Introduction
Death is a common phenomenon; it is eternal, expected, and often misunderstood. We will all die; however, determining where, when and how is impossible. Death is an unacceptable concept to acknowledge in life (Cupit Noppe & Noppe, 2004). Death was indeed an incomprehensible idea to take in. For my family, it was a very trying period. I was 18 when my grandfather died due to complications of cancer. He left behind his wife of 20 years, nine children and 17 grandchildren. I was at home when I got the news. My mother called to inform my brother and me that she had lost her father. This was the first time I encountered an actual death in the family. Being raised in an emotionally reserved family, I was unable to express my sympathies to my grief stricken mother. My mother was reaching out for both my brother and me for comfort and I couldn't reciprocate well enough. How can someone offer care and support when you yourself do not know how to offer assistance, more so, understand what just happened? To this day, I am still amazed at how we managed to pull through.
Background
Death, up to this day, is a continuous effort for people to understand (Cupit Noppe & Noppe, 2004). According to Green, Green, & Kingsley (2006), the concept of death and burying the dead are still important rituals for diverse cultures. Philosophers have continuously counseled on the "correct" approach to death (De Sousa, 2003). Modern society immediately presumes that such recommendations are based on reflections on what is natural and "proper". He states that there are actually two things to observe when mourning and grief come into play: first, there will always be perverted attitudes towards death; second, there are facts about that specific death to justify the evaluation on the perverted attitudes. This approach presents a more reasoned standard of rationality.
De Sousa (2003) reveals that there are three types of rationality for the grieving process: Practical rationality, Epistemic rationality and Axiological rationality.
Practical rationality focuses on the proactive approach to happiness like finding the means to the achievement of over-all emotional health Epistemic rationality aims at making the most of correct beliefs and Axiological rationality is the combination of both rationalities and tends to reflect on emotional attitude appropriateness.
Children & Death
With the media packed with all sorts of disturbing references to deaths, murder, war, famine, accidents, suicides, adolescents, depending on their various personalities and cultural outlook, have special ways of reacting to death (Cupit Noppe & Noppe, 2004). When my grandfather died, my comprehension of death as an adolescent was small. I didn't understand why it happened and the question lingered "Why us?" I was lost and shocked by the course of events that I resorted to withdrawal and isolation due to my limited understanding of the situation. Though death is associated more with the elderly, adolescents have their own distinctive encounters with equivalent coping mechanisms (Cupit Noppe & Noppe, 2004). As my mother reached out for both my brother and me throughout her grief, I myself did not know that I was in grief, which I acknowledged through shock and indifference.
Mourning & Grief
On the day of the wake, I sat with the whole family and accepted sympathies from close friends and acquaintances. During this period, I overheard my mother mention to a neighbor that the news hit her the hardest as she was the eldest in her family. She kept repeating that she was now an orphan. I was struck and angered by this declaration. I thought, "You are not the only one who lost someone, so did the rest of us." Jenkins & Merry (2005, p. 12) states that for every unique death, there is also a corresponding unique response to it. Feeling competitive during grief is a normal phase to go through. Most people are unaware that grieving can sometimes become competitive such as what happened during the wake. My grief clouded my rational mind and I clearly misunderstood my mother. I myself failed to acknowledge that I was also a "victim" of my family's loss. Jenkins & Merry (2005) adds that it is normal to forget that we do not have the monopoly on grief as what my mother declared in the wake.
Sudden & Traumatic Death
It relieves me to say that my grandfather's passing away in the hospital was a peaceful episode. He was with his family when he silently, forever, closed his eyes. I guess, in a way, my family was fortunate enough to say their last goodbyes during that difficult time. According to Clements et al (2004), our loss was more auspicious compared to the traumatic and sudden deaths other families have gone through. They indicate that deaths are assigned to five medico legal categories: homicide, suicide, accident, natural, and undetermined. The authors also added that bereavement literature reports state; deaths involving an act of "human design" are more likely to create complicated grief responses such as violence, trauma, and suicide. Disbelief, shock, and anger are deepened due to the assumption that these deaths are "untimely" and "unfair".
