All death leads to grief for loved ones, but some kinds of death may cause more grief than others. In the instant research paper, an evaluation is made on whether sudden bereavement can result in more grief than sudden death. Among the forms of sudden death evaluated include sudden infant death syndrome (SIDS), accidents, violent deaths, suicide, and drug overdose among others. Based on available research, there is a reason to believe that sudden death does exacerbate grief, causing those whose loved ones die suddenly to grief more and for longer. The need to know what happened or find a point of blame is among the main exacerbating factors. This greater grief can cause actual mental health problems. Mitigation includes how the grieving loved ones are treated after death has happened and also long after as they grapple with the grieving process.
Key Words: Sudden Death, Bereavement, Grief, Grieving Process .
Introduction
The death of a loved one always results in enormous grief for the living, leading to the need for effective ways of overcoming grief. However, not all deaths are the same as one of the major classifications of bereavement being the one caused by expected and unexpended deaths respectively (Goldstein at al., 2014). Due to modern advancements in diagnostics, most people get to know that their deaths are imminent, so do their loved ones. They thus get to say goodbye and prepare themselves for the imminent death. However, sudden death is still a reality even in the modern world. Among the most disturbing forms of sudden death is sudden infant death syndrome (SIDS), the explained and sudden death of infants (Goldstein et al., 2018). Other common causes of sudden death include acute illnesses, suicide, substance abuse overdoses, and violent deaths (Goldstein at al., 2014). By their very nature, these deaths deny the loved ones the opportunity to say goodbye and be heard by the deceased. They also may also come with secondary complications such as investigations at the very moment when the loved ones are supposed to be ventilating their respective losses. Many sudden deaths also carry stigma which complicates the grieving process (Pitman et al., 2016). Finally, most sudden deaths are either unexplained or unexplainable a fact that leaves an insatiable desire to know what happened. The totality of the above begs the question: Does sudden death exacerbates the grief of bereavement?
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Literature Review
Due to the prominence of death as a subject in psychology and also the complexity of the issue of sudden death, a lot of research has been carried out on the instant subject. The said research has led to a monumental amount of publications some of which agree on general issues but not always. After a careful evaluation of available research, information that could provide answers for the research question and solutions for the problem that the said question poses has been synthesized as hereunder.
What Amounts to Sudden Death
The determination of what about to certain death forms a critical foundation of any research about the subject and is thus essential to understanding if indeed sudden death execrates grief. Based on available research, sudden death can be attained through a variety of common or uncommon ways (Raven, 2017). Among the common ones in the modern world is suicide which happens when an individual intentionally and fatally harms his or her body. Accidents, be they traffic work-related, or even freak-accidents are another major cause of sudden death (Raven, 2017). Complications of manageable chronic illnesses such as diabetes or hypertension can also lead to a sudden death where a loved one can shift from healthy to die rapidly. In children, sudden infant death syndrome (SIDS) is an uncommon but extremely traumatic form of sudden death (Goldstein et al., 2018). Drug overdoses have also become an important form of sudden death. Some researchers also classify death on the operating table or even in the ICU as sudden death, when loved ones had every reason to believe that their patient will pull through.
Shock, Self-Blame, Disbelief and a Desire for Information
Available research shows that by its very nature, sudden death exacerbates grief because of how it affects the grieving process. When a loved one passes on, it is critical for the bereaved to focus on coming to terms with the loss of the loved one (Garstang, Griffiths & Sidebotham, 2016). However, in the case of sudden death, news of the death is either incomplete or ridden with extra baggage that interferes with the process of grieving. Incomplete news about death means that it is known that a person is dead but it is not known why they actually died (Goldstein et al., 2018). Instead of the loved ones focusing on their grief, they will either be seeking for answers or speculating which exacerbates grief. Conversely, in deaths such as suicide or SIDS, the bereaved may either be in disbelieve or blame themselves for what happened which will increase grief or affect the grieving process (Garstang, Griffiths & Sidebotham, 2016). Blaming one another is also common which augments emotions and creates conflict hence making the grief worse. In the case of violent or improbable deaths failure to believe that the loved one died can also delay the grieving process hence worsening it.
Investigation and Stigmatization
Most forms of sudden death will be the subject of investigations and also stigmatization a fact that not only augments grief but also interferes with the grieving process (Pitman et al., 2016; Garstang, 2018).
