When Grief Comes to Work: Loss in Community Health Care

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When Grief Comes to Work: Worker Wellness in Complicated Times

Yvette Perreault and Chris Leonard Good Grief Care Consultants goodgriefcare@gmail.com


Today’s Lunch and Learn       

Facilitator meet and greet Losses in this time Some basics about Multiple Grief and Loss Impact on the Workplace Breakout Room – time for you to say a little Wrap-Up Resources


Facilitator Intro:  

Yvette Perreault

Good Grief Care Consultants ECMH (CMHA) Hastings County (part time- Traumatic Grief Specialist) Retired Director of provincial agency: AIDS Bereavement and Resiliency Program of Ontario Bee shepherd


Facilitator Intro: Chris Leonard


Responding Effectively to Grief & Loss As a Person, a Professional, a Colleague, a Manager, a Role Model and Leader in Community… helping ourselves and each other with language, practice and rituals that support our collective letting go, remembering and making meaning. Grief Resilience as Self awareness, Self Care and Collective Care

So that you retain “heart for the work and heart for your life”



1-1 confidential sessions – debriefing, problem solving, accessing resources

Traumatic Grief and Loss educationals & training Capacity Building

What’s Available from Good Grief Care? Support for development of memorials and rituals

Small group or full team debriefing following critical events


Beat the Burn ~ a practical initiative to build awareness, normalize conversations and end misconceptions about burnout and job exhaustion among workers in frontline organizations. Includes scales (Quality of Life; Stress Index etc) 

The website https://www.letsbeattheburn.com/themission also includes links to a variety of tools and information. 


Heart for the Work

* Grounding ourselves in our own stories/identity. What brings you here? What keeps you here? What does it mean for you to do this work at this time?



No road maps for the AIDS journey- ’80-’90s • • • • • • •

Waves of losses Stigma of AIDS / gay /drug-users Heart for community A desperate need not to suffer alone Activism as fuel Need to right wrongs Not service-provision, but social justice


In those early years- 96% of people with AIDS died.

Smallpox and Ebola kill around 60% of those infected


Three good lessons from earlier years~ “As Workers, the capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work” Charles Figley




Consider the impact of your current context


Opioid Crisis Deaths Have Surpassed AIDS Epidemic 

ALLISON TIERNEY May 15 2017, 2:09pm

“The death toll is worse than any other infectious epidemic in Canada.” "We know that at minimum in Canada, there were 2,300 Canadians that died last year of an opioid overdose," Philpott said to a crowd of harm reduction workers, activists, and others. "The death toll is worse than any other infectious epidemic in Canada, including the peak of AIDS deaths, since the Spanish flu that took the lives of 50,000 people a century ago."

Nearly 4 years later- 20,000 deaths)


There are important distinctions

Way death is experienced:  Time to say goodbye and to shape a dignified death vs sudden/tragic.  Unpreventable vs Preventable.  Anticipatory loss vs Expected losses.


Still Fighting for Justice


Stressors & Losses in this covid pandemic 

Changes: in life/work/ our social context/ finances/ ability to plan/ family dynamics & care/grief ….

Normal isn’t normal & new normal = indefinite uncertainty

Message: keep it together and keep going

But how to do that in a prolonged crisis?


Grieving the loss of living our lives


Except some of us aren’t closed!!!!


Bizarre, haunting images that paint a COVID-19 pandemic year



Mental Health and Covid-19: Hitting ‘Surge Capacity’ https://coronavirus.medium.com/mental-health-and-covid-19-hitting-surge-capacity-and-vacation-risks-1eb945b4451a Coronavirus Blog Team



What’s in your grief-aware toolkit?

Tools that help you understand what’s happening and how to work with loss comprehensively – updated Kubler-Ross’s model! 

(we use William Worden’s Task model, Parkes & Bowlby’s Attachment theories and Terese A. Rando’s Traumatic Grief framework )

Must include both complex loss and traumatic bereavement and a process that offers grieving people possibility and purpose


Grief and Loss 

A Human Experience

We attach, we lose = we mourn.

Tangible & Intangible

No timetable; not linear

Current loss will resurrect old losses



Important to Know…. How Grief Affects the Brain

Grief results in a “broken brain” as much as in a “broken heart”

https://www.youtube.com/watch?v=eEcaUhxAH2g


Covid-19 Your unique context ??????

