Professionals and caregivers agree that there are some things that can help before and after the death of a loved one.

Pat Williams felt her heart fall to her feet and the world rushing around her, unable to really see or hear anything. "Cancer," the doctor had said. Her husband Jack had cancer. For the next year, Pat's life became dedicated to caring for her husband through his illness.

She didn't think twice about her priorities, knowing how important it was to have two pairs of ears listening during doctor visits or having a hand to squeeze during treatments.

"I have always had the natural tendency to be a caregiver," Pat says.

When Jack passed away in January of 2004, Pat woke up as a different person. "I went to bed as Mrs. Jack Williams and when I woke up in the morning, I wasn't … but I wanted to be." she said.

Beyond the immeasurable grief of losing her partner of several decades, there was another layer of sadness. For 12 months, she was immersed in her role as a caregiver for her husband. Overnight, she lost that job, in addition to the man she loved so completely.

This double loss is very common among caregivers, according to Helen Keegan-Geroux, LPC, of Greensburg.

Oftentimes, caregivers have been so busy providing care, they haven't had time to prepare for the death of their loved one, which often catches them off guard.

"You also experience the death of a routine, of giving energy and love to this person and some of your grieving is over the lack of this role. It compounds the grief," Keegan-Geroux explains.

Many caregivers who lose their loved one also struggle with their identity after the death. They come to define themselves by their role as caregiver and suddenly are left to struggle not only with sadness, but also with a redefinition.

"Who am I now?" is a question Keegan-Geroux hears frequently.

These questions sometimes transition to feelings of anger for caregivers, who feel upset at the time they lost during the period they were giving so much care and love.

Keegan-Geroux helps people look at these feelings. "I always tell them, feelings are neither good nor bad; feelings are just feelings. They don't mean you weren't a loving or good caregiver."

The Good Grief Center for Bereavement Support located in Squirrel Hill offers one-on-one support in person or over the phone, plus support group meetings on-site and in various locations throughout the city. The non-profit organization stresses that there is no specific process, healing formula, or right way to manage grief; however, there are healthy, effective ways to cope.

Marilyn Chapla, associate director of the center, points out the importance for grievers to find support from people who understand the process. Grief counselors and support group facilitators encourage grievers to express their feelings and then help guide them through the pain and sorrow.

"This can be particularly important early on in the grief process, when there are overwhelming emotions surfacing," says Chapla.

Having experienced the grief of a caregiver after losing her father, Keegan-Geroux found that American society isn't very skilled at dealing with grief. There is a social stigma attached with grieving and people often hide their grief because they don't want to make others uncomfortable. Because of this, people don't learn that it's natural to feel these tumultuous emotions, and to feel them for a long time. "I try to connect with [clients] and let them be there in their grief," Keegan-Geroux says, adding that coping techniques range from talking, to prayer, to writing letters to loved ones or even to God.

While the grieving process is different for each individual, both professionals, as well as caregivers who have experienced a loss, agree that there are some things that can help both before and after the loss.

Support

For starters, all agree that it is absolutely essential for caregivers to find a support network. For Pat Williams, both she and her husband began attending support groups together, and she continued to attend after her husband passed away.

"If you don't fit in one or you feel uncomfortable, try another group," says Williams. "It's good to be around and communicate with people who are going through the same thing as you."

The Good Grief Center helps place people with groups and counselors appropriate for their situation. One support group is designed specifically for daughters dealing with the loss of a mother. Support groups through the Good Grief Center are facilitated by social workers, psychologists, or even volunteers with life experience who have completed training courses.

Anticipatory grief can start long before a loved one actually passes away. Chapla often sees families together and answers their questions, and helps educate them about the grief process. "People ask, 'Should I be feeling this? Am I normal?' and we just try to explain that talking about what you are feeling and experiencing can be very helpful," she says.

Take Care of Yourself

Caregivers need to maintain a connection with their own lives. "You need a balance. You can't make your loved one the center of your life," says Keegan-Geroux of caregivers. "Taking care of yourself while you are caring for another will help to better prepare you if your loved one should pass away."

Chapla agrees. "You feel so isolated when you're a caregiver because your world is so focused on the person who is sick," she says. "Sometimes getting out of the house, just spending time for you, can be extremely restorative."

