- [Voiceover] Health Matters is proudly supported by MultiCare.

(pensive music) - Grief is one of the few universal human experiences.

Coming up on Health Matters, we'll talk about the ways we handle grief and the resources available to us.

(pensive music) Welcome to Health Matters.

I'm Aaron Luna.

At some point in our lives, we will either experience grief or be supporting someone dealing with grief.

It's a complex emotion and can impact our mental and physical health.

There are ways we can better understand and cope with grief before and after a loss.

Joining us tonight, experts on grief: Katie Curran, licensed therapist, Vanessa Wheat, certified grief coach and program director for R.I.S.E.

Northwest, Bill Strunk, the spiritual care supervisor and chaplain at Deaconess Valley Hospital.

Katie, you specialize in grief therapy.

In your practice, how does grief differ from general feelings of sadness or even depression?

- Well, I think grief is the human response to either the loss of a loved one, or a beloved, or often, other things such as like a pet, or a breakup, or a divorce, or things like that.

It can take a lot of different forms, but more often than not, it's the response to someone, losing someone.

- And tell us what can happen when we don't experience our grief.

- I don't personally believe that it will go away.

I don't think that even if you do respond to your grief, that it ever really goes away in any kind of concrete before-and-after kind of idea.

I think that grief is something that we learn to live with and it stays with us, and it's more about learning how to adapt to the reality of grief and what that means for our life.

But I've seen people who haven't addressed grief and it's like 10 years later and it's still is like, it just happened yesterday.

I don't think it's something that can leave the body unless we face it in a real way.

- It's not something where someone would say, "time heals all wounds," and that's the case for grief.

- I don't think grief or trauma, which are often overlapping in a lot of ways, work that way.

I think that there is often a response from the individual where they wish there was an ability to go back to who they were before grief or trauma.

But in general, we are changed by grief, fundamentally changes our way of being, the way we move through the world.

And I think as far as like the treatment goes or addressing it, the biggest key is learning how to reorient your life with that reality.

- And Vanessa, you're the program director for R.I.S.E.

of Bereavement Group for children and teens who've lost parents.

What can you tell us about children who experience that kind of loss?

- You know, it can be just really lonely.

You feel different from everyone else.

You know, you're young, you don't know, kind of that maybe a tummy ache is actually your grief.

And so it is really beautiful when they can all come together and build that community and really share what they're experiencing and see that there's other people like them.

That's the hardest part is you kind of just feel so different, you know, from everyone around you, from your peers.

- And how does R.I.S.E.

support those children?

- We support them by having a mentorship program.

So they have a mentor that they're with, and a lot of our volunteers have also experienced some sort of loss, so that really helps.

We do kind of, we call it like a grief 101, where we just talk about some of the symptoms of grief and some of the things they could be going through.

And then we also just have fun.

We want them to come back.

So we have pizza.

You know, we play some games.

We try to make it a joyful experience for them.

- How long is that program or are there steps that you take with the children?

- It's about an hour long, so.

And yeah, we just, they come in, they get with their mentor, they have pizza.

Then we kind of, we try to, at least once a month, have everyone go around the table and it's just so powerful to say, you know, "I lost my dad" or "I lost my mom."

It's just they don't get a chance to really say that very often, and they want to.

So it's kind of also like practice for them.

And then we sort of do like our little grief course and then we have fun and play games.

- Yeah, and Bill, as a chaplain, you help families as they're preparing for a loss, and how can seeking out a chaplain help during that grief process?

- Yeah.

I think being able to tie into what matters most for that individual person or that family, being able to tap into that, especially there in the hospital, how is it that we are, yeah, remaining tapped into what matters most to each individual.

And so being able to facilitate conversations around that within the family, be able to tie them into their own spiritual community if they have one, but being able to help facilitate that preparation that will lead into how is it they're processing the grief after the loss happens.

- And how do you breach those topics?

Everyone's a little bit differently.

You know, connecting with someone can be very simple or sometimes very challenging.

- Yeah, yeah.

And so trying to build some rapport right away.

I think that there's a lot of preconceived notions about chaplains.

When I walk into a room, I often am met with, you know, "I'm not dying, am I?"

