Wednesday, September 28, 2022

But I Didn't Say Goodbye


 Book Review

September is Suicide Prevention Awareness Month, and in our bereavement library here at the funeral home, we have a wonderful book penned by Barbara Rubel entitled, But I Didn't Say Goodbye: For parents and professionals helping child suicide survivors. 

But I Didn't Say Goodbye is broken into two major parts. As Barbara Rubel explains in her introduction, part one introduces us to a young boy named Alex, whose father has just completed suicide. Naturally frightened, confused and mourning his father's passing, Alex is asking those in his life questions, including whose at fault for his father's suicide, could he have prevented it, what will happen to his mother and how to tell his friends and classmates about his father's dead. The second part, is geared towards parents and professionals and offers information on setting up a Memorial Fund, and aids to help them in finding survivor support. 

What is nice about this book, is the format in which it is written. During part one, which is Alex reflecting back five years ago when he was ten and in the fifth grade, it is broken into nine small chapters of no more than 2 to 5 pages at most. Each chapter starts with Alex speaking directly to whoever is reading his story, as he's explaining what's going on at that particular moment. When he begins to ask questions of the person he is speaking to, these are separated into individual questions, with Alex's question in bold print, and the adult's answer directly underneath his question. Alex also takes the time to tell the reader what he is thinking while asking questions, which helps the reader to understand that this is truly a discussion going on. 

At the end of each chapter, there is a Stop to Process page, with a serious of questions, that can help facilitate a deep and meaningful discussion between an adult and the child reading this section of the book. Questions on these page include, "How do I feel about the person who told me that my special person died?" or "How does the word suicide make me feel?" There are also options for the child to explore their feelings in other ways other than talking, such as drawing a picture, making a list, or writing a special poem. 

The final chapter of the story is a note written from Alex, and explains how Alex, his sister Debbie, and his mom have continued to celebrate and remember his father. He also speaks about how he went to a support group and what it was like. He ends his note by encouraging everyone to keep reading and researching their feelings to help them continue to cope with their loss. 

Part two of the book is for the parents, professionals and caregivers of children dealing with the loss of a loved one from suicide. This section is simply titled Bereavement Referrals, and is a very detailed list of various organizations and other resources for those looking for suicide awareness, prevention and survivor support; death education and grief counseling; crises intervention; addictions; information on depression and suicidology websites. For many of the organizations, Rubel has provided the name and contract information, as well as a detailed description of the organization. 

Rubel has chosen to conclude her book by adding an appendix with lists of recommended resources for children, adults and professionals. 

In 2020, Ms. Rubel updated her book, and what follows below is the summary of the updated version from Barbara Rubel's website. 

But I Didn't say Goodbye: Helping Families After a Suicide tells the story, from the perspective of an eleven-year-old boy, Alex, and his family, as they are rocked by suicide and reeling from the aftermath. Through Alex's eyes, the reader sees the transformation of feelings after going through a suicide from a child's perspective, although he has the wisdom of a bereaved adult. 

New to the third edition, each chapter ends with Alex reflecting 10 years later on his experience, introducing family and friends in his recollections. Barbara Rubel has combined our modern academic theories of grieving, and the research that supports those theories, and then translated them into a readable story for anyone bereaved by suicide. 

The revised edition is an evidence-informed and contemporary treatment of a devastating form of loss that uses a hypothetical case study to render it in human terms. Through the story, the reader will understand what losing someone to suicide might be like for a family, how to make meaning, and ways to experience personal growth. This book provides guidance and education for clinicians and families to help suicide loss survivors. 

Part 1 offers a basic understanding of suicide postvention, complicated grief, mourning theories, and the impact on clinician survivors. Chapters have been updated, based on mourning models and the latest research.

The chapters in Part 2 build upon one another from the day of the suicide to the anniversary. At the end of each chapter, there are follow-up questions to explore in counseling sessions, support groups, therapy sessions, or at home. At the end of each chapter, Alex, at the age of 21, reflects back on how his father's death has changed his life, wounding him, but also helping him to grow. 

This award winning book explores a trauma-informed and grief-informed approach to helping those who are traumatically bereaved. 

For those who'd like to borrow But I Didn't Say Goodbye: For parents and professionals helping child suicide survivors, you can contact the funeral home and borrow it from our bereavement library.

