• Share the sorrow- Allow or encourage the bereaved person to talk about feelings of loss and share

memories of the deceased person.

• Don’t offer false comfort- Saying such things as “It’s all for the best” or “You’ll get over it in time” is
not helpful. Instead, simply express sorrow and take time to listen.
• Offer practical help- Babysitting, cooking, and running errands are ways to help someone who is
grieving.
• Be patient- It can take a long time to recover from a significant loss. Be available to talk and listen.
• Suggest professional help when necessary- Don’t hesitate to recommend professional help when it
appears that someone is experiencing too much pain to cope alone.
TABLE 1 Helping Someone Who Has Lost a Loved One
This may help someone you know through the grieving process:
Source: National Mental Health Association, n.d.

The 5 Stages of Grief by Elisabeth Kübler-Ross

1st stage: Denial – it helps to reduce the overwhelming feeling of pain and loss. Denial attempts to slow
this process down; one step at a time rather than risk the possible overwhelming feelings and emotions.
It is also the time of trying to absorb and understand what is happening.

2nd stage: Anger - it allows us to express emotion with less fear of judgment or rejection. Also, it tends to
be more socially acceptable than admitting of being scared. There is so much to process that anger may
feel like it allows us an emotional outlet.

3rd stage: Bargaining – it allows us to cope up with loss and to seek for some help directing the requests
to a higher power, or something bigger than we are that may be able to influence a different outcome.
The feeling of helplessness can cause to react in protest by bargaining. While bargaining, the focus is on
the personal faults or regrets.

Example of bargaining: "I promise to be better if you will let this person live."

4th stage: Depression - it is the start of feeling the loss of loved one more abundantly. As the panic
begins to subside, the emotional fog begins to clear and the loss feels more present and unavoidable. In
those moments, the sadness grows big and it can lead to isolation.

5th stage: Acceptance - in acceptance stage, it does not mean that person is no longer feel the pain of
loss. However, they no longer resisting the reality of the situation, and they are not struggling to make it
something different.
REFERENCE: Clarke, J (2020). The Five Stages of Grief: Learning about emotions after loss can help us
heal. Verywellmind. Retrieved from https://www.verywellmind.com/five-stages-of-grief-4175361

ATTITUDES ABOUT DEATH AND DYING ACROSS THE LIFE SPAN

There is no single way of viewing death at any age; people’s attitudes toward it reflect their personality
and experience, as well as how close they believe they are to dying. Broad developmental differences
apply. Typical changes in attitudes toward death across the life span depend both on cognitive
development and on the normative or nonnormative timing of the event.

Childhood and Adolescence

CHILDREN

(Speece & Brent, 1984), sometime between ages 5 and 7 most children come to understand that death
is irreversible —that a dead person, animal, or flower cannot come to life again.

 Children realize two other important concepts about death: first, that it is universal (all living
things die) and therefore inevitable; and second, that a dead person is nonfunctional (all life
functions end at death).
 They also may believe that a dead person still can think and feel. The concepts of irreversibility,
universality, and cessation of functions, these studies suggest, usually develop during the shift
from preoperational to concrete operational thinking, when concepts of causation become
more mature.
 Research suggests that children may acquire a partial understanding of what happens after
death as early as age 4, but that understanding may not be complete until well into the school
years.

Age 7: 91 percent of the children were consistent in their knowledge that such biological processes as
eating and drinking cease at death.

 Can better understand death if they are introduced to the concept at an early age and are
encouraged to talk about it.
 Children sometimes express grief through anger, acting out, or refusal to acknowledge a death,
as if the pretense that a person is still alive will make it so. They may be confused by adults’
euphemisms: that someone “passed on” or that the family “lost” someone or that someone is
“asleep” and will never awaken.
 (AAP Committee on Psychosocial Aspects of Child and Family Health, 1992), Adjusting to loss is
more difficult if a child had a troubled relationship with the person who died and if the child has
had previous behavioral or emotional problem.
 Parents and other adult caregivers can help children deal with bereavement by explaining that
death is final and inevitable and that they did not cause the death by their misbehavior or
thoughts.
- The death of a pet may provide a natural opportunity.
- If another child dies, teachers and parents need to try to allay the surviving children’s
anxieties.
- For children with terminal illnesses, the need to understand death may be more
pressing and more concrete.
- Parents may avoid bringing up the subject, whether because of their own difficulty in
accepting the prospect of loss or because they are trying to protect their child. In so
doing, they may miss an opportunity for the child and family to prepare emotionally for
what is to come (Wolfe, 2004).
Note: In the Piagetian framework discussed in other chapters, we learned that children have difficulty
with abstract thought, so euphemisms used to describe death can be confusing to them.