Or they think that I'm gonna try to proselytize and convert them.

And so being able to immediately come in and "Hi, I'm Bill with Spiritual Care," and being able to immediately tap into, "Hey, what matters most to you?

What's most important to you?

How are we focusing on that?," within whatever's going on in the hospital.

There's something that's changing and there's often some grief that's happening within that, whether that is leading towards end of life or just a change in autonomy because of an illness.

- Great.

Another program that helps families and patients in their time of grief or loss, no one dies alone at MultiCare Deaconess Hospitals where volunteers bring healing and love to patients, families and staff.

(air swooshing) It takes a lot of color.

- We just sit there and we just get creative.

- [Aaron] A lot of time.

- And then you could just say, "Oh, I think I'll make one of those."

- [Aaron] And a lot of love.

- We all amaze ourselves with what we turn out.

- [Aaron] To make beautiful quilts like the ones you see here at MultiCare Deaconess Hospital in Spokane.

Marie Schultz has been volunteering with MultiCare for years.

A lot of that time has been spent creating these beautiful works of art.

- Because I love to sew (chuckles) and you could only make so many quilts for your family members.

- The quilts go to patients, some of them in the hospital's No One Dies Alone program.

- Just to know that it brings comfort to people when they are in their final days is just warms your heart a little bit.

- [Aaron] The No One Dies Alone program started in 2001 and was adopted by MultiCare in 2021.

Nancy Rich is also a volunteer who works in the program.

And while her job is slightly less colorful, it's no less important.

- I think the worst thing that could happen to someone is that they do die alone.

And just to have a presence there of someone who's caring, and all I can do is hold their hand.

I don't nurse, I can't feed them.

All I can do is be a presence for them and let them know that they're not alone.

- The COVID pandemic really highlighted the importance of the No One Dies Alone or NODA program.

Emily Calabro is the system's clinical nurse scientist at MultiCare Deaconess and nurse educator for the End of Life curriculum.

- So we like to train our end of life champions, is what we call 'em, in different various end of life concepts, including pain and symptom management, communication techniques, ethics, cultural and spiritual considerations, loss, grief, bereavement, and final hours.

- [Aaron] When patients die, it's not uncommon for nurses to feel a sense of loss or sadness, often referred to as disenfranchised grief, grief that goes unacknowledged.

And as COVID took more lives, often with the patients isolated from extended family, the impact increased for hospital staff, which spurred the growth of the hospital's End of Life program to deal with the impacts of that grief.

- And it tends to resurface over time if you don't deal with it.

- [Aaron] And left unchecked, grief can lead to other issues in nurses and family members who lost someone.

- So then you'll have extreme sadness, you'll feel very lonely.

You won't be able to go beyond or start the healing process.

You could have symptoms of even depression and you may have seeking behaviors or avoidance behaviors from something that reminds you of that loved one.

You need to be able to acknowledge that grief to be able to begin that healing process.

- [Aaron] The quilts, the companionship at the end all play a role in easing the impacts of a death.

- When we talk about grief, it's really how we pull meaning from that loss.

That's really important.

- [Aaron] Preparing for a loss plays a big role in dealing with the pain as well.

Calabro says nurses who were able to deal with disenfranchised grief experience something called post-traumatic growth.

- Over half of them experienced a moderate to great deal of growth in the ability to relate to each other.

They also recognized new possibilities in life.

70% realized their own personal strength and spirituality.

But what was most remarkable was that 90% had a greater appreciation for life.

- [Aaron] That growth can be seen in the volunteers we introduced you to earlier, something tragic turned into something wonderful.

Marie's mother was in hospice at the end of her life.

It's a big reason she sews those wonderful quilts.

- She had a special blanket that my niece made for her, and she wanted to make sure that that blanket was with her every day, every moment of the day.

And then just kind of like a light bulb went off and it was just like, "Wow."

- [Aaron] A beautiful handcrafted quilt, warmth for the body, peace for the soul.

Nancy Rich unexpectedly lost her sister to cancer.

She turned that pain into power, sitting with strangers in their final moments.

- It'll be three years in November.

And I had to do something to fill that emotional void.

