Many caregivers watch their loved ones endure a long, slow decline that will eventually end in death. As they age, we grieve every mental and physical loss they incur. At the same time, we struggle with mixed emotions about how their passing will bring an end to their discomfort and indignities. Some struggle greatly with both dread and anticipation when it comes to thoughts of a loved one’s death.

The whole process is nearly too much to bear. Rather than facing the complexities of our anticipatory grief, far too many of us stuff our emotions deep down in an attempt to simply get on with life. This approach may enable us to get through our day-to-day responsibilities, but it isn’t a healthy or sustainable way of coping with these difficult yet very normal feelings.

Healthier Ways to Handle Grief

No matter how hard we try to suppress them, challenging emotions like sadness, fear, anger, confusion, shock, loneliness, guilt and regret always manage to surface in one way or another. Grief is a mentally exhausting process that can cloud our judgement, impair our ability to focus and leave us feeling scattered, but these feelings can affect our physical health as well. This is why self-care is crucial for caregivers, especially those who are experiencing anticipatory grief or have recently suffered a loss.

Prioritize Your Physical Health

It can be very easy to neglect your physical needs while grieving. As difficult as it may seem, making every effort to get adequate sleep, eat nutritionally balanced meals, and fit in regular exercise and intentional relaxation can do wonders.

“Sleep is one of the best medical ‘treatments’ available, especially for grief and shock,” says Margo Rose, a fitness trainer with more than 15 years of experience who specializes in practical ways of managing loss, stress and disappointment. Rose is the author of Body Aware Grieving: A Fitness Trainer’s Guide to Caring for Your Health During Sad Times.

“It is very common for people to want to sleep much more than they are used to while going through an upsetting time. This natural tendency is generally worth giving in to without feeling guilty,” Rose explains. “However, another typical response to stress can be the exact opposite: difficulty falling and staying asleep. Being sleep deprived can impair all our senses, especially the abilities to think clearly and stabilize our moods.”

When we are well rested, we are better prepared to handle both emotionally and physically demanding situations. Unfortunately, quality sleep is often in short supply for family caregivers who keep unusual hours to ensure seniors’ needs are met. These sleep habits tend to persist even after a loved one’s passing, and it often takes some time to establish a new routine.

Rose recommends staying well hydrated during the day, reducing or eliminating caffeine products past noon, and keeping one’s sleep environment as peaceful, cool and dark as possible. If you need respite care or a haven away from your normal routine to get the rest you need, make it happen. Delegate the responsibilities you can and take some time for yourself to process how you’re feeling and recuperate.

Make Time to Grieve

Grief is an intensely personal process. Accept that it follows no magic formula or time frame. Think of the care you would extend to a friend who has just suffered a loss and allow yourself that same patience and consideration. Be careful not to take on responsibilities beyond what you are realistically capable of handling. It is best to allow for some flexibility in your obligations while grieving.

“For traumatic and confusing events, you may want and need a long time to comprehend what is happening/has happened,” Rose points out. “For example, my father had been blessed with excellent health his whole life, until he was diagnosed with cancer at age 70. This may not make sense, but after he passed, I still hadn’t adjusted to the concept that he could even get sick. It took time for me to fully realize that he had actually died.”

It’s important to allow yourself as much time as you need to process your feelings and the events surrounding the loss itself. Keep in mind that there is no definite timeline or step-by-step process for accepting a loved one’s passing. Be gentle with yourself and the fact that you are going through something that has a lasting impact on your life.

Rose recalls that, “One of the few relaxing moments before, during or after my dad’s funeral was when I told myself, ‘It is okay. I do not need to try to understand or accept this all right now. My father will be dead for the rest of my life and I have that long, if necessary, to adjust to the changes that are taking place.’ ”

Ask for Help While Grieving

Understand that mourning is very difficult. It requires a great deal of energy and can be exhausting, which is why many refer to this emotional process as “grief work.” Even though we place a high value on self-sufficiency, it is important to ask for and accept help from those you trust.

Rose is emphatic that we sometimes need to ask for help so that we can engage in proper self-care. “It is possible to be independent and strong while still accepting and requesting help from the people around you,” she says. It can often take an event like a severe injury or illness to realize that no one can take excellent care of themselves in all circumstances. There’s no shame in asking for assistance.

Physical limitations are easier for others to pick up on and help with, but we must be honest with ourselves and ask for assistance with emotional and mental challenges as well. “Instead of using energy to fight the fact that you need a helping hand, it can be more efficient to research which forms of support most appeal to you and serve the current situation,” Rose explains. This can help you narrow down options to those you are most comfortable with so you can seek them out or accept them as they are presented to you.

In addition to family members and close friends, hospice is an invaluable resource for families who are coping with terminal illnesses. Patients facing the end of life receive comfort care through hospice programs, but what many do not realize is that these providers also offer emotional support and counseling to family members both during a loved one’s decline and after their death. Even if your loved one did not receive hospice care before their passing, you can contact a local hospice group for information on grief counselling and bereavement support groups in your community.

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Navigating Additional Sources of Stress

When a family is under extreme levels of stress, it is common to see aspects of yourself or the people around you that are unfamiliar. “People who are grieving can behave in surprising ways that can be either very uplifting or upsetting,” notes Rose. “Perhaps a person who you thought was dependable pulls away when you need them most. It is also very possible that someone new or unexpected might step forward in a very caring and supportive manner.”

While grief is not an excuse to be uncaring or distant, it isn’t uncommon for the bereaved and their friends and family to withdraw or act out in uncharacteristic ways. Do your best to express yourself constructively and be gentle with yourself and others who are processing the loss. Sometimes time and space are needed to adapt, find one’s bearings and establish a new normal.

Finances can contribute to stress and complicate the healing process as well. Money issues are often present during our caregiving years and may linger after a loved one dies. “When money is tight, couples can either pull together or become torn apart,” Rose says. “Siblings who lose a parent may cooperate skillfully or start to fight about inheritances. One’s own responses and abilities may be surprising during an emergency. Sage advice is to expect the unexpected from yourself and others.”

Reminiscing Is Part of Healing

Since my own father lived with severe dementia for 10 years before he died, I had to emotionally process many things before I could allow myself to start moving back through time to remember the man he was prior to his botched brain surgery. The trek back was painful but rewarding. I used the same process to help me accept my mom’s long illness and death. I called it “working my way back.”

“Salvaging beautiful memories from before such a painful transition may take a while,” Rose acknowledges. “It can be a matter of waiting long enough so that raw and often conflicting emotions can simmer down. Eventually, though, most forms of loss can be replaced by loving memories and better times together.”

No One Is Ever Fully Prepared for a Loved One’s Death

The last important fact that Rose mentioned to me was that it still can be surprising when our loved ones finally pass. After thinking about my own experiences, I had to agree. Both my parents were ill for quite some time and declined slowly over several years. Strange as it may seem, their deaths still came as somewhat of a shock. No matter the length of a loved one’s illness or the amount of mental preparation we feel we have done, there is still something deeply unsettling about this irreversible event that changes our lives forever. We may anticipate and be at peace with their passing, but we must still grapple with the true gravity of their absence.

“Caregivers can spend months or years handling the challenges of caring for a loved one,” Rose says. “However, that quiet moment when they are really gone can still be quite stunning, especially if that person has survived many potentially fatal health problems before. It can be hard to get used to them being gone.”