If you'd like a copy of the newest edition of But I Didn't Say Goodbye, you can purchase a copy by visiting Barbara Rubel's website by clicking here.


Wednesday, September 7, 2022

September's Kid Corner Activity: Memory Mobile


Hey everybody,

We're excited to share another great activity that you can do to help remember your loved one. 

This month we're going to make a Memory Mobile.

To make a memory mobile, you will need:

  • Paper plates (get as many as you'd like in whatever sizes you want)
  • A sheet of stars (or whatever shape or design you'd like)
  • A sheet of big star (or again, whatever shape or design you'd like-you may have to go to a craft store or draw your own star on a sheet of cardstock)
  • 2 ribbons
  • 5 pieces of cording
  • Markers, Colored Pencils or Crayons
  • Stickers
  • Beads
  • Scissors-make sure to ask mom, dad, or another trusted adult to help you if you need it
  • Hole Punch
  • Paper Clip
  • Stapler

  1. Write memories about your loved one who died on the stars (or whatever shape or design you selected). 
  2. Decorate the stars and paper plates with markers, colored pencils, crayons, or stickers.
  3. Cut out the stars.
  4. Punch holes in the stars.
  5. Punch 4 holes on the out most portion of the paper plate in each of the 4 quadrants. Tie each of the 2 ribbons to a punched hole on the backside of the plate and then tie to the hole directly across. This is how the mobile will hang. **Make sure the ribbons are the same length when they are tied. 
  6. String pieces of cording with beads (the beads weight down the stars). Tie or staple stars to the end of the cording.
  7. Staple the other ends of the cording randomly to the paper plate; opposite of the ribbon.
  8. Attach the paper clip to the ribbon to hang the mobile. 
This month's project may be a bit more difficult then most we will share or have shared on our blog page, but we found great value in it. A perfect activity to do with children of all ages (yes, even with teenagers), it creates a memory object, while providing an opportunity for artistic expression to honor and remember loved ones. Lastly, this provides a forum for sharing stories of self, family, and memories. 

This month's Kid's Corner Activity Time comes from the Clinical Grief Activities for Working with Bereaved Children handbook for Safe Crossings Children and Teen Grief Support Program, sponsored by Providence Hospice of Seattle. For more information, please visit their website at

Tuesday, September 6, 2022

Fall, 2022 Support Groups-Hospice of the Western Reserve


Below, we have provided you with a list of Hospice of the Western Reserve support groups for Fall, 2022. For additional information on any of the grief support groups listed, please contact the facilitator listed for each program

Monday, September 5, 2022

A Labor Day Journaling Prompt

 As we celebrate Labor Day, we share with all of you a journaling prompt from A Year of Special Days: A Journal for Coping with Grief co-authored by Jennifer Mosely, M.S.W., L.I.S.W and Marilyn Deliberato, L.F.D. for Foresight Family Funeral Homes.

"Come to me all of you who labor and are heavy laden, and I will give you rest." (Matthew 11:28)

Focus for Today:  This special holiday is a time to take a break from the tasks of daily life. On this Labor Day, focus on rewarding yourself for the toil of your grieving. You have been working hard!
What can I do for myself to help with my grief?
  • Indulge in the luxury of a massage for all of the "labor" of grief you have been doing. If you're uncomfortable with a full massage, a neck/shoulder or hand massage will do wonders.
  • Find a stone or rock and paint on it a memory or symbol of your love. Place it in a special place and hold it when you need to visit your grief.
  • Be adventurous by taking a daytime or overnight trip to someplace you have not been before. This may be a new town, state park, historical site, or another attraction. 
Journaling Prompts
  1. Have I put too much time and effort into grieving so that I have worn myself down? In what ways might I be making it overly laborious?
  2. How much of my grief can I discuss with other in my support network before they become overburdened? How can I balance my interactions so that I can continue to receive support?
  3. What can I do to replenish my inner well of strength? 

Sunday, September 4, 2022

Remembering Those We Love: The August, 2022 Necrology

 On this first weekend of the month, we take a moment to remember those we've loved in August. 

