After spending significant time volunteering at Karunashraya, I thought I was familiar with all our processes—until one afternoon, I overheard a counselor mentioning “bereavement” to a colleague. When I asked for clarification, she gently explained, “Bereavement is the period of mourning and coping with the loss of a loved one”. I exhaled a long breath, realizing once again how the holistic care provided here constantly deepens my respect for this work.
This period of mourning is a process of physical and emotional adjustment supported by Professor J.W. Worden’s renowned framework of the four tasks of grieving. By helping caregivers navigate the initial acceptance of loss and the intensity of pain, we guide them toward adjusting to a world without their loved one and, eventually, reinvesting in a new reality.
While many believe bereavement begins only after a loss, for many families, the journey starts much earlier through “anticipatory grief”. This occurs when a patient’s decline is visible and the reality of loss becomes inevitable. Consider the story of Rebecca, who was admitted to Karunashraya for end-of-life care while battling metastatic breast cancer that had spread to her bones and brain. Her husband, Keith, was her constant shadow. As the end neared, our counselors shifted their focus to Keith—normalizing his emotional outbursts and acting as an anchor for the family as they navigated the impending loss.
A powerful component of this care is “legacy work.” Amidst her difficult transition, Rebecca held onto one profound hope: to see her younger son receive his Holy Communion. Fulfilling the patient’s wish towards the end if life is a critical element of bereavement care, offering both the patient and the caregivers a sense of closure. In a beautiful, bittersweet twist of fate, Rebecca passed away peacefully the day after the ceremony, her final wish fulfilled.
This immediate transition from life to loss is where the Prayer Room, or Bereavement Room, becomes essential. These non-clinical areas provide the privacy and personal space families need to be with the deceased. It is a place where tears can flow naturally, facilitating the first stage of grieving: the raw reality of acceptance.
While “acute” grief typically lasts up to six months, we remain vigilant for those experiencing delayed or complicated bereavement who require extended support. On Rebecca’s first month Memorial Day, Karunashraya gifted her family a framed art piece featuring the handprints of Rebecca, Keith, and their two boys. This act of remembrance was deeply cherished by the family.
Ultimately, bereavement care is a core pillar of palliative care, ensuring support continues long after a patient has passed. Properly navigating grief helps individuals process trauma and prevents long-term health issues. We often try to stay strong, but suppressing emotions can make the healing process longer and more painful. The goal isn’t to “get over it,” but to feel and process the loss. There is no ‘normal’ way to grieve—except for the way we each uniquely do it.
Author
Shilpi Agrawal, Volunteer at BHT – Karunashraya
Michelle Normen, Lead Psycho-oncologist at BHT- Karunashraya