And I think her legacy to me is she's given me the strength to be able to do that.

- [Aaron] Not everyone can prepare for the pain and suffering when they lose a loved one, but for those who can, Calabro says, "Start now.

Talk with your family and friends."

- Call your loved one.

Talk to your spouse about this.

We're not talking about death and dying early enough.

And it seems to still have a stigma, unfortunately, but if we have these conversations early, what it does is it relieves the burden when the time comes.

Everybody has their own way that they're going to grieve and the best thing we can do is we can validate those feelings and normalize it.

- [Aaron] Calabro recently told a friend who was losing her mom to have this conversation with her.

- I told her, I said, "Before things that matter most, I forgive you, will you forgive me?

Thank you and I love you."

- Death will never be easy, but there are ways to make it through and celebrate the ones who lived as colorfully and brightly as these quilts.

(soothing music) (air swooshing) And Bill, you work alongside the volunteers for the NODA program.

What are some of the ways spiritual services are able to encourage and support families in these very tense moments?

- Yeah.

I think that one of the ways that I most often get to share with families in this situation comes from a book by Ira Byock called "The Four Things That Matter Most."

And being able to help facilitate conversations with this patient and their loved ones around being able to say, "Please forgive me, I forgive you, thank you, and I love you."

And then that helps make sure that some of the most important things are said that does allow for a little bit of an easier goodbye.

Not that makes it easy, but it makes it maybe a little bit easier that the most important things have been verbalized.

And sometimes that's something that the patient is able to respond to when loved ones are saying it.

Sometimes the family needs to imagine how they might respond.

And sometimes this is even things that they would need to process and communicate for themselves after the loss has already happened, maybe through a journal or through conversations with others, still being able to express these sentiments even if they aren't able to say it directly to their loved one.

- So it sounds to me like you're saying there's an action plan, there's there's steps that you take to start processing.

- Yeah, yeah, yeah.

And I think being able to start that process there in the hospital, knowing that that's something that continues well beyond the walls of the hospital and beyond a certain amount of time.

But being able to start people on that journey of processing through their grief and carrying it with them, like Katie said.

- And Katie, what are the recommended ways for us to really confront and sort of sit in our grief?

- I think the biggest piece is kind of grappling with the new reality that is before them.

Oftentimes I'm seeing people kind of after the fact and there's usually this overwhelming sense of "What now?"

and "How do I even begin to face this?"

I think that part of it is figuring out how to honor the loved one in moving forward.

I think that's a really important aspect of it all.

But then as Vanessa was speaking to earlier, community is so essential in moving through any kind of loss.

And there's something so wildly healing about hearing others say, "Me too," or not feel so alone in it.

Because depending on how old you are and when you face the loss, not everybody has been through that.

Not everybody can sit with it and understand it.

And then there are often societal responses that make grieving more complicated and frustrating for people because we don't have a great narrative around grief in our country and we don't have a lot of practices or rituals that people follow and it's not talked about often enough.

So often when people are coming into spaces like mine, it's because they're desperate to be able to speak freely about the loss or the person without the fear of someone being too uncomfortable to sit in it or handle it.

A lot of the work is around the learning to speak into it and learning to speak about the person again and be okay doing that.

But like I said earlier, it's a lot of reorienting of how do I fit this into my current understanding of myself and my surroundings and my life.

And it's often just finding ways to walk through it.

- In your experience when you're talking to someone who has experienced grief, do you notice a difference with people who have maybe taken steps like Bill was talking about earlier, to kinda address it before it happens and someone who was unprepared and is now dealing with it on almost a surprise level?

- Yeah, I think there is this kind of knowing in a sense of like when you know someone who is going through grief, I think that anybody who has experienced it themselves can kind of see that in others in a way.

Often if they haven't taken the steps, like Bill was saying, to kind of start addressing the things or even facing the reality of it, there's often this, "I know that I need to do something about this.

I feel it.

It's either messing with my life or my relationships," or however that looks for them.

But there's this feeling of, I'm afraid if I start this, I'll unravel.

I'm afraid that if I start crying, I'll never stop.

I'm afraid that if I open this box, I'll never be able to put it back in, kind of a thing.

