Healing Together: Helping Couples Cope with Miscarriage, Stillbirth or Early Infant Loss

  

For many couples, a miscarriage, stillbirth or early infant loss is the greatest loss they have ever experienced together. Yet, husbands and wives often feel alone in their grief. Certainly there are marriages that have been strengthened by a shared loss, but more common is the marriage that suffers under the weight and stress of mourning.

The Meaning of the Loss                     

A major task for the pregnant woman is to accept the fetus as part of herself. The well—being of her baby becomes intertwined with her own feeling of self-worth. If her baby dies (even very early in her pregnancy), her self-imagine and sense of competency may be shattered.

Since a father does not experience any physical changes during pregnancy, the early months of his wife’s pregnancy may not feel very real to him. As the pregnancy progresses, the reality of the baby becomes clearer to the father. Men tend not to experience an early miscarriage as an acutely personal loss, but they usually find a second trimester loss or stillbirth more painful because they have seen and felt physical evidence of their child.

Healing Together: Helping Couples Cope with Miscarriage, Stillbirth or Early Infant Loss was co-authored by Marcie K. Lister, ACSW and Sandra M. Lovell, RN, ACSW for the October 1990 issues of Bereavement              Magazine.

This article is several pages long and will not fit in this column, therefore, we broke the article into several pieces. In our next issue of New Horizons, we will share their next two headings: Grieving the Loss and Guilt.

 

Keep Calm and Carry On? Not So Fast!

  Hi, kids! I see a lot of t-shirts, posters and memes with the phrase "Keep Calm and Carry On." You've probably seen them too. The message is clear-when times are hard, keep your emotions in check and keep moving on.

Sometimes this is useful advice. The message comes from a 1939 poster that the British government produced to boost the morale of its country's people. A war was coming, and it was a scary time. Showing calm and a determination to carry on gave people a common goal and helped to promote unity during a very trying time. 

But there are times in our grief when we need to do more than just "keep calm and carry on." When waves of sadness, anger or guilt crash into us, our brain, heart and body may feel out of sorts-not calm at all. And that's okay. The thoughts and emotions that come with grief can be intense. They speak to the strength of the love you had for the person who died. Life is different without them, and it isn't really possible to carry on as if nothing has happened. So what do we do? 

Instead of trying to simply keep calm and carry on through grief, let yourself feel everything that bubbles up, even if it is messy. If you need to yell, let out a nice scream-into a pillow is always good. If you need to cry, grab a box of tissues and let the tears flow. If you have pent up energy that needs a place to go, punch a pillow or throw water balloons against the sidewalk with a shout and watch them burst (remember to pick up the pieces when you're all finished). These actions gives us a way to express what we're feeling rather than trying to keep it inside. You or the people in your life might have some other ideas, too. And always remember to let someone know if you have feelings that seem overwhelming or too much to handle on your own.

You have the right to feel your pain and to give it a voice. Doing that can help soften your grief, and when you've gotten out some of those BIG feelings, you may feel again like you really can "keep calm and carrying on." 

Keep Calm and Carry On? Not So Fast! was penned for the August, 2021 Hospice of the Western Reserve blog page. 

Funeral Planning & Medicaid: Spend Down Rules

Making the decision to enter long-term care
at a nursing facility is not an easy decision. 
You have all the heavy emotional toll on the 
family, as well as the very high cost of care. 

 As you may know, Medicaid can be helpful in paying for long-term care, but only after your assets are reduced to below the state-mandated allowable amount or set aside as "exempt" assets. 

So, you and your family may be wondering..."How can we preserve as many assets as possible before our life savings are drained by nursing home costs?" 

Fortunately, you can set aside or "spend down" some of your assets in very specific ways to that they are excluded-and thus sheltered-from the total assets considered to qualify for Medicaid. Prepaid funeral and burial space plans for yourself and your spouse are one way to protect and preserve some of your assets. 

For this quarter's End of Life Chats articles, we are going to be explaining Funeral Planning & Medicaid from the Funeral Directors Life Insurance Company brochure-Funeral Planning & Medicaid. 

Please be aware that Medicaid rules vary greatly from state and state & constantly change. Ohio uses their own rules to establish eligibility for Medicaid and are different from the Social Security Administration's Supplemental Security Income guideline. 

Who Qualifies for Medicaid?

Eligibility tends to vary for those who qualify, but generally, seniors aged 65 or older, families living in poverty, pregnant women and disabled individuals can qualify depending on the assets held. The limit on how many assets and how much income a person is allowed are determined at the state level. If your assets are more than allowed, you will be required to either spend them down or move them into types of assets that are considered exempt before Medicaid coverage is approved. Depending on the transfer of assets, this may need to be done up to 5 years before your application is made to Medicaid, so planning ahead, if at all possible, is extremely helpful.

