My parents start the day by reading the obituaries and many older adults do the same. They think about their own mortality while grieving the death of family, friends and the community at large.


Older adults experience grief much the same as younger and middle-aged adults. However, due to their age and life experience, many factors can impact their grief reaction.


The natural process of aging includes many losses. These include loss of physical strength and endurance, loss of independence, loss of mobility and loss of youth and beauty.  Older adults may have to give up their role in the family and subsequently, family dynamics change.


Losses that accompany physical disease and mental illness also have an impact.  In addition, older adults who experience spousal death may experience the loss of financial security, their best friend and other social contacts.  Finally, older adults may feel sad, but do not identify their feelings as grief and certainly are not willing to share these feelings with others.


Specific Issues Impacting Older Adults


Older adults often experience several losses within a short period of time. They are more likely to have had a friend or family member die in close proximity. All their childhood friends may have died or have dwindled in numbers. The Saturday night club, which originally hosted 6 couples, now has two and many widows or widowers. Older adults may go to 12 funerals or more in one year. What is important is that each loss has a different level of significance.  Grieving many losses concurrently can result in feeling overwhelmed or numb.


Some older adults lack awareness that they are grieving. Maybe no one asks them how they are feeling. They may be unwilling to tell others because they don’t want to be a burden or they may fear being “placed” somewhere.


They might feel grief is just part of getting old and disenfranchise their own feelings of sadness. However, many older adults suffer from untreated depression. Depression can occur with other medical illnesses and healthcare professionals often mistakenly conclude that depression is a normal consequence of these illnesses. The elderly do this as well.  Some people believe that depression is a normal part of being elderly. This makes the depression under-diagnosed and under-treated. Depression is not normal for people of any age.


Older adults may lack the support systems they once had.  After the funeral families return to their homes (often out of state) and their busy lives. Consequently, many older adults become isolated.

How can we help?

  • Give older adults more time to become aware of and express their feelings.
  • Point out signs and changes in behavior and sadness.
  • Older adults who are isolated can benefit from the company of others.
  • Talk about the deceased. Encourage the older adult to share memories.
  • Since many older adults have experienced multiple losses, encourage them to talk about each loss separately.
  • Be aware of the signs of depression.




Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC





This column is dedicated to my cousin, Mark Bixby, 44-year old husband of Theresa and father of Ryan, Kirra and Jessica.  His life was cut tragically short on March 16th when he and four other men were killed in a small plane crash on their way to a ski trip.  These are the words I spoke at his memorial service on March 25th at the U.S. Sailing Center in Long Beach, Calif.

Mark was like my little brother.  I was four when he was born, and I loved him from the minute I saw his cute little baby self.  Even though our families lived across the country, every summer our California cousins spent a month in New Hampshire with my family, giving us hundreds of hours together to forge strong bonds and lasting memories. 

Lately I’ve been picturing Mark’s face and, in particular, his eyes; not so much the grown-up Mark, but the little boy Mark. When he was a kid there was something special about the way he looked at the world; his little brow would furrow a bit, like he was concentrating real hard.  He was taking it all in; he was Born Curious. 

As a kid, he worshipped my brother, who was a super smart engineer-type kid. He followed David around like a shadow, always asking him about how things worked.  But Mark’s curiosity was about more than just the physical world.  He’d have long discussions with my dad (a philosophy major in college) about the Big Life Questions. As adults, he’d pick my brain about my work as a psychologist, trying to understand how to use his empathy and compassion to help others.

Mark was my kindred spirit; we both loved to perform, but we both knew we weren’t talented enough to make a career of it.  Still, we found plenty of opportunities to perform together.  As kids we’d dress up as Shields and Yarnell (remember the mime duo from the 70’s?) and act out skits where we’d walk around stiffly like robots, spilling drinks and trying not to blink.  As we got older, we’d harmonize together whenever we found ourselves near a karaoke machine or whenever Brett would indulge us on guitar.  His attitude was “Who cares if we don’t win a Grammy; the point of life is to have fun!”    


As a psychologist I work with people who struggle with insecurities, question their worth and worry what others think.  In fact, that description probably fits the vast majority of us at some level.  But one of Mark’s notable gifts was his utter confidence in himself— not in a narcissistic way, but a confidence built from a solid belief in his inherent worth.  

Because he did not waste precious time or energy worrying about other’s opinions of him or second-guessing his instincts or desires, he was free to act in courageous ways.      

Most of us know that as a young boy, Mark lost his father; there are those who never recover from such a loss.  But Mark was able to internalize that consistent love he’d received from his dad, the steady support from his mom and then Denny, the unwavering connection with Brett and Grant, and the devotion of his friends and his community.   This love-swell grew into an invisible 20-foot wave that he surfed throughout his life; it lifted him up and propelled him forward.


I was so thrilled that he found an incredible soulmate in Theresa, a woman whose energy and vision matched his own.  At their wedding reception 18 years ago, I made a toast that amounted to a public promise: that we would all continue a tradition of closeness for the generation of children that we would raise on opposite sides of the country. I’m so thankful that our family gatherings at Lake Almanor and Lake Winnepesaukee have allowed our kids to form lasting bonds.  Happily, my boys love their California cousins as much as I love my California cousins. Let me take a moment to paint a picture of how these gatherings look:

It’s morning at a lodge on a lake in New Hampshire. The rising sun is burning off the fog over the glassy water.  The kids are up early, but the grown-ups rise slowly…we’re on vacation after all!  We’re shuffling around, bleary-eyed in our PJs, sipping coffee, reading the paper.  Someone asks….where’s Mark? 

*Turns out he’s driving to the other side of the lake to pick up the motorboat he’ll be using for the next five hours teaching the kids to ski and wake-board. 

*Or, Mark is strapping the canoe to the roof of the car so he can take the boys to the swamp to catch turtles and frogs. 

*Or, Mark’s filling up dozens of water balloons for the fierce battle that’ll take place before lunch. 

In Mark’s world, vacation wasn’t for vegging out: it was for experiencing, singing, learning, growing, laughing – creating memories.  

Whenever Mark passed through Atlanta for a brief business trip, he’d stop by just to play with my boys.  He taught them Mancala; he sang them “The Bear” song; he crawled on the floor in his business suit, pushing toy cars down the hallway.  At our house he became known as: “Uncle Mark, Get Set, Go!”

One final note: Mark was a soft-hearted romantic, an old-fashioned guy who appreciated the value of ritual and tradition. He was the kind of man who actually called me every year on my birthday; not just my 30th or my 40th, but random insignificant birthdays…and this was way before Facebook told you to write a Happy Birthday post to your “Friends.”  How many people do this these days…and at the risk of sounding sexist, how many MEN do this? Actually pick up the phone to call a cousin for a real conversation? 

About a month ago, I got an email from him with an attachment.  The note said, “Look what I made the kids for dinner tonight?” with a smiley face. Attached was a photo of dinner, little pita pizzas that I’d taught him to make when we were teenagers.  It wasn’t just that he made the pizzas: it’s that he thought: “Oh, Dina taught me to make these. I’ll bet she’d get a kick out of this!” so he took a picture, uploaded it and sent me a sweet note.  He took the time to share this moment because family traditions were an organizing principle for him; they served as his North Star.

So the way to keep Mark alive is to make his mission, our mission.

Ryan, Kirra, and Jessie: I see Mark in your eyes.  I see his love, his curiosity, his compassion. I see his confidence and his courage.  These qualities inside of you will serve as the steady surfboard beneath your feet; our love for you will be the wave that buoys you up and carries you forward into your amazing lives. 

And when you grow up, I hope that your children and my sons’ children will hunt for frogs together, and toss water balloons at each other and sing “The Bear” song… because Mark’s mission was this: nothing, absolutely nothing, not time nor distance nor loss, will ever break the ties of love that hold our family together.

To learn more about Mark, click here: 



Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.


More Dina Zeckhausen articles, click here.


©2011 ShareWIK Media Group, LLC



Last week an adult daughter called the bereavement center very distraught. She was worried that she had made the wrong decision in withdrawing life support from her mother. I killed her… I killed her she repeated.


After expressing my condolences, I asked about her mother …her likes… dislikes… what kind of person she was…what kind of mom she was. After the woman was settled I asked if she and her mother had talked about what her mom wanted at the end of life. She was very clear that her mother did not want to be hooked up to machines or to be a burden, and that she would have wanted to be remembered as the very lively woman she was. Even though she knew what her mother would have wanted, the two did not talk about advance directives. If they had, the daughter’s anguish could have been averted. She would still have her grief, but not the anguish.


National Healthcare Decision Day is April 16th, 2011.  The day mobilizes national, state, and community organizations, healthcare providers, and others to promote awareness, completion and discussion of advance directives.


Most of us know the benefits of planning ahead and being prepared for major life transitions.  We are careful to plan for such major life events as graduations, weddings and births, but most of us tend to avoid planning for the one event that is absolutely inevitable for all of us, namely the end of our life – our death.


Advance Care Planning is a process for reflecting on, discussing and ultimately making our health care choices for the future so that we may receive the care we want as we approach the end of our life. It means knowing treatment options and values. It means talking about them with trusted individuals who will follow our wishes.


Advance Directives are the written documents that result when we complete the Advance Care Planning process. A 2005 Pew Research Center study found that, although 84 percent of those surveyed said that they support laws that let terminally ill patients make decisions about whether to be kept alive through medical treatment, only 29 percent report that they actually have completed a Living Will1.  Even when documents are completed, they are often put in a “safe” place and forgotten rather than copied and distributed to health care providers and family members so that they are readily available when needed.


For the bereaved, Advance Directives are a gift. Knowing what your loved one wanted and abiding to that can provide comfort in a difficult time.


To help you get started:


      .                  Caring Connections at 1-800-658-8898 (Helpline)
or 1-877-658-8896 (Multilingual Line), or at http://www.caringinfo.org/

      .                  Five Wishes at 1-888-594-7437 or at http://www.agingwithdignity.org/five-wishes.php (Note: The Five Wishes document is only legal in 42 states and Ohio is NOT one of them)

      .                  Advance Care Planning booklet Courage in Conversation: A Personal Guide available from Hospice of the Western Reserve, Cleveland, OH 1-800-707-8922 or at http://www.hospicewr.org/planning/ 

     Note: Some information in this booklet is accurate for Ohio only

      .                  Your personal attorney

      .                  American Bar Association Commission on Law and Aging website at http://www.abanet.org/aging/



1.         Kohut A, Keeter S, Doherty C: More Americans Discussing – and Planning – End-of-Life Treatment: Strong Public Support for Right to Die.  The Pew Research Center for the People & the Press. Washington, D.C., 2006.


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC



People volunteer for many reasons. One of the most obvious is that they want to give back. Others may want to learn a new skill, have a sense of accomplishment or an opportunity to meet new people. Perhaps they are looking for a job or want to keep busy. Maybe it’s a requirement for school. There are hundreds of reasons to volunteer.


