HJNO May/Jun 2022

of statements can almost re-traumatize the individual who has suffered a traumatic loss. Grief never goes away. That’s not a bad thing, it’s just different from what they knew before.” Swalm has seen firsthand that grieving processes are as unique and individualistic as people are. She believes that many loved ones of grieving individuals need to under- stand the fundamental fact that there is no “standard”or “normal”timeline of treatment for grief or bereavement. “I would definitely say allow the per- son as much time as they need. I think it’s extremely important that grief does not have a timeframe on it,” Swalm said. “I would also encourage individuals to check in with their grieving loved one every so often, just to show their continued sup- port but not necessarily to pressure them to speak about their grief. Grief can be a really private experience for many people.” The question of how to speak to bereaved individuals is a common one, Malhotra said. It’s normal for loved ones of the bereaved to wonder “what to say” about the loss. Mal- hotra’s advice? In some instances, consider saying nothing. “Sometimes, you don’t need to say any- thing. Sometimes people just need to know that you’re there for them,” she said. “Being comfortable with silence is very important. Just let the person know that you’re there and you love them.” Kaplow from the TAG Center believes that there is one important thing to say when speaking to a bereaved child. “The most important thing that adults can do to support grieving children is to acknowledge the death,” Kaplow said. “So often, adults are afraid to bring it up, but the reality is that the child is thinking of their lost loved one. By saying ‘I really miss them, too,’ what you’re doing is validating the child’s reality.” So much about the nature of bereave- ment is determined by circumstances that it seems impossible to divide different types of grief and bereavement into neat catego- ries. However, it is obvious that a child’s sudden loss of a parent is a different expe- rience than a middle-aged person’s expected loss of a loved one due to a lengthy illness. “I think that we expect that a sudden loss would cause more grief, but I’ve found inmy clinical practice that it doesn’t play out that way,”Malhotra said. “If someone has a chronic or terminal ill- ness, oftentimes the spouse and the fam- ily have a terribly long grief trajectory,”said Melissa Pennebaker, a palliative care nurse practitioner at Touro. “They experience anticipatory grief, knowing that their loved one is going to die.” Pennebaker helps her patients navi- gate the difficult and emotionally trying circumstances of a life-limiting diagnosis. This often means that she helps her patients have important conversations surrounding end-of-life plans. “I really think that, as a society, we need to normalize talking about death,”Pennebaker said. “On some level, it’s a topic that is really avoided. Death is terrible, but it’s a part of life. We should be more open as families, talking about it.” The most important part of her job, she said, is to be a “good listener” and to do everything that she can to improve quality of life for those under her care. “I do a lot of discussions with families GRIEF 12 MAY / JUN 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   “The most important thing that adults can do to support grieving children is to acknowledge the death,” Kaplow said.