Health Care Quarterly:

The grieving process is universal, yet unique

The last words Antonio Sanchez ever heard were whispered by his 21-year-old daughter, Raquel.

Sanchez had been diagnosed with terminal cancer only a year prior. The sickness, which had started in his colon, spread to his liver.

The diagnosis was grave. Overnight, minutes and hours had become a precious commodity.

There were many days spent in faith and laughter in that final year, but on that cold, grey California day in February of 2001, hospice workers called Raquel home from work, and she knew that their time together was coming to an end.

The pair was able to say goodbye in what Raquel describes as a beautiful experience — one that both comforts and haunts her to this day.

“I was the only one in the room when he passed,” Raquel said. “I was a little bit of a wild child in my teens, and I told him that I was sorry … that he was the only man I had ever loved. He wasn’t really conscious at that point, but I know he heard me. I said my goodbye, and then he was gone.”

Raquel, who had been planning to move to San Diego before the diagnosis, remembers the time after her father’s death as both heartbreaking and numb-like.

“My mom took his death really hard,” she said. “So it was left to me and my brother to make funeral arrangements. I just remember picking out a casket and feeling numbness.”

Now, at 37, Raquel said she knows that even though she believed she was coping well, she did not accept the reality of her father’s passing for a long time.

“The grief was consuming,” she said. “But at the time all I could feel was anger, and I don’t think I realized that was part of my grieving process.”

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Grieving is a very personal process, according to Matthew Metevelis, spiritual care supervisor at Nathan Adelson Hospice. There is no right or wrong way to grieve, and many people worry that they are fundamentally flawed in some way because they aren’t progressing in a way they find acceptable.

“When it comes to death and dying, there are stages of grief, and they can come in any order or not at all,” he said. “There are so many variables and the process is intensely personal, so it’s hard to put a strict schedule on it. I’ve had people want to talk because they’re not crying or they don’t feel angry,” he said. “They wonder why they aren’t going through the stages ‘properly.’ But there’s no such thing.”

Raquel said she felt guilty for not being as sad as her mom appeared to be, but she still experienced a long period of sadness.

“It was my faith that got me through,” she said. “And there came a point where I was tired of feeling sad all the time, and I had conflicting feelings about that. Then I’d remind myself of how lucky I was that he was my dad, and that I got to say goodbye.”

Metevelis said that one of the most important components of grieving is self-compassion.

“Grieving is natural,” he said. “If you have loved someone or something and it’s not with you anymore, grief is how that love continues. But it’s important to remember that you’re not broken. It hurts, but you will get through it. Society teaches people to run from their grief. It’s uncomfortable, but I recommend that those suffering run towards it. Embrace it. Try to understand it. This is where healing begins.”

Metevelis said that staying mired in intense grief without progression for longer than approximately 18 months might be signs of a deeper problem, and that those who find themselves stuck should consider joining a grief support group or private counseling. He said Nathan Adelson Hospice offers free bereavement groups, and more information can be accessed on the hospice’s website: www.nah.org.

“The biggest challenge is getting through the first year with anniversaries and reminders of your loss,” he said. “But if you’re doing the hard work of rebuilding your life, the pain becomes more of a dull ache over time and continues diminishing. The pain never goes away but the intensity lessens. You will never forget your loved one. You will always miss them. You will always be bothered by the fact that they aren’t with you. But the loss of them in your life will no longer be blinding and debilitating. And you will be surprised when you look back just how far you have come.”

Metevelis said that the old model of grief management treated the condition like a disease that could be cured with the right therapy, medications or processes. Now, it’s better understood that the experience of grief oscillates between the dual tasks of understanding the reality of the loss and building a new life after the loss. Part of the difficulty is that you’re never quite all the way out from under it.

“What helps is really trying to tap into your emotions and face them head on,” he said. “Practice self-care. Focus on things that give you a sense of meaning and purpose. Make sure that your life honors the legacy of your loved one. These are things that can give you a sense of meaning and purpose and help with the recovery process.”

All these years later, Raquel still tears up when talking about her father. There’s a wistful sadness just beneath the surface when she murmurs his name. But now she can talk about him. In the beginning, it was too hard.

“One of the things that really helped me was attending grieving support groups,” she said. “Being around people going through the same thing helps lighten the burden. When you have someone to relate to, it helps to keep things in perspective and to remember you’re not alone.”

For Raquel, honoring the legacy of her father has meant keeping strong in her faith and living a life she knows he would be proud of. Today she’s a talented social media and public relations professional, a reality she said was made possible only with the work ethic and characteristics garnered from her father.

“He was very outgoing, the life of the party, he had a million friends,” she said. “Those are some of my most prominent memories of him. I had friends who would come to hang out with him and not me. He worked hard, but he had fun. At the time it annoyed me, but now I see how blessed I was to have him in my life. It makes me smile when people say I remind them of my dad. I had the best dad on the planet.”

Amanda Llewellyn is an account executive with the Ferraro Group.

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