Johnson County Medical Examiner Grief Information

Grief

The Johnson County Medical Examiner Department would like to offer our sincere condolences for the loss of your loved one. No one is ever prepared for the death of a loved one. The sudden and unexpected death of someone we love can bring a range of emotions including guilt, shock, anger, sadness, resentment and regret, as well as a number of unanswered questions. Listed below is some information that may help you understand your own process of grief. Johnson County offers a number of services that are available to those who are grieving a loss. A list of these resources is described below.

Grief

Normal Grief

Complicated Grief

Sudden Death

Resources

		Grief
Grief is a broad range of feelings and behaviors that are common after a loss. The most commonly described reactions during the process of grief are shock, denial, anger, guilt, depression, acceptance, and growth. Some people experience the grieving process in this order. Most often however, a person moves back and forth through several of these emotions at the same time, experiencing them in different degrees. There is no time frame for your grief and no right or wrong way to grieve. It is important to understand that everyone grieves differently. Grief is an individual experience that is unique to each person and to the relationship he or she had with the deceased.

		Normal Grief
Normal grief encompasses a broad range of feelings and behaviors that are common after a loss. Normal grief is manifested in four ways (1) feelings, (2) physical sensations, (3) cognitions, and (4) behaviors. Feelings Following a significant loss, we are overcome with a number of feelings. The most common grief responses illicit feelings in us such as sadness, anger, guilt, anxiety, loneliness, fatigue, helplessness, shock, yearning, and numbness. Most people experience a range of these emotions and often move rapidly between them. These feelings are all a part of the normal grieving process. Physical Sensations Physical sensations are often overlooked but play a significant role in the grieving process. The following is a list of the most commonly reported sensations experiences by those who are grieving. • Hollowness in the stomach • Tightness in the chest • Tightness in the throat • Oversensitivity to noise • A sense of depersonalization: “I walk down the street and nothing seems real, including me.” • Feeling short of breath • Weakness in the muscles • Lack of energy • Dry mouth Cognitions There are many different thought patterns that mark the experience of grief. These thoughts are all a part of normal grieving. These include disbelief, confusion, preoccupation with the deceased, feeling a sense of presence with the deceased, and both visual and auditory hallucinations. Behaviors There are a number of specific behaviors frequently associated with normal grief reactions. These behaviors are commonly reported after a loss and usually correct themselves over time. • Sleep Disturbances • Appetite Disturbances • Absentminded Behavior • Social Withdrawal • Dreams of the Deceased • Avoiding reminders of the Deceased • Searching and Calling Out for the Deceased • Sighing • Restless Overactivity • Crying • Visiting Places or Carrying Objects That Remind the Survivor of the Deceased • Treasuring Objects That Belonged to the Deceased

Complicated Grief

It is possible for the pain of grief to become so severe that it starts to interfere with our ability to function in daily life. This kind of grief is called complicated grief. There are different kinds of complicated grief that manifest itself in different ways. Here are some signs that you or someone you know is developing a complicated grief reaction:

1. Showing no signs of grief after a major loss.
2. Experiencing grief that is excessive in duration and never comes to a satisfactory conclusion – being stuck for a long period of time in one particular part of the grieving process.
3. Putting off grieving at the time of loss but becoming overwhelmed with grief several months later.
4. A person experiences some signs of grief, but they are less than what you might expect.
5. A person experiences extremely intense grief that develops into clinical depression, anxiety disorders, phobias, agoraphobia, mania or maladaptive behaviors such as alcohol or drug abuse.
6. Experiencing symptoms of grief but not recognizing their relation to loss; usually turn up in one of two ways, physical symptoms or maladaptive behavior.

If you are experiencing any of these reactions to grief we urge you to discuss your situation with your family physician, a licensed mental health professional or contact the JCME Grief Services Counselor at (319) 339-6197 to assist you in finding resources that may help.

Grieving a Sudden Death

Grieving the loss of someone who died suddenly and unexpectedly can be very difficult. The following list illustrates some of the difficulties that may accompany the sudden death of a loved one.

