All of us will experience grief and loss at some point in our lives. It is part of our human experience. Those who have acquired disabilities typically experience a traumatic loss and unimaginable grief that could derail their lives. Parents also face immense grief upon the diagnosis of their child’s congenital or acquired disabilities. In this article, senior social worker Angela Chung sheds light on the grief and loss arising from the onset of physical disabilities in adults and the elderly.
What is grief
Grief is defined as a reaction to loss that is not necessarily related to death. Most theories and models of grieving agree on its common symptoms and manifestations:
- Shock, disbelief and denial that the loss has occurred or will occur
- Sadness, despair and loneliness
- Anger and resentment
- Regret, guilt and shame
- Anxiety, helplessness, insecurity and fear
- Depression, numbness and feelings of emptiness
Primary and secondary losses
Acquiring a physical disability is often more than just a physical or tangible loss. For example, a person might grieve over their functional losses upon the onset of a permanent physical disability such as spinal cord injury or amputation. At the same time, persons with disabilities also experience secondary or intangible losses such as losing a sense of significance when having to relinquish the role of the family’s breadwinner, or when losing a sense of being safe after surviving a road accident, and the loss that is associated with having to give up their initial dreams and aspirations.
Role of social workers in grief work
When an individual is referred to SPD’s Specialised Case Management Programme (SCMP), the first meeting and engagement usually takes place when they request for practical assistance such as application for financial assistance. However, as social workers, we need to be adept in probing further to uncover any masked grief and losses experienced by these clients with disabilities. Such topics are never easy to broach, but if we provide them with a safe space, we could validate their grief and loss experiences and promote healing.
Risk of complicated grief
Although there is no timeline for grief recovery, social workers need to watch out for complicated or chronic grief which could impact the mental well-being of our clients and caregivers in the long run.
For example, there was a client with physical disabilities who had developed chronic and complicated grief upon her mother’s demise. Even several years later, she continued to mourn daily and could not accept that her mother had passed away. Memories of her late mother would permeate her thoughts throughout the day which led to frequent crying bouts. She eventually lost the will to live as she yearns to join her deceased mother. Her risk factors were exacerbated when she did not have any meaningful preoccupation. All she did was being surrounded by her late mum’s images and belongings at home as she privately languished in her grief.
Thankfully, her situation was flagged out by an alert social service provider who promptly referred her to SCMP. We worked with her and offered psycho-social support to help her process her grief. It is an ongoing journey, but this client was reported to be feeling more hopeful about life now with our intervention and support.
Grief work among caregivers
While clients who experience debilitating effects of disabilities often face an uphill task of working through their grief and losses, let’s not forget about family caregivers who also experience losses and adjustments. For example, caregivers of clients with traumatic brain injuries or dementia often face ambiguous loss.
Coined by family therapist Dr Pauline Boss, ambiguous loss depicts a loss without closure. One of the categories is psychological loss or absence that is accompanied by physical presence. For instance, clients with traumatic brain injuries or dementia may be physically present, but their condition has robbed them of their premorbid personalities, memories and cognitive functions. Caregivers may struggle to recognise and accept the alternative personalities whom the clients have morphed into. Therefore, another pillar of support that SCMP provides is the individualised supportive counselling sessions as well as the group activities and programmes to support and alleviate caregivers’ grief and stress.
Universality of grief versus personal grief
Grief is universal. But how each person process and experience grief and loss are different. It is usually dependent on the circumstances surrounding the grief, the individual’s temperament, support system, as well as other mitigating factors. Hence, as social workers, we need to customise our grief intervention according to the individual’s needs. Since each grief journey is unique, we need to listen to our clients empathetically without rushing to “silver line” their losses. For example, we should avoid saying to a client with amputation, “although you have lost a limb, at least you still have another limb.”
Grief recovery
A part of the grief healing process involves making sense of the clients’ losses in meaning reconstruction, exploring different perspectives, and unravelling the clients’ hidden strengths and resiliencies. Hopefully with time and intervention, clients and caregivers could slowly adapt to a new normal and rebuild their lives after devastating losses.
Community resources
- SOS runs structured support groups called Healing Within as well as open support groups named Healing Bridges for suicide survivors.
- Wicare provides support for widows and fatherless.
- Whispering Hope helps people learn the skills of grieving well through the language and tools needed around the concept of grief and guide you step-by-step through their signature programme Grief Recovery Method®, which is internationally recognised.
References
Cover photo credit: Shutterstock
