Christy Kessler

Sleep is essential for human beings. Without it, your mind and body will quickly begin to show the negative effects of sleeplessness. As you’ve cared for your loved one through hospice, your body, mind, and emotions are taking a beating, and more than likely, your feelings of grief have grown stronger. Because grief is a struggle, you must take care of your body to ensure that you have the energy you need for the grief journey.

Dr. Alan Wolfelt, a nationally respected grief expert, counselor, and author, puts it this way: “Good self-care is important at this time. Your body is the house you live in. Just as your house requires care and maintenance to protect you from the outside elements, your body requires that you honor it and treat it with respect. The quality of your life ahead depends on how you take care of your body today. The ‘lethargy of grief’ you are probably experiencing is a natural mechanism intended to slow you down and encourage you to care for your body.”

Grief is Hard on the Body

Grief doesn’t just affect your mind or emotions; it takes a toll on your body. Physical symptoms differ from person to person, but one of the most common physical experiences is a disruption in sleep habits. This may mean that you have trouble falling asleep or that you fall asleep easily enough but wake up in the middle of the night and then can’t get back to sleep.

Just like you need sleep when recovering from illness, you need sleep when recovering from the physical and emotional strain associated with losing someone you love. A few reasons why you might experience difficulty sleeping while you are grieving:

• Intrusive thoughts
• Stress, worries, anxiety
• Bad dreams or anxiety about having bad dreams
• Trouble sleeping in the bed (for those who have lost a partner)
• Other disorders like depression, insomnia, or PTSD

Questions may plague you. Could I have done more? What if we’d sought treatment sooner? Should I have seen that this was going to happen? What comes next? How am I going to work and take care of my family? And so on.

The Importance of Sleep

If you are grieving, and you don’t get enough rest, then it’s even harder to deal with the complicated feelings associated with grief. You’ve just lost a loved one, so you may be more easily overwhelmed, feel more irritated, get angry more quickly, become hostile or depressed, feel hungrier than is usual, and generally feel less friendly. On top of that, your immune response is weaker, which leaves you more susceptible to illness.

So, what happens when you don’t get the recommended 7-8 hours of sleep each day?

The science is a bit staggering and alarming. According to research, long-term sleeplessness can lead to accelerated aging, decreased bone density, and an increased risk of stroke, obesity, heart disease, and cancer. Sleep is incredibly important to your overall health and well-being in addition to being essential to healthy grieving.

If you aren’t sleeping well, here are some tips to help!

6 Tried & True Tips

Create the ideal sleeping environment

Our bodies and minds need time to unwind before we can fall into a deep, restful sleep. The ideal environment is going to vary from person to person, but a few tips from the experts are:

• Block out as much light as possible (use an eye mask, if necessary)
• Leave your phone in another room and refrain from using it for at least 60 minutes before sleep
• Keep the room cool (60-68 degrees) – we sleep better at cooler temperatures
• Consider adding a white noise device (to block out sudden changes in sound or city noises)
• Make sure your bed is comfortable – good mattress, pillows, blankets, etc.
• Avoid doing anything stimulating, frustrating, or anxiety-inducing just before bed (or in your bedroom in general; you want the bedroom to be associated with peace and rest)
• If you have lost your partner, you might rearrange your room, get a new bed, sleep in a different room, or get a body pillow to help with sleeping

Set a nighttime routine

Having experienced hospice care and your loved one’s decline, you understand how grief and caregiving can throw your life and routines off balance, which is why you need to re-establish them to help with your rest. Routines give a sense of peace and calm. You know what’s coming and can enjoy the comfort of regularity. So, determine what the best routine is for you. Perhaps you dim the lights an hour before bed, read, snuggle with a furry friend, journal, or listen to soothing music. Find what best fits you but make sure that it is a relaxing, non-stimulating activity.

Stick to a regular sleeping and waking time. And if you haven’t fallen asleep after 20 minutes or so, get up. Read, meditate, work a puzzle – choose a relaxing activity. You could even practice breathing exercises to calm your mind and lull you to sleep. However, make sure you don’t turn on the tv or look at your phone. Research shows that the artificial light from screens actually reduces your melatonin production, which then affects your sleep.