	1. Feelings of Numbness
		It is completely normal to feel shocked for some time after a sudden loss. Many people report feeling as though they are walking around in a daze. This is not unusual. It is common for survivors to experience nightmares and intrusive images after a sudden loss, even if they were not present at the time of death.
	2. Feelings of Guilt
		Feelings of guilt are common after any type of death. In the case of sudden death, we often express the “if only” statements. (If only I hadn’t let them go to that party, If only I had been with him) It is important for you to understand that the death was not your fault and to think realistically about your own feelings of responsibility. Could I really have prevented this? Most often the answer is probably not.
	3. Involvement of Medical and Legal Authorities
		In instances of sudden death, it is common for families to encounter the many systems that surround this particular type of death. These types of systems include the Medical Examiner Department, Law Enforcement, Autopsy Agencies, Donor Network and the Legal System. It is not unusual for families to feel overwhelmed by all of the processes that are taking place. To help relieve these feelings, make sure you have a clear understanding of the involvement of all of these systems with your loved ones death. Do not be afraid to ask questions.
	4. Sense of Helplessness
		When someone we love is taken from us suddenly, it causes an assault on our sense of power and on our sense of orderliness in the world. This helplessness is often linked with an incredible sense of rage. It is very common to feel angry, as we are forced to accept that we had no control over what has happened. However, we need to be sure that we release that anger in a healthy way. It is getting stuck in anger that can cause problems.
	5. Agitation
		Agitation and anxiety are common feelings after a sudden death. This is most often due to a sudden increase of adrenalin and the stress of sudden death.
	6. Unfinished Business
		Sudden death often leaves us with many regrets for things that we did not get to say or do. It is important for survivors to find a way to have closure with these regrets. This may involve writing a letter that includes things you want your loved one to know, taking your family to do something your loved one really enjoyed, or taking a trip you had planned on doing together. It may take some time before you are ready for these types of activities but it is important that you address whatever unfinished business you may have had with your loved one.
	7. Increased Need to Understand
		Families working through a loss find themselves constantly questioning why this had to happen. In the case of sudden death, there seems to be an especially strong need to find meaning. Making meaning is a large part of the mourning process. Finding meaning after sudden death is one of the most difficult but important tasks endured during the grief process.

