objectives. Your spouse’s death may ignite a healthy sense of urgency about your life.

There is much to do in the weeks and months that follow your spouse’s death. Your duties may temporarily distract you from your grief, but don’t “lose” yourself in them. Move at your own speed. Enlist the help of family, friends and professionals. When you sense that you are racing, becoming frantic and losing touch with yourself, stop, breathe and make time for yourself.

Sometimes, amid the cacophony, I stop
and feel the cool breeze on my face.
I draw a long deep breath,
filling my lungs with moist fresh air.
I pause and savor a complete exhale.
I linger, I wonder, I think, that for at least this moment
It is good to be alive.
Franco Bollo (The Healing)