How do I get through this?

Understanding grief

We have been told that the death of a loved one may bring about profound changes. Grief is our normal response to life's losses as well as a natural part of the cycle of change. It is not an event but a process which takes time to unfold. Often, with the initial shock, people don't feel the full impact of the loss right away. It may come sometime later, when all the activity surrounding the funeral or service is over, and the initial shock has worn off.

People have different ways of expressing their feelings around death. You may feel the need to cry or talk about your feelings. Some people become focused on "doing something", while others prefer to work it through alone. There is no right way to grieve. Do what you need to do.

While every individual experiences loss differently, a number of reactions may be experienced as part of grief. Some people experience these feelings in a matter of days - for others, these feelings can come and go, on some level, throughout life.

Shock - "I just can't believe it."

The first actual announcement that a death has occurred is often shocking. The impact of the tragedy may take a few minutes, or days, or weeks, or even longer to realize. This sense of shock may occur even if you are "prepared" for the death. The sense of unreality of the death may even reoccur in the future.

Emotional release - "I can't stop crying."

Tears may be one reaction to death, and may ease the tension and strain of grieving.

Guilt - "I should have..."

Frequently, survivors recall things that they think could have been done for the person who died. These feelings of guilt are common, and frequently are tied to our sense of regret when someone dies. Sometimes people even experience guilt stemming from situations that were beyond their control, for example in the case of traumatic, sudden death.

Anger - "Why me? It's not fair!"

You may feel anger toward the health care team, family, friends, or the deceased for leaving you alone, or anyone you think might have been able to prevent the death, and even toward the Creator. These feelings can be both surprising and uncomfortable. Disclosing these feelings may be helpful.

Sadness - "Is life worth living? Life will never be happy again."

Sadness is a feeling which you turn inwards, and is highly personal. A feeling of weariness may develop from depression and frustration. Sometimes, people can't imagine how they will go on living. At times, suffering in silence seems easier than sharing with others. No one has ever felt these feelings exactly as you do. Memories of your loved one may be both joyful and sad, but in time, the sadness will lessen. Be patient with yourself. The expression of sadness is not a sign of weakness but an indication of strength.

Depression - "Life is not worth living. What's the point?"

Bereaved people often feel deep despair, unimaginable loneliness, and a sense of hopelessness - nothing feels worthwhile. Your life has changed and you feel that you cannot adapt. These feelings are most intense if you are on your own, or have limited family or social supports. Depression is not just feeling sad. It is a combination of emotions and physical reactions which can go on for a long time. Prolonged depression, panic, a desire to run away, and suicidal thoughts may occur. If you are experiencing any of these, it is time to get help and consult a professional.

Loneliness - "I just can't bear it. Without her/him, I can't go on."

Bereaved people often feel isolated. Quiet times can be most difficult after friends and family leave and return to their daily routine. Anxiety and loneliness can create emotional pain. The strain of grief can even cause physical distress. If you find that physical symptoms continue for any period of time, you may want to contact your family doctor.

Confusion and preoccupation - "I feel like I'm going crazy!"

It may be difficult to concentrate on anything because of constant memories of the deceased. Your mind is bombarded by a storm of emotions and thoughts. This could result in you experiencing confusion, memory loss, having trouble concentrating or making decisions. It might feel like you are "going crazy." This state of confusion is temporary. In fact, continual preoccupation with the loss may cause us to worry about our own stability, and feel that we are losing control. Not knowing what to do and not understanding what is happening can result in panic. Give yourself time to remember as well as a way to remember - perhaps by creating a memory book, or framing a special photograph. Move forward at a pace that is comfortable for you.

Lost - "We had plans together... I don't know how to go on alone."

The death of a loved one may involve the death of your dreams, and the loss of your future as you thought it would be. You may feel completely lost. This feeling is often accompanied by intense anxiety over what the future holds for you. Part of the healing process is to regain a sense of self and purpose. You will either need to work towards this, or it may happen without you even being aware of it.

Relief - "I feel lighter... she/he would have wanted it this way."

If the death has followed a long illness, you may feel a sense of relief that the suffering is finally over. This does not mean a lack of love for your loved one, and will not lessen your times of sadness, loneliness and tears. It is okay to feel relief. You can strike a balance between your feelings of loss, and honouring your loved one's memory.


Checklist - signs and symptoms of grief

In addition to the roller-coaster of feelings, there are a number of other reactions related to grief. They may occur at any point in the bereavement process - early on, or much later, even when you might think that you are no longer experiencing the effects of grief. Although there is a wide range of grief reactions, some common ones are listed below:

Physical reactions

  • exhaustion, sighing
  • change in appetite
  • susceptibility to illness
  • sleeping problems
  • lack of strength
  • headaches
  • lack of/increase in energy
  • increased sensory awareness
  • change in self care
  • numbness
  • palpitations/breathlessness

Spiritual beliefs

  • spiritual confusion
  • questioning belief system
  • shattered faith
  • loss of hope
  • search for meaning/purpose
  • support from Higher Power/God

Behavioural reactions

  • disoriented to time and place
  • searching and yearning
  • blaming others
  • apathy

Thought processes

  • impaired self-esteem
  • repeated review of events
  • detached from surroundings
  • difficulty concentrating
  • increase/decrease of dreams

Associated feelings

  • emptiness
  • despair
  • hopelessness
  • helplessness
  • bitterness
  • euphoria


Getting through the crisis

Grief "work"

It is often difficult to come to grips with the full reality of what has happened. Some people say that viewing the body of the deceased and discussing the death with friends, helps them to begin accepting the permanency of the loss.


As soon as you are able, you might want to accept the sympathy of people. Their warmth and support may be helpful at this critical moment, and throughout the grief process. Being with friends, sharing your feelings with them, is one way to allow others to show they care.

Hasty decisions

Sometimes we might be tempted to make hasty decisions during periods of crisis or loss.


Your own memories of the person who died are important. By remembering the past, good and bad, you may eventually be able to move on.

Consulting professionals

Feel free to contact your clergy, faith leaders, family doctor, and/or local grief support services. They can all be excellent resources.

Caring for yourself

"I don't have time to think about myself."
All of the practices that make sense for maintaining good health are more important to remember now. There is a strong relationship between high levels of stress, such as that which is endured when a loved one has died, and your body's ability to resist illness.

Do what you can to take the best care of yourself physically, emotionally, and spiritually. It is important to remember to get enough rest, eat nutritious food, exercise and share your feelings with someone you can trust and feel comfortable talking to.


Location and contact

Palliative care unit admissions (K1E/K1C)

For Palliative Care Unit Referrals.
Please refer to Making A Referral
Phone: 416-480-6182
Fax: 416-480-6118

Palliative care consult team

For inpatient consultations and ambulatory care clinic visits.
Please refer to Palliative Care Consult Team
Phone: 416-480-6100 ext. 67255
Fax: 416-480-5146
Monday - Friday: 8:00 a.m. - 4:00 p.m.

If you have any questions regarding palliative care referrals and resources, please do not hesitate to contact us.

For urgent matters outside of business hours, please call locating at 416-480-4244 and ask the operator to page the "on-call palliative care physician/consultant".

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