		Grief Resources
Described below are a number of resources available for you to turn to for grief support. If you are having difficulty finding the right choice for you or having difficulty finding services in your area, please contact the Johnson County Medical Examiner Grief Services Department at (319) 339-6197 for assistance. Iowa City Hospice Iowa City Hospice provides grief support services free of charge to ALL adults, children and teens in their seven county service area (Cedar, Iowa, Johnson, Linn, Louisa, Muscatine and Washington) who have experienced a significant loss. *The person who died need not have been an Iowa City Hospice patient.* Iowa City Hospice welcomes those who have experienced the sudden loss of a loved one to also participate in their bereavement services. Services include educational programs, support groups, social events, supportive visits and phone contacts by staff and volunteers, a library of books and video resources, referrals, grief counseling, bimonthly newsletters, and monthly mailings of articles about grief and loss. For more information please contact Chris Klug, Grief Support Services Coordinator at (319) 688-4205 or (800) 897-3052. You can also visit Iowa City Hospice online at http://www.iowacityhospice.org. If you do not reside in the Iowa City Hospice Service area, they may be able to direct you to a hospice in your area that can provide support. Johnson County Crisis Center The Crisis Center offers a variety of services to those in need. All services are free and confidential and most are available 24 hours a day, every day of the year. A counselor is available through their crisis line at all times for anyone who may need support and/or assistance by calling (319) 351-0140. Face-to-face counseling is also available from 9 a.m. to 11 p.m. The Crisis Center also offers a Survivors of Suicide Support group. To find out more information, please contact the Crisis Center at (319) 351-0140 or visit their website at http://www.jccrisiscenter.org. The Compassionate Friends The Compassionate Friends (TCF) is a national nonprofit, self-help support organization that offers friendship, understanding and hope to bereaved parents, grandparents and siblings. TCF services include educational information and opportunities, nationwide support groups, monthly newsletters, national magazine, social events, resources for parents, grandparents and siblings, conferences, and volunteer opportunities. The mission of The Compassionate Friends is to assist families toward the positive resolution of grief following the death of a child of any age and to provide information to help others be supportive. For more information please contact The Compassionate Friends national office at (887) 969-0010 or visit http://www.compassionatefriends.org. First Candle First Candle is a nonprofit organization working to advance infant health and survival. First Candle’s primary focus areas include education and awareness, advocacy, research and family support. First Candle offers services for those who are dealing with the loss of an infant child due to stillbirth, SIDS or other unexpected infant death. Services include a 24 hour bilingual crisis line, grief resources, conferences and training, message boards and a number of memorial opportunities. For more information please visit First Candle at http://www.firstcandle.org or contact the 24 hour toll free crisis line at (800) 221-7437. GriefNet GriefNet is an internet community of persons dealing with grief, death and major loss. The GriefNet site offers support groups, a grief library, bookstore, guide to resources and memorial opportunities. GriefNet offers support groups specifically for children, veterans, loss of spouse or partner, loss of child, loss of parent, loss of sibling or friend, losses related to health, unique losses, working with the bereaved, living with loss and supporting others. For more information please visit http://www.griefnet.org. Survivors of Suicide Survivors of Suicide (SOS) is an independently owned and operated website whose purpose is to help those who have lost a loved one to suicide resolve their grief and pain in their own personal way. SOS provides information not only for suicide survivors but for friends of survivors. SOS offers resources such as links to support groups, questions and answers about suicide and grief, poetry, a memorial wall, and a discussion board. For more information please visit http://www.survivorsofsuicide.com. Amanda the Panda Amanda the Panda provides support to grieving children and their families through a variety of services. Extensive support is provided to children, teens, and adults who are grieving the death of a family member through accident, illness, suicide, or homicide. This support is provided through weekend camps, support groups, home visits, fun days, school presentations, pen pal programs, Halloween and Christmas parties, birthday cards and remembrances on the anniversary of the death. Amanda the Panda is located in Des Moines, but provide and offer their services to people all over the state. For more information please call (515) 223-4847 or visit http://www.amandathepanda.org. Beyond Indigo Beyond Indigo is an online source of information on grief, grieving, death, and dying. It offers detailed support and information. This site provides opportunities to discuss various topics in chat rooms and message boards. Beyond Indigo offers information, polls, grief tools, advice columns and articles related to grief. Beyond Indigo also provides personalized grief support. Each day for a year a person can receive personalized grief support sent directly to his/her e-mail account. For more information, please visit Beyond Indigo at http://www.beyondindigo.com. Horizons Survivors Program The Survivors Program addresses the immediate and long-term needs of persons who are survivors of homicide victims or whose lives have been impacted by violent crime. The program offers crisis intervention, individual counseling, criminal justice system advocacy, referral services, assistance in filing for compensation, community education and a long-term support system. Services are available 24 hours a day at no cost to clients and are confidential. Horizons partner with law enforcement, prosecutors and other professionals to create a seamless system of support for survivors of homicide and vehicular homicide victims. Support groups meet the 2nd Tuesday of the Month at St. Luke’s Hospital and the 4th Tuesday of the month at the North Liberty Community Center (March-October). For more information please call 319-398-3943, toll free at 877-338-3411 or via email at eblomme@horizonsfamily.org. Horizons is located in Cedar Rapids, IA at 809 5th St SE 52401 and serve approximately 23 counties in east-central Iowa. Iowa Hospice Iowa Hospice provides support to individuals and families before, during and after the death of a loved one. Iowa Hospice actively follows the bereaved for at least 13 months after a loss by mailing materials, phone calls and home visits. Services and support are available to all bereaved persons free of charge, even if their loved on was not cared for by Iowa Hospice. They also welcome concerned friends, neighbors, spouses and family members who have concerns about a loved one who is grieving. For more information you may contact Lynnea Andersen, Director of Bereavement, at (641) 755-4114 or contact Iowa Hospice directly at (800) 752-4692. You may also visit the Iowa Hospice website at http://www.iowa-hospice.com/.

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