August, 2022 Necrology

  • Jason Edward Johnson
    • Born: April 9, 1971 
    • Entered Into Eternal Rest: August 4, 2022
  • Harold C. Mooneyham "Chuck"
    • Born: February 5, 1963
    • Entered Into Eternal Rest: August 4, 2022
  • Martha Snyder
    • Born: February 22, 1924
    • Entered Into Eternal Rest: August 4, 2022
  • Darlene Marie Mathews
    • Born: April 14, 1946
    • Entered Into Eternal Rest: August 7, 2022
  • Rita Marie Loksa
    • Born: December 1, 1937
    • Entered Into Eternal Rest: August 11, 2022
  • Kathy Sue Pigman
    • Born: August 20, 1958
    • Entered Into Eternal Rest: August 14, 2022
  • Pablo Contreras "Tito"
    • Born: December 19, 1954
    • Entered Into Eternal Rest: August 15, 2022
  • Henry Murry, Jr.
    • Born: June 22, 1966
    • Entered Into Eternal Rest: August 17, 2022
  • Janice Meade
    • Born: December 9, 1942
    • Entered Into Eternal Rest: August 20, 2022
  • Gary Wilson Moore
    • Corporal, United States Marine Corps, Vietnam Veteran
    • Born: July 3, 1948
    • Entered Into Eternal Rest: August 28, 2022

Friday, September 2, 2022

Developing Your Advance Care Directive

 One of the more common topics take come up when a family is discussing end-of-life items are Advance Care Directive. For those unfamiliar with Advance Care Directives, they are a series of forms that allow you to express your wishes for your health care in the event that you are unable to speak for yourself. In Ohio, the forms, which are commonly known as Health Care Power of Attorney (Health Care POA), Living Will, and some form of an Organ Donation form, allow you to name those people who you feel comfortable handling your medical care if the need arises. It is highly recommended that you speak in depth with your medical team prior to completing these documents, so you understand what rights, powers, and responsibilities those named in the document will have over your care. Once completed, it is recommend that you provide a copy of the forms to your medical team, nursing home/skilled nursing facility/hospice or other long or short care term facilities, family members and lawyer. At the bottom of this evening's post, we have provided you a link to the Cleveland Clinic Foundation's website so you may print out these forms if needed. In addition, we will be devoting several additional posts to further explaining each form of the Advance Care Directive that is acceptable for Ohio. 

What is an Advance Care Directive?

An advance care directive (ACD), also known as an advance healthcare directive (AHD), ensures that your medical wishes will be followed when you are unable to speak or are no longer in a mental state to make cogent decisions. By planning out your wishes in writing ahead of time, you provide healthcare professionals with important guidelines for medical care. The term advance care directive generally refers to two types of documents, the living will and the healthcare power of attorney, although other written and verbal instructions can fall under this category. 

The Living Will

The most common type of ACD is known as the living will. Not to be confused with a Last Will & Testament, which deals with decisions to carried out after your death, the living will is written ahead of time to explain the kinds of medical care that you wish to receive and those that you do not. It helps doctors make important decisions regarding tests, medicines, surgeries, blood transfusions, CPR and feeding tubes.

Healthcare Power of Attorney

A living will does not technically allow you to designate a person to make decisions for you. For this, you will need to turn to a healthcare power of attorney. However, these two forms can often be combined into one document. The person you choose to represent your wishes is often referred to as a health care proxy, and his or her authority will be limited to decisions of a medical nature: legal and financial decisions do no fall under his or her jurisdiction.

DNR and DNI Orders

Thought DNR (Do Not Resuscitate) and DNI (Do Not Intubate) orders may be included in the living will, they don't have to be. A DNR prevents a medic from performing CPR, and a DNI prevents the use of breathing tubes. These orders can be communicated verbally to your physician, who will put them in his or her medical records. 

 Planning Your Advance Care Directive

According to the National Institutes of Health, more than one in four Americans will have medical decisions made when they are in physical or mental state than renders them incapable of communicating their wishes. Some of these people have prepared advanced care directives, but others have not. Without an ACD, this can be a very stressful time for physicians, friends, and family members. It's never too early to start planning ahead. Here are some tips for getting started:

"Of course, at the end of the day, it's YOUR plan..."

