Every one of us is likely to be touched by the
death of someone we know at some stage in our lives. The loss of a
family member, friend or anyone else who feels significant can be a
bitter blow. The way in which the person has died may lay down its
own distressing memories or leave unanswered questions. Death can
trouble us soon afterwards, a time when there are also practical
issues to sort out, as well as many years later. Bereavement
is the most stressful event we can go through (above moving house
and divorce on the scale.). While this fact makes sense it can be a
challenging time to get through when feeling raw and already
managing mental health problems.
I recently lost my father to prostate cancer
and had to confront a loss I didn’t expect for some years yet. His
illness was diagnosed at a very advanced stage at which all medical
help could do was try to make him comfortable. He lived for 18
weeks in a way which was hard for him to endure and for me to
witness. His death marked the end of his suffering but a new stage
of life for me. I have ongoing mental health difficulties which
have affected me for 15 years but this is my first major experience
of bereavement. This is my own account of the practical and
emotional issues that have come up so far.
The practical things to do after someone’s
death depend on the place where they died and will usually be the
responsibility of those closest in relationship. My dad died in a
hospice where a doctor signed a certificate about the cause of his
death the following day. If the death has been at home a GP
would need to be called to complete the death certificate.
Unexpected, suspicious deaths (which would include suicides) those
in prison and also where the doctor had not seen the person
recently, would be reported to the local Coroner who would decide
whether to investigate.
The practical arrangements were very stressful
but I was not the only family member. I found funeral directors to
be sensitive and able to assist with any plan for burial or
cremation. The death has to be registered at the registry offices
of the local council as a priority. The Department of Work
and Pensions may make a funeral payment if someone is on certain
means-tested benefits and responsible for organising the funeral,
there are also bereavement benefits in some circumstances where the
bereaved is a partner. A solicitor may need to be consulted over
issues such as wills, probate and legacies where complex. There is
information on the website www.direct.gov.uk about all
practical issues. You can also contact your nearest Citizens Advice
Bureau where trained advisers will be able to help you. The DWP has
a booklet called
What to do after a death?
My biggest worry then became the funeral and
getting through it. I tend to feel faint (a feature of my anxiety
disorder) and didn’t know that I would be able to stay standing for
the duration of the service at the cemetery. The funeral did pass
and provided a sense of closure. I now gain comfort from the fact I
have a grave to visit and the peaceful surroundings where my dad’s
body has been laid to rest. Funerals have personal significance and
spiritual importance depending on that person’s beliefs. Different
religions have their own customs around death and its meaning.
Talking to a faith leader or minister may be an important part of
the grieving process for you. Some people may not want any
religious element to their funeral, for example, choosing a
Humanist content, there are also natural burial sites in
woodland.
The emotions that hit me after my dad’s death
were a mixture of shock, relief and tearful distress that he had
been through so much. Then I began to feel as though I could have
done far better for my dad to the extent where anything less than
being angelic was not good enough. I remember feeling very empty
after the funeral and it seemed as though I had much time on my
hands where before this all my thoughts had been focused on my
dad’s ill health. I understood not to make big decisions in case I
later regret them. Two months later I can feel that ‘no-one
understands’ despite knowing otherwise, and as though I am separate
from the world because my experiences are so far from everyday
conversation. When people remark ‘but you look well’ they have
little idea of my intense emotional hurt and inner turmoil. My own
recurrent depression feels more intense and now has a tangible
cause. I have heard that it will get easier as the days pass,
although no time scale can be given.
I try to see the positives such as the close
relationship with my dad and how I managed to say everything I
wanted to him so that nothing felt unresolved. I have relied on my
own support network and confided most in my community psychiatric
nurse. My consultant psychiatrist has shown real understanding and
offered me the opportunity to make appointments as needed. It has
been important for me to let go of any guilt as I know I did my
best at the time. I need to try to be kind to myself including
enough sleep, food and not becoming withdrawn. I also try to resist
doing too much of anything, for me this is around my eating as I
have a history of severe anorexia. For others it could be drinking,
smoking or drug use, as a way of burying or avoiding feelings.
Keeping an eye out for any symptoms that may return from previous
episodes of mental illness may help to prevent a crisis.
If you feel that you are not coping with your
own grief there is bereavement counselling. This may be provided
privately, by voluntary organisations such as Local Mind
Associations, from NHS primary care or specialist mental health
services. GPs can also refer to psychiatrists to diagnose and treat
mental illness that may be triggered by bereavement. Cruse
Bereavement Care have a national information service and helpline
0844 477 9400. I have found a supportive cancer
drop in centre open to anyone affected by cancer. Many hospices or
hospitals where the person was cared for until their death offer
bereavement support services.
While no-one knows exactly how it feels for
you at this sad time there are many people, such as friends and
professionals who can empathise and want to help towards a sense of
recovery where you learn to live with a loved one’s death. There
are many emotions and certain well recognised stages of grief
though you go through them at your own pace and in no set sequence.
I had issues within my own mental health management I was trying to
address before my dad’s death and now believe I can’t let this
event take away all I was working toward. You can’t be expected to
feel on top form whilst going through bereavement, but you don’t
have to go it alone on the path to acceptance and moving
forward.
Alex
Alex is a service user. Her father died from prostate cancer two
months ago
Sept 2009
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In this section of the website we publish personal
contributions that focus on peoples' experience of being
unwell or on their recovery. Ideally they should contain
information that others might find useful. The views expressed in
these articles are personal. They do not necessarily reflect the
vews of the Royal College of Psychiatrists.