According to Jenkins & Merry (2005), sudden death can never prepare you for goodbyes. Traumatic and sudden deaths compared to an expected one can cause greater shock and pain (Clements et al, 2004). Just as the deceased's pain and suffering is gone, the loved ones who have to deal with the trauma, injustice and shock, their journey is only the beginning. Without the ability and time to prepare mentally and emotionally, "co-victims" like surviving family, friends, and co-workers, feel wronged as a result of sudden death (Clements et al, 2004). Typical responses in the beginning of sudden death are shock and numbness. Along with these behaviors, there are also the encroaching responsibilities that go along with it: notification of friends and family, funeral and burial preparation, and attending to tasks brought about by the tragic loss which often results in more confusion. Such deaths bring about dramatic change to a family system. This triggers a 360-degree turn for structure assessment and adjustment of roles in the family. For health workers, if they are able to understand the obscure factors related to traumatic and sudden death, intervention and guidance is improved (Clements et al, 2004).
Survivors
For any family or individual who has experienced loosing someone, regardless of natural or tragic causes, the path of grief is a lonely trek (Clements et al, 2004). Even with the support of family and friends, survivors are aware that their grieving process is unique only to them. As each response is unique, so are the responses that go with it. This is given confirmation through the discomfort and avoidance of discussing the pain the individual survivors experience for their loss. Usually, surviving family members who have experienced death in a violent nature mask a seeming hush-hush attitude. With the loss of my grandfather, I reacted in a manner that was epitomized what Clements et al (2004) say as "affective disturbances." This is differentiated in two: internalization and externalization responses. Depression, withdrawal and avoidance are all internalized responses exhibited by a grieving survivor, such as my indifference and isolation from my other grieving family members while an externalized response consists of anger, outbursts, or unstable moods.
Social Stigma
At the funeral, I had mixed emotions. The reality that my grandfather was going to be buried did not fully sink in. I could still talk about certain everyday things, but when the topic of my grandfather's demise came up - I had nothing to say, or would brush off any sympathies given. I didn't know how to handle such an emotion and what to actually say at those events. According to Clements et al (2004), since the world of grief can be a lonely and secret place, survivors will frequently feel misunderstood. It is also typically common in our society for death to be hidden, making the grieving process longer and unbearable. Though there is no "wrong" or "bad" grief response (Clements et al, 2004) such as what I portrayed in the funeral, careful cultural assessment can prevent unnecessary concern among survivors burdened with great emotion. Another good example of social stigma is men undergoing loss who do not cry. Society dictates that not crying is considered ineffective grieving therefore unacceptable behavior. Every death is unique and every response to that loss is unique in itself (Jenkins & Merry, 2005). If some people choose not to cry in the presence of others, it does not mean they are grieving improperly.
The Health Worker's Role
Though death is the last frontier, (Cassell, 2005) doctors and health worker's still find it difficult to discuss dying and Do Not Resuscitate (DNR) orders. Nurse Rachel Giarizzo (2008) observes that depending on spiritual beliefs, death and dying mean different things to different people. While others may fear death and "fight" it, some accept death with amazing calmness and peace. During her duties, she witnessed that some dying patients preferred to be alone during their final hours, while others wished to have someone with them at all times, terrified of the unknown. She states that nurses and health workers should give the best comfort and empathy for the families and patients during these grave moments (Helping nursing assistant with dying and death, 2009). A health worker must focus their effort on making the patient comfortable. A health worker should watch out for a dying patient's critical signs such as: bed sores due to body positioning, temperature and other signs of pain & discomfort. The patient's mouth will become dry during his/hers final hours of life; the health worker should apply petroleum jelly if the lips start cracking.