In the hospice setting, there often is a different reason. Many of our volunteers often make comments of this general nature: They took such good care of Bill and I want to repay that kindness. Our volunteers amaze me with their thoughtfulness as well as their generosity of time, spirit, and expertise.


April is National Volunteer Appreciation Month. If you have ever volunteered or have been on the receiving end of this kindness, I am sure that you will join me in thanking the hundreds of people who volunteer in all capacities in our country and abroad.


If you are thinking of volunteering with a hospice after the death of your loved one, take time to consider why you want to volunteer and where you are in the grief process. Grief can take a powerful toll on you.


It is important to take responsibility for yourself and be sure that you are truly capable of working in the environment of death and dying and grief and loss. It’s hard enough when you are not actively grieving the death of a loved one. Volunteering does not take the place of grief work.


When is the right time to start volunteering for hospice after the death of a loved one?


This is a difficult question to answer. It is important to have made an appropriate adjustment to any major losses in your life. As a general rule, if you have experienced a significant death within the year or if you have someone in the family with a serious illness, you may need to re-assess your readiness.  Ask yourself where you are in your grief process? If you are at the beginning of your journey, you may want to wait as there are many triggers lurking.


All that being said, it may be that you are indeed okay to volunteer within that first year of the death. Busying yourself with such tasks as copying or mailing may provide you with a sense purpose, a routine, a time to get moving and much more. But sitting vigil or making friendly visits may prove to be too difficult in the early days of grief.


Here are two of my favorite volunteer stories:


Joe is an accomplished jazz musician. After his mom died, he wanted to give back. After completing the volunteer training, he began playing jazz in the afternoons in the atrium at Hospice House. This has branched out to his providing music to select patients in nursing homes. Ray, a veteran, volunteers with hospice patients who are also veterans. He provides an important presence in our pinning program and often wears his uniform while volunteering. 


Be sure that you take time for personal reflection before you begin to volunteer.  



Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC


For the past three years, Mrs. James went to the nursing home every day to feed her husband lunch. Despite bad weather or feeling poorly, she still made it every day. Prior to that, she cared for Mr. James in her home. As he declined, Mrs. James changed her lifestyle more and more. Eventually, she stopped going to lunch with her girlfriends and seldom made it to church or her volunteer activities. She never complained. After all, wasn’t that what marriage was about? Shortly after their 65th wedding anniversary, Mr. James died. After the busyness of the funeral she had less and less to do.  Mrs. James didn’t know what hit her.


When someone you love dies, you don’t just experience the loss of your loved one. You also experience secondary losses that occur as a result of illness and death and are often overlooked. When you experience the death of a loved one, try to identify if there are secondary losses related to the death. For Mrs. James it was the loss of the role and responsibilities she had in caring for her husband.


Secondary losses can be physical or psychosocial losses that develop as a result of the initial loss. These losses include not only the roles that made up the relationship (confidant, companion) but also intangible losses (dreams, hopes, self-esteem). Secondary losses can include grieving your role as a parent, child, spouse, friend, grandparent or grandchild.


Other examples include the hopes and dreams for the future. You design and plan for that retirement road trip. You put the down payment on an RV and then the world changes when your husband suddenly dies the first week into retirement.


Financial security, faith or belief in God, sense of safety, self-confidence, and changes in residence, life and routine can be secondary losses.  Even couples who encounter divorce experience secondary losses. Who gets the friends? Who gets the dog, the cat?


According to noted grief expert Therese Rando in Treatment of Complicated Mourning (1993), each secondary loss results in its own grief reaction and needs to be mourned.


Sometimes it can be overwhelming just to think about these secondary losses. Remember there is no right or wrong way to grieve. Be kind and gentle to yourself and know that you do not have to grieve alone.


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC





We’re often asked if men grieve differently from women. Truly, there is really only one way to grieve and that is to move through it. You can try to push it down or move around it, but grief will catch up with you. Only by experiencing grief can it be resolved.


That being said, men have some very similar grief experiences that differ from women.


Society disenfranchises men’s grief. In Men Don’t Cry…Women Do, Doka and Martin describe a continuum of grievers. On one end, there are intuitive grievers who express grief in a variety of ways that include crying and expressing feelings. On the other end, there are instrumental grievers who manifest their grief through physical, behavioral and cognitive ways. Their affect is modulated. Men mostly fall into the instrumental pattern although that is not to say that some men are intuitive grievers and some women are instrumental grievers.


After the funeral, my cousin asked how my wife was holding up. She was doing okay. I was one who was barely holding on.


In our culture women and girls are encouraged to be expressive, to cry, and to share their feelings. Men appear weak if they cry. Cultural expectations make it difficult for men to express their feelings. Regardless of the type of loss, men are expected to repress their emotions, be supportive, take charge, and be strong for others. Men respond the way they’ve been taught to do so – the way our culture expects them to. And so what do men do? They often hide their grief.


In Men & Grief: A guide for Men Surviving the Death of a Loved one (1991) Carol Staudacher, writes about five coping styles of grieving men.

· Remaining silent – Many men keep their thoughts and emotional pain to themselves. By not saying anything or saying very little protects their vulnerability.  When others ask how your wife or parents are doing, they are reinforcing this silence. Men aren’t invited to share their feelings.

· Engaging in solitary mourning – Most men find it easier to mourn alone. I vividly remember my husband sobbing in our dark basement in the middle of the night months after his mother died. I could not comfort him. He needed and wanted to be alone.

· Taking physical or legal action – Some men initiate action immediately after the death of a loved one. This ranges from chopping down a tree to litigious activity to assisting in a police investigation.  “Taking control” of the loss by taking action could be all-consuming activity for an extended period of time.

· Becoming immersed in activity – This is closely related to taking action and is about keeping constantly busy. This usually centers on work or home. If one is immersed in activity, there is no time for feeling the pain of grief.

· Exhibiting addictive behavior - Unfortunately we live in a society that is death-denying and pain-avoiding. Men who want to numb the pain may turn to substance abuse after years of sobriety.


· Acknowledge your feelings

· Talk about the death, communicate

· Join a men’s support group

· Cry – Releasing tears is healthy and the body’s way of cleansing itself.

· Give yourself permission to grieve

Understanding the way men and women grieve provides insight into the grieving process. There is no right or wrong way to grieve and each gender, each person, uses their own strengths to manage and move through grief. Respecting differences helps us enfranchise the grief of those we try to support.



Golden, Tom. (1996) Swallowed by a Snake: The Gift of the Masculine Side of Healing.

Martin, T. & Doka, K. (2000) Men Don’t Cry…Women Do.

Staudacher, Carol. (1991) Men and Grief: A Guide for Men Surviving the Death of a Loved One.


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC

Memorial Day is the day set aside to honor America's war dead. This month Osama Bin Laden was killed. This causes us to remember those who died and feel relief that there is a little less horror in the world. We thank the soldiers for their acts of bravery. Bin Laden’s death triggers memories of 9/11 and those that died of that act of terrorism. For many, it triggers strong grief reactions and while difficult, these responses are very normal. Our world has changed since 9/11 and many soldiers have given their life to serve our country.

Originally called “Decoration Day,” this holiday started in 1868 by General John A. Logan for the purpose of decorating the graves of Civil War veterans. Within 20 years, it was changed to Memorial Day in which all war dead are commemorated. It became a federal holiday in 1971.

You may also notice members of the Veterans of Foreign Wars collecting donations for poppies in the days leading up to Memorial Day. The poppy relates to John McCrae’s poem In Flanders Fields. In the First World War, during the Second Battle of Ypres, a Canadian an artillery officer was killed on May 22nd, 1915. He was a friend of the Canadian military doctor Major John McCrae. John was asked to conduct the service and it is believed that later that evening John began the draft for his famous poem.

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

Memorial Day is May 30th this year. Friends and family may be making plans for picnics and parades, but for some it is time to visit a national cemetery to remember loved ones who have served their country. In addition to your festivities, spend a moment to honor our loved ones, ancestors, and friends who died in conflicts and wars. Let it be a time of remembrance and celebration.


You can also:

  • visit cemeteries and place flags or flowers on the graves of our fallen heroes
  • visit memorials
  • fly the U.S. Flag at half-staff until noon.
  • fly the POW/MIA Flag
  • participate in the National Moment of Remembrance at 3 p.m.
Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC




There are many intense and confusing feelings after the death of a loved one. Our grief is heightened on days that we are accustomed to celebrating…days that were so meaningful to our deceased loved one and family. Coping with grief can be particularly difficult when annual traditions and special occasions are continued in the friend’s or relative’s absence.  During these times our deceased loved ones are noticeably missed and their absence is more palpable than on a typical day. With our expectations for joy, these special times can be complicated. 

Birthdays, wedding anniversaries, anniversaries of the death, holidays, and special occasions often trigger our grief response. Sometimes the anticipation of the event can be more difficult than the actual date or the occasion itself.

If you have been taken by surprise by a grief reaction on an anniversary or special day or if you are dreading  an upcoming special event, consider having a grief response plan. What will you do? Whom will you call for support? What coping strategies will you initiate? Will you visit the cemetery, go to your faith community, hike, journal, bake, donate to a charity, read letters? Try to specify a plan. Be prepared.

Remember that life has changed since the death of your loved one. In grief we are adjusting to new roles. Family get togethers are different now. For some, they might be more commemoration than celebration.

As I watched all the events surrounding the royal wedding, I thought about the brides who might be planning a wedding or walking down the aisle without the physical presence of their mom or dad or grandparents.  This too can trigger a grief reaction. The experience may be bittersweet. In the midst of joyful planning, your mind wanders back to that special person who will not be there to see you get married. You can only imagine their look of pride seeing you on that momentous day.

Find ways to bring your deceased loved one into your special day.

·      Wear an article of their clothing or jewelry

·      Carry something symbolic in your bouquet like a broach or charm.

·      Keep a candle lit or some memorabilia visible (like a flag)

·      Hold their prayer book or religious artifact.

·      Play a song they loved

·      Include a meaningful silence


Honor your sadness and your joy. The person you are missing contributed to who you are. Don’t be afraid to acknowledge them and pay tribute. It is your day. Be confident in your remembrance and embrace your emotions.

Grief triggers help you stay in touch with feelings and help you move forward on the journey. Hold on to the thought that although our loved ones are no longer physically with us, they will always remain in our hearts.



Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC    

Despite the best efforts of healthcare professionals, despite prayer chains and positive energy, some children with cancer die. During this journey many parents and children find comfort and support with hospice and palliative care.  Hospice care is provided wherever the child lives, at home, a residential facility or a hospital. Goals of hospice are to relieve physical, emotional, social and spiritual suffering, thus enhancing the quality of life for seriously ill children and their families.

Parents and child share a unique bond and when a child dies, a piece of the parent dies too. No matter how long the child lives, the grief is palpable. The death of a child is also the death of a friend and a source of support. If it is an only child, it is the loss of the role of a parent and the possibility of grandchildren. It is the loss of hopes and dreams parents had for their children. Part of the future dies along with the child.