Avoid caffeine and alcohol in the evening

We all know that caffeine is a stimulant, and if you’re trying to sleep, it’s best not to have it in your system. It takes 3-5 hours for your body to eliminate just half of the caffeine you consumed. One study even found that consuming caffeine within six hours of bedtime reduces your total rest time by one full hour.

And alcohol, while it does help you relax, actually suppresses melatonin, a key component to restful sleep. Research shows that drinking a moderate amount of alcohol an hour before sleeping will reduce melatonin production by almost 20 percent. To read more about the negative effects of alcohol on sleep, click here.

Avoid naps as much as possible

If you are already having trouble sleeping, a nap can really throw things off and mess up your established routine. Instead, stay awake until a decent hour and then fall into bed. Think of it like jet lag. When you are jet-lagged, you stay awake as long as you can so that the next morning, you can rise with the correct time zone. In some cases, especially early on in the grief journey, it’s important to take naps, but when the naps begin to interfere with your nightly rest, it’s time to change things around.

Engage in some form of exercise

Did you know that regular exercise improves sleep? The research shows that it does. Exercise reduces stress and improves mood, which is important while you are grieving. Studies have even found that daytime physical activity may trigger a longer period of slow-wave sleep, which is considered the deepest and most restorative stage.

If you already participated in a regular exercise routine before the death of your loved one, try to continue. If you did not practice a lifestyle of exercise, start out small. Take a walk, ride a bike, or pick up some small hand weights. Even moderate daily exercise can help you sleep better and improve your outlook on life.

Don’t be afraid to get help

Perhaps you’ve already tried all of these tips, and nothing has worked. Don’t be afraid to make an appointment with your doctor. They may have other resources available to you that will help. Deep, restful sleep is critical to rejuvenating your body throughout the grief process. But in addition to that, sleep is necessary for you to live a healthy life, physically, mentally, and emotionally.

Even if you knew a loved one’s death was coming, you will experience a wide range of emotions when faced with the death someone you love. And those emotions aren’t the same for everyone. Perhaps, if everyone grieved in the same way, we could craft a formula for grief – something that worked every time. But that’s not how it works. There’s no “correct” response to death, and there are many normal reactions to loss. Every grief journey is different, as are the emotions swirling around within us.

As you deal with emotional stress, it’s important to name your feelings and acknowledge them. Nationally renowned and respected grief expert Dr. Alan Wolfelt says, “I have worked with thousands of grieving people and they have taught me about many, many different thoughts and feelings after a death. Rest assured that whatever you are thinking and feeling, while in one sense your thoughts and feelings are completely unique to you, they are also usually a common human response to loss.” Whatever you’re feeling – whether it seems typical or unusual – is normal. There are, however, a few normal emotional reactions that are often viewed negatively – ones that we think we shouldn’t feel after a loss. Let’s take a few moments to discuss them.

Anger

If you are feeling angry, you are not alone. Your anger may stem from feeling helpless, powerless, or abandoned. It may also be directed at the illness your loved one struggled with, someone in particular, like the doctors, your loved one’s choices, God, or even life in general.

It’s important to remember that being angry is a normal response. As long as you don’t hurt yourself or others, it’s good to find a way to vent your feelings. If you are able to articulate what you feel, then consider writing it down or talking with a safe person (either a counselor or a good friend). However, if your emotions are more explosive, you might try using a punching bag, running, or participating in some other physical activity to help you release your anger.

Also, pay close attention to your words and actions. You may be more irritable and easily triggered than normal, causing you to be short-tempered with those you love.

Anxiety, Fear

For some, death can stir up anxiety or fear. Questions may arise in your mind. Will I be okay? Does my life have any purpose after this? Will other people I love die soon, too? What if something happens to me?

Feelings of anxiety or fear are often triggered by feeling vulnerable or that your security is threatened. For example, a child who loses a parent may feel anxious or fearful about whether something will happen to their remaining parent as well. Other options are that fear and anxiety are learned responses (a previous experience has conditioned you to respond this way) or that you aren’t sure how you will be able to cope so your anxiety rises, or you are worried that other sad things might happen.

