Losing a loved one is part of life, and yet few experiences find us so unprepared. Death remains hard to name, and even harder to imagine until it touches close by. The World Health Organization (WHO) considers grief one of the most severe stressors, particularly in the face of the loss of a partner, a child, or a parent. Universal yet profoundly personal, every grief raises more questions than certainties. Can one speak of an expected duration? Is it necessary to go through five stages? What place do emotions such as anger, guilt, or even relief have? Is it possible to prepare for a loss? How to distinguish one’s own pain from grief that requires professional help?
Lorena Etcheverry, a psychologist, and María del Pilar Mendiguren, coordinator of Nursing for the Integrated Care Unit at Austral University Hospital, work daily with these questions. They are part of the palliative care team, whose care also extends to families, and they coordinate workshops to help those going through grief. From that experience, they debunk some common assumptions and sketch a map to navigate the absence.
Do we have to go through the famous five stages?
Denial, anger, bargaining, depression, and acceptance are not rigid stations that must follow one after the other. Today, the specialists explain, grief is conceived in a more dynamic way, with progress and setbacks. From this viewpoint, we speak of tasks: to accept the loss, to give vent to emotions, to reorganize a life that has changed, and to rebuild the bond with the person who has died. “There is movement toward accepting death and learning to live with that absence, and another, opposite, that tries to hold on to that person and deny the pain,” describes Dr. Etcheverry. Grief unfolds in that tension: it does not follow a straight line nor does it require completing one stage to move to the next.
How long does grief last?
There is no set deadline or a date from which someone should have overcome it. The year often used as reference actually refers to the first holidays, birthdays, and anniversaries without the loved one. But each grief has its own pace, influenced by the closeness and dependence of the bond, the circumstances of death, personal resources, age, and the possibility of rebuilding one’s own project. Also weighs what remains around you: it is not the same facing the absence in solitude as having an affectionate network and finding new places to channel energy. Losing a partner, for example, often requires redefining a future that had been envisioned as a duo.
What is it reasonable to feel?
The sadness does not monopolize grief. Anger, fear, irritability, loneliness, guilt, and even relief can intrude, especially after a long illness or months of care; and that relief, in turn, can awaken guilt. Reactions do not follow a single pattern: some people feel the impact immediately; others initially remain numb. Even the body can respond, with palpitations, nausea, dizziness, a feeling of suffocation or chest tightness. “Although these are emotions with an unfairly bad reputation, which we tend to flee from, not only is crying okay, but it is also sometimes necessary to feel a certain anger,” warns Mendiguren.
What can one do well?
Giving yourself time, allowing yourself to feel, and not retreating are among the team’s key recommendations. Pain is part of the process of assimilating the absence: trying to dodge it, they explain, does not necessarily shorten it. It is wise to maintain connections and accept companionship, but also, gradually, to begin putting life back into motion. “Having networks is protective. Having a life that activates is protective.”, they summarize. Looking after one’s own health, avoiding self-medication, and postponing, whenever possible, important decisions are other guidelines; and, if questions remain about what happened, asking for information or clarifications can help to understand and assimilate what was lived.
Do rituals help?
A wake, a ceremony, visiting the cemetery, or another farewell gesture can give concrete shape to an absence that is hard to assimilate, as long as they make sense to the person in mourning. Rituals mark a before and an after; perhaps for that reason, Etcheverry notes, different cultures have preserved them for centuries as ways to bid farewell and to inscribe what happened into a story.
Elaborating does not mean forgetting
The bond with the deceased does not disappear: it changes its form. And something similar happens with memory. “After a prolonged illness, memories may initially be crowded by the decline, the caregiving, and the last days; over time, those scenes tend to yield space and the person reappears beyond their illness: their character, their story, what you lived together,” says Etcheverry. For the specialists, this shift is also an indicator that grief is being processed. Missing the person can last a lifetime: processing does not require erasing the bond, but giving it another place while one’s life continues.
Is it possible to prepare for a loss?
A progressing illness tends to bring small losses before the end: autonomy, activities, roles, and ways of relating. Mendiguren calls these “microgriefs”: they allow one to adapt to changes and anticipate what is coming, but they do not amount to grief for someone who is still alive. “Until the absence is faced, grief technically does not begin,” she notes. The risk is bidding farewell emotionally too soon: deterioration might foster a disconnection capable of generating distance, abandonment, or loneliness in the patient. So, preparing does not mean disconnecting, but taking advantage of that time. Because knowing that the end is approaching offers something a sudden death does not: time to care for and accompany, but also to “leave a legacy, ask for forgiveness, say thanks, say goodbye.” adds Mendiguren.
Speak, but without forcing
The taboo around death, so present in Western society, has a cost: what is not spoken about cannot be thought of or shared easily. “It is not usually talked about, and therefore no one typically shares details of their own experience,” says Mendiguren. Talking about the end of life can open space for farewells, wishes, or unresolved matters, but it should not become a mandate. Some people need different times to face those conversations; accompanying someone also means recognizing them and not rushing what cannot yet be said.
When is it advisable to seek help?
Grief is not a disease, and pain, even intense, is part of an expected response. The alarm bell appears when that suffering overwhelms the person’s resources, becomes unbearable, or, with time, provides no relief and interferes with daily life. “Sometimes it stagnates, it gets stuck and needs support of another kind,” explain the specialists. More than counting months, then, it is important to observe whether the absence gradually integrates into one’s life or if the process seems to have become arrested.
Meeting with others
From that premise, the interdisciplinary grief team, formed by the Integrated Care service of Austral University Hospital, proposes therapeutic workshops for families of the patients who are there admitted. The team is composed of psychologists, Lic. Lorena Etcheverry and Lic. Jimena Saravia; nurses Lic. Pilar Mendiguren and Lic. Romina Vera; and music therapist Agustina Iturri. The space offers three successive monthly gatherings, aimed at different groups of relatives of patients who died in each month. In the fourth month, a joint meeting brings together all relatives who participated in the previous sessions. This instance, with higher attendance and participation of the full team, allows deeper exploration of the various aspects of the grieving process. Participation is voluntary and each person can choose to attend the corresponding group meeting and/or also participate in the joint session. And so on throughout the year. A story or a song serves as a trigger to share experiences, difficulties, and resources; the team offers guidance. But a large part of the power comes from peers: hearing in someone else’s words what one believed was strange or uniquely one’s own. The format even respects the oscillations of grief. If someone one month does not feel ready to participate, they can do so the next month: “Today not; next month, yes,” sums up Mendiguren.
The grief does not undo the bond: it gives it another form. Talking about the loss and processing what happened allows, over time, for the pain to yield space to memory and to all that person left in those who loved them. Moving forward does not require forgetting, but learning to live with a different presence.
Source: Specialists from the Austral University Hospital.