How can a parent survive such loss? Grief responses for parents are intense and last a long time. Shock, overwhelming sadness, guilt, and anger are only a few of the more common grief reactions. Parents often question their faith and the meaning and purpose of life. People frequently put timetables on grief, but there is no calendar. The intensity will ebb and flow over time and the deep sadness will always be there.

Parents who have experienced the death of a child offer the following:

  • Give yourself permission to grieve. Cry when you need to cry.
  • Tell and re-tell the story. Use your child’s name.
  • Beware of expectations. Plan ahead for special days and anniversaries, as well as plan responses for questions about your family.
  • Reach out to others. Seek out a bereavement counselor or a support group if that feels right for you.
  • Be kind to yourself.

Fortunately there are many resources available to assist you on this difficult journey. You do not have to grieve alone.


Hospice and Palliative Care










Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC    

I have aging parents. My dad just turned 85 and my mom will turn 85 in November. The past few years have been interesting to say the least. My mom survived breast cancer. She also underwent angioplasty as a result of a heart attack, which she kept secret for three days not wanting to disrupt a relative’s bat mitzvah celebration. Mom volunteers in my office weekly and helps out with the bereavement mailings. Dad is a person with memory loss. This came to light the past couple of years and it has been a roller coaster of emotions, appointments, emotions, tests, emotions, more appointments, emotions, more tests,  emotions and more emotions. 

Did I mention Mom was a saint?


Having been the point person between my agency and the Alzheimer’s Association for a grant a few years back, I knew a little too much about the disease’s progression.  I knew that Mom was bearing the brunt of Dad’s moods and that she and my siblings were experiencing and would continue to experience anticipatory grief.  Did I mention Mom was a saint?


Anticipatory grief is the form of grief that occurs when one is confronted with a chronic or life-threatening illness or when one anticipates the death of a loved one (or oneself).  It may be expanded to include illnesses like dementia where the person with the disease and their family are experiencing losses over a period of time.


Anticipatory grief is not a device for completing the tasks of grief prior to the death of the individual. It does not substitute, or necessarily lessen, the post-death process.  It is not post-death grief pushed ahead in time.  But recognizing anticipatory grief can afford families to better manage the illness, problem solve and address losses as they occur.


Adapting to the new and ever changing environment.


When a family member has dementia, things are constantly changing.  Often one feels they have just adapted to one situation and then a new crisis makes more change necessary. This can keep everyone in physical and emotional high gear.  Losses are constantly happening. 




Communication is the key to coping and growing as a family through grief.  It is important to be together to talk, cry, rage, or even sit in silence.  At the same time there should be respect for each member’s way of handling their anticipatory grief.  Some family members will grieve privately, others openly, and others a combination of these two styles.  In many ways each family member must grieve alone. 

  • Maintain a balance of attention between the family member that is ill and the other family members. 
  • A hug or a hand on the arm or back can provide comfort and a sense of closeness.
  • It may be helpful to set aside time to be alone together as a family or even to hold a family meeting.
  • Encourage but don’t pressure family members to talk and express their anticipatory grief in their own way.  Be a good listener.
  • Create a memory or legacy project and talk about feelings regarding memories.
  • If depression, withdrawal or family problems are worsening or out of control, seek professional help.


If you can learn to share your anticipatory grief as a family hopefully you will grow as a family. I am fortunate to be one of five adult children who are amazingly all on the same page with addressing these issues. With our individual strengths and weaknesses, we do the best we can to keep Mom and Dad active and healthy. And while it’s heartbreaking to see my dad put on his gloves and hat in 70-plus-degree weather, it’s kind of hilarious too. Did I mention Mom was a saint?


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here

©2011 ShareWIK Media Group, LLC    

Alexa Renée Provo was born on March 22, 1979. I dreamed about Alexa during my pregnancy. I remember laughing the next day as I described my dream: “The baby was a girl with blonde hair that stuck straight out all over her head. She had huge blue eyes.” Imagine my surprise months after her birth when Alexa looked exactly like the infant in my dream, although her eyes turned green by the time she was two.  That deep connection was one we continued to share.

Alexa was the type of child who changed the minds of people who were firmly against having children. I had a friend whose marriage ended when his wife decided she no longer would abide by their marriage’s no-kids clause. He met Lexie, changed his mind, married (a different woman), and became a dad.

Alexa’s life was a gift, a gift cut short by pediatric cancer on November 2, 1986. I am honored and grateful to have had such a magical, loving, dear, sweet child in my life. I miss her, I love her, and I always will. 

Big scary words exist, words no parent should ever have to hear regarding their child. Words such as primitive neuroectodermal tumor, glioblastoma multiforme, occipital temporal lobe, radiation oncology schedules, a room number at the Ronald McDonald House, vincristine, cisplatin, dexamethasone, valproate. Those words and more became a part of my vocabulary on July 11, 1985, when my six-year-old daughter Alexa fell out of a tree. A cerebral hemorrhage followed, then came a coma, then came emergency surgery, and then came a bizarre pathology report: the tissue from the hemorrhage had tumor cells. The worst words—primitive neuroectodermal tumor with glioblastoma multiforme cells—translated to a diagnosis no parent ever wants to hear: brain cancer.

My life as well as my vocabulary changed over the next several months. My full-time job became caregiver to a child with a life-threatening disease. Our days were spent hearing frightening words as we went from doctor to doctor, hospital to hospital, discussing treatment plans, drugs, and therapies, and as Lexie endured additional surgeries: one to remove the tumor; a second surgery to remove even more tumor tissue; and a third surgery to insert a shunt to relieve pressure on her brain from accumulating fluid. During that time, we heard more scary words: survival rates (not good), radiation therapy side effects (also not good), and possible negative results that a surgeon read aloud preceding each surgery and my required signature on the consent form. I don’t remember those pre-surgical warning words, except the last one—death.

Scary sounds also exist, sounds no parent should ever have to hear: the beeping of machines surrounding your child’s bed in an intensive care unit, sobs when yet another nurse, PA, or resident again failed to find a vein strong enough to hold the IV needle your child must have to receive chemotherapy. Sounds of a doctor gently informing you that your child is being sent home: no more drugs, no more treatments, no more hope.

The worst sound I ever heard during the 16 months of Alexa’s illness was that of her final breath on November 2, 1986. She was seven and died with her dad, her sister, and me at her side.

Silence… no more scary words.

Big scary words, however, are not the sum of our lives during those 16 months, nor the sum of my life since November 2, 1986. The scary words were always there, hovering, the proverbial dark cloud we try in vain to ignore while seeking sun and clear skies. In spite of that cloud and those scary words, words of light and love and warmth prevailed in many ways. Those words held within them worlds of kindness, hope, faith, and love. I was blessed to hear them.

Lexie’s ICU nurse Ron, who happened to be our neighbor, heard we were vegetarians and his wife brought a tofu pie to us during our vigil at the hospital during the early days of Alexa’s illness. He also told us we had to learn the meaning of those big scary words and use them to communicate with Alexa’s doctors.

Lenore, a pediatric nurse at Shands Hospital, loved Alexa, and she often hooked up Lexie’s IV pole to a wheelchair and brought Alexa with her as she did her evening rounds. The two of them sat at the nurses’ station while Lenore did her charts. I still smile at the memory of the sound of their laughter from the jokes they shared. One night after a stormy drive from Gainesville, Florida, to our home four hours south, Lenore’s voice on the phone wanted reassuring words that we had made it home safely.

“What is the amount of the insurance premium? I’m writing a check.” were the words of my pediatrician’s office manager. Earlier that day, I told Dr. K we had to go to a hospital that accepted uninsured patients. We were out of money and the policy was going to lapse. He wanted us to go to another hospital without a pediatric ward so we would be spared seeing children who would get well and go home. Because he paid the premium, we were able to do so. The office manager also used the following words: “What time is the funeral? The doctors are closing the office so the entire staff can attend.”

Memories of the words on a sympathy card from my high school friends and their mothers still bring tears of gratitude to my eyes. The check enclosed meant that I had the funds for words on a stone to mark Alexa’s grave.

Words naming foods, words naming hope, words naming help, comfort, encouragement, and love filled our lives during that time. That I still walk the Earth is a testament to the significance of those words.

Words also brought me back to life after Alexa died. I was consumed by grief; it oozed from every pore. I also was afraid, afraid of a life of darkness, tears, and perpetual mourning. I was afraid, but not suicidal, just low, so low in spirit, that I felt as if I couldn’t move, couldn’t breathe, couldn’t live any kind of real life. One day, my grief was even too much for me to bear. I had to decide if I it was enough for me to simply plod about the Earth as a moving lump of cells, rather than a person who participated in life. I looked in the mirror and said aloud: “I want to live.”

Those words brought me back to the land of the living, step by step. The steps were not quick; I still take them, every day, as I live, breathe, move, and remember. As part of my process toward being less broken, I also began using different words. A few years before Alexa died, I had a friend who lost her husband in a car accident. I was supportive early on, but as months went by, I became impatient with her grief. After receiving another tear-filled phone call, to my shame, I remember thinking these foul words: “It’s been six months. Why doesn’t she have it together?” Now that I know the depths of grief and that it has no timetable, I would never think such words.

It took a few years, but I gradually became more than my grief. My vocabulary also enlarged. I now have more words—words I use to offer comfort, hope, solace, compassion, empathy, and love. I have those words because they were given to me by the people who held me as I took my steps back to the land of the living.

I learned more than words during the days that began on July 11, 1985. I learned that the human heart has a huge capacity for pain, pain that at times seems it cannot be endured. More important, I learned that the human heart has an infinite capacity for love—love that others send into our hearts when we need it most. That love holds the pain that otherwise might be too much for us to bear. That love has sustained me since July 11, 1985 and continues to do so today. In this different life, life without Alexa, each time I have the opportunity, I use my new words. I reach out and place my love in someone’s grieving heart in an effort to hold a part of their pain. In that way, perhaps I can help them begin their walk back to the land of the living, where big scary words are heard less often, where they will hear words of comfort, hope, caring, and love. I do this in gratitude for the love that held my own pain. I do this in memory of Alexa.

What I Know Now.  


November 2 will mark 25 years since Alexa died. In the intervening years, I have done so much more than grieve Alexa’s loss. I celebrate life, family, friends, and what I know now:


·    Love lasts forever. It spans time, and experience, and loss.

·    Grief has no timetable.

·    Family and friends hold our hearts when we cannot hold them ourselves.

·    God is good and can take my questions, my anger, my dismay, my love.

·    Compassion and empathy are gifts, hard-won, but ones I will share.

·    Life is good, even in the face of extreme anguish and loss.

Christine Clark writes, edits, and gardens at My Sister's Garden in Vero Beach, Florida. She is the mother of Venus, 39; Tarah, 23; Chelsea, 21; and Paul, 18. She still considers herself Alexa's mom. If Alexa had lived, she would be 32. Christine also blogs at http://mysistersgarden.blogspot.com.

©2011 ShareWIK Media Group, LLC



Last week I was asked to do an interview to offer advice and resources for adults grieving the death of a parent. Thankfully, I am not yet a member of this club. However, I work with several colleagues who have unwillingly joined the club in recent years as well as serve many adults in our bereavement center. 