Guilt & Regret

Another common emotion after a loss is feeling guilty about what happened or what didn’t happen. However, in many cases, the guilt is misplaced, though that doesn’t make the feeling any less real. You might feel guilty for not being a donor match, for not calling or visiting more often, or for being away from their side when death occurred.

If you are dealing with feelings of guilt, remember that, while it’s a normal reaction to feel this way, your feelings may not be accurate. Consider why you feel guilty and whether you might actually be feeling regretful. There is a difference. Guilt, by definition, means that you have intentionally done harm to the person who has died. However, regret means that you wish you had done something differently. The main difference between the two is intent.

If you determine that you are guilty of some wrongdoing, look for ways to make up for your mistake – write a letter to your lost loved one to apologize or ask forgiveness of other people affected by your actions. Also, try to forgive yourself. We all make mistakes. On the other hand, if you are feeling regret, work through your emotions. Determine what changes you can make to avoid regret in the future.

Relief

Relief may be one of the most common reactions when a loved one dies after a prolonged illness.  We feel so strongly that we shouldn’t be relieved that we sometimes hide the fact that we are. But relief is to be expected, especially after a period of intense suffering (as is the case with hospice care and terminal illnesses).

If a person dies after a long period of illness or was the cause (directly or indirectly) of increased stress in your life, it’s only natural to feel relieved when you are no longer suffering under high levels of stress. It doesn’t mean you wanted them to die or that you didn’t love the person. It simply means that you have been through a difficult time and are now emerging on the other side. Relief is normal and natural in such circumstances. As human beings, we are complex and can feel both relieved and sad at the same time. What you feel does not minimize your love for the person or the depth of your grief.

A Few Tips for Dealing with Your Emotions

1. Don’t bottle them up. Let yourself feel what you feel.
2. Realize and accept that your emotions are complex.
3. Find a way to express yourself.
4. Give yourself time to grieve and process. There’s no rush.
5. If you need additional help, consider joining a grief support group or visiting a grief therapist.

Taking time to process and confront your emotions is a necessary part of every grief journey. Experiencing any or all of the emotions we’ve covered is normal, as are others we didn’t cover, like sadness, numbness, denial, and confusion. However, as time passes, and you do the work of mourning, the emotional intensity should lessen. As Dr. Wolfelt puts it, “Your feelings of loss will not completely disappear, yet they will soften, and the intense pangs of grief will become less frequent.  Hope for a continued life will emerge as you are able to make commitments to the future, realizing that the person you have given love to and received love from will never be forgotten. The unfolding of this journey is not intended to create a return to an ‘old normal’ but the discovery of a ‘new normal.’”

Embrace your grief in all its complexities and allow yourself to feel all of your emotions (they are natural!). In time, if you do the work of mourning, you will find your way forward.

Grief is an inescapable part of life. As human beings, we possess deep, complex, multi-faceted emotions, and it’s our responsibility to learn how we individually need to process those emotions. Whether your loved one is just entering hospice care or has recently died, keeping a grief journal might be the answer to helping you cope with and process your feelings.

I know now that we never get over great losses; we absorb them and they carve us into different, often kinder, creatures. – Gail Caldwell

Why Should I Keep a Grief Journal?

1. Writing things down can often make you more aware of what you are feeling. Some people don’t know what they are feeling until they write it down. Putting thoughts and emotions into words forces you to slow down and gives you an opportunity to deeply reflect on, and perhaps better understand, the emotions within you. It’s a method of self-reflection and can reveal things you haven’t consciously thought about.

2. Journaling helps you remember your loved one. Recall your favorite memories. Record their favorite colors, smells, foods, places. Write down what they meant to you and why. Create a narrative of your relationship with them and how they impacted your life, the good and the bad. Share how it felt to care for them in hospice and be there for them in the final days. In your journal, if it’s helpful, you can even write directly to the person you’ve lost, saying whatever you feel needs to be said.