(Garstang, 2018)
As the chart below reflects, when a child dies of SIDS, investigations will take a minimum of up to six months when no foul play suspected and much longer if there are suspicious circumstances. It is also clear that several officers from different agencies will be involved, which may result in a high number of different interviews (Garstang, 2018). Anxiety about the process may also delay or worsen the grieving process. Stigmatization is also associated with many forms of sudden death including SIDS, suicide, and overdoses (Pitman et al., 2016). The loved ones are also torn between trying to handle the grief and trying to manage the stigma that they face because of how their loved one died.
Mental Health Complications
According to available research, a combination of how sudden deaths happen and the exacerbation of grief as outlined above can lead to actual mental health problems. Stress is a common outcome of sudden death grief, which if not properly mitigated can lead to depression (Goldstein at al., 2014). Further, factors that make it hard to grief conclusively can lead to an inordinate elongation of the grieving process, normally referred to as prolonged grief disorder (PGD) (Goldstein at al., 2014). Further, the way the death happened and the moment the news of that death was communicated can also lead to post-traumatic stress disorder (PTSD) (Raven, 2017). Finally, research has also found that in a bid to overcome grief or due to recklessness caused by the exponential grief, some people will turn to substance abuse in a misplaced effort towards mitigation. Addiction and other adverse effects of substance abuse including fatal overdoses can ensue in extreme cases (Goldstein at al., 2014).
Possible Mitigation
Mitigation for the extreme grief caused by sudden death combines what happens at the point of death, what happens immediately after death and also long after the sudden death. How information is passed on to the loved ones is critical to how they will handle it hence how it will affect the grief they will experience and also their grieving process. Information about sudden death should be communicated with caring not as a by the way by a busy professional (Garstang, 2018). Training is thus necessary on how to deal with those bereaved through sudden death to professionals who deal with such cases often, such as ER nurses. Immediately after the sudden death has occurred, it is also important for the loved ones to get to say goodbye to the deceased (Garstang, 2018). Where possible, the loved ones should be allowed to spend time with the body, say what they need to say and even touch it. The deceased will not hear or respond, but this is important of the bereaved. Secondly, after a sudden death, it is important for the loved ones to be provided with full information about what happened to their loved one including the uncomfortable details. Available research has shown that having unpleasant information about what happened to a loved one is better than being left wondering what would have happened (Garstang, 2018). The third solution is counselling and the provison of information about what happened to the loved one. Such counselling and support should continue for as long as the bereaved need it which may stretch for months or even years. It is also during such follow up that complications such as depression, PTSD or PGD can be diagnosed and treated (Garstang, 2018).
Conclusion
The answer to the question of whether sudden death exacerbates grief is, based on the literature review above a resounding yes. The very nature of most forms of sudden death can increase the amount of grief involved so does the inability to say a proper goodbye. Further, sudden death may also interfere with the grieving process due to the introduction of unfavorable information or the lack of crucial details. Conversely, stigma and investigations may, by affecting eh grieving process increase the duration of grieving hence exacerbating the grief itself. Any bereavement may cause extreme grief and even psychological problems, but chances for the same are enhanced in a sudden death situation. Among the psychological issues that might ensue are stress and depression, PTSD or PGD. Treatment and management should be provided for loved ones suffering from the same. Several mitigation avenues have been developed for assisting loved sudden bereavement victims, but there is still a lot of room for improvement that calls for further research to improve available knowledge in the subject. As reflected above, the training of professionals on how to deal with victims is also critical.
References
Garstang, J. (2018). Working with families after a sudden child death. Paediatrics and child health .
Garstang, J., Griffiths, F., & Sidebotham, P. (2016). Parental understanding and self-blame following sudden infant death: a mixed-methods study of bereaved parents' and professionals' experiences. BMJ Open , 6 (5), e011323.
Goldstein, R. D., Lederman, R. I., Lichtenthal, W. G., Morris, S. E., Human, M., Elliott, A. J., ... & Prigerson, H. G. (2018). The grief of mothers after the sudden unexpected death of their infants. Pediatrics , 141 (5), e20173651.
Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. American Journal of Psychiatry , 171 (8), 864-871.
Pitman, A. L., Osborn, D. P., Rantell, K., & King, M. B. (2016). The stigma perceived by people bereaved by suicide and other sudden deaths: a cross-sectional UK study of 3432 bereaved adults. Journal of psychosomatic research , 87 , 22-29.
Raven, R. F. (2017). Adding Trauma-Informed Care at a Bereavement Camp to Facilitate Posttraumatic Growth: A Controlled Outcome Study Irene Searles McClatchey.