Knowing that parents will one day die does not diminish the pain and soul-searching that is experienced when they do die. Parental death often happens during the midst of the busiest time of adult’s careers and lives, just as they begin to confront their own aging process. Adult children grieve not only for their parents, but also for the passing of their childhood and youth.

Social and psychological factors determine how this important loss will affect us. Were you living day-to-day as a caregiver? Were you a long distance caregiver? How did your parent die? What kind of relationship did you have growing up? What was your current relationship? Will this death just be a personal crisis or also an opportunity for growth?

While attending a wake last month, I offered my condolences to a colleague on the death of her father. She had a good relationship with her father, as well as her mother who had died two years ago. As we were hugging, she repeated, “It’s so final. It’s so final.”

Sometimes there can be unfinished business or unresolved relationship issues and the finality of death takes away the opportunity to finish or mend these matters. This can cause additional pain, anguish, and guilt. 

One of the first things people ask is ‘What was your mom/dad’s age?’ Is there an equation for how much sympathy you should give or how much grief you should experience based on age? It doesn’t matter if you parent was 50, 60, 90, or 105. They were still your mother or father.

It’s surprising how difficult this is for me.

Grieving is often hard work, but society believes that in a few weeks you should be finished with your sorrow. Adults sense impatience from others and consequently put expectations on themselves that they should return to “normal.” But what is the new normal? Things are different now. You may start looking at your own mortality. And your relationships with spouses or siblings may change.

In your head you know that your parent has died, but your heart may be telling you something else. Accepting the death of a parent, someone you thought would always be there in good times and in bad, can be overwhelming and intense.

Here are some suggestions you may find helpful:

·      Give yourself permission to grieve

·      Work your way through the pain of grief

·      Beware of clichés

·      Find ways to cry and talk

·      Talk to your deceased parent

·      Forgive yourself for being human

·      Grow from your experience with this tragedy

·      Join a parent loss support group

·      Seek professional counseling


The Orphaned Adult: Understanding and Coping with Grief and Change after the Death of our Parents– Alexander Levy

Grieving the death of a mother – Harold Ivan Smith

Grieving the death of a father – Harold Ivan Smith

When parents die:  a guide for adults – Edward Myers

Motherless Daughters (and workbook) –Hope Edelman

Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist and also a regular contributor to juicyheads.com.   To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC

I miss seeing “love, mom” on a birthday card.  My day feels empty.

I have spoken to a number of individuals who have remarked how difficult their birthday has become after the death of their mother or father. Every year on my birthday, I wait for the phone to ring for my aging parents to sing to me. I will miss their out of tune voices when I no longer get that call.

Knowing that this is a trigger for her, one of my employees consistently requests her birthday off. She is planning ahead. She knows she will not be productive at work. Whether she plans to visit the cemetery or look at photographs or allow herself to just sit, she has a strategy for the day.

Anniversaries, special events, birthdays, holidays, the date of death, smells, sights and sounds can all spark a grief reaction. You might be able to anticipate them or they can strike you out of the blue. Much has been written about anniversary reactions, but I have read little about the bereaved person’s birthday as the trigger. It makes sense to me. We wouldn’t be celebrating our birthdays if our parents hadn’t brought us into the world. Initially I thought my employee’s reaction was idiosyncratic, but since then I have met many other woman who experience the same trigger. 

Preparing for an episode of grief could be beneficial. Knowing that you are likely to experience this yearly reaction can help you understand it and turn it into an opportunity for healing and growth.  And sometimes the anticipation can be worse than the actual day.

What can you do?

  • Remember that grief never goes away completely.
  • Many people experience anniversary reactions.
  • Start a new tradition in your mother’s or father’s memory. For example, make a donation to a favorite charity organization in their name.
  • Enjoy one of their favorite cakes or desserts.
  • Reminisce about your relationship with your parent and focus on the gifts he or she gave you and the good times you had together.
  • Look at greeting cards saved from previous birthdays.

Birthdays will continue to mark the passage of time. May the memory of your mother or father bring you comfort and joy.

PLEASE NOTE OUR NEW BLOG ADDRESS.  Thanks! www.hospicewr.org/bereavement-center-blog

Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist as well as a regular contributor to Juicyheads.com. To learn more about Diane, visit her blog.  

Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC

Aug 28

One is hesitant to even remotely capitalize on someone else’s grief.  This is hardly the intent here; rather, a desire to share something that informs my life.  Beyond that, it haunts me and I sense that it is just at the cusp of a deeper, national impulse of despair that is authentic as it is discomfiting.                       

In my role as a rabbi to a congregation of elders, I immediately phoned a member this week who is suffering from a uniquely grievous tragedy.  Her grandson was one of the 30 Navy Seals who was killed in the helicopter attack that so shocked our country and deepened our national malaise. 

What do you say to someone suffering through a blow like this?  How do you honor her experience in this life without patronizing her wisdom and personal history?   I’ve learned over more than three decades (especially from mistakes and presumptions) to say as little as possible and to do more listening than talking.  Platitudes and/or theological clichés only work if you are certain that the person you are addressing is simple. 

Reacting to sudden and/or violent deaths, most particularly when it involves children or grandchildren, is personal.  A common refrain, overwhelmingly understandable, is for the older person to cry out in anguish: “It’s unnatural.  I should have died before him.”  Or:  “If only God had taken me first!”  In my own case, there is not a scintilla of a possibility that I wouldn’t give up my life instantly in exchange for that of either of my two daughters. 

The problem is that war brutally disarticulates the natural flow of the generations.  We, the elders, deliberately and calculatedly send our youth to be killed, maimed, or psychologically damaged by this most diabolical form of human enterprise.  Sometimes, we have had to—only dreamers could have questioned our need to dispatch the flower of our populace to stop the fascists of World War II.   The threat posed by the Nazis and the Japanese in those uncommonly grave times was existential and real. 

Nobody was rationalizing anything when, standing over the fresh grave of a GI between 1941 and 1945, we labeled the young man or woman as a hero—someone who gave up his/her life in a genuine moment of national danger.   

It’s not that the 30 Navy Seals (and the thousands and thousands of their peers in all the services) are not heroic people.  It’s just that, as my congregant told me immediately when I expressed my sympathy and indicated that I would not try to be clever with some formulaic response, declared:  “Well, this was so stupid and I’m angry.  How does a government put 30 fine young people in one helicopter like that and expose them to fire?”   And then:  “There’s nothing really to be said beyond that.”

It turns out that the grandmother said everything in her brief, tortured, elegiac proclamation about the choices the United States has been making for decades when it comes to the profoundly serious question of when and where we send our children.

Ben Kamin is one of America's best known rabbis, a multicultural spiritualist, NYT Op-ed contributor and author of seven books, including his latest, "NOTHING LIKE SUNSHINE: A Story in the Aftermath of the MLK Assassination."  He is a regular ShareWIK.com columnist.


More Ben Kamin articles, click here 

©2011 ShareWIK Media Group, LLC

The lazy days of summer are quickly coming to an end; soon school halls will be buzzing with laughter, excitement and activity as students file into their classrooms. As we move into the routine of another school year filled with promise, death is typically the last thing on our minds. Unfortunately, sudden death can strike the lives of students and school communities without warning, leaving despair, uncertainty and pain in its wake. 


Sadly, tragedies occur every day.  Sometimes these tragedies involve students who may be killed suddenly or who may die from an anticipated illness.  While the grief is intense for the family of the child or teen who has died, the friends of the deceased young person grieve as well. 


They may be afraid that they will die too.  They may be feeling overwhelming sadness at times.  They may feel intense anger – at themselves for letting their friend get into the car, at God for “taking” their friend so early, at their parents for “hovering” over them, or at other friends for grieving “too much” or “not enough.”  They may disregard school, thinking, “Who cares about it, anyways?  I can die tomorrow.”  They may feel lonely, no longer able to talk to their deceased friend. They may feel isolated from other peers who seem “fine.”  They may feel guilt at enjoying a movie when their friend has just died.  If your child is touched by the death of a young person, help them see that it is normal to feel pain when someone dies – especially when it is one of their friends.


Here are some ways to show support:


1.    Be available to listen when your child or teen is ready to talk. When listening, give your undivided attention.

2.    Try not to take it personally if your teen opens up with his or her peers and seems to be pushing you away.  Developmentally, they are more likely to turn to their peers first.

3.    Explain that grief is different for each person.  One person may express their grief via frequent crying spells while another shoots basketball for hours.  This does not mean one person is grieving “better” than another.  Just like we are all unique people, our grief is unique to us.

    4.    Give them permission to have fun at times. Children grieve intermittently and it is nothing to feel ashamed about.


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC


October is National Pregnancy and Infant Loss Awareness month, and it’s a good time to promote support, education and awareness about this difficult topic. Too many families grieve in silence. Parents, grandparents, siblings, relatives often deeply mourn these deaths, but society often disenfranchises their grief. Well-intentioned phrases from others can be hurtful. At least you have two other children. You can always get pregnant again.


In addition to the community not recognizing or minimizing the loss, there are other challenges. Grief is impacted by hormonal and physical readjustment.  It may be difficult to be with others who are pregnant or have babies. There are two anniversary dates, which can trigger a grief reaction: the date of death and the due date. Finally, expectant moms may experience increased anxiety, fearfulness of repeating the experience and the loss of “bliss and joy.”


October 15t is National Pregnancy and Infant Loss Remembrance Day. This day has been designated to remember miscarriages, ectopic pregnancies, stillbirths, and loss of an infant. In September 2006 a resolution was passed by the United States House of Representatives. This resolution was the result of tireless efforts by a group of miscarriage awareness activists led by Robyn Bear, who had six first-trimester miscarriages from 1997 through 1999.  On her website Bear asks that parents light a candle at 7 p.m. (in the time zone in which they live) for one hour to create a “wave of light” around the world in memories of babies.  For the Remembering Our Babies website, visit http://www.october15th.com/


If you are experiencing a pregnancy loss, know that you do not have to grieve alone.  Our bereavement center specializes in grief counseling for this type of loss. In addition, some hospitals offer pregnancy loss groups and there are national organizations that offer support as well.


Here are some helpful resources:


Hospice of the Western Reserve’s Perinatal Palliative Care program.



The Elisabeth Severance Prentiss Bereavement Center



Share Pregnancy and Infant Loss Support, Inc . 



Remembering Our Babies





 Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.  


 Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC

With our aging population, there are many of us who are grieving the slow dying of our elderly parents.  More and more of my fellow Baby Boomers are becoming part-time caregivers when our parents become less and less able to care for themselves. For some adults, this can be extreme, for others it is less so. It becomes routine for us to consider our parents’ needs before making plans. We make certain that they have food in the house and clean clothing.  We manage their finances and make sure prescriptions are filled and taken appropriately.  Juggling everything can be pretty complicated, but we do it because we love our parents and appreciate how they cared for us when we were children. 