Loss & Trauma Related to Work

Personal Losses Come to work

BIPOC protests against systemic violence Shadow Pandemics Racism, poverty, marginalization, homelessness, mental health, addictions

The Work and the Workplace

Opioid overdoses/deaths

Agency Loss, Change & Transition


Disenfranchised and Complex Grief Primary Trauma Vicarious Trauma

Loss and Trauma associated with Clients

Uncertainty Unpredictability Lack of control

PTSD/PTSI/CPTSD

Burnout Changes & losses associated with the workplace

Compassion Fatigue Moral Distress


Traumatic Grief The loss

Not only who died but how they died

Grief resulting from loss in a traumatic situation‘how’ the loss occurred has traumatic elements: natural, accidental, disaster, violence, terrorism, etc


Grief Sucks

“Hope is the feeling that the feeling you have isn’t permanent.” ~Joan Kerr


There is a process…..

That we move through uniquely



But the impact of avoiding?


“Is It Okay for You to Be Okay?” “Is it Okay for You NOT to Be Okay?

To remain connected while moving into the new  Resilience: Doesn’t mean it didn’t matter 


What happens with all our Unclosed Grief Loops?

So much loss- sometimes it becomes “What has died?” (assumptive world and core beliefs) rather than a list of “who has died?”


In a time of relentless losses, uncertainty and being “in the trenches” : smart practice is to consciously build a suspension bridge

Purpose: support and stabilization Through predictable, consistent, meaningful supports & rituals that acknowledge loss and help people regroup and move forward


Not the only pandemic

????

Variant? Vaccine? Herd Immunity?

A suspension bridge that might to be going into fog. Where is the end? When is the end? What is the end? A suspension bridge that may feel a little rickety right now…


Or there might be obstacles on your bridge!


We are not all the same in our responses Intuitive Physical

Emotional

Mental

Spiritual

Instrumental Martin and Doka



How Grief Manifests in our Workplaces


Grief Shows Up in the Workplace Fight Minimize

Flight Enforced Positivity

Freeze

Fawn


Self care and Collective Care

Begins with Acknowledging and Accepting the Presence of Loss Responses which serves to validate the fact that the worker is a caring human being ****Who are your go-to people? Who do you debrief with?


How do you find Functional Balance? Engagement

Detachment

*** See Vikki Reynold’s work: www.vikkireynolds.ca


The dogs of 9/11: Incredible story of hero animals who searched for life among the ruins https://www.mirror.co.uk/news/real-life-stories/remembering-911-herosearch-dogs-13152751 Steve Myall

“When the World Trade Center collapsed on September 11th 2001 nearly 10,000 emergency rescue workers began to search the rubble at Ground Zero helped by more than 100 hero dogs During the aftermath search and rescue dogs found so few living people that it caused them great stress because they believed they had failed. When dogs were pulled out to rest, handlers and rescue workers had to regularly hide in rubble in order to give the rescue dogs a successful find and keep their spirits up.”

** Eugene Dufour Stratford Hospice part of the mental health team that went to New York after 911


Caring for Workers- Structurally 1. Personal care practices: 

Talking about it, listening, stress relief, rituals for saying goodbye, encourage peer supports, counseling Use workplace supports: training, debriefing, EAP (specialized)

2. Workplace: 

What are the structures in place: 

death notification protocols;

support after critical events; memorials?

   

Informal Debriefing with peers at work Impact Debriefing after loss/stressful events Incident Debriefing after critical incidents Organizational Legacy: how do you remember?


Impact Debriefing 

How are you doing? 

Really?

What supports you?

What doesn’t support you?



Breakout Rooms 

Your Current Realities 

What have you Lost in this time? (can be personal and professional, concrete and existential)

Have there been Gains?


Brief Report Back from Breakout Rooms 

Anything surprise or move you?



Role of rituals “By doing something concrete and visible, such as engaging in ritual, we can begin to create symbolic mastery over events. Ritual allows a reorganization of community and continuity in a chaotic time. Collectively, it offers a reassurance that while we cannot control the tragedy itself, we have reasserted control in its aftermath”.

Doka


Public Memorials

Circle of Stones- AIDS Memorial

Copper Flame- Drug Users Memorial


Saying a Good Goodbye to….

What are your personal, team, agency and community Goodbyes? How do you Remember? In remembering others, we remember ourselves and who we were with them.


Wrap-Up •Take a moment, feet on the ground, gaze lowered, slow deep breaths. Tuck in what needs to be comforted and protected. Stop and take in this last hour before going off to the next thing!

•1-2 word check out•leaving with…. (in chat)

•Name of someone you are remembering today (in chat)

•Reminder about resources


Your take-away: a centering tool 3 minute guided meditation from https://www.youtube.com/watch?v=uNHLhHyjbd0



Thank you for the work you do!

Yvette Perreault & Chris Leonard Good Grief Care Consultants goodgriefcare@gmail.com


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