  • Consider your family's medical history: By examining the medical issues that run in your family, you can construct a good genetic map for determining potential health problems. For example, if older family members have suffered strokes, you may spend some time researching strokes to determine the kinds of decisions that would need to be made if this ever happened to you. 
  • Determine your values: What is most important to you? Would you like to be kept alive by any means necessary? If so, provide clear instructions for doing so. Or are there specific issues that would reduce your quality of life so completely that you would rather not have your life prolonged artificially? If feeding tubes and breathing machines are out of the question for you, make this known, so that physicians and loved ones don't have to worry about making the wrong decision. 
  • Talk to your loved ones: Once you have started to consider the medical decisions that you would like to make, bounce your ideas off the people closest to you. Ask for feedback from family members and to see what they think of your plan. Of course, at the end of the day, it's your plan, and you don't want to distort your wishes to confirm to the will of others. But it can be useful to get the opinions of people that you trust. 
  • Research your state laws: As is the case with most medical issues, rules and regulations on advance care directives vary to a certain degree from state to state. Be sure to research your state laws ahead of time to ensure that all of your wishes are interpreted or documented in a way that is legally valid. A lawyer can be helpful in this area, but is not required.
  • Seal the deal: Consult with your doctor and talk through your wishes to make sure they can be accommodated. Then, fill out the required forms according to your states laws to ensure your wishes will be carried out. 
  • Keep it handy: Once you have completed your ACD, make sure that it is readily accessible. Provide copies for your doctor and your family members, and keep copies of it in locations where it can be easily found. It is not uncommon for people to go through the trouble of creating an ACD that cannot be located when an emergency strikes. It may be a good idea to put a copy in your wallet or your glove compartment of your car for quick and easy access.
  • Reviewing your ACD: If you change your mind about any issue that has been documented in your Advance Care Directive, don't worry. You can always update it to reflect more current wishes. If you do this, just make sure that you have destroyed all previous copies to avoid future confusion.

Be Prepared

While the elderly are most in need of ACDs, people of all ages can benefit from a little preparation. Tomorrow is never promised. A sudden onset of an illness or an accident resulting in serious injury could force your family and physician to make some tough decisions. Consider taking these precautionary steps so that you can rest assured that if the occasion ever arises, your medical wishes will be followed and your healthcare team will know how to proceed. 
Developing Your Advance Care Directive was penned for, a website designed with the funeral consumer in mind to provide them with quick and accurate information. You may find a direct link to this article by clicking here.

A copy of Ohio's Advance Care Directives may be downloaded by clicking here.

Thursday, September 1, 2022

September is National Suicide Prevention Awareness Month


It's okay to not be okay.

Since the start of the COVID-19 pandemic, many of us are finding it harder and harder to be okay. That's to be expected with everything we have had to face, and it's hard to imagine that everyone will be okay and that we will ever go back to being fully okay like before the pandemic. In fact, according to research done by the Ohio Suicide Prevention Foundation, 1 in 5 people are living with mental health or substance use disorders, which are major risks for suicide. 

As we begin Suicide Prevention Awareness Month, we'd like to use our blog posting tonight, to share with you an article we found on the Purdue University website that was just posted before the start of the Fall, 2022 school season. 

September is National Suicide Prevention Awareness Month 

Suicide is an uncomfortable topic to discuss but one that should be discussed openly and honestly. To help raise awareness and open the dialogue, September is recognized as National Suicide Prevention Awareness Month. 

According to Psychology Today, suicide is a difficult topic, but silence can have tragic results. And those who are the sounding board for a suicidal friend or family member also need resources to help them navigate their journey in that role. 

It's important for everyone to remember that suicide's reach goes far beyond the individual who is having suicidal thoughts and even actions. Those around them-family, friends, co-workers, neighbors, associates, etc.- are impacted as well. In addition, while a suicidal person may not directly ask for help, that doesn't necessarily mean they don't want help. So, what can someone do to help?

Recognizing warning signs
An important part-the first step actually-of suicide prevention is recognizing the warning signs and taking them seriously as well as knowing how to respond to them. Warning signs of suicide include:
  • Talking about suicide.
  • Looking for access to guns, pills, knives, etc.
  • Having a preoccupation with death.
  • Sudden mood swings or personality changes.
  • Hopelessness.
  • Self-loathing/hatred.
  • Neglecting appearance.
  • Changes in eating and sleeping patterns.
  • Saying goodbye.
  • Withdrawal.
  • Self-destructive behavior. 
Suicide prevention tips
  • If someone is worried about another individual, they are encouraged to speak up and start a conversation. Giving a suicidal person the opportunity to share their feelings can provide relief. 
Melissa Covarrubias behavioral health counselor at the Center for Healthy Living (CHL) on Purdue's West Lafayette campus, suggests starting a conversation with a simple statement that reflects the concerns. For example, "You haven't seemed like yourself lately, so I wanted to check in," or, "How are you doing? I've noticed some changes in you and want to be sure you're OK."