It is okay feel relief. When parents die after a long illness, many adult children feel relief. Grief is the expected emotion; relief often comes as a surprise. I have seen this time and time again in our bereavement center. Unfortunately, the bereaved feel ashamed or embarrassed to admit that their primary emotion is relief. This could lead to feeling guilty and conflicted.

It is okay to feel relief. In truth, caregivers experience grief over the months and years that their loved one was declining. If the parent had dementia, they may notice in retrospect that mom or dad had been slowly disappearing for years. These caregivers have been grieving over the continuum of the illness.

It’s okay to feel relief.  There are many other reasons to feel relief. In addition to feeling relief that the disease process and pain symptoms that went along with it are gone, one could feel relief from the caregiving responsibilities. For those who experienced abusive or domineering relationships, it may be feelings relief and independence.

Grief is a roller coaster of emotions. Feelings can include deep sadness, anger, regret, guilt and yes, relief. Please don’t beat yourself up for experiencing feelings. They are neither right nor wrong, nor good nor bad. 

They are YOUR feelings. Many people find a group setting or working with a grief counselor helpful in exploring and learning from these natural grief reactions. Remember, you do not have to grieve alone.

You may also find this article helpful.



Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog


Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC



Here comes Thanksgiving.  This is the holiday that focuses on giving thanks where loving families celebrate by coming together. After all, the television and media bombard us with this truth. Hallmark movies embrace the returning vet or the estranged brother, and bickering couples always seem to re-unite.

And yet, you’re not up for all this brouhaha.

Do I sound cynical? I don’t mean to be. Many people have a hard time with holidays in general let alone when they are bereaved. When you are grieving the death of a loved one or caring for someone with a chronic or terminal illness, you might not feel ready for festivities and celebrations. 

The media and retail industry constantly promote the wonder of the season and folks walk around dressed up in holiday regalia. You might be feeling a bit angry. And while anger is a big part of grief, you might feel extra angry at this time – towards your loved one, towards the disease, towards the media, the healthcare industry and even towards yourself for feeling the way you do.

Like Sally from Schultz’s Good Grief: Charlie Brown’s Thanksgiving says …Why should I give thanks on Thanksgiving? What have I got to be thankful for? All it does is make more work for us at school. 

You too might be asking yourself:  What do I have to be thankful for this year?

Giving thanks and gratitude might seem like crazy concepts in the midst of grief.

You are in the process of becoming a different person than you were last year. Perhaps you are now a widow or a motherless daughter. You may be adjusting to this new role, which brings different priorities, different benefits and different challenges. What you were thankful for last year might not have the same meaning for you this year.

I encourage you to think about how you have changed and what you have learned since the death of your loved one. You may want to find a way to give thanks and express gratitude as many bereaved persons find this to be healing.

In a previous column I wrote about journaling as a way to manage grief. You may want to consider a gratitude journal where you can list or write about things that you can be thankful for even though your loved one isn’t physically here. You can include the things you acquired directly from your loved one as well as your new perspective as a grieving person. You can write about lessons learned, recipes, values, warmth and security, love, walks in the woods, previous adventures and new adventures.

You have changed and grown.

Sometimes, taking a step back and jotting it down can put it in a different perspective and the memories can continue moving from bittersweet to sweet.

Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.

Read other Diane Snyder Cowan columns here


©2011 ShareWIK Media Group, LLC





On the evening news recently, there was a feature story about a five-year-old boy with Down’s syndrome.  He is a clothing model for Nordstrom’s and other high-end fashion stores. In addition to being completely adorable, his parents commented on how completely “normal” he is. Children and adults with intellectual disabilities are indeed normal and share all the feelings, wishes, and desires as do people without disabilities. This includes grief and loss.

No two persons experience a disability the same way just as no two persons experience loss the same way. The personality of the person, their support systems and life experiences determine their grief reaction and how best to help meet their needs.

Persons with intellectual disabilities experience a number of losses that often go unrecognized. Most do not get a driver’s license, get married or have children. Some live with their parents into adulthood, and when their aging parents die they may need to move into a new home, which becomes yet another loss. In addition, many people with intellectual disabilities experience a history of disenfranchised grief. He doesn’t understand death, don’t worry about him.

Communication problems contribute to this misunderstanding.  There may be expressive and receptive language limitations. Feelings are often expressed through changes in behavior such as “acting out” or withdrawing.  Helping the person identify and express feelings may be challenging. Modeling feelings and/or utilizing art and music for self-expression can be beneficial. 

Attending the funeral and/or visitation (even if special arrangements need to be made to go early or late), participating in rituals if possible and visiting the cemetery aid the grieving process.  When death is impending, anticipation and preparation through looking at pictures or a field trip to the cemetery or funeral home can be highly effective.

For persons with intellectual disabilities, the grief journey may be different but the road is the same.  Support and understanding by normalizing and validating their feelings is just as important in assisting them to successfully move through their  journey as it is for everyone else. 

To read more about hospice, grief and this population, here is a link to a recent article Finding Their Voice: Helping the Person with Intellectual Disabilities Grieve that I co-authored with Rex Allen, MA, Grief Support Services Manager, Providence Hospice of Seattle in National Hospice and Palliative Care’s NewsLine Magazine (December 2011).

Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.

Read other Diane Snyder Cowan columns here.

©2012  ShareWIK Media Group, LLC

Mar 23

Brilliant, funny, dear, kind, sensitive, and grief-stricken to a fault.


Many alcoholics –  and the people who love them – are  just plain terminally grief-stricken. Not the healthy form of grieving we go through when we’ve lost someone we love. I am talking about an all-encompassing grief for self.


I only know about this because I have been there myself. Right now, someone who is in this grief is in my prayers.


Her grief is palpable. Her grief over her past. Her future. Her failures. Her successes that weren’t enough. Her having had some sobriety and losing it. Her losing her sobriety and not being able to get it back. Her relationships going south.  


So I watch her family ride the grief roller coaster – soaring to unbounded heights of joy and anxious expectation when she is sober. Then all plummeting again six feet under, when she drinks. She finds, in her drink, momentary comfort and the next reason for self-loathing. They find greater ammunition to doubt her ability to ever succeed. Their fear feeds her fear; her fear feeds their fear. It is a cycle. A downward spiral.


Guilt also runs this spiral. Guilt and shame and blame. They are all based in fear – a lack of faith that God forgives and wants us to forgive ourselves – that keeps this tragedy circling. We, as humans, remember, and torture ourselves, taking others with us while God keeps forgiving and yearning for us to forgive each other, and most of all, forgive ourselves. God forgives, plain and simple. Asking for and allowing that forgiveness means surrendering control; it means surrendering our own self-important "pride in reverse" of obsessing about how horrible we are. When we spend our time beating up on ourselves, it is still self-will; it is still self-centeredness.


This is big stuff: allowing that forgiveness and having the faith to allow it means there is no need to dredge up the past. God forgave it. No need to get anxious about the future. God has it. No need to stay focused solely on ourselves: God wants us all to help each other. There is someone for everyone to help.


Others affected by this grief are in my prayers: A dear friend called yesterday to tell me that her father – a longtime drug and alcohol abuser – had succeeded in this, his most recent suicide attempt.


His God, in his mind, could not forgive his infidelities, failures, and relapses, his not measuring up.


His God, in his mind, was not big enough to love him no matter what; not big enough to embrace his humanity; not big enough to allow him to trust the therapists and medications and treatments that would have helped ease his depression (anger turned inward) and terminal grief. He did not believe that somehow, somewhere, there was someone who could have benefitted from his incredible sensitivity, compassion, and talent as an artist. I have no idea whether or not he ever asked for forgiveness, or trusted that he was forgiven. I just know that she is having a hard time explaining grandpa’s death to her children.


And so my friend is grieving the for-real death of her dad, who, despite glimmers and shimmers of being present, sober, and healthy through the years, had been, in many ways, dead already by ongoing returns to alcohol, drugs, and self-grief. She and I will visit soon; we’ll do some grieving and some celebrating of his life.


Springtime brings a bittersweet grief for many. As life is bursting from every inch of earth, many feel despair over their own lack of life, youth, rebirth. Springtime is a big time for suicides and relapses. It is also a time for turning old earth under; asking for new life. Giving up our own ego-driven self-remorse -- self-grief -- to allow all manner of forgiveness to give way to a new way of life. It is possible. I know. I have seen it happen thousands of times.


If you have an addiction challenge, Alcoholics Anonymous has been a source of help for millions upon millions of people, worldwide. Online meetings and information are available at www.aa.org


If you are affected by the addictions of others, Al-Anon, a support group for family and friends of alcoholics, is also a source of experience, strength, and hope for millions of people worldwide. Visit www.al-anon.alateen.org


You, and the people who love you, deserve at least a chance at a life free of self-grief. People who once thought that they, too, had nothing to offer, are very willing to help you and yours take the first step.



Carey Sipp's first book, The TurnAround Mom – How an Abuse and Addiction Survivor Stopped the Toxic Cycle for Her Family, and How You Can, Too, guides fellow “children of chaos” to create the kind of sane and loving home life that helps prevent next-generation addiction and abuse. Her book is available here.  

Read more articles by Carey Sipp here.

©2012 ShareWIK Media Group, LLC

For a species as enlightened as we are, we have some surprisingly closed-minded ways of handling life and death. I mean, we know we’re mortal, we are aware that no one lives forever, and yet we have entire industries founded on postponing the inevitable, prolonging life at all costs. We fight death at every turn, and often consider it a defeat. 

Yet, there is so much life to be found in the dying process. This is not just a pollyanna approach, seeking a silver lining to sadness. In truth, there is opportunity to take advantage of, to appreciate, to find joy and celebrate. 

I called my grandmother “The Mighty Sylvo,” and she called me “gorgeous.” We were a mutual admiration society of two, though we occasionally let my mother and grandfather in to play with us. Let’s just say: we were tight.

I’ll never forget the day my mother called to tell me “The Mighty One,” my other name for that 4’10” master of the Toll House chocolate chip cookie, had been diagnosed with cancer. The news wasn’t good. Her days were measured.

I cried all the way from my office to her apartment, “NO!” screaming loudly inside my head. I wasn’t ready to lose her. I had so much more life I wanted to share with her. It just wasn’t time for her to go.

Of course, all those messages were about me, not her. But that understanding came later.

It turned out, she wasn’t quite ready, either, and we had two more wonderful, intentional years to share with each other. It got harder for her over time. The pain intensified. I still didn’t want her to go, but it was increasingly more difficult to hold onto that position.

It’s crazy the conflict we often feel, wanting to keep our loved ones alive for us, and yet wanting them out of their misery. As the cancer grew, large cell after another taking up residence in her lungs, battling with fresh air for breathing room, the conflict intensified.

That, I believe, is the essence of grief – it is love locked in a tug-of-war with death.

Meanwhile, as the cancer’s foothold became a stronghold, I was busy growing joyfully in a pregnancy I hoped would lead to the birth of my first child. I was anxious – I’d lost a previous pregnancy quite late, an IUFD (intra-uterine fetal death) discovered in a routine ultrasound. It was a pretty harrowing experience for me. Apparently, my grandmother had taken it to heart, as well.

