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INTERACTING WITH THE BEREAVED

Interacting with a person experiencing grief is an important skill: several academic studies have shown that respectful and supportive interaction with a professional is of great help to people who have lost a loved one, both in the short and long term (according to the evidence-based clinical guidelines for nursing by the Finnish Nursing Research Foundation). We can say that the skill of interacting with a grieving person is an integral part of the support that a professional can give to the bereaved. Whether your job description includes reporting, examination, rescuing, nursing or diagnosing, your duty as a professional is to ensure that your actions help the grieving person during a very stressful period in their life. 

Sources on the Internet: 

  • Hoitotyön tutkimussäätiö (2018). Äkillisesti kuolleen henkilön läheisten tukeminen. Hoitotyön suositus (online). Hoitotyön tutkimussäätiön asettama työryhmä. Helsinki: Hoitotyön tutkimussäätiö, 2018 (accessed on 4 September 2018). Retrieved from www.hotus.fi.
  • Poijula, S. (2018). Suru. Soili Poijulan kotisivut (accessed on 9 November 2018). Retrieved from www.soilipoijula.fi/tietosivut/suru/ 

Literature:

  • Aho A-L., Savolainen S. (2012). Kirjallisuuskatsaus: Vanhempien selviytymistä edistävät ja estävät tekijät lapsen kuoleman jälkeen. Thanatos 1 (2), 1–28.
  • Dyregrov K., Dyregrov A. (2008). Effective Grief and Bereavement Support. The Role of Family, Friends, Colleagues, Schools and Support Professionals. Lontoo: JKP.
  • Erjanti H., Paunonen-Ilmonen M. (2004). Suru ja surevat. Surevien hoitotyön perusteet. Helsinki: WSOY. Vaikeus auttaa surevaa 145–148, Auttajan taakka 151–152
  • Hautala, E., Tuominen, E. (2017). Ensivaiheen tuki äkillisesti puolisonsa menettäneelle. Tampereen ammattikorkeakoulun opinnäytetyö (AMK).
  • Hedrenius S., Johansson S. (2016). Kriisituki. Ensiapua onnettomuuksien, katastrofien ja järkyttävien tapahtumien käsittelyyn. Tallinna: Tieotsanoma. Finnish translation by Strellman U. Swedish original Krisstöd vid vid olyckor, katastrofer ock svåra händelser: att stärka människors motståndskraft (2013).
  • Itkonen J. (2018). Kun vauvaonni vaihtuu kuoleman suruun – Narratiivinen tutkimus kohtukuolemasta, lapsen kuoleman aiheuttamasta surusta ja selviytymisprosessista sekä kirkon tuesta. Helsinki: Helsingin yliopisto.
  • Pulkkinen M. (2017). Surun sylissä. Suomalaisten kokemuksia menetyksestä. Helsinki: S&S.
  • Saari, S; Kantanen, I.; Kämäräinen, L.; Parviainen, K.; Valoaho, S.; Yli-Pirilä, P. (toim.) (2009). Hädän hetkellä – psyykkisen ensiavun opas. Helsinki: Kustannus Oy Duodecim ja Suomen Punainen Risti.
  • Savolainen S., Kaunonen M. & Aho A-L. (2013). Vanhempien selviytymistä auttavat tekijät lapsen kuoleman jälkeen. Hoitotiede 25 (3), 222–235.
  • Shariff, A., Olson, J., Santos Salas, A. & Cranley, L. (2017). Nurses’ experiences of providing care to bereaved families who experience unexpected death in intensive care units: A narrative overview. Canadian Journal of Critical Care Nursing 28 (1), 21–29. Surevien saamaan tukeen vaikuttavat tekijät.
  • Virta T., Kaunonen M., Aho A-L. (2017). Henkirikosuhrien läheisten suru sekä selviytymistä edistävät ja estävät tekijät. Thanatos 6 (2), 5–48.
  • Välimäki, Elina (2017). Ei unohdu koskaan. Henkirikoksen jäljet. Jyväskylä: PS-kustannus.

Other sources: 

  • Poijula, Soili: Monikasvoinen suru. Lahden kesäyliopiston 14.11.2018 järjestämä koulutus ja koulutusmateriaalit.

What constitutes as good support and interaction?

Treat the grieving person as an individual.

Treat the grieving person as an individual. Graphics by Surevan kohtaaminen

Map the support network and need for support. Ask what kind of support the grieving person wants.

Show compassion.

Show compassion. Graphics by Surevan kohtaaminen.

It is important for the grieving person to know that you care. Listen and be present.

Give them your time.

Give them your time. graphics by Surevan kohtaaminen.

Reserve enough time for meeting the bereaved.

Give information.

Give information. Graphics by Surevan kohtaaminen.

 Talk in a direct and easy-to-understand manner. The grieving person needs information about what has happened, their grief and support options – also in writing.

Respect the grief.

Respect the grief. Graphics by Surevan kohtaaminen.

Loved ones have the right to grieve, no matter the situation. Do not try to diminish the grief or make your own interpretations.  When talking about the deceased, use their name.

Refer them forward.

Refer them forward. Graphics by Surevan kohtaaminen.

It is good to make sure that the grieving person continues to receive support and is not left alone. The grieving person may need:

  • crisis support
  • health care
  • conversational therapy
  • peer support
  • financial support
  • practical help.

Each instance of loss and grief is individual. The causes leading to death vary, and the loss always occurs at a particular point in life. People are different, each with their own life history and personal ways of reacting in and dealing with difficult situations. These things influence how the bereaved person deals with and expresses their grief. Each grieving person should be treated as an individual. Remember to ask them what kind of support they need. Grief also affects children and young people. Their grief is just as deep as that of an adult, even though the way that they express grief is different depending on the age of the child. The death of a loved one affects children and young people very strongly, and they always need adult support to cope with loss and grief. Read more about the grief of children and young people.

