Living With Grief: At Work - A Practical Guide for the Workplace

By Kenneth J. Doka, PhD, Hospice Foundation of America

Living With Grief: At Work

After her child died, Jennifer returned to work. But she does not seem the same. The quality of her work has declined and sometimes she just bursts into tears. Many of her co-workers have started to ask each other, "When will she just get over it?"

Harry continues working as he undergoes chemotherapy for cancer. When he enters a room, the other employees seem uncomfortable and ill at ease.

Since Ross, a delivery driver, died in a car accident, there has been increased tension among the other drivers. Some drivers never talk about Ross, while others reminisce about him. The driver who has taken his route resents the jokes made about how the route is now "cursed."

These situations occur every day in workplaces across the country. Sensitive responses can do much to support grieving individuals while maintaining staff morale and productivity. Both employees and their supervisors will find useful information within these pages for dealing with illness, death, and grief. Whether you are an employee struggling with these issues, a co-worker, or supervisor, we hope this pamphlet will help.

Encountering Illness at Work

For many years the diagnosis of a life-threatening illness meant that a person would almost inevitably leave work. Today there are more options. Many illnesses can be controlled or even cured; hospital stays are shorter, and many treatments are available on an outpatient basis. There has been a change in philosophy, too: one stressing that even in the midst of illness it is important to continue to live life as normally as possible. For many people, that includes maintaining a connection to their work environment.

Illness also affects the workplace when an employee's loved one becomes ill. A life-threatening illness is a family illness. The day-to-day challenges of coping with life-threatening illness can be enormous and affect everyone involved.

Whether caring for an aging parent who may live far away, or attending to the daily needs of an ill family member, employees constantly face anxieties about their loved one and the care that is being provided. They may also struggle to balance the demands of caregiving with their ongoing responsibilities at work.

As an Employee

The diagnosis of a life-threatening illness is not only a medical crisis; it is a personal one as well. It turns your whole world upside down. Everything-career, family, future plans-now seems in flux. It affects you psychologically, socially, and spiritually. It challenges all of your assumptions and threatens your hopes. Often shocked by the diagnosis, you must grapple with whatever symptoms exist as well as deal with such practical issues as arranging for treatment.

During that time, you may want to keep things exactly the same, proceeding with life as if no crisis exists. You may want to make definitive decisions, regardless of the uncertainty that exists. This is unlikely to be a successful strategy, since the illness has already created, or soon will create, changes that must be confronted.

While you cannot control the fact that a diagnosis changes your life, you can control the ways in which change occurs. It is important to decide which issues need to be settled now and which can be left for a later time.

Here are some ideas that can assist you as you struggle with the illness.

Recognize the ways that illness affects you

Because dealing with an illness is stressful, you may have less energy or patience. Awareness of your physical and emotional health will help you make adjustments and assist in your planning. Some employers may arrange for you to share your workload, or even allow work to be done at home.

Naturally, work environments differ in their flexibility.

Communication is key

One of the decisions you will need to make is how much to share about your illness with co-workers and supervisors. While each work environment is different, remember that it can be difficult to completely control information. Co-workers will attempt to make sense of absences as well as changes in your appearance and behavior. Illness may cause you to have to adjust your work schedule and performance expectations. Communication with supervisors allows more effective planning and, when necessary, readjustments. Open and honest communication provides the best climate for effective teamwork and problem-solving.

The decision became not, "Do I tell?" but rather, "What information do I need to share with others, and at what points during my illness?"

Find and cultivate effective sources of support

Struggling alone is always more difficult. Even at work you may need to find effective ways to help yourself and seek support. This may be as simple as creating a private space when you need time to collect yourself, or as structured as setting up a time once a week to speak with your Human Resources director or Employee Assistance Program.

Learn about health benefits and options

Be informed about your medical benefits and options. Human Resources personnel can assist in reviewing benefits, discussing options such as disability leave, clarifying company policies, and processing claims. You may have additional protections under federal laws, such as the Family and Medical Leave Act, as well as state and local laws.