Non-Exempt Assets

Non-exempt assets are those that Medicaid considers as part of your accessible, countable assets when you apply for assistance. Non-exempt assets will be considered as available to you to use toward paying the cost of your care. This includes money and a variety of real and personal property which can be valued and turned into cash. These include (but are not limited to):

• Cash
• Checking and saving accounts
• CDs, stocks, bonds, or mutual funds
• Retirement accounts including IRAs, 401(k)s, 403(b)s
• Prepaid funeral contracts that are not irrevocable (can be canceled)
• Trusts (depending on how they are set up and your access to them)
• Property other than the primary residence
• Jewelry and valuable art or collections
• More than one vehicle, boats, RVs, etc.
• Cash surrender of life insurance with a face value of $1,500 or more

Exempt Assets

Exempt assets are assets that are protected, at least for the time-being, from being included in your non-exempt or countable assets. This is not an exhaustive list, but indicates the types of assets that are generally excluded. Rules will vary from state to state, but generally exempt assets include:

• Your principal residence (subject to equity limits in some states) if you, your spouse, or dependent child still live in the house, or if you intend to return to the house
• Personal property and effects, such as furnishings, belongings, appliances, and household goods. Some states place a cap on the allowable amount. 
• Life insurance with a cash value up to $1,500. Term life insurance is generally excluded as an asset.
• A designated revocable account for burial funds with a value of up to $1,500 per spouse. Other burial funds and cash surrender value from life insurance will reduce this amount.
• One wedding and engagement ring 
• An irrevocable contract for burial space items (with no limitation on the amount) for you and your immediate family members including your spouse, your children (including adoptive and stepchildren), their spouses, your siblings and their spouses, and your parents. Burial space items include caskets, urns, vaults, burial plots, cremation niches, headstones, opening and closing of the grave, and perpetual care. Burial space items are counted as separate from burial funds. 
• A larger irrevocable prearranged funeral contract for you and your spouse that includes funeral service costs such as transportation of the body, embalming, cremation, flowers, clothing, services of the funeral director and staff, etc.
• One automobile (in some cases there is a limit on the market value) for spouse or child if used to visit the person who is ill
• A married couple can keep considerably more if one spouse is still well and does not need Medicaid (in most cases, half the assets up to a certain amount)

To get a copy of the FDLIC brochure Funeral Planning & Medicaid: Spend Down Rules, you can click here. 

A New Understanding: processing Grief through Writing

 

 "Being able to reflect on a loss through writing may allow you a safe and healthy way to process and adjust to your grief journey." 

Throughout my life, I have always been a journaler. Once or twice a day in high school and college, I would open my journal and take stock of my day. Random musings, snippets of poetry, or the play-by-play of daily events may come up. But most importantly, this world of written words was my space to reflect on complex emotions, even those I could not fully explain or understand. 

Within grief, we may find it hard to verbalize everything we're experiencing. There may be times when writing something down-something you can come back to and reflect on-can be just as helpful as talking to someone about it. Experts in the field of writing and writing theory suggest  that the act of writing can allow the writer to produce new ideas and increase awareness. According to the philosopher Paul Ricoeur, "to narrate is to reflect on events and, in the story, a pattern of understanding is formed based on one's own experiences. This interweaving may yield new insights and new stories and create coherence in life that allows the individual to adapt to an altered life situation."  Being able to reflect on a loss through writing may allow you a safe and healthy way to process and adjust to your grief journey. 

There are various forms of writing that can be used to cultivate a daily writing practice:

Structured writing: This can include using writing prompts or doing a specific project like writing a letter to your loved one who died. Examples of prompts that may spark you to write include:

• "Today, I miss," "Today, I remembered...," "If I could say something to you, I would say..."
• "What feelings am I looking forward to? What feelings do I want to leave behind?" 
• "Here are five ways I can be compassionate with myself today..."

Free writing: Free writing is typically writing without a prompt or goal in mind-just writing intuitively. The idea of free writing can be intimidating, but it can be an incredibly restorative practice. Free writing asks you to write continuously, without concern for grammar, punctuation, or spelling. It asks that you don't cross out anything and don't let your inner editor try to control what you're writing. Try writing down the first thoughts running through your head in the morning and continue writing. Keep your hand moving and try not to pause to read what you just wrote, as that can unleash that inner editor. 