3. A grief journal gives you a safe and judgment-free place to explore your jumbled thoughts and feelings, to find ways to remember your loved one, and to record your ongoing journey through grief. Often, it’s comforting to look back and see just how far you’ve come from day one. Sometimes, it’s hard to see the progress you’ve made, but when you have something tangible to look back on, it’s easier to see how far you’ve come on the grief journey.

4. There are no rules. This journal belongs to you, and you can utilize it in whatever way you see fit. There may be days when you don’t feel like writing. That’s okay – you can also draw, color, paint, glue, or create something else in the journal’s pages. It’s entirely up to you – it’s your space.

5. Journaling can actually improve your physical and emotional health. By putting your thoughts and feelings into words, they come into sharper focus, and you can outwardly express what you inwardly feel. Among other things, this outward expression, this releasing of thoughts and emotions, reduces stress, which improves sleep.

Selecting a Journal

Ultimately, you should choose a grief journal that appeals to you. However, if you’d like some tips, here are a few questions you could ask yourself before making a purchase.

• How big or small do you want it to be (i.e. easily fits into a backpack, purse, or pocket)?
• Do you want it to have writing prompts included or not?
• Do you plan to use the journal to record your grief journey exclusively, or do you want to use it for multiple purposes?
• Will you add art to your writing or use a special pen? If so, you might consider how thick the pages are so the ink doesn’t bleed through.
• Do you prefer ruled or unruled paper?
• Would you want the journal to include quotes or information about grief and loss?
• Is it important to you that the journal appeal to you visually?
• Would you want a journal that carries meaning for you, such as one that depicts something your lost loved one valued (i.e. favorite animal, work of art, color, etc.)?

Also, it’s not a requirement that you handwrite your grief journal. If you prefer, you could type it or even dictate it. The simplest way to keep a digital journal is to open a Word document and start typing, but there are websites online that offer a place to record your grief journey. Another option that may appeal to some is creating a blog where thoughts are recorded and shared with others.

Journal Writing Prompts

You can find writing prompts online easily, but here are a few to get you started.

1. Think of a word that reflects how you feel today and explore it. What does the word mean to you? Why do you feel that way? How would you describe how you’re feeling to someone else?
2. Find a quote that speaks to you and mull over it. Write down why you chose that particular quote and what it means to you.
3. Spend time remembering your loved one – days you spent together, things they loved.
4. Write down things they used to say and why you remember the words so well.
5. Write a message to your loved one.
6. Ask yourself open-ended questions, like:

1. • “The things I miss most…”
   • “A color that makes me think of you…”
   • “This memory always makes me happy…”
   • “I wish I knew…”
   • “Today, my grief feels like…”

Feel free to add your own prompts and make the journal personal and intimate. It’s about you, your journey, your grief, your loss.

Write what comes out and don’t be ashamed of it. Some of the things you feel may be unexpected or scary, and that’s okay. Giving voice to your feelings will help you identify them, take responsibility for them, and eventually, release them. Nationally respected grief expert Dr. Alan Wolfelt believes that we never truly get over grief, but instead, we become reconciled to it. We learn what life looks like beyond our loss. He puts it this way, “To experience reconciliation requires that you descend, not transcend. You don’t get to go around or above your grief. You must go through it. And while you are going through it, you must express it if you are to reconcile yourself to it.”

After losing a loved one, whether they spent months in hospice care or mere days, sometimes talking about your grief isn’t enough. Maybe your words don’t fully say what you want them to say. Or they don’t capture the depth of what you feel. This is why creative expression is such an integral part of the human experience and an excellent way to process the painful feelings you may encounter, especially during times of grief. For many, participating in creative self-expression can help bring deep-rooted, complex emotions to light.

As part of your grief journey, you might consider taking up an activity that allows you to express yourself creatively. For many of us, painting comes to mind first, but you don’t have to take up painting if you don’t want to. There are many ways to express yourself creatively and tap into what is hiding below the surface. For example, you could: draw (pencil, pastels, ink), paint, sculpt, scrapbook, keep a grief journal, take photographs, garden, write poetry or prose, cook, bake, take up calligraphy, compose music, restore a car, woodwork, or create a memory quilt or box.