People have a hard time facing death, but health workers need to know and do better (Brown, 2009a). If there is no more hope for the patient, and the body is wasting away, the health worker and nurse can recommend better options for the patient to make his/her final days as comfortable as possible. Sometimes, providing care is a bitter pill to swallow. Treating and caring for terminally ill patients is never easy (Brown, 2009c). Patient "Craig" is one example. Doctors and nurses gave him treatment that eventually killed him. The patient was fully aware of the risks involved but chose it as his only chance for a normal life. When he passed away, he was cancer-free. The really hard part about a health worker's job is not giving up hope (Brown, 2009b). That patient-nurse moment, even if there's so many deaths and even if it's only for a year or two, the patient's time on earth is preserved. For grieving survivors, the nurse also plays an essential role. The health worker must be ready to endure various response patterns such as: hostile outbursts to silence (Clements et al, 2004). During my grandfather's stay in hospital, my cousin was a witness to such courage of a stranger. It had been a busy, stressful day, but the nurse behaved as though she had all the time in the world, leaving many spaces where my family could ask questions regarding my grandfather. When the nurse left, my cousin observed that my grandmother and my mother appeared unburdened.
Acceptance
Grief is a `family affair', Dowling (n.d) states that improved family communications and the promotion of shared grief are processes that `nurture' and promote healthy mourning. I always try to remind myself that grief is a continuous process and should never be considered an endpoint of something (Clements et al, 2004). The objective of grief is to remember the deceased, understand the types of adjustment created by the loss, and determine how to advance again in life. As the pain begins to decrease, survivors typically begin to feel increasingly comfortable talking about the loss (Clements et al, 2004). As I look back on the time I got the phone call, I still get upset but I remind myself that he's no longer suffering and that thought makes me ease up. I can talk now talk about my grandfather with my mother. My mother on the other hand, can mention his name without bursting into tears. Death touches many people, and the dying can teach us valuable lessons (Jenkins & Merry, 2005). It is a given that there are traumatic and socially destructive aspects of grief (Kellehear, 2002). Individuals grieve relationships at their own pace (Dowling, n.d.). The length and passion of sorrow depends on the extent in which the person is involved (Separation, loss and grief, n.d.).
Conclusion
Whenever I think about death , I remember the poem from Ecclesiastes (2007): "For everything there is a season, and a time for every matter under heaven, A time to be born, and a time to die; A time to plant, and a time to pluck up what is planted; A time to kill, and a time to heal; A time to break down, and a time to build up; A time to weep, and a time to laugh; A time to mourn, and a time to dance; A time to throw away stones, and a time to gather stones together; A time to embrace, And a time to refrain from embracing; A time to seek, and a time to lose; A time to keep, and a time to throw away; A time to tear, and a time to sew; A time to keep silence, and a time to speak; A time to love, and a time to hate, A time for war, and a time for peace." (p.1)
Death comes in many forms. It can be the death of a relationship, a promise, or something tangible, like the death of a loved one. The poem strikes me as exquisite and gives me peace whenever I think about my grandfather. We are all given the opportunities in this world: to feel, to take action and to live to the maximum of our potential.
While most of us would prefer to ignore the concept of death, sometimes it will be too late to ignore it at all (Jenkins & Merry, 2005). Ignorance, as a result, will leave us feeling shocked and numb. When trying to make sense of things, we selfishly ask "Why me?" Sometimes, forgetting in our sorrow, the grief other people feel (Cassell, 2005). Death is not necessarily a defeat, but a tragic and inevitable necessity.
All these trials and tribulations test people's character (The Sydney Morning Herald, 2009). History has always shown our need to survive, we then seek meaning from the melancholy while transcending to the reality of doing something about it. My grandfather was a very private person. He was man of few words but whenever he sat with me out back during summer afternoons, his presence always gave me comfort. His quiet ways were a refreshing escape midst the chaos of our household. The way he tended to his garden after lunch and how he would cut my cousin's hair and mine just so we could save up on money. It's been years since he left us and I still miss him. I open the cupboard once in a while to polish his beloved shears. I guess the pain will never really go away. Life will never be the same but I guess when you lose someone, it never will. We all have our burdens to carry and we also have our own roads to travel. It is making that journey worthwhile for the people around us are all that matters. Each life is indeed unique and that we all have our places on this earth. My grandfather, though short his stay had a life well-lived. The memories that I have of him are beautiful and peaceful. He was a loving husband, a dependable father and doting grandfather. I guess I was lucky that I got to know him. To be able to hear his kind words and witness his silly grin, that my younger cousins will never be able to experience.