"Remind them that they are not alone and that you are in their corner. Let them know the way they are feeling now will change and that you care about them and want them to be OK," Covarrubias says. 
  • Respond quickly. It's important to try to determine if the individual is in immediate danger. 
HelpGuide offers the following suggested questions to ask to help assess the immediate risk of suicide:
  1. Do you have a suicide plan?
  2. Do you have what you need to carry out your plan?
  3. Do you know when you would do it?
  4. Do you intend to take your own life?
Determining the level of risk-HelpGuide offers the following risk assessment. 
  1. Low-Some suicidal thoughts. No suicide plan. Says he or she won't attempt suicide.
  2. Moderate-Suicidal thoughts. Vague plan. Says he or she won't attempt suicide.
  3. High-Suicidal thoughts. Specific plan. Says he or she won't attempt suicide.
  4. Severe-Suicidal thoughts. Specific plan. Says he or she will attempt suicide. 
"It's important to pay attention and take them seriously, even if you do not think that the person you're trying to help is in immediate danger," Covarrubias says.
  • Offer help and support. "Trying to help someone who is suicidal can be emotionally challenging," Covarrubias says. "While trying to offer support, remember not to put the responsibility on yourself for making the individual better. You can offer support, but only the individual in question can make the decision to get help and commit to ongoing treatment and therapy." 
Some things to do to offer support:
  1. Help find professional help for the individual and encourage him or her to go see someone.
  2. Be proactive in regard to reaching out. Don't wait for the person to call or ask for help. Stop by to visit, keep calling and invite the person out for dinner or even a walk.
  3. Encourage lifestyle changes that will positively affect the individual. Things such as a healthy diet, getting plenty of sleep, getting outside and so on. 
  4. Make a safety plan. Assist in developing a plan for the individual so he or she can identify triggers and follow the steps that are determined to be most helpful. Include the contact numbers for the individual's therapist (if applicable), crisis center hotline, Suicide Prevention Lifeline and other contacts who can help in an emergency. 
  5. Continue supporting the individual long-term. Keep in touch, periodically stop by to visit, call to check in and remind the individual that there is hope. 
  • Get training:
  1. Suicide Prevention QPR Gatekeeper-QPR stands for Question, Persuade, Refer-three simple steps that anyone can learn to help prevent a suicide and save a life. 
  2. Additionally, the American Foundation for Suicide Prevention offers many training resources, as does the group, Suicide Awareness Voices of Education (SAVE), by providing tools to community leaders to help prevent suicide. 
  • Get involved. During September, when the focus is on raising awareness for suicide prevention, it's easier for individuals to join in to support those around them and in their communities. However, that support is needed all year long regardless of whether an individual is directly helping someone in need. 
There are many ways to get and stay involved. Share information about suicide and suicide prevention on social media to help reduce the stigma associated with it. Keep the dialogue going with family and friends about the need for increased awareness and support. Volunteer at a local crisis shelter or similar organization. Donate to agencies who work nonstop to provide support and services for individuals in need.

Suicide prevention resources
  • 988 Suicide & Crisis Lifeline-The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. 988 has been designated as the new three-digit dialing code that will route callers to the National Suicide Prevention Lifeline. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat (
  • American Foundation for Suicide Prevention (AFSP)-Offers resources for suicide prevention for anyone in need, including resources supporting diverse communities and the LGBTQ community. 
  • Centers for Disease Control and Prevention (CDC)-Shares resources, facts, risk factors and more.
  • National Institute of Mental Health-Shares action steps to help someone and more.
  • Suicide Prevention Resource Center (SPRC)-Shares multiple resources on suicide prevention.

As September is National Suicide Prevention Awareness Month is penned for Purdue University News, we have left out some information that pertained directly to the university. However, we encourage you to visit the link below to read the entire article as well as to visit the numerous helpful links within the article. September is National Suicide Prevention Awareness Month