In the end, the final product doesn’t matter. The healing value is in the doing. You don’t have to be good at something to take it up as a vehicle for healing. In other words, you don’t have to be a writer to keep a grief journal. You don’t have to be a painter to use watercolors or oils. You don’t have to be a photographer to take beautiful pictures. All you need is the motivation and the desire to see if creative expression will help you.

Here are a few reasons why delving into your creativity may help you deal with loss.

1. It helps you express things you might not be able to put into words.

We all know how it feels to be at a loss for words. After walking alongside a loved one through hospice care, there may be things you just can’t put into words. Creative expression allows you to become more aware of how you actually feel. In the creative process, you can slow down a little and think about your emotions, actions, moods, and behaviors. There may be something going on inside that you don’t realize is there until you take the time to explore it.

2. The creative options available to you are wide and varied.

As mentioned above, you aren’t limited in what medium you choose as your creative outlet. An Australian woman did choose to paint and is now exhibiting her work, while another woman created works of art made from the clothing left behind by the son she lost. Eric Clapton, a musician who lost his young son in a freak accident, used music to help him deal with his grief. No matter what form of expression you choose, the results can contribute to the healing and reconciliation you come to regarding the death of the person you love.

3. It’s a safe way to express your emotions.

Grief can bring out a myriad of emotions. Some of your emotions may even make you nervous or afraid. Using your creativity to deal with loss is a way to safely express yourself. No other person needs to be around when you create, unless you want them to be. It’s a time when you can choose to be alone to constructively explore what’s in your heart and mind. Your work is as private as you want it to be, and even if the emotions that reveal themselves are ugly, it’s better to get them out than to bottle them up inside, waiting for a moment to burst.

4. It’s something you can control in a world that may seem out of control.

You’ve been on a journey ever since your loved one received their terminal diagnosis. When they died, your world was rocked. Things that felt safe and secure before may now feel shaky and uncertain. Depending on the depth of the loss, it may feel like everything is spiraling out of control. By taking up a creative habit, you create an opportunity where you can exert a certain level of control over at least one aspect of your life. It’s your work, and you make the rules. Throughout the process, creativity may become a reliable friend – a means of self-support during a time of confusion and pain.

5. It provides you with an opportunity to engage with others who are grieving.

Some will choose to engage in solitary creative expression. Others will take the opportunity to participate in collective creative expression. If you decide to paint, you might join a group of other painters who are going through loss. If you decide to write poetry, you could join a writing group focused on grief. You are not alone in your journey – so many others are also dealing with grief in their own way. You may find a kindred spirit in a class who will come alongside you as you grieve.

6. It is beneficial to your health.

It has been discovered that self-expression, particularly the arts, can actually help relieve feelings of stress, fear, and depression. The body calms during the activity, which, in turn, contributes to reduced blood pressure and even releases chemicals in the brain to decrease some types of depression. By allowing the emotions building up inside you to find outward expression, you are actually allowing your body to relax, resulting in less strain and better health.

7. It helps you remember that there is still beauty in the world.

After spending so much time walking alongside your loved one on the path toward death, you may have become discouraged or disheartened. With creative expression, no matter which medium you choose to interact with – photography, journaling, woodworking, painting, etc. – at some point you will make a realization: there is still beauty in the world. The flowers are still delicate, the mountains are still impressive, and people are still worth knowing and loving. Even in grief, you will have good moments – days when you remember that life can be good. When those days come, don’t reject them. Embrace them. Remember that life can be good again…not the same but still good.

A brief note regarding creative expression and children in grief: Creative expression activities (most often arts & crafts) are very helpful for children experiencing grief. Children have a difficult time identifying what they are feeling, much less putting it into words. Arts & crafts allow them to communicate without words and provide an opportunity to release their emotions and express their thoughts.

If you’d like to give creative expression a try, you first need to pick an activity that appeals to you – even if you don’t think you’re good at it! Then, for three or four consecutive days, spend at least 20 minutes a day doing your chosen activity. After a few days, evaluate how you feel and if you’d like to continue. Fully embrace the activity during the trial phase and express yourself fearlessly. Your emotions are important, and they need to be expressed so that you can move forward.