Avoid rash decisions

In times of stress our decision-making can be affected. It may be better to focus on short-term solutions, allowing major decisions to wait until they can be more carefully assessed. For example, instead of deciding whether or not to quit work, you may wish to focus on less definitive options: scaling back, taking a medical leave, working at home. Try to remain flexible in the midst of uncertainty. Remember that as your condition changes you may need to revisit earlier decisions.

As a Supervisor

When an employee is struggling with a life-threatening illness, your involvement and support are essential, and will set a tone for the workplace.

Be supportive

Ask yourself, "In what ways can I help?" Recognize that your employee is struggling not only with the physical symptoms of the illness and its treatment, but with many fears and difficult feelings as well. It may be hard for the person to focus on the work that needs to be done. Performance may, at times, slip. Negotiating the demands of work with an employee's ability to fulfill them always works best in a context of compassion. Never lose sight of the individual.

Respect confidentiality

As a supervisor, the employee struggling with illness may share with you details not only of medical problems, but other issues and problems as well. While it may be appropriate to discuss some of these issues with your own supervisors or Human Resources personnel, this information should never become workplace gossip.

Help problem-solve

Assist your employee to plan and problem-solve. Help to assess the ways the illness and treatment are affecting his or her ability to work. You may have the flexibility to suggest options such as shifting or reducing hours, reassigning tasks, or allowing work to be done from home.

Leslie noticed that Tom tired easily while undergoing radiation treatments. After discussion, Leslie and Tom decided that it would be helpful to reassign his tasks to others during these periods.

Know your company's policies and programs

When an employee struggles with a life-threatening illness, it can be hard to focus on all the new information that he or she may have to absorb. By being aware of policies and persons within the organization such as Employee Assistance Programs or Human Resources staff who can help, you can provide vital support to your employee.

Take care of yourself

Recognize that you may need to discuss how another employee's illness is affecting you and other co-workers. These situations can be stressful for everyone in the workplace. Be open to seeking assistance from Human Resources or your Employee Assistance Program. Unless you take care of yourself, you will be unable to care for others.

Maintain contact

If a person is home, it is still important to let him or her know that co-workers care. Maintaining contact through cards, calls, or tangible acts of support will help morale. You may wish to do this yourself, or appoint someone to act as a liaison.

Once a week, we all brought in food to work and Darrell's secretary would take it to him and his family. It felt so good to do something helpful, rather than to just watch and worry.

Assess the effects on co-workers

Recognize that the illness of an employee can affect coworkers in many ways. Some employees may have formed close friendships. Work responsibilities may have to be reassigned, making some employees resentful. Other employees may struggle with their own feelings or fears about illness and death. Rumors about the way that the organization is responding to the ill employee may affect morale. Supervisors need to continually assess the effects of illness on the work environment.

As a Co-Worker

When a co-worker becomes ill, you can play a big role in assisting that person. Because you may feel ill at ease with the situation, or do not know what to say, you may avoid that person. Instead, try to follow these few basic principles.

Offer your support

Support can be offered in a tangible way, such as bringing a meal to the family or taking on some additional work. Support can also be shown by just listening to your co-worker.

Follow their lead

Remember that your co-worker will sometimes need to talk about his or her experience, and other times will choose not to talk. Remember, too, that keeping a sense of normalcy is important; whatever you talked about before is appropriate now. When you are in doubt, it is always worthwhile to ask that person how you can best offer your help and support.

After I was diagnosed, it meant so much to me that the other teachers acknowledged my illness and offered their support, but still treated me like they did before. I really began to look forward to our weekly lunches, where we talk about school, current events, sports-the same things I used to talk about before I got sick.

When Death Occurs: Encountering Grief

Not only does illness affect the workplace, but death does as well. Employees must return to work after the funeral of someone they loved. Co-workers may die, perhaps even in work-related incidents. Grief, like illness, will affect the work environment.

Understanding Grief

Whenever you experience a loss, you experience grief. The loss may be a death, an illness, or a divorce-anything that significantly changes or ends a relationship. Other losses may be more subtle. Downsizing, work-related transitions, even slight changes in the workplace culture can create a sense of loss, which brings about feelings of grief.

