The journey doesn’t end with the departure of a loved one, but continues in the comforting of those who have to deal with the void in their lives.
Bereavement care is part of the continuum of palliative care for patients and their families and is as important as the care before the end. While bereaved persons are mostly able to cope with their bereavement within their own support network, there are some who will benefit from professional help. These may include those who experience traumatic loss when the death is perceived as sudden, untimely or unprepared for. Those who have limited social support, difficulties coping with the loss of a child or experienced multiple losses in the family will also need more trained counselling. This group would also include people with known mental health conditions, or who have expressed suicide ideation or have carried out suicide attempts in the past. It is important for them to receive the needed support on their grief journey.
Assisi Hospice has strengthened bereavement support through the creation of the specialised Bereavement Care Programme, which reaches out to more family members of our late patients through individual counselling, art and music therapy and support groups when needed. From January to November last year, the Bereavement Care team reached out to over 394 families in the first month after their loss to assess their need for support, and over 110 family members of our late patients received support from the Bereavement Care team.
The members of Assisi Hospice’s Bereavement Care Team have shared the stories of family members of former patients who benefited from the Bereavement Care programme.
She learned to say goodbye
Madam Tan (name has been changed) was devastated when her husband, a patient of Assisi Hospice, passed on. She had been married for many years and her family requested for bereavement support when it appeared that she was in denial. She was having disturbed sleep and would visit the place where his wake had been held, in the hope of seeing him again. She also had poor appetite, experienced giddiness and sudden crying bouts, especially when she visited places they had visited together.
Assisi Hospice’s Senior Medical Social Worker/Counsellor Ivee Tee said, “She knew that he had passed on, but she was unable to accept it and still held on to a hope that he would be back. Before she was emotionally ready to confront the fact of loss, this small hope seemed to give her strength to live on.”
Ivee, who is from the Bereavement Care Team, started providing face-to-face counselling for Madam Tan once or twice a month. It was half a year after her husband’s passing that she gradually accepted that he was not coming back. Coming out from the shell of denial and facing the loss was not easy for Madam Tan at all. It was cruel to her as it meant a permanent loss of her beloved life partner and the purpose of her remaining life.
Ivee continued to journey with Madam Tan for over a year. During the counselling sessions, Madam Tan learned coping strategies to manage her emotions, including breathing techniques, creating rituals to reminisce her husband, reconstructing new meaning of her losses and even dreams. With facilitation on her narration of loss stories, she recollected the preferences, values and perception of her late husband with regard to his care, dying and death, which helped her to look at his death from a different perspective and embed it with new meanings. Madam Tan also began to explore and discover her new roles in the family, which gave her a sense of purpose that eased her into her post-loss life. Gradually, she was able to say goodbye to her late husband.
Young child obtained closure through art therapy
Eight-year-old Alice (name has been changed), the granddaughter of a patient, had always been a sensitive and empathic child who would cry when hearing about death or watching scenes from TV portraying death. Alice’s mother decided to keep her from visiting her seriously ill grandfather during his stay in the hospice and from attending the wake and funeral when he passed on, as she was afraid that it would be too emotionally overwhelming for her. As such, Alice did not have a chance to see her grandfather before he died nor say goodbye upon his passing. Alice dreamed of him, cried and wondered why people had to die. Alice’s mother agreed to a referral for art therapy sessions with Assisi Hospice Art Therapist Vivian Wong from the Bereavement Care Team, to find out if art therapy could provide deeper insights into Alice’s thoughts and how she was coping emotionally.
Vivian held three art therapy sessions with Alice and her mother. In the first session, Vivian conducted a warm-up art activity to get a sense of the dynamics between mother and daughter. The topics of grief, loss and rituals arose when Alice spoke about her pets dying. Alice expressed misgivings about being excluded from her grandfather’s last rites, and her mother had the opportunity to explain her reasons for it.
In the second session, Alice painted a memory box to commemorate her grandfather. Alice, after consulting her mother, included elements related to travelling and drinking, which her grandfather loved, on the box cover. Subsequently, she created roses with air-dry clay to be placed inside the box. Her mother worked alongside, creating a round paperweight, with a heart in the centre and Chinese characters that conveyed “I love you, Father”. Alice raised questions about staff actions when patients die, whether the bodies looked scary, and how did her grandfather looked when he passed on. Vivian answered her queries and her mother assured her that her grandfather passed away looking peaceful. Alice expressed feeling “weird” that “Gong Gong” was no longer with them, to which her mother said with teary eyes that “it takes time” for them to get used to it.
In the final session, Alice told Vivian that the completed memory box was placed near to her bed. She co-created a friendship bracelet with Vivian and wore it on her wrist as a parting gift. Vivian said, “The sessions provided a safe space and dedicated time for Alice to express her thoughts and to seek answers surrounding her grandfather’s death; and for her mother to explain her decision and actions. Both mother and daughter were given the opportunity to create tangible items to remember their loved one. With their love and wishes for their father and grandfather translated into artworks kept safe in a box, this engendered a sense of closure and continuing bonds with their loved one who has passed on. There was mutual support between mother and daughter as they honoured their loved one within the same space. Working together and listening to each other affirmed the trusting relationship they share.”