Around the time we prepared to bring in hospice for my grandmother, I was approaching my 20-week ultrasound. The interplay of life and death in my world was palpable. I entered the technician’s theater with a good deal of fear. 

We emerged tearfully, excited and confident in a healthy pregnancy, and drove immediately to my Mighty Grandma, videotape in hand. We wept together, celebrating the potential life that was flourishing.

About 12 hours later, my grandmother died.

Now, all the time I was holding tight to not wanting to lose my grandmother, I am convinced that she was waiting to let go. She wanted to know that all was okay with my pregnancy, and she’d held on until she felt confident she could leave me. I must admit, I have a mixture of gratitude and guilt about that.

When my daughter was born, nearly five months later, I knew from the moment she arrived that she had a guardian angel. Now, 18 years ago today, I am more certain of that than ever before. It’s a good thing, too, cause that kid has definitely needed extra loving, watchful eyes.

When I think back on the loss of my grandmother, and I merge it with more mature experiences when my grandfather died 15 years later, I’ve come to understand a few things about life in the midst of death.

Here’s What I Know Now:

“Losing” people is all about us, about those of us who stay behind. While it is a legitimate perspective, we honor our loved ones when we are aware enough to try to keep the focus on their needs, not ours.

“Letting go” is a job for all parties involved with the dying process. 

           • For those of us who stay behind, we must try not to focus so much on ourselves, and let our loved ones go. 

For the dying, peace comes with the “letting go.”

Our loved ones often need our encouragement, our permission to let go. We don’t have to be afraid to share it clearly, out loud. They know they are dying. It helps them when we acknowledge it and remember that its part of life.

We keep people alive with our memories. It’s not just a saying – it’s true. None of my children ever met The Mighty Sylvo, but you’d never know that to talk to them. As she has been alive in my heart and mind, she has been a presence in my children’s lives. Over time, the pain of her death has absolutely shifted to the joy of knowing … that she would have loved a moment, or a gesture, or even a particular piece of cake.

As such, our relationships with relatives no longer alive take on a new quality, but the relationships remains. Human bonds are, indeed, eternal. 

Elaine Taylor-Klaus is the co-founder of ImpactADHD.com, a virtual coaching community for parents of kids with ADHD. She is a regular columnist on ShareWIK.com and MySpecialNeedsNetwork.com, and writes for “Living Without” magazine. Elaine coaches women and parents from around the country, on the telephone, to live full and empowering lives. She works together with her husband, David Taylor-Klaus, in their company, Touchstone Coaching.

Read more articles by Elaine Taylor-Klaus here.

 ©2012 ShareWIK Media Group, LLC

Recently I presented to a group of parents about the differences between trauma and grief. When a child dies due to a tragedy or traumatic event, the whole community mourns. Some children are directly impacted. They may have witnessed the event or have known the deceased. Some are indirectly impacted. They heard about it at school, saw it on the news and can see that their parents are visibly upset. 


Whether you and your children are directly or indirectly touched by the event, here are some themes to consider about grief and trauma reactions:

When you are grieving, the generalized reaction is sadness. When you are traumatized, it is TERROR.


When you are grieving you can usually talk about what happened. When you are traumatized, you do not want to talk about it.


Grief reactions stand alone. Trauma reactions include grief reactions.


Guilt that accompanies grief includes thoughts like “I wish I would have…if only I…” Guilt that accompanies trauma feels like “It should have been me. It’s my fault. I could have prevented it.”


When you are grieving, your dreams may be about the deceased. When traumatized, your dreams are often nightmares where you are the potential victim. In addition, your child may have difficulty falling asleep and staying asleep and may want to crawl into bed with you.


Grief does not include flashbacks. Trauma includes flashbacks, startle reactions, hyper-vigilance and numbing.


The pain associated with grief is about the loss. The pain associated with trauma triggers tremendous terror and an overwhelming sense of powerlessness.


What can you do?


Give children opportunities to ask questions and talk about what happened.


Be honest. Use simple language that is appropriate to your child’s developmental level.


Don’t be afraid to admit that you don’t have answers to their questions.


Listen, don’t lecture. Use phrases like “We’ll get through this together.”


Monitor television watching and video games.


Help children understand that there is no right or wrong, good or bad emotion.


Model and encourage healthy ways to express feelings such as through exercise, art, music and nature.


As a parent you model effective grieving. Remember that you are grieving too. There are resources and help available in your community. You do not have to go through this alone.


Parent toolkit: http://www.hospicewr.org/wp-content/uploads/2011/08/Final-PTO-Toolkit.pdf


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.

Read other Diane Snyder Cowan columns here


©2012 ShareWIK Media Group, LLC

This is a hard one to write.  I could say I was too busy or have nothing new to offer on this subject.  But truthfully, my hesitation about facing this column is that words feel inadequate, hollow, empty.

All I want to do is tell you about my cousin Mark, present you with a slide show of his big life, create a documentary, share a thousand stories. But I only have 1,000 words and this is about what it’s like to lose someone we love.  

How do we bear the pain?  How does it change us? How can we thrive and not just survive?  

So there’ll be no bullet points, no “Top Ten Tips on How to Cope with Loss.” I’m just going to share my reactions and experiences over the year that followed the worst day of my life. 

Driving home from work on March 16, 2011, my cellphone rang. My mother was sobbing: an airplane crash, my cousin Mark in the plane, he was dead. 

I’ll never erase the sound of anguish in her voice as she cried those horrific words.  A sick feeling emanated from the pit of my stomach, crawled up the back of my throat. I left my body. This was not happening.  Sweet Mark, whom I’d known and loved like a little brother since he was born… 

I don’t remember the drive home.  At the house, in a daze I sat at the computer and Googled “plane crash Longbeach.” And there it was: scenes of wreckage, a plume of smoke, witness reports…then the victims were identified and there was Mark’s name and his smiling face.   This bad dream was only getting worse.  

Mark and five buddies were on a small plane headed to Salt Lake City for a ski trip.  Immediately after takeoff, the plane banked and plunged to earth.  Only one man survived.  

Mark was only 44, a gifted athlete, a kind and generous man, a devoted father to his three teenage kids.  He had made an indelible impact in his community.  His motto was “Go Big or Go Home.”  His memorial service included a bike ride, a beautiful outdoor service and a Hawaiian paddle out ceremony with hundreds of people on surf-boards wearing leis. 


For weeks afterwards, my mind flashed with images, which triggered a fresh torrent of tears.  Alternating between images of the crash itself, was the gut-wrenching pain I felt for those who’d be most affected by his loss on a daily basis. I’d picture Mark’s mom losing her beloved son, his kids who’d experience a gaping hole in their lives. I’d imagine Mark’s two younger brothers and the indelible bond of this threesome since losing their Dad when they were kids.  I’d cry for Mark’s wife and the responsibility she’d feel to be strong for their kids.  I grieved that he would be missing from our family gatherings, that my kids wouldn’t experience a life-long relationship with their uncle. 

Mark was such a large presence that he seemed invincible.  I always felt that our family was blessed with good fortune, but deep down I feared that one day our “luck” would run out.  Mark’s death was so sudden, violent and unexpected that it shoved my previous world view off its axis.  I never imagined that THIS would be the unforeseen tragedy that the Universe had in store for our family.   


In those first few months I wondered what other tragedies were waiting around the corner. I started imagining horrific scenes of tragic accidents, deaths and losses happening to those I loved.  Anticipating worst case scenarios, my mind was trying to ward off death.  

Those first few months were an emotional roller coaster filled with flashes of pain, fear, sadness, disbelief, and then spells of denial.  But each morning I’d wake up, slapped by the harsh truth that Mark was really gone.   


As the denial wore off, I became more aware of a profound and deep sense of the fragility of life.  Even though I felt more vulnerable, the panic subsided.  While the pain and sadness were still very present, a new sense of peace was taking its place.     

Eventually more life-energy returned, which I experienced as a deep connection to Mark. He had a “Go-for-it,” “No-Excuses” philosophy of life.  Connecting to his drive, I found myself saying yes to new projects and no to things that didn’t feel like a valuable use of my time.  I took on new challenges with renewed optimism. 


I also started to experience each moment more fully.  I’ve become more present with my children, aware that in the blink of an eye they’ll be leaving home.  And because I know that at any moment I could be taken from them, I fill their love cups to the brim, pouring every drop of me into them.  I take extra time to focus on them, listen to them, touch them.  I’ve become more appreciative of all of my relationships and try to infuse more love into my interactions with others. 


I have also found myself feeling greater empathy to anyone experiencing grief or loss.  I now know from the inside how hard it is to navigate this world with a huge ball of pain in your heart.  

I still cry a lot in my car listening to the radio. Two popular songs can trigger a flood of tears: “If I Die Young” by The Band Perry and “Live Like We’re Dying” by Kris Allen. Rather than turn the station when these songs come on, I cry without regard to the concern of people in the adjacent vehicle.  The other place I weep is at my computer.  I click on certain Facebook pages- Mark’s page, his kids’, his wife’s, his brothers’, his mothers.’  Their words and pictures help me feel connected to the community of people who love, miss and were impacted by Mark’s life.  This alleviates some of the loneliness of the grief.  My heart needs these Tear Releases.  It doesn’t feel right when I go too long without crying. 

Near the anniversary of Mark’s death, my family flew to Salt Lake City to ski, embarking on the trip that Mark never got to complete. I wondered if I’d have a panic attack on the plane, but instead a feeling of calm washed over me. As we flew into Salt Lake City, a bright moon rose over the Rocky mountains.  “Hello, Mark.”  

I felt his presence traveling up the lifts, surveying the gorgeous craggy mountains and watching daring skiers carve turns on the off-trail runs.  Mark would’ve been one of those guys hiking with his skis on his back, then whooping with joy as he gracefully dominated the mountain.   

I stuck to the groomed trails and wore a helmet for the first time in 45 years of skiing (no more illusions of invincibility).  I warned my boys, “Be careful!” and caught my breath as I watched them ski away into the woods.    


Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web at dinazeckhausen.com and MyEdin.org.


For more Dina Zeckhausen articles, click here.


©2012 ShareWIK Media Group, LLC.

Mar 18

     I finally saw the George Clooney movie, “The Descendants,” last night. I knew something about the subject matter, but I wasn’t really prepared for the degree of focus on children losing their parents. Perhaps it was the timing that made it hit me so hard.

      Less than a week earlier was the 50th anniversary of my father’s death. He died, at age 37, just two months before my 10th birthday, and I remember so much about those times.

I remember saying goodbye to my father before he went into the hospital to have brain surgery (in 1962!). His last words to me – which I once wanted to drape on a banner in my bedroom – were: “Take care of your mother.” Me, a 10-year-old, was designated to take care of my mother. (I suppose it could have been worse; after my father died a week later, my seven-year-old brother was told that he had to be the “man of the house.”)

