Peace and Resolution

For the dying person, the prospect of death provokes essential questions, such as "What have I accomplished in my life?" "Has my life been meaningful?" and "What happens to me after death?" Some people find answers to these questions in spiritual and religious traditions. Others look to their work or to their family for a sense of meaning. Still others find no comfort from these sources and instead face a spiritual, religious, or personal crisis. They may ask questions such as "Why has God done this to me?" "Why now?" and "What could I have done differently that would have prevented this?" People with these questions need spiritual, religious, or mental health counseling as much as they need medical care so that they can live meaningfully and die peacefully with a sense of completion. Many hospitals and hospice programs can provide such counseling through clergy, prayer groups, and mental health services.

Peace and resolution at the end of life are important not only for dying people but for their families as well. Yet family members who are grieving may find it impossible to find peace and resolution. Although grieving is a normal process, it is always painful. It involves feelings of shock, denial, regret, anger, sorrow, uncertainty, and painful longing. A peaceful death, characterized by caring, love, a chance to say goodbye, and resolution of conflicts and unvoiced feelings, helps minimize these reactions but cannot prevent grieving. Indeed, a long-expected death can still seem unanticipated and unbelievable when a loved one finally dies.

For some people, death of a loved one brings tremendous anxiety in the months after. A loved one may develop symptoms such as headaches or vague chest, abdominal, or other pain. Some people have vivid dreams of the deceased person, sense the deceased person's presence in familiar places, or hear the deceased person's voice. These reactions are generally normal.

Tremendous variation exists among individuals and cultures as to what constitutes normal grief. For many, grief may be so intense that the ability to function is impaired. However intense grief becomes, it diminishes in most people over a period of 6 to 12 months. People who experience more prolonged periods of disabling grief may face expectations "to get over it." At the same time, they may have less support from family and friends. When the bereaved become stuck in their grief and show no sign of resuming previous life activities, counseling is appropriate.

Every person and every culture has a different timetable for working through grief. Family members should be aware that older men are especially likely to become depressed and to contemplate suicide after the death of their wives. Family gatherings and anniversaries of important events are common triggers for memories and grief. Even long after the time of death, thoughts of the deceased person never completely go away. Effective grieving is marked by the bereaved's ability to move beyond the point where loss and sadness dominate thoughts to a time when painful memories about the deceased give way to fond ones.