Bereavement care

Psychological Aspects – Cancer as a Loss Experience

Receiving the diagnosis of a brain tumor is a huge blow. The shock inevitably raises questions, fears, and uncertainties. Confronting a brain tumor, and cancer in general, can be seen as a loss. After all, you lose your health. Your daily life takes a complete turn. You have to consider doctor visits and treatments. The consequences of the disease and the therapies can limit your options. Losing the ability to drive, losing the ability to work, fewer opportunities for social interaction, changes in family roles, and uncertainty about the future are just a few of the many consequences of facing a serious illness.

To process this profound loss (processing loss/grieving), according to William Worden, four major tasks must be accomplished. Completing these four tasks, over time or longer, ultimately leads to a point where one can say the loss has been processed. It is important to note that the tasks mentioned do not necessarily have to be completed in the given order. The four tasks often overlap. However, tasks 1 and 2 are more important at the beginning of the grieving process, task 3 gradually becomes more prominent, and task 4 becomes particularly important at the end. The other tasks remain present regardless.
Task 1: Facing the loss. This involves accepting reality. "Life will never be the same again."
Task 2: Experiencing the emotional pain resulting from the loss. Feelings such as denial and numbness, disbelief, sadness, despair, anger, fear, uncertainty, guilt, difficulty concentrating, etc. are very normal at the beginning of the grieving process. They are important, but usually also very painful. Expressing them can be done in various ways: for some people, talking helps, while others are helped by other methods such as sports, painting, drawing, music, etc. Everyone has their own way of dealing with these feelings and thoughts. Someone who doesn't express pain or sadness is often said to be repressing or not wanting to feel. However, it's important to realize that expressing feelings is not the same as experiencing them.
Task 3: Adjusting to the new situation. The middle of the grieving process is often characterized by a fluctuating range of reactions. One moment, one feels sad, angry, or confused. The next, the grief reactions seem to have vanished, and one can focus on things unrelated to the loss.
Task 4: Emotionally processing the loss and resuming life's thread. This involves a gradual transition. Gradually, one becomes better able to resume life's thread, adapting to the new situation. Grief and other grief reactions have faded from the forefront to the background. This doesn't mean that experiencing various grief reactions is then definitively and forever over. Difficult moments, such as check-ups, doctor's appointments, or confrontations with the hospital, can cause you to experience intense feelings or thoughts again.

A very stressful factor that burdens you with a serious illness like cancer is uncertainty. Will I survive? How will I feel after treatment? What are my long-term prospects? What about my family? What about my work? When a brain tumor is diagnosed, it can lead to a number of specific consequences, specific to the condition.
- A brain tumor can confront you with loss of control, for example in the case of epilepsy or hyperventilation.
It's also important to know that restoring brain function is a long process. Gradually, remaining brain cells take over the functions of destroyed or damaged cells. However, this takes a long time.
- After any surgical intervention, depending on the area surgically treated, changes in the patient's personality may occur.
- After opening the skull, skull trauma often occurs, possibly resulting in post-traumatic stress disorder (PTSD) or depression.

Not only the patient themselves, but also those around them (family members, friends, neighbors, colleagues) are confronted with questions. While the perspective is usually the patient's, it's important to recognize that loved ones also experience similar emotions. They, too, need support. One patient once put it succinctly: "Cancer doesn't just affect me; it has affected my entire family."

During the various stages of the disease process, healthcare providers (psychologists, moral counselors, pastoral workers, social workers, psychiatrists) are available to support you and your loved ones. Attention should be paid to more than just the medical aspects. Facing a serious illness also has social, spiritual, and psychological consequences. Support from those around you is crucial, but sometimes it can be helpful to talk about your feelings with someone who can view the situation from a more detached perspective. Therefore, don't hesitate to contact healthcare providers at the hospital where you are being treated who are specifically dedicated to supporting patients in your situation. Your doctor or nurse will certainly be able to help you connect with a psychologist or other healthcare provider.

Titia Dergent Clinical Psychologist The Scream – Edvard Munch

Every hospital has an oncologist. You can always make an appointment; the consultation is free. A psychologist with experience working with ABI is preferred.

What bereavement care is available after a death?

Bereavement care Waasland: a local example

At the Waasland Palliative Care Network, we aim to provide bereavement care to those who have lost a loved one. Our mission allows us to support seriously ill patients and their loved ones in the Waasland region during the final stages of their illness and for a short time after the death. However, there are several other organizations in our region that, each in their own way, strive to support and connect those grieving, both long-term and in the long term. An overview can be found below.