The Greek philosopher Heraclitus said you can never step into the same river twice. The waters that surround you are not the same waters you waded into even moments ago because rivers, like life, are constantly flowing.

We know that nothing is constant but change. Yet most human beings resist change. We prefer some predictability and continuity. Except for a youthful person, who may welcome change with excitement, most people, including young children, want things to stay unchanged.

In some measure, this is because change involves loss. Even change for the good can be touched with loss. Yes, we upgraded to a brighter, bigger, newer house--but our kids had a lot of friends in the old neighborhood. The new car runs better and is prettier--but Old Faithful got us through that ice storm and it didn't matter how muddy the baseball team's cleats were inside the car.

Major age-related changes may include a serious health setback for an elder, an unhappy and unwelcome diagnosis, rapid and sudden neighborhood decline, or financial losses. These things may have been on the horizon, but we may not have prepared for them. We preferred to deny they were happening rather than face the oncoming loss.

For example, the death of a parent is something few people are prepared to face. Our parents, in most cases, have always been supports for us. They have been ahead of us, making a path. Once a parent dies, the shield between us and death is suddenly not there. We're next. There is no longer someone ahead of us on the road blocking our view of our own end. Naturally, we put up a wall of denial about that.

As we go through the ups and downs of caregiving and cope with life's changes, how should we respond with resiliency to losses? Here are some tips.

  • Realize and accept that there are some recognizable patterns to emotional reactions to loss.

Elisabeth Kubler-Ross's five stages of reaction to loss are helpful, although they have been questioned. For instance, a Yale Bereavement Study reported that few people suffer from initial disbelief or denial (Kubler-Ross's Stage 1). Researchers found that yearning for the lost person was usually stronger than a depressed response (Kubler-Ross's Stage 4). The researchers also said, though, that the peaks of a person's emotions about loss follow Kubler-Ross's stages closely and that her five-stage paradigm of grief is useful.

These five stages of grief are: 1. Denial: "Mom will be all right. They'll fix her at the hospital and everything will go back to what it was." 2.) Anger: "That darn doctor! Why didn't he order that test six month's ago?" 3.) Bargaining with God or the fates: "If Mom lives, I promise to go to church for the rest of my life!" 4.) Depression: "Nothing seems colorful, vibrant or interesting. I just want to lie down and pull the covers over my head." 5.) Acceptance: "Mom had a good, long life. It is time for me to go on with mine."

  • Realize you have weathered many losses in your life already and you will get through this one.

You may have experienced your first losses in grade school. Maybe you lost a contest for a coveted prize in school. Maybe you lost friends because families moved or changed interests. You probably lost a pet. As you grew up, you undoubtedly experienced the loss of a real or potential relationship with someone you cared for romantically: "The one that got away." You may have experienced the loss of a position or job, a marriage, certain hopes and dreams, or perfect health.

Remember, you are good at this, You've been there and done that. The sun always rises again.

  • Realize that the first six months are the hardest.

Researchers have affirmed specific patterns to the intensity and duration of grief. The Yale Bereavement Study showed that the first six months after the death of a loved one are the most difficult. The passage of time does not mean that the feeling of loss departs but only that after six months, people tend to return to their normal selves and are better able to cope with their losses.

  • Realize that others can help.

Some people can process grief on their own, but many find the support of family and friends indispensable. No one should hesitate to tap into these vital sources of support and comfort.

  • Know that time heals all wounds.

An analysis by Neimeyer and Currier showed that sufficient passage of time allowed for the recovery of grief, whether people received the grief intervention of counseling or not.

  • Understand that you should be kind to yourself

The Desiderata says: "Beyond a wholesome discipline, be gentle with yourself."

Be kind to yourself. Don't neglect dental and doctor appointments, grooming, exercise, a nutritious diet, etc. Every time you do something for yourself, you experience a boost.

Loss is part of life, including the ultimate loss of life itself. Understanding how to cope with loss tempers the blows and provides a passage through grief.

Sources

Currier, J.M., Neimeyer, R. A., Bermand, J.S. (2008). The effectiveness of pschyotherapeutic interventions for bereaved persons: a Quantitative Overview. Psychological bulletin, APA, Vol 134(5): 648-661. As reviewed in The Truth About Grief, by Ruth Davis Konigsberg (2011). Simon & Schuster, Inc.

Laffranchinid. Modesto Junior College. Kubler-Ross's Five Stages of Grief. Available online at http://laffranchinid.faculty.mjc.edu/Kubler.pdf.

Maciejewski, P.K., Zhang, B., Block, S.D., Prigerson, H.D. (2007). An Empirical Examination of the Stage Theory of Grief. JAMA, 297(7):716-723. doi:10.1001/jama.297.7.716. Available online at http://jama.jamanetwork.com/article.aspx?articleid=205661.

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