End of Life Care and Bereavement

Planning for your future care - Advanced Care Planning

Advance Care Planning (ACP) can help you prepare for the future. It gives you an opportunity to think about, talk about and write down your preferences and priorities for your future care, including how you want to receive your care towards the end of your life. Anything can be included. If it is important to you,record it, no matter how insignificant it may appear.

ACP can help you and your carers (family, friends and professionals who are involved in your care) to understand what is important to you. The plan provides an ideal opportunity to discuss and record in writing your views with those who are close to you. It will help you to be clear about the decisions you make and it will allow you to record your wishes in writing so that they can be carried out at the appropriate time.

To see the Advanced Care Planning Form - CLICK HERE

It is usually helpful to discuss the content of this document with somebody you trust.


Coping with Bereavement

The death of someone close is likely to be one of the most distressing experiences we face.  When someone dies a relationship is lost and we move into a new and largely unknown situation.  Grief is a natural reaction which allows us to begin to come to terms with our loss and to adjust to the change it has made to our lives.  For every individual the loss of the relationship and the changes experienced are different; each person’s grief is unique.

Grief can express itself in many different ways and is often accompanied by very powerful, frightening and confusing feelings.  It is common for those feelings to ebb and flow over a period of time, sometimes for several years, but gradually most people begin to cope on a day to day basis. 

How Grief can make you feel

Shock, numbness and disbelief

These feelings can be experienced in the period soon after a death.  Numbness may provide temporary protection and we may feel quite calm and detached.  After a death there is so much to do – relatives to be contacted, death certificates to be organised, paperwork to be gone through, a funeral to be prepared – and while we are so preoccupied with these demands we may not be able to take in the reality of our loss.  Although we may ‘know’ the death has taken place, we may sometimes ‘forget’ and feel the person who has died is still with us.  This often happens when we least expect it and can be very painful.

Sadness and turmoil

We cannot be protected from the fact that the loss may hurt or disorientate us.  We may lose confidence.  It may make us feel unsafe, frightened, sad, regretful and empty or without purpose or hope.  We may be unprepared and unwilling for the changes in our lives and feel anxious, confused and alone.  We may experience emotional turmoil as a result of this huge change in our lives so that we lose concentration and the ability to think clearly and fear for our sanity.  We may feel tearful - crying unexpectedly is quite normal.

Despair and depression

Grieving is hard work.  It takes time and energy.  We may frequently feel exhausted or we may suffer health problems.  However, unless grief is allowed to follow its course, it may bring risks to mental and physical health with the possibility of our personal relationships being affected.  There may be times when it seems hard to find anything to live for; when we feel that there is little point in going on and that nobody understands us.  It can be a very lonely time.  We rarely have any idea whether, when or how our grieving will end.  It is, however, a natural human experience.

Anger and guilt

Grief often brings anger and guilt in its wake and we can experience these in many different forms.  We may feel anger that the person died, anger that we have been left behind or anger that family and friends have not been sufficiently supportive.  If we believe that the person who has died was not well cared for, anger may be directed at figures of authority such as doctors, nursing or caring staff.  We often feel the need to find someone to blame.  Sometimes, too, anger may be self-directed and we feel guilt, perhaps linked to things we have or haven’t said or done.  We ask ourselves ‘What could we have done differently?’  Sharing these thoughts with others may help to resolve these feelings.

Support from family friends and work colleagues is immensely valuable immediately after the death and as we grieve and gradually adjust.  Sometimes, sadly, other people’s inability or unwillingness to face death and grief leads to avoidance and hurtful behaviour.

The pain of bereavement has been compared to the experience of losing a limb – it doesn’t come back, we will always miss it, but we can learn and adapt to living without it.  Our hope is to be able to cope, eventually, with daily life and to keep a continuing bond with those we have lost.

What you can do to help yourself

  • Accept that it is normal not to feel normal.
  • Let yourself experience the feelings you have and talk to others about them.  Many people feel the need to talk about what has happened and how they feel over and over again.
  • You may need to find out more about the person’s death if all the facts around the death are not clear.
  • Remember the importance of eating, sleeping, exercising and relaxation.
  • Take time to reflect and remember.

As time goes on grieving can become increasingly lonely and a bereaved person can feel that no-one else understands them and what they are going through.  If you find this is the case for you, the following pages list organisations that can offer support or a listening ear, counselling, advice and information or practical help.

Resources to help you cope with grief

We have put together a bereavement support directory containing information and the contact details of organisations who specifically help people to come to terms with loss and overcome grief. You can download the bereavement support directory here: 

Herefordshire Bereavement Support Directory

Lists of further reading, other resources and local services are available at:

NHS website

BBC website

Child Bereavement website

Cruse Bereavement Care website