TABLE 2 Manifestations of Grief in Children

The way children show grief depends on cognitive and emotional development.

Under 3 Years 3 to 5 Years School Age Children Adolescents

Regression Increased activity Deterioration of school Depression

Sadness Constipation performance caused by Somatic complaints
Fearfulness Soiling loss of concentration, Delinquent behavior
Loss of appetite Bed-wetting lack of interest, Promiscuity
Failure to thrive Anger and temper lack of motivation, Suicide attempts
Sleep disturbance tantrums failure to complete Dropping out of school
Social withdrawal Out-of-control assignments, and
Developmental delay behavior daydreaming in class
Irritability Nightmares Resistance to attending
Excessive crying Crying spells school
Increased dependency Crying spells
Loss of speech Lying
Stealing
Nervousness
Abdominal pain
Headaches
Listlessness
Fatigue
Source: Adapted from AAP Committee on Psychosocial Aspects of Child and Family Health, 1992.

ADOLESCENCE

 Death is not something they normally think much about unless they are directly faced with it.
 Many of them take unnecessary risks like hitchhike, drive recklessly, or experiment with drugs
and sex—often with tragic results.
 Their urge to discover and express their identity, they tend to focus more on how they live than
on how long they are likely to live.

ADULTHOOD

Young Adults - who have finished their education and have embarked on careers, marriage, or
parenthood are generally eager to live the lives they have been preparing for. If they are suddenly struck
by a potentially fatal illness or injury, they are likely to be extremely frustrated and angry. Rather than
having a long lifetime of losses as gradual preparation for the final loss of life, they find their entire
world collapsing at once.
Middle Age - (Neugarten, 1967), most adults understand that they are indeed going to die. Their bodies
send them signals that they are not as young, agile, and hearty as they once were. More and more they
think about how many years they may have left and how to make the most of those years.

Older Adults – (McCue, 1995), have mixed feelings about the prospect of dying. Physical losses and
other problems and losses of old age may diminish their pleasure in living and their will to live. Some
older adults give up on achieving unfulfilled goals. Others push harder to do what they can with life in
the time they have left. Many try to extend their remaining time by adopting healthier lifestyles or
struggle to live even when they are profoundly ill (Cicirelli, 2002). According to Erikson, older adults who
resolve the final critical alternative of integrity versus despair achieve acceptance both of what they
have done with their lives and of their impending death. One way to accomplish this resolution is
through a life review.

 Middle-aged and older adults may prepare for death emotionally as well as in practical ways by
making a will, planning their funerals, and discussing their wishes with family and friends.
 People who feel that their lives have been meaningful and who have adjusted to their losses
may be better able to face death.

SIGNIFICANT LOSSES - Difficult losses that may occur during adulthood are the deaths of a spouse, a
parent, or a child.

SURVIVING A SPOUSE - women tend to live longer than men and to be younger than their husbands,
they are more likely to be widowed.