You can show compassion through both words and deeds. When interacting with a person who has lost a loved one, you should express your sympathy and condolences in some way. Expressions such as “I am sorry for your loss” or “My condolences” are considered common and neutral expressions in professional interactions and in Finnish culture. The life of a person who has lost a loved one has been greatly disturbed, and they feel hurt if what has happened is ignored during the interaction. Expressing your condolences acts as a conversation opener, after which you can discuss other issues related to loss and grief. You can also tell the grieving person that you have no words suitable for the situation. In addition to words, you can show compassion through actions, like touching or looking at the bereaved, or simply being present for them.

Having a professional present and listening is very important to the bereaved. Grieving people value compassionate interaction and unhurried presence. People who have lost a loved one often want to talk to someone about what has happened, and they need someone who listens to them. When supporting the bereaved, listening is more important than talking. When supporting a grieving person, you have to accept that you cannot take away or diminish their grief. It is important that the grieving person is not left alone, but that there are people who can bear their pain. 

The important thing is not to try to “solve” a person’s grief. We cannot make grief go away by acting in a certain way or by trying to find an explanation or meaning for what has happened. You should also never compare different kinds of losses with each other or value one kind above another. Well-meaning advice or expressions used to comfort the grieving person often feel hurtful to them. Expressions such as “No one is given more than they can bear”, “Time heals all wounds” or “It will feel better in a year” may be said with good intentions, but they do not comfort the bereaved.

The grieving person needs information about what has happened. Professionals should provide the bereaved with information about matters related to death and answer any questions they may have. It is often comforting for the bereaved to hear facts about what has happened and to receive general information about grief. This information helps the bereaved to understand what has happened, as well as their own reactions related to the death of a loved one. Professionals should speak clearly and use terms that are easy to understand. If the grieving person is in shock, it may be difficult for them to receive information. There should also be an opportunity for discussion later, and information should also be provided in writing. The bereaved should also be given information about the support available to them.

People who have experienced loss are allowed to feel grief throughout their lives. You should always respect the grief of a person who has lost a loved one. Everyone has the right to grieve, no matter the situation. Never downplay anyone’s grief. When talking about the deceased, you can and should use their name. Do not expect the grief to progress through certain stages or set time limits for how long it can last. People live with grief, and it often accompanies them in some way throughout their lives. It is natural to occasionally feel intense grief even after a long period of time after the loss. The initial pain does ease, however, and life goes on, also bringing good and positive things with it.

In addition to the support of loved ones, the bereaved may also need professional help. The grieving person should be informed about their rights, the different forms of support available and, if necessary, referred to professional support. You should also encourage the bereaved to accept support. If the death occurs at an early age or suddenly, crisis support is an important first line of support, in addition to the support of loved ones. You should also give the grieving person written information about the different forms of support available to them, so that they can familiarize themselves with this information later. The need for support may not arise until some time after the loss. That is why it is important to offer support both at the initial stages and later on. Learn more about the different support channels, peer support and grief organizations.

Nursing Research Foundation
In autumn 2018, the Nursing Research Foundation published a set of research-based guidelines created by experts: Supporting the loved ones of a person who has died suddenly. We have used the nursing guidelines as the basis for the practical advice given on this website on how to interact with the bereaved.
Nursing Research Foundation
Nursing Research Foundation
In autumn 2023, the Nursing Research Foundation published a set of research-based guidelines created by experts: Supporting and interacting with the loved ones of patients in palliative and hospice care.
Nursing Research Foundation

What issues may make interacting with the bereaved more difficult?

  • We are trying to solve their grief. When a fellow human being faces a devastating loss, we feel a great need to help them. In our desire to help, we may forget about the fact that you cannot heal someone’s death or make a person’s grief smaller.

  • We do not understand grief. Grief is a holistic experience, and it affects all aspects of life. Grief is always individual, and people have different ways of grieving. As our knowledge and understanding increases, our interactions with grieving people also improve.

  • We try to protect ourselves either consciously or unconsciously. The death in question may be so devastating that we do not want to think about it, and the grief of the loved one is so enormous that it may be difficult to face. Most people want to avoid being exposed to things that cause them distress, which is completely natural. But if a professional distances themselves too much from grief, the bereaved person may interpret it as indifference.

  • Our resources are lacking. Many organizations run on insufficient resources. This makes it difficult to interact with clients in an unhurried and empathetic way.

What factors affect the support given to the bereaved?

Many different factors affect how a grieving person receives support from professionals. These factors can be related to both professionals and organizations. When helping a grieving person, the focus should be on the person’s wants and needs. Below, we have collected some tips that may help professionals and organizations contribute to the support offered to the bereaved.

  • Having more knowledge about grief and how to interact with the bereaved.

  • Dealing with and clarifying a professional’s relationship to grief and death. Professionals should address their own experiences of loss and be aware of their potential impact on the interactions. It is important for professionals to talk about and deal with their own emotions and the situations they face at work with an expert, such as a work counsellor

  • Work community support and taking care of yourself. Looking after your own well-being and coping at work is important. Being able to talk about stressful issues within the work community and receiving support from colleagues help professionals cope better at work.

  • Attitudes and practices within the organization. The organization must make sure that it has adequate resources, policies, staff skills and support available. Being compassionate when interacting with a grieving person and helping them get further support should be seen as an inseparable part of the work of professionals who help bereaved people