And helping people move through the reality that, while that is a very valid and understandable fear, it's not that it's not real, but you will run out of tears, (chuckles) so to speak, or you will be able to put yourself back together.

It's just a matter of what that looks like for you and what you desire in regards to that.

- And you talked about community, Vanessa.

You've seen the important role community plays in your personal experience and professional experience at R.I.S.E.

- Yeah.

So I lost my dad when I was 12 years old.

And I was one of those teens who thought that nobody was like me and nobody in the world knew what I was going through.

And my mom put me in a group similar to R.I.S.E.

and I mean, I can still remember the table.

I remember three other people lost their parent the same way I lost my dad.

And there was so much healing in that, just to know that I wasn't alone and other people are experiencing what I'm experiencing even though it looks different.

We're all in a different journey, but there is some comfort in that, and acknowledgement of these things that I feel.

And I've even seen this with the team group at R.I.S.E., that, you know, like these things that they're feeling, it's nice to be able to say it out loud and somebody say, "Yeah, I do that too," you know?

And it just makes you not feel so weird or different, so.

- Yeah, I think anybody like, especially that experience who has like lost someone or someone who's also lost a parent, anybody I know who has experienced loss in an extremely profound way remembers so vividly the first person that understood their experience.

There is just something about that experience where someone's like, "Oh my gosh, me too," that it just, it's like a core memory that locks in you and it changes the trajectory I think of the grief profoundly.

Groups are so instrumental to grief work, yeah, because it is, it just touches on that community aspect of this is a human experience.

You aren't alone in it, even though it feels really isolating.

- [Vanessa] Yeah.

- [Katie] Yeah.

- I would imagine there's a lot of feelings out there that you kinda, you know, hold it inside, keep it together, don't show your weakness, don't show your suffering, you just kinda power through it.

Are we still seeing kind of that structure in some society today?

- Yeah, I see it a lot, and people are scared.

They want to talk about their person, but then it's, other people are uncomfortable and so then they don't talk about it.

And I believe in just, you know, raising awareness about how we talk to people in grief and you know, just like, just say something.

You're not gonna get it wrong.

If you acknowledge them, you won't get it wrong.

They wanna be acknowledged.

They don't want you just talking about the weather.

Like they've got real stuff going on.

- Or the cliches too that get thrown at you.

I think that people clinging to the cliches in our society because we don't have language around this and how to make sense of it or how to deal with it.

And so I think often those cliches are said for the people saying them, rather than the people receiving them because they don't know what else to say, but often that feels inauthentic and disingenuous when you are the person receiving them.

And I do think that while you don't have to have the right words or know how to fix this, 'cause there's no fixing this, that's not even relevant to the context of grief.

But how do you sit with the person?

How do you not leave them in their grief?

Which I think happens way too often, unfortunately, which is where people do seek out support from people who know.

- [Vanessa] Yeah.

- And where do you think those cliches come from?

Is it just kind of a coping mechanism when someone else doesn't know what to do or what to say?

- Yeah, I think that that's a part of the coping that we have for ourselves.

Like you said, we don't know how to respond, we want to say something.

And so we go back to these cliches and then that can help us feel better as the consoler of like, "Oh, I did my part."

But I think that being able to express emotions, you know, often I encounter people who say, "Oh, I'm just trying to be strong for someone else and I'm not gonna show my emotions," but I think it takes a lot of strength and vulnerability to acknowledge the emotions that are there.

Mr. Rogers, one of my favorite things that he said was, "If it's mentionable, it's manageable," as he talked about emotions.

And so being able to mention them then allows us that place to be able to manage, but I think more get through and process and carry them better.

- Bill, you mentioned earlier, especially with the NODA program, the four things that you wanna say, I love you, I forgive you, - Yeah.

- Thank you.

- So it's two sides of forgiveness, so please forgive me- - Please forgive me, yes.

- And I forgive you, thank you, and I love you.

- Are there other things that we can say along with those?

- I think telling the stories of what are the stories that go along with any of those messages?

That's one of the things I love to get to help facilitate at the bedside is the story time that families are able to have of, I'm so grateful for this family trip that we went to when I was 12 and I remember when we went to the coast.