No matter how you decide to give writing a try, know that it can be a safe space just for you, to express your grief in whatever way you need to. 

A New Understanding: Processing Grief through Writing was penned by Sarah McIntosh, MSSA, LSW for Hospice of the Western Reserve's About Grief, Summer, 2023. You can read a condensed version of this article in our Summer, 2023 New Horizons newsletter. 

Grief and Father's Day: Remembering Your Child

  

Father's Day, like other holidays, can be a trying time for those grieving-especially for fathers who have lost a child. While losing a loved one is never easy, losing a child is one of the most painful challenges we can face in life. The pain of loss can consume all we do, making it feel impossible to find joy. That pain can also rob us of celebrating life's happiest moments, like Father's Day, as celebrations become just another reminder of what we have lost.

Whether this is your first Father's Day following the loss of a child or if it's been years since their passing, your grief may be overpowering your joy. You may be dreading the thought of celebrating Father's Day. You may even wonder if you are allowed to celebrate Father's Day if your loss was of your only child. 

No matter how much pain you're feeling, remember that you and your family are allowed to enjoy special days while grieving. The key is finding a balance between joy and grief. 

So, this Father's Day, lead your loved ones in celebrating the paternal figures in your life and the memory of your child. Remember the positive impact you child had on you, your spouse/partner, and your other children. Here are a few ideas to help you get started.

Honor You Child's Memory

Your child's memory will be with you forever, but it can be hard to remember the good times when grief consumes all you do. Use Father's Day as an opportunity to honor your child's memory by taking part in their favorite activity. You can watch their favorite movie, eat their favorite meal, play their favorite game, or do something else they enjoyed. This intentional activity can help you feel closer to your child and make Father's Day truly special for you and your family. 

Tell Favorite Stories of Your Child

When we lose a loved one, the pain of loss can sometimes grip our ability to talk about them. That's why sharing heartfelt stories of your loved one is important. Stories can help you acknowledge the reality of the loss and move you toward healthy grieving. The same is true if you've lost a child. Share stories of your child that make you laugh, smile, or even cry. But ultimately, share stories that make you proud to be their dad. Your child touched so many lives, so embrace their impact together as a family. 

Share Your Love and Support for Your Family

Sometimes it takes losing a loved one for us to understand the importance of saying 'I love you.' Whether you say it every day or typically keep your emotions to yourself, tell your family how much they mean to you this Father's Day. Let your words speak life and support your family on their grief journey. Father's Day is the perfect time to express how much your family means to you. You can even write notes or letters to your surviving children, letting them know how much you care.

Take Time to Reflect

Spending time with your family on Father's Day is important, but you may need a few moments for yourself as you grieve the loss of your child. You'll likely feel a mix of emotions, which is perfectly normal. So, take time to reflect on your loss without distractions. Write your thoughts in a journal. Visit your child's grave. Speak to a trusted friend or mentor, if you don't want to be alone. All these options can help you take account of your emotions on what may be a difficult day. 

Make Father's Day Special

Balancing joy and grief is one of the most difficult things we can do in times of loss. Yet, finding that balance is also one of the most important things we can do to heal. You may believe that it's wrong for you to celebrate Father's Day with your family, but finding happiness through your pain is key to healthy grieving. Enjoy the time you have with your family, go out for a nice dinner, and smile as you unwrap your Father's Day gifts. Though grief never leaves us, it also should stay at the forefront of our lives forever. 

If you've experienced the horrible pain of losing a child, you know that holidays, like Father's Day, can be difficult. But find peace in knowing that your grief is proof of your intense love for your child, and that love with never fade. Instead of fearing Father's Day, use that special Sunday in June to remember all the joy your child brought you and your family. And don't forget, your child will live forever in your memory, so you'll never have to celebrate Father's Day without them. 

Grief and Father's Day: Remembering Your Child was penned for funeralbasics.org, a website designed with the funeral consumer in mind to provide them with quick and accurate information. 

Sleeping Angels: When Miracles Become Memories

  

"But burying infants, we bury the future, unwieldly and unknown, full of promise and possibilities, outcomes punctuated by our rosy hopes..."

It is the loss that no one ever expects-the sudden loss of a pregnancy. The delivery of the stillborn. The death of the infant. The grief that parents and grandparents experience with these losses are different than most. We grieve the future these little angels will never get to experience. 

On our Sleeping Angels: When Miracles Become Memories, we will share with you pieces that we feel may help you on your grief journey, that we hope will provide you help, guidance and comfort. 

Know that we are here for you, and will do everything we can to assist you.