Grief and Acceptance

After surviving a stroke, you and your family may feel like you’re on an emotional roller coaster. This is normal. Shortly after the stroke, survivors and families begin to comprehend their personal losses and go through a grieving process.

Grief is a natural reaction to loss. And stroke survivors and their caregivers face loss every day. The loss of former abilities or routines can be just as profound as a physical death. Recognizing common stages of grief can help you better cope with the emotional changes that go along with it. Friends can gain insight into the grieving process as well, so they can better understand your thoughts, feelings and actions.

You may not go through every stage or each stage “in order”. One stage doesn’t abruptly stop so the next one can begin. Rather, grieving is a gradual healing process that takes time and work. Each person moves at his or her own rate and form.

Stage 1: Shock

Shock usually occurs during the initial phase of hospitalization or rehabilitation. A feeling of helplessness may accompany the shock. During this time the support of family and friends is extremely important.

Stage 2: Denial

An inability to believe that something terrible has happened after a crisis and a great loss is normal. Denial lets you and your family escape the overwhelming aspects of the disability. You may be more motivated to work toward recovery than to learn to function with a disability. The focus should be on the “here and now” and the new realities you must face.

Stage 3: Reaction

This stage begins when you and your family start to realize the full impact of the disability. The most common psychological reactions are anger, bargaining (with God or others), depression and mourning of losses and changes. If these reactions interfere with rehabilitation or usual activities, it’s important to talk to a mental health professional.

Stage 4: Mobilization

This is the stage when you may say, “OK, I want to live. Show me how.” You might become more eager to learn during this stage. Family members start to show more interest in learning how to help you. This is often a good time to try short trips or outings.

Stage 5: Acceptance

Acceptance is the final stage of the grieving process. This is when you and your family learn to live with the disability stroke has caused. You can say, “I’m going to do as much as I can, and when I reach my limit, then I’m going to see how much I can do within that limit.”

Acceptance isn’t a one-time thing, and it doesn’t mean a person won’t sometimes have strong feelings about changes, losses or problems. But it means those feelings won’t keep you from feeling hopeful and grateful about being alive.

Here are some practical tips for coping:

• Give yourself permission to express your feelings. It could be a heartfelt talk with a trusted friend. Some like to write; others draw. Whatever form you choose, stick to it. v Learn to listen and keep listening. The grieving person's agenda should drive the conversation. Talking and processing feelings out loud can help the person understand that the stroke really happened.
• Forge a spiritual connection. Reach out to your church or synagogue for counseling.
• Understand that there's no right way to grieve. Many people grieve in private, and there's nothing wrong with that.
• Deal with your emotions, which might include pain, guilt or shame. There's also fear and anger: "If my dad had a stroke, could I have one too?" or "My grandfather was a nutritionist who never smoked or drank. Why us? p>Guilt can leave lasting scars and some caregivers dwell on what happened before the stroke. Allow yourself to experience these feelings but cut yourself some slack. There's no benefit to beating yourself up. Do something active. Visit the gym. Go for a jog. Swim a few laps. Just taking a walk can give the caregiver and the stroke survivor a different perspective. Can't get outside? Stay inside and watch a funny show. Let go with a ritual. Proactively cope with your losses -; but only when you're ready. Some suggestions: meditation, lighting a candle or planting a tree. Take a ritual bath, get a massage or play some music. Like hymns or Big Band tunes? Open your ears to whatever fills your heart.
• Evaluate your roles and look to the future. Once you have a handle on day-to-day issues, think about what's yet to come. How do I redefine who I am, who my loved one is and how we relate to each other and themselves.