     The day my father died, I was at my maternal grandmother’s house, determinedly punching the keys of an old black typewriter, writing a letter to my father in the hospital. I remember that I kept forgetting to push the space bar between words on this very first typewritten letter. As my grandmother drove me up to my house later, we saw a number of cars parked and knew something was up. I walked into our den and over to my mother, who was sitting, crying on the couch. “Daddy is in heaven. God needed him.”

     I had two reactions. First, that I needed my Daddy more. Then I ran to a nearby wastebasket and tore up the letter I had written to my father. I knew he would never receive it. I was angry.

    I’ve always wished I had kept that letter. But, as it turned out, after religiously writing every day in my first diary that year, I abruptly stopped for the rest of the year. I had shut down emotionally.

     Back in those days, adults didn’t know how to tell children that a parent had died. Probably no one in the early 60s sent their children to therapists to encourage them to express their anger, their loss, their sense of abandonment. I finally learned how to fully express my feelings about this devastating experience as an adult with a therapist.

     I distinctly recall the shock I felt when I understood how poorly the adults in my life had handled the news of my father’s death. I was at a cousin’s house for dinner and the husband of her daughter related his experience of losing his father. He told about how his mother kept photos of her late husband around the house and encouraged her children to talk about their father. This was the exact opposite of what occurred in my house.

     After receiving the news of my father’s death, and after ripping up the letter to him, I vomited. An adult friend quickly gave me a pill to relax my stomach and anesthetize my feelings. It wasn’t long before my mother removed every photo of my father from the walls and picture frames in the house. We rarely talked about him.

     In the mid-1980s, I saw the movie, “Back to the Future.” There’s a scene in which Marty McFly (Michael J. Fox) accidentally prevents his parents from ever meeting as youth. He holds a photo of his family, years later – his father, mother and siblings – and watches the impression of his father fade away. That’s how I felt. My father’s image was removed from our family portraits, and our lives.

     In the last 50 years, I’ve thought and felt a lot about the experience of losing my father at a young age, and how that impacted my life. I will never know how I would have grown into adulthood if he had lived. I will never really know him as a person, despite my constant questions of my mother, his brother and friends who knew him. I will never have all the answers. But I do know that the loss changed me. I hope for the better.

     Jan Jaben-Eilon is a long-time journalist who has written for The New York Times, Business Week, the International Herald Tribune, the Jerusalem Report and Womenetics. She was a founding reporter for the Atlanta Business Chronicle and was international editor for Advertising Age before she fulfilled a lifelong dream of moving to Israel. Jan and her Jerusalem-born husband have an apartment in that city, but live in Atlanta.


     In November 2006, she was diagnosed with late stage ovarian cancer and has kept a blog on her cancer journey since December of that year. Click here for her blog.

©2012 ShareWIK Media Group, LLC

It was only a pet....


The love relationship between pets and their owners take on many qualities – companionship, comfort, security and love. When a pet dies, these aspects of the relationship are lost and the grief can be intense. Yet society often disenfranchises pet loss with cliché’s and unhelpful comments such as you can always get another one.


The death of a pet can be very significant especially when you look at the nature of the pet/owner attachment. Some children lay claim to the family pet – they feed, clean up after, and play tirelessly with the beloved animal. The death of a pet is often a child’s first major loss.  Isolated older adults often have significant relationships with their pets and the death of a pet can trigger grief reactions from other losses. Many hospice patients worry about what will happen to their pet when they die and only find peace once their pet has been placed in a home. Indeed, pets have become family members.


If you are a multiple pet owner, you may find your other pets grieving. This has happened to me several times. When our older dog Snow died, our younger dog Max wandered around for days looking for her in all her old hiding places. When Max died, our cat Kenny sat in front of his grave (in our yard) for hours. He still frequents that spot. Your pets will miss the departed pet. Just take note and treat them with loving kindness.


Some helpful hints for managing pet loss:


  • Create an atmosphere where losses can be felt and talked about openly.


  • Confide in someone who is an animal lover. They are more likely to offer an empathetic ear.


  • Rituals can be helpful. It may seem silly to have a funeral for a pet, but is often beneficial. Some pet hospitals host yearly memorial services. Design a ritual that provides meaning to you and your family. Don’t forget to involve your children.


  • Resist the impulse to replace the pet too quickly. Take the time to work through your grief and loss before developing a relationship with a new pet. Also, other family members may feel that you are being disloyal to your deceased pet.


  • Memorialize your pet. With pets, as with people, poems, pictures, music, hugs, laughter, memories and tears will help your special relationship with your pet live on.



Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regularShareWIK.com columnist.  To learn more about Diane, visit her blog.  


Read other Diane Snyder Cowan columns here


©2012 ShareWIK Media Group, LLC

Just as each person with Autism Spectrum Disorder (ASD) is unique, their grief is unique. Recognizing that children with ASD do indeed grieve and being sensitive to how that grief is displayed can be beneficial in helping manage their reactions.


Death is part of the life cycle. We all know that. Plants die. Pets die. People die. Most Disney and other animated films include a death (Bambi, Snow White, Cinderella, Little Mermaid). Children often experience the death of a pet, classmate, teacher, or caregiver before experiencing the death of a family member.


When death is expected, take the time to plan and prepare your child with ASD. The unexplained and unknown can be scary and produce challenging behavior. Do not believe that you can keep all information from children. Children are intuitive and will know that something is different from your behavior, changes in routine, your feelings and the fact that someone is missing. It is best that you explain things in simple language the child can understand based on their developmental abilities. Beware of euphemisms such as "The angels came and took him." or "He went to sleep.", as this may result in fear of going to sleep and never waking up or scary angels swooping in to grab people. Also, if you plan on visiting an ill loved one, be sure to let the person with ASD know if there is a change in physical appearance. This can be startling or disturbing. In fact, you may want to take of photograph of the person and look at it together before going to visit.


It is helpful to explain religious practices that will occur at the time of death. If possible, make a visit to the funeral home and cemetery prior to the service. If that isn’t possible, use pictures or photographs to describe what will happen. You may want to assign a family member to be with your child during the funeral.

Rituals are helpful when someone dies, be it a pet, family member or celebrity. This can be as simple as lighting as candle or displaying a photograph. By doing this routinely, you are preparing your child for losses that will occur throughout life.  


Sudden deaths can be extremely confusing. Reassure your child that he or she is safe. Answer questions with simple and honest responses. It’s okay to say "I don’t know." or "We’ll get through this together." You may not recognize the grief reaction in your child with ASD, but you may notice a change in behavior.  Your child may not cry or appear sad or ask any questions, but a typically withdrawn child may act out and one who normally acts out child may withdraw. Knowing your child’s baseline behavior is paramount. Behavioral changes can be delayed and may not occur for several weeks or months. Anniversaries and special days can trigger these behaviors. Sights, sounds and smells can also be triggers. One child became incredibly distraught when a new caregiver wore his recently deceased mother’s perfume.


Memory books and boxes can be a way to honor the person that died as well as be a legacy and keepsake. The box or cover of the book can be decorated to honor the special person that died. Reminders, writings, mementoes can be added throughout a lifetime and can be shared with others as a way of getting to know both the person that died and the person with ASD.


In summary:


When possible, be prepared. Keep to routines as much as possible. Reassure your child. Be honest and use simple language. Help create ways to honor the person that died.


Helpful links



Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.


  Read other Diane Snyder Cowan columns here


©2012 ShareWIK Media Group, LLC

This past week, Lisbeth Rhine, the head of the Eating Disorders Information Network, lost her battle with anorexia.  Her death is a devastating blow to those who knew and loved her as well as the eating disorder recovery community as a whole.  It is especially tragic when a person who is a champion for this cause succumbs to the illness.  We feel an overwhelming sense of futility and hopelessness when we lose a warrior on the front lines.   

I met Lisbeth when she joined the EDIN board four years ago.  She was passionate about the issue because she had battled with an eating disorder for decades, dating back to her days dancing with the Atlanta Ballet.  She was an active and involved board member, always raising her hand when we needed a volunteer.  When EDIN needed a new executive director, Lisbeth stepped in as interim director.  She did such an excellent job that the board made her role official.

Lisbeth took on the role of running a nonprofit just as the economy was tanking.  Dozens of charities were closing their doors. Lisbeth made sure EDIN was financially sound, sometimes refusing to pay herself so that EDIN would be in good shape.  She was a dedicated steward of our resources, eliminating expenditures and making us a lean, mean nonprofit machine.  

Over the years Lisbeth’s role expanded.  In the tough economy, she steered EDIN away from annual galas to a popular new fundraiser, the Celebrity Dance Challenge (CDC). She worked tirelessly behind the scenes to organize these highly successful, entertaining (and affordable) events.  

Even as the leader of an organization, Lisbeth was uncomfortable in the limelight.  Two years ago, I was invited to dance in the opening Bollywood number at the CDC.  Just before the big night, a dancer dropped out. I convinced Lisbeth to take her place.  Lisbeth’s dance background was evident as she instantly picked up the moves.  Remembering her out there onstage, I imagine this was a healing experience for her.  After the high-pressured world of ballet, here she was in a rocking, sexy, funky dance.  It was gratifying to watch her take a risk and experience dance in a new way.  

Despite dancing in front of crowds, Lisbeth had a terrible fear of public speaking, an important part of her new role with EDIN.  She recognized that it was important for her to conquer this fear, so after some coaching and encouragement, she started addressing groups of kids, teens and parents.  This past fall, she even spoke at the CDC, openly sharing her own struggle with an eating disorder.  For someone who held her cards close to the vest, this was a big moment.   

To see how much she had grown personally and professionally, people might think that she had conquered the demon, maybe even driven him out of town.  This is why we were all so shocked by her sudden and unexpected death.   

An event like this leaves survivors with a painful mix of feelings.  After the initial shock is a wave of guilt.  “What could I have done?  Did I miss the signs?  Could I have saved her?”

After the guilt comes anger: “How could she abandon us?” 

Then, the loss of hope: “How can we defeat an enemy that destroys our leaders?”  

Then, guilt about feeling angry: “How can I be angry at someone who suffered and died? I am horrible.”  

Please do not feel guilty for feeling angry.  What happened should make you feel angry.  We all feel angry at the senselessness of this loss.  

Losing Lisbeth is wrong.  

Those of us in the trenches often feel like David fighting a cultural Goliath.  We need tireless optimism and hope to keep soldiering on.  Such a loss can steal our resolve or throw us off our trajectory.    

So we must utilize and channel our hurt and anger.  Used properly, anger propels us to act.  This is why it’s helpful to think about the Eating Disorder (ED) as an entity separate from the person suffering from it.   This is the only way to understand how a loving, kind and caring person like Lisbeth can hurt herself.  Lisbeth was tormented by an inner bully so evil that it took her life.  

Be angry about this.  Be angry at ED.  Be angry about all the places that ED appears in our lives, then speak up, confront it, challenge it and change it.

Lisbeth’s death does not make any sense, but her life was important.  The way to honor her life is to continue in her mission.  And that means we must love fiercely.  Be brave in your love, and give your compassion away freely, not just to others but to yourself.  Beating yourself up only feeds the enemy.   

