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a A Proud to be a Banner Health Center of Excellence

The Three Stages of Grief

Audio/Video Transcript

Audio: Music over opening title

Text: Three Stages of Grief

Text: Jan Dougherty, RN, MS

Director, Family and Community Services

Image: Jan Dougherty on-camera

Audio: "We know that grief and loss is very different for family members who are experiencing someone with a progressive illness like Alzheimer's disease and that they're grieving often what is, what was and what will be-all kind of tied up in one package. And it's interesting in that we highlight a lot about that caregivers are stressed, that caregivers are burdened, that caregivers are depressed, but the underlying issue is that they're grieving this person that they love and how they're changing their abilities, their brilliance, their social persona. And we see a difference in how adult children grieve versus how spouses grieve."

Text: Early Stage Grief

Audio: "So typically early on in the illness, when a diagnosis is established of mild Alzheimer's disease, we see that spouses are often feeling a mild level of sadness, dysphoria, that this is happening to this person that I love."

Text: Caring for a person with Alzheimer's or another dementia is often very difficult, and many family and other caregivers experience high levels of emotional stress as a result.

Audio: "And they, too, are having to reevaluate so what's now retirement going to be like for us if, in fact, they're even retired. Imagine if you're still working. Early on, for adult children, typically they're more removed because they've been living separately and they're not probably feeling a lot of grief at this point because they often don't appreciate some of the differences that are taking place in mom and dad because they're not seeing it, perhaps, on a daily basis."

Text: Moderate Stage Grief?

Audio: "As the disease progresses more into what we call the moderate stages when the person is needing more assistance for grooming and bathing and getting food, that sort of thing. We see that the spouse's grief continues to rise, that they're feeling more sadness, that many of them will begin to isolate because more of their time is being spent in direct care. They're grieving that they're losing this person that they knew: their friend, their lover, their mate who is now more like a child to be cared for. In the middle stages for the adult children, on the other hand, this is when often, if they haven't been involved in care, they're more likely to get involved in care. And they're often, what we call, that sandwich generation. This is a working adult who might have children at home, who has a lot of things happening. And so you can imagine one of the responses is a lot of anger: 'Why me?' 'I can't believe this.' I've had to give up so much.' 'I have no time.' They're frazzled. They're tired. And we see a lot of direct anger actually coming from adult children."

Text: Advanced Stage Grief

Audio: "By the time the disease progresses into the advanced stages of the illness, we find that caregiver grief for spouses absolutely soars. And even when a spouse has to move the person into another setting beyond home, many times the public thinks, 'Well, they should be relieved. They should be feeling better that they don't have the burden of care.' And, in fact, their grief absolutely soars through the ceiling."

Text: Family caregiver interventions, such as education and support groups, can improve caregiver knowledge, skill and well-being, and decrease depressive symptoms.

Audio: "The adult children, on the other hand when placement occurs, we see kind of a softening and a lessening of their anger. And we often see their emotions turn more to sadness and their missing the relationship for what it was and missing out on this ability to be a friend with my parent. And so the experiences are very different for the two types of caregivers and they need very unique approaches to how they cope with their own grief and loss. So rather than talk about the symptoms of grief and loss, which are stress and burden and depression, we need to look at what's the underline, what's the root cause of stress and burden and depression? It is grief. It's unmet grief and loss. So if we're not helping you adapt and come to grips with the loss that you experience in the day, how can we expect that in the end, you're going to have eight to ten years of work to do? That had we worked with you throughout the illness, you're more likely to experience a sense of success at the end."

Text: We are here for you.

Text: Banner Alzheimer's Institute