 (Federal Interagency Forum on Aging-Related Statistics, 2010), 25 percent of U.S. women, but
only 7 percent of U.S. men, lose their spouse by age 65.
 (Stroebe, Schut, & Stroebe, 2007), The stress of widowhood often affects physical and mental
health. Bereavement can impair the immune system, resulting in headaches, dizziness,
indigestion, or chest pain. It also entails higher risks of disability, drug use, hospitalization, and
even death.
 (Martikainen & Valkonen, 1996), In a large-scale Finnish study, men who lost their wives within
the 5-year period of the study were 21 percent more likely to die within the same period than
men who remained married, and widowed women were 10 percent more likely to die than
nonwidowed women.
 (Ray, 2004), Thus, the loss of companionship may help explain why a widowed person, especially
a widower, may soon follow the spouse to the grave.
 (Carr et al., 2000), The quality of the marital relationship that has been lost may affect the
degree to which widowhood affects mental health. In one study, widowed persons who had
been especially close to, or highly dependent on, their spouses tended to become more anxious
and yearned more for their partners 6 months after the death than did widowed persons who
had not been so close or dependent
 (Marks & Lambert, 1998), The loss of a husband may be especially hard for a woman who has
structured her life and her identity around pleasing or caring for him.
 (Hungerford, 2001), widows whose husbands were chief breadwinners may experience
economic hardship or fall into poverty.
  For Women: the main consequences of widowhood are more likely to be economic strain,
whereas for men the chief consequences are more likely to be social isolation and loss of
emotional intimacy (Pudrovska et al., 2006).
- women said they had become stronger and more self-confident as a result of their loss
(Carnelley, Wortman, Bolger, & Burke, 2006).
 Older Widows: are more likely than older widowers to stay in touch with friends from whom
they receive social support (Kinsella & Velkoff, 2001).
 Widows continued to talk and think about their deceased husbands decades after the loss, but
these thoughts rarely upset them.
- Bereavement also can lead to memory problems, loss of appetite, and difficulty with
concentration, and it heightens the risks of anxiety, depression, insomnia, and social
dysfunction.
- (Lieberman, 1996), ultimately, the distress of loss can be a catalyst for introspection and
growth—for discovering submerged aspects of oneself and learning to stand on one’s
own feet.

LOSING A PARENT IN ADULTHOOD - The loss of a parent at any time is difficult, even in adulthood. In-
depth interviews with 83 volunteers ages 35 to 60 found a majority of bereaved adult children still
experiencing emotional distress—ranging from sadness and crying to depression and thoughts of suicide
—after 1 to 5 years, especially following loss of a mother (Scharlach & Fredriksen, 1993).

TABLE 3 Self-Reported Psychological Impacts of a Parent’s Death on Adult Children

It can push adults into resolving important developmental issues: achieving a stronger sense of self and
a more pressing, realistic awareness of their own mortality, along with a greater sense of responsibility,
commitment, and attachment to others (M. S. Moss & Moss, 1989; Scharlach & Fredriksen, 1993).

IMPACTS DEATH OF MOTHER DEATH OF FATHER

(PERCENT) (PERCENT)
Self-concept

More “adult” 29 43
More self-confident 19 20
More responsible 11 4
Less mature 14 3
Other 8 17
No impact 19 12
Feelings about mortality

Increased awareness of own mortality 30 29

More accepting of own death 19 10
Made concrete plans regarding own death 10 4
Increased fear of own death 10 18
Other 14 16
 No impact 17 23
Religiosity

More religious 26 29
Less religious 11 2
Other 3 10
No impact 60 59
Personal priorities

Personal relationships more important 35 28

Simple pleasures more important 16 13
Personal happiness more important 10 7
Material possessions less important 5 8
Other 20 8
No impact 14 36
Work or career plans

Left job 29 16
Adjusted goals 15 10
Changed plans due to family needs 5 6
Moved 4 10
Other 13 19
No impact 34 39
Source: From Scharlach, A. E., & Fredriksen, K. I. (1993). Reactions to the death of a parent during
midlife. Omega: Journal of Death and Dying, 27, p. 311, Table 1. Copyright 1993 by Baywood Publishing
Company, Inc. Reproduced with permission of Baywood Publishing Company, Inc. in the format Textbook
via Copyright Clearance Center.

 (Aldwin & Levenson, 2001), The death of a parent often brings changes in other relationships. A
bereaved adult child may assume more responsibility for the surviving parent and for keeping
the family together.
 The intense emotions of bereavement may draw siblings closer, or they may become alienated
over differences that arose during the parent’s final illness.
 A parent’s death may free an adult child to spend more time and energy on relationships that
were temporarily neglected to meet demands of caregiving.
 (Scharlach & Fredriksen, 1993), this awareness can be an opportunity for growth, leading to a
more mature outlook on life and a greater appreciation of the value of personal relationships.
 Recognition of the finality of death and of the impossibility of saying anything more to the
deceased parent motivates some people to resolve disturbances in their ties to the living while
there is still time.