Bereavement is the period of grieving after someone dies. Mourning is the outward, physical expression of grief.

“Everybody hurts and experiences pain after a death or a loss,” said Nikki Rosswog, bereavement coordinator at Good Samaritan Hospice. “The pain from the loss never goes away. It's present and is going to be with them for the rest of their life.”

Good Samaritan Hospice Bereavement, 116 Browns Hill Road in Valencia, offers grief support for 13 months to people who have or had a family member under Concordia Lutheran Ministries hospice care in Armstrong, Butler, Lawrence, Beaver, Allegheny and Westmoreland counties.

In a year, it typically follows 1,300 families, she said. As people are educated and become familiar with hospice and palliative care, more are taking advantage of bereavement services, she said.

A helping hand

“It's a lot of listening and trying to find out how they feel like they're going to cope,” she said.

Phone calls are the usual method of contact. During those conversations, they find out about a person's support network and what is helping them through the grief, such as a church community or volunteering. If they are under self-care, counselors check for possible suicidal thoughts or self-harm.

An initial phone call is made within a couple of days of a loved one's death. The frequency of follow-up calls is based on the survivor's needs and how much support they want. Families also are given the opportunity to opt out of the program.

Rosswog also works closely with the hospice team to identify people who have limited support systems, several significant losses in a year's time, and other challenges or situations that can complicate the grieving process.

Rosswog, along with a recently added social worker, provide support to people identified as higher risk who need to be followed more closely through increased numbers of phone calls and those who want supportive grief counseling visits.

Throughout the year, they also have grief support groups and workshops that are open to the community. In the three years Rosswog has been with the program, she has started holiday grief workshops, a butterfly release and support groups that have expanded into the North Hills.

Journey in grief

Factors that contribute to how a person grieves include the nature of the relationship with the deceased, the age of the person and cultural factors. Grief does not have a specific time frame.

“What you would like to see for most people is that they begin to feel around six months to a year a softening of the pain that's going along with loss,” she said, however, adding it can go beyond a year. “As they heal and move through their grief, I feel like they should begin to see more moments where they have times where the focus isn't always on the sadness, where they feel like they get a little break from their harsh pain they're experiencing.”

They also assist people who need guidance to access more support and therapy in the community and to find grief support groups closest to them and programming for children who are grieving.

The first few months for people who are feeling high emotion can be difficult for them to know what they might need as far as support, she said.

“They are often in a period of disbelief trying to get familiarized with this new life that they're thrown into,” Rosswog said.

Rosswog advises people not to start a support group until two to three months after their loved ones death because emotions are intense at that time.

After three months, people begin to come out of that initial fog and the reality of the situation sets in, she said.

In six to nine months, the person starts to have thoughts of making changes and acclimating to the new norm and adjusting to a life that's different without that special person.

Someone to listen

“For most people, what they find is through talking with us they have someone that's going to listen without offering advice all the time,” she said. “Sometimes people just need someone to listen to what they're going through and validate that experience for them.”

Rosswog tries to educate people about grief and loss.

“In general, we don't do a good job with conversations about death and dying. A lot of times people don't even know how to approach someone after they have a death,” she said. “We really need to open this communication and understanding about death and dying and grieving and loss.”

Grieving is not a quick process; it is a journey, Rosswog said.

“Sometimes people have the idea in mind that they're going to move through this very fast and that they should be feeling better by two months after the death and they're wondering about what's wrong with them,” she said. “There's nothing at all wrong with them; they just loved someone so much that now they're having to deal with the pain of losing them.”

<b>Grief Support Group</b>WHAT: A six-week groupWHEN: 10 to 11:30 a.m. Thursdays, April 23 to May 28WHERE: Haven II Education Room on the second floor at Concordia Lutheran Ministries at Cabot, Entrance 5, 148 Marwood Road, CabotREGISTRATION: Deadline April 16FOR MORE INFORMATION: To sign up or for more information, contact Nikki Rosswog, MSW, bereavement coordinator, 1-800-720-2557, Ext. 4423.CAMP ERIN PittsburghWHAT: A three-day, overnight weekend camp for children and teens, ages 6-17, who are grieving the death of someone significant to themWHEN: June 12 to 14WHERE: YMCA Camp Kon-O-Kwee Spencer, 126 Nagel Road, FombellTO APPLY: Caregivers must complete an application and in-person interview for each child or teen who want to attend. Clinical staff will assess each applicant and communicate final decisions to the family based on camper readiness and bereavement needs.APPLICATIONS: Available at camperinpittsburgh.org or call 1-724-869-6102

Reach out for support and counseling.Connect with support groups and programming in the community.Practice self-care.Be patient with yourself as you grieve.Attend events you find enjoyable.Set boundaries. You can decline invitations and accept them when you are ready.Identify things that might trigger emotions and feelings.Seek support from others who have gone through something similar.wAYS TO HELPBe open and present and listen to the person grieving.Ask how you can help and support them through their loss.Avoid phrases and sayings such as “the person’s in a better place” or “you just need to move on.”Check in on the person regularly because support tends to fall by the wayside after a few months.SOURCE: Nikki Rosswog, Good Samaritan Hospice bereavement coordinator