Whatever those very specific things to that individual, to that relationship are, those are beautiful moments to get to be a part of.

And I feel so privileged to get to help those stories come out.

- And what would you say other ways to help prepare for a loss?

- Prepare for a loss?

I think really, like similar to how Bill was describing, being able to lean into whatever community it is that you have, whether it is your family immediate or otherwise, or yeah, just those that you considered loved ones because I'm hesitant to say that there's like a way to fully be prepared for grief.

I think the steps that Bill takes to set people up is brilliant and is absolutely needed and to an extent, there is no preparing for grief.

I think that we have ideas that if we like play through scenarios in our head enough that when it happens, somehow we'll be okay with it.

Brene Brown speaks to this and she calls it "foreboding joy" when we're trying to predict pain before it happens and thinking that somehow it will mitigate the pain or the loss of it all.

And I think grief is one that like, until you've experienced it, you cannot comprehend it, you can't fathom it.

And so there's a way of just kind of trying to do your best to support yourself by surrounding yourself with those that lift you up in that time.

I think that's probably the best medicine you could give yourself in prepping for it.

- This is a question for everyone on the panel today.

What is the one thing you'd want someone experiencing grief to know and understand?

- I think that just know that what you're feeling is true and right to you, whatever you're feeling, that that's okay and to go with that, and to take the rest when you need the rest.

I mean, it is a full body experience, so take the rest.

Let people nourish you, you know, and just do what's right for you and that you're not alone.

- [Aaron] Bill.

- Yeah, I think a big part of it is the normalizing the different emotions that come along with it, of that you are not an outlier if you are still sad after a funeral has happened, whatever the case may be of those emotions are true to where you're at.

And how do you acknowledge those and express them with trusted people, I think is a big part of it.

- I think that there's like different aspects to grief that I think unfolds over time through my own personal experience, but also professionally.

I think a piece of moving through the grief that feels difficult is to kind of connect any goodness to their grief experience or any kind of silver lining feels kind of like sacrilege in a way for people in that it feels offensive.

But often there are people who are holding onto this kind of secret thought that they have that like, If I say this, I'm a bad person, or if I say that I'm grateful for this aspect, whatever, whether that is a prolonged grief where they feel relief and that the process isn't dragging on further, that often there's a lot of guilt surrounding those thoughts.

I don't think I've encountered a single person who hasn't had some version of that thought.

And to try and help people understand, to let go of that shame surrounding it and that like everybody has some version of it within them, and that's okay.

And it's also okay to find beauty in grief.

I think through my own experiences, there's such a well or depth that accompanies the change that grief brings within you that you can not only like see within the universe around you, but also others around you.

I enjoy the work because I like the well and the depth that shows up in humans and that it's humans in their most raw, vulnerable, real tate.

And there is a beauty in that, as weird as that feels for people to acknowledge.

- So it sounds like while there's no one one specific way forward, no one path forward for everyone, there are ways, best ways to prepare, but everyone kinda walks the path in a different way.

And it just seems as if community support and acknowledgement are pretty key factors in that.

Would you agree or, I mean, it's a complicated issue.

- I wanna emphasize the normalization.

I think that's the bulk of the work personally in my practice, is that it is often just, people have all these shoulds in their minds about how you should react to grief, how you should move through it, how you should feel about it.

And like you have to drop them.

You have to drop the shoulds because there is no like, cut and dry experience for everyone.

It looks different across the board, - Looks different, but you're not alone.

- But you're not alone.

Absolutely.

Everybody, like you said, everybody experiences this.

This is quite the universal experience.

We don't really get out of this world not being touched by grief.

And so to take solace in that, like you will find a community, you will.

You just have to look for it.

- Well, I wanna thank everyone here today.

Thank you for your time so much and sharing your insights and expertise on this challenging and like we said, universal topic of both R.I.S.E.

Northwest and the No One Dies Alone program are always looking for volunteers.

You can find more information RiseNorthwest.org and at MultiCare.org/volunteers.

And if you wanna share this program with someone you know who is struggling with grief in their life, it's always available online at ksps.org.

I'm Aaron Luna.

Have a good night.

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