Ask For Help

Williams has come a long way in the years since her husband's passing. At first, when she went to her grief support group, she couldn't even find the courage to say her name. Asking for help was not something she was accustomed to doing.

"That was the hardest thing for me," says Williams. "It was okay if I was doing it for someone else, but I didn't want someone helping me."

Eventually she learned. "When you're a caregiver through a catastrophic illness, it's very important to accept any and all help."

GRIEF AND THE HOLIDAYS: A Survival Guide

At some point in life, everyone will experience grief. During the holiday season, when everyone expects you to be happy or at least act happy and join in the festivities of the season, the added pressure and stress can make grieving even more difficult.

Whether you're grieving the loss of a loved one or are the friend, coworker, neighbor or family member of someone who's grieving, here are a few tips to get you through.

For the person grieving

You don't have to If certain family traditions are making you uncomfortable this year don't do them. For instance don't carve the turkey if you don't want to, or don't sing along if you don't want to. Be careful not to throw out all your traditions, but don't be afraid to drop some either. You can always pick them up again later.

Drop before you shop

Feeling overwhelmed by a long gift list – 12 days of Christmas, 8 days of Hanukkah, or everyone seems to have been born in the same month! Simplify. This is a perfect time to give yourself the gift of simplicity and the joy that comes with it.

Checking it twice

Whether the holiday involves, cooking, shopping, cleaning or organizing, you have plenty of details to keep up with. Let a list do the work for you. If you are grieving, your memory may not be up to par, or you may be having trouble concentrating. That's "normal." Rely on your notes and lists, and keep them handy.

Do you remember? Companionship, laughter, tenderness -- what do you remember?

The person you are grieving gave you all kinds of gifts – tangible and intangible during your time together. Write them down and keep them someplace special.

Where's the party?

Just because everyone always comes to your house for the holidays or special occasions doesn't mean they have to come this year. Feel free to try something else to give yourself the space you need to grieve. Too tired to whip up your famous recipe? That's okay. Let someone else prepare it to your specifications.

Surprise!

Be prepared for the holidays as well as birthdays and anniversaries and other special occasions to be an emotional time for you. Don't be surprised by tears and sadness, and don't fight them off. Instead carry tissues. Tell the people you are with that you probably will cry, and invite them to cry with you.

Just say no

If you are feeling pressured to participate in more than you're comfortable with - try saying "no."" No thank-you." You don't owe anyone an explanation. Be kind, but firm. People will want you to feel welcomed and included, but they will also understand that you need some time.

Share the love

Holidays and special occasions where gift giving is the custom may be hard in that no gift is being purchased for the deceased. Consider buying a gift for someone who would otherwise not have a gift or make a contribution to a charitable organization in that person's name.

Tell me again

Instead of trying to push back memories of the person you are grieving this holiday, ask friends and family members to share recollections of the person with you in photographs, stories, and mementos. Some families box, wrap and give each other memories. Trinkets that remind us of the family member or friend are especially enjoyed by, and helpful for, children.

Pay attention

Most importantly, pay attention to yourself. Listen when that little voice tells you you're tired, and need to take a break from holiday preparation.

Give yourself the option of not attending another party or event. And be sure to let your friends and family members know what you're up for and what they can do to help.

For the boss / coworker / neighbor of someone who's grieving

A little acknowledgement goes a long way!When confronted by a situation where a good friend, coworker or other such associate is grieving during the holiday season, a little acknowledgement can go a long way in an already alienating environment.

Express your sympathy honestly and openly. And while someone who is grieving may choose not to attend, it's still important to extend the invitation to regular holiday activities like lunches and office parties.

Have a little faith in me

Trust in the decision of someone who's grieving. Despite their world being turned potentially upside down, it's critical that you trust their judgment and not push them to join in on the fun at an office party because YOU think "it will be good for him/her." Listen to them when they say, "Thanks, but I'm just not ready yet."

Use the deceased's name

Often there's a fear about saying the name of the person who's died; as if somehow saying the name will cause more pain. However, phrases like, "So sorry for your loss," and even using only pronouns like, "She was so wonderful," and "He will be truly missed," tend to negate the person's existence in the first place.

COURTESY OF GOOD GRIEF CENTER FOR BEREAVEMENT SUPPORT

www.goodgriefcenter.com

(412) 224-4700, (888) 474-3388.