Finally, I want to share a beautiful poem that was sent to me today.  Obviously the universe wanted me to share it with you.   


The Summer Day by Mary Oliver

Who made the world?
Who made the swan, and the black bear?
Who made the grasshopper?
This grasshopper, I mean-
the one who has flung herself out of the grass,
the one who is eating sugar out of my hand,
who is moving her jaws back and forth instead of up and down-
who is gazing around with her enormous and complicated eyes.
Now she lifts her pale forearms and thoroughly washes her face.
Now she snaps her wings open, and floats away.
I don't know exactly what a prayer is.
I do know how to pay attention, how to fall down
into the grass, how to kneel down in the grass,
how to be idle and blessed, how to stroll through the fields,
which is what I have been doing all day.
Tell me, what else should I have done?
Doesn't everything die at last, and too soon?
Tell me, what is it you plan to do
with your one wild and precious life?

Dina Zeckhausen is a nationally known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com. You can visit her on the web here and at MyEdin.org.


For more Dina Zeckhausen articles, click here.


©2012 ShareWIK Media Group, LLC

Every year at our bereavement day camp, we end with a flower release. After three days of camp, the children are ready. Campers write a message to their special person that died on rice paper and attach it with hemp to a carnation that is then released into a moving body of water. This is all done with great ceremony.  It is a time of great meaning and purpose for all in attendance.

Rituals are vehicles for transformation of meaning. Any act done with intention that transforms meaning can be a ritual. Rituals often have secular and/or spiritual dimensions. They punctuate and mark significant events in our lives such as weddings, births, confirmations, graduations and deaths.

In grief, rituals are an important part of the healing process. Rituals provide order to the chaos of grief. They usually involve distinctive ingredients such as candles, food, a special space or place. Rituals have a beginning, a middle and an end. They speak to our hearts and legitimize our emotions while forcing us to focus on the present. 

Rituals create bridges for moving from one psychosocial status to another. From spouse to widow or from child to orphan, rituals can help with the transition.  Anything that has special meaning to us may be part of our mourning ritual, from displaying photographs to bringing flowers to the grave. Again, any act done with intention can be a ritual. It’s about the intention -- not just going through the motions.

Here are grief ritual ideas:

·         Release ceremony: butterflies, balloons, flowers

·         Create a memory book of pictures, photos and stories

·         Plant a tree or memorial garden

·         Eat at your loved one’s favorite restaurant

·         Design a shrine

·         Wear something that belonged to your loved one

·         Create a memory quilt or teddy bear

·         Keep a journal

·         Visit the cemetery or other special place

·         Light a candle

·         Write a letter

·         Help Others

One camper who comes to mind is a young boy who returned to camp for three years running. The first year, he was unable to let go of any part of his flower and walked away from the water very weepy. The second year he released the flower, but kept several petals and stuffed them into his pockets. Year three, he was one of the first campers to proudly toss his entire flower into the water. Each time he participated on his own terms and he was a bit transformed. Each time, the ritual took on new meaning. It was a simple act done with intention.

Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.


Read other Diane Snyder Cowan columns here


©2012 ShareWIK Media Group, LLC




For many, the death of a loved one becomes a time to revisit world views and beliefs. 

Death can shake core beliefs and throw the bereaved into a time of chaos. Finding meaning in the death of a loved one can be helpful in adjusting to the loss. The meaning is personally determined. The meaning one person finds can be vastly different than that of the person’s spouse, children or siblings.  Some folks search for concrete meanings such as how their loved one died. Some find themselves trying to figure out who am I now that my spouse died. Yet others question their spirituality and ask why did God let this happen?

This begs the question: how does one find meaning in loss? There is no easy answer. Counselors won’t tell you. It’s their job to listen and accompany you as you figure it out for yourself.  Ultimately, each individual will manage grief in their own way. Some will allow it to be transformative. Some will find meaning in the process.

Here are lessons that others have shared:

1. There is “something” after death.  One of my siblings remarked after our father died that she did not previously believed in a world after death, but sitting with him and watching him nearing death, made her a believer.

2. Help others. One young bereaved adult made meaning of the tragic loss of her father by volunteering and helping others go through painful experiences in their own lives. It’s important not to do this too soon after the death.

3. Love never dies. Many bereaved maintain a connection with the deceased, which provides great comfort.

4. Do not take for granted what really matters in life – what is truly important, what is valuable.

5. Explore difficult emotions such as anger, resentment and guilt. This can provide insight into yourself and your relationship with the deceased.

6. Become part of a caring community. After a group tragedy, those directly impacted often become more compassionate and find ways to give back to their community. It takes a village….

Sometimes trying to make meaning out of death seems impossible. How does one find meaning in the death of an infant or child?  How does one find meaning in a life cut short by tragedy? 

Searching for meaning is part of the grief journey. Seek help from a trusted friend or counselor to support you as you search for meaning and allow your grief to be transformative. Join a support group. The sharing of stories in a support groups not only offers the members the chance to be helped but to help others. No one needs to grieve alone.

Please visit our on-line grief discussions groups at  http://www.hospicewr.org/discussions/grief/.


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio. She is a regular ShareWIK.com columnist. 


©2012 ShareWIK Media Group, LLC


Birthdays, holidays, anniversaries and other special days can all be grief triggers. This past Father’s Day it seemed as if there were countless advertisements and media displays about dads. I am certain there were just as many last year but as this was this first Father’s Day post dad’s death, I was hypersensitive.


Our feelings of grief are heightened on days that we are accustomed to celebrating with our love ones.  They represent family togetherness and expectations of joy and happiness. On Father’s Day we always celebrated Dad’s birthday, which was in close proximity. The standing joke was that my dad required that we have TWO cards.


Some suggest that you be prepared and have a plan. You can do something special or something completely different. Some bereaved try not to think about it or pretend it‘s just another day. They want to skip over the holidays or erase them from the calendar.  In truth, the day will come and go. It will be different from previous years just by the mere fact that your loved one is no longer physically present.  It can be helpful to brace yourself.


While these celebratory days may be changed forever, they can become special occasions to remember your loved one in a positive way and keep including that person in your life. We can view these special days as commemorations rather than celebrations.  As we adjust to life without our loved one, we need to try different ways to manage the pain of grief.


Birthdays can be marked by making and eating your loved one’s favorite dessert. Wedding anniversaries can be observed by looking through photo albums of vacations taken together.  Light a candle, visit a favorite spot, buy a gift to add to your loved one’s collection, or donate to a charity that meant something to your loved one. These are ways of remembering and honoring their life.


Please visit our on-line grief discussion groups at: http://www.hospicewr.org/discussions/grief/


Diane Snyder Cowan is the mother of two grown daughters and a national leader in music therapy and grief and loss, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.

Read other Diane Snyder Cowan columns here


©2012 ShareWIK Media Group, LLC


As the Baby Boomers age, so does the average age of the workforce. This increases the likelihood that we, as employees, are caregiving and subsequently grieving the death of a loved one.  In addition, we may experience the death of a co-worker. 

According in the American Hospice Foundation, at any given time, 25 percent of the workforce is grieving a loss.  Just because one might take three days of bereavement, it doesn’t mean the grief process is complete. Grief is ongoing and can sneak up uninvited at unexpected times.

Some grieving people find the routine of work a break from their grief. Work allows the bereaved to return to a safe environment surrounded by friendly colleagues. Others find the workplace overwhelming and it becomes too difficult to maintain focus and attend to the task at hand.

According to The Grief Index (Grief Recovery Institute 2003), the impact of grief in the workplace can result in:  unexpected tardiness or absenteeism, distraction from tasks, incomplete work assignment, and difficulty making decisions, decreased concentration, increased accidents, and leaving the workforce.

If you are a grieving employee returning to work, follow these guidelines:

·         Be realistic about your expectations

·         Ease into your work

·         Prioritize your work

·         Ask for help

·         Know your limits

·         Create a place to take a breather

·         Utilize professional help (EAP) if available

Here are ways to support a grieving co-worker

·         Do ask about their grief

·         Listen

·         Avoid the clichés of grief “Time will heal”…

·         Speak of the person who has died by name

·         Allow the person to repeat their story

·         Don’t be afraid to share your own feelings


The bottom line is that we are all impacted by grief in the workplace.  Be sensitive to others around you and if you are grieving, know that you are not alone. There is support and hope.


Please visit our on-line grief discussions groups at  http://www.hospicewr.org/discussions/grief/.


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.

Read other Diane Snyder Cowan columns here


©2012 ShareWIK Media Group, LLC


Sometimes death feels sudden. But when you stop and think about it, your loved one has been suffering from a chronic illness for several years.  In my work in the bereavement center with community clients and with hospice families alike, this is a common theme.


Consider this.  Your loved one had heart failure.  There were multiple times where he or she went into the hospital and then came home.  Relapse and remission became part of your vocabulary. One day, the doctor said something different.  He said that it’s time to go home with hospice or it’s time to admit your loved one into a nursing home. You were completely caught off guard. Perhaps you were able to make  arrangements or maybe your loved one died before even leaving the hospital. The death certainly feels sudden.


Perhaps your loved one had diabetes. Along the course of the illness, there were many hospitalizations. In addition, there may have been other losses – including the loss of eyesight or a limb or there were heart issues. The same thing happens. Instead of going home to recover, the doctor suggests hospice.


Dementia.  People die from dementia. Caregivers are surprised at this. Their loved one may have dementia for five to 10 years and there are countless losses along the way.  One day, death happens. It seems out of the blue and feels like a sudden death. No one told me you could die from dementia.


What can we do?  Well, I won’t get on my soap box and talk about the need for physicians to be honest with patients, provide complete information about the trajectory of the illness and let families know what is on the horizon.

I will talk about grief – about what I know.


Whether the death is sudden, feels like it is sudden or has been anticipated for months, the pain of grief is not diminished. GRIEF HURTS. You need to be kind to yourself.  Allow yourself time to wrap your head around what has happened.  Don’t let others disenfranchise your grief with sayings like but she was sick for so long. Don’t disenfranchise your own grief.  Grief is hard work that takes a lot of energy. Suggestions come from many sources, but trust yourself to do what is right for you. Talk with others. Seek a professional counselor if that seems helpful. Please know that you do not have to grieve alone.


Please visit our on-line grief discussions groups at  http://www.hospicewr.org/discussions/grief/.


Diane Snyder Cowan is the mother of two grown daughters and a national leader in using music in grief therapy, as well as the director of Elisabeth Severance Prentiss Bereavement Center of Hospice of the Western Reserve in Cleveland, Ohio.   She is a regular ShareWIK.com columnist. To learn more about Diane, visit her blog.

Read other Diane Snyder Cowan columns here


©2012 ShareWIK Media Group, LLC



©2011 ShareWIK Media Group, LLC. All rights reserved. ShareWIK does not provide medical advice, diagnosis or treatment. For more information, please read our Additional Information, Terms of Use and Privacy Policy.

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