Your grief may affect you in many ways. You may feel it physically; you may feel tired or ill. Your appetite or sleep patterns might change. You may experience different emotions including sadness, anger, anxiety, guilt, jealousy, or even relief. You may be troubled spiritually. It may be hard to concentrate, and you may find yourself more tense and irritable.

Grief is a process, not an event you suddenly get over. It may be helpful to think of grief as a roller coaster, full of ups and downs, times when you are doing better and times when you feel worse. Some lows, like holidays, anniversaries, or birthdays, seem expected, while others seem to catch you by surprise.

Grief is as individual as you are. You have your own relationship and attach your own meaning to the loss. Respect others' ways of dealing with their grief. But respect your own ways as well.

There is no timetable to grief. With time, you will find that the pain lessens and you can return to earlier levels of functioning. But you will never forget the person who died. The end of grief is not the end of memory. Over time, you will be able to remember the person without the same pain you once felt.

Coping With Grief at Work

Accept your grief

Much as you might wish, you cannot turn grief off when you come to work. Accept your grief. Recognize that as you grieve, certain days may be easier than others. Be gentle with yourself.

Susan realized that Sundays were particularly lonely days for her after her husband died. She did not sleep well and did not feel rested for work on Monday mornings. Consequently, she was more tense and irritable at this time, and tried to start off each week with some quiet time at her desk.

Be flexible

As you plan your own work, try to be as flexible as possible. When you experience a rough day you may not be able to accomplish all you wished. Recognize that other days will be more productive.

Be gentle with others

Others may feel uncomfortable, not know what to say, or even say things that seem harmful.

When Margaret's son died, one co-worker told her, "It's good that you have other children." Margaret gently responded, "They are a great comfort, but I will miss Tommy always."

Understand that such comments, however insensitive, are attempts to offer help. No one will truly understand your loss or how to best help you unless you tell them.

Seek support

One choice you have is to share your grief with others, to seek support. You may find support from empathetic friends or co-workers. Others may need guidance as to how they can help. Support groups or counselors may help you understand your grief and the ways you are dealing with your loss. Human Resources or Employee Assistance personnel will have information about available services, as will local hospices.

Take care of yourself

Grief is very stressful. Adequate sleep, good nutrition, and exercise are ways to build up resistance to stress. Avoid drugs or alcohol; they only delay grief and cause other difficulties. Consult a physician if you feel ill or have difficulty sleeping or eating. And use whatever techniques have been helpful in the past to reduce stress, whether a vigorous walk or a soothing bath.

John had always enjoyed running, both as a physical exercise and a stress reliever. After his wife died, he found that while it was often hard just to get out of bed, his regular morning run became an even more important way to start his day.

Supporting Grieving Employees and Co-Workers

Review policies before a crisis

Periodically review your organization's policies, including medical leave and bereavement leave. Learn more about the Family and Medical Leave Act, which affects any company with 50 or more employees. Some workplaces allow co-workers to donate sick leave or vacation days to other employees.

Get training

Since grief is a common experience, you will benefit from professional training. Seek out seminars, programs, or other resources that can help you to be more effective in assisting grieving employees. Your local hospice is a good place to contact for this type of information.

Offer sympathy and support

When someone at work experiences a loss, it is important to offer your sympathy and support. Simply ask the person how they are doing and express your sorrow at their loss. Listen to their responses; this is not the time to share stories of your earlier loss. If you knew the person who died, you may wish to share what you will remember about him or her. Even better, write your comments in a brief but sincere note.

Even more difficult than the sometimes insensitive comments were the times when Paula's death was not even acknowledged. It meant so much to me to have my loss recognized, even when people did not quite know the "right thing" to say. Just hearing the words, "I'm sorry" was enough.

Remember, too, that individuals may form strong attachments with many people in their lives. Do not assume that because the person who died was an aunt, rather than a parent or spouse, that the loss is not as great. In the same way, the age of the person who has died does not necessarily mitigate the grief of the survivor.

Think before you speak

We can hurt grievers unnecessarily by trying to say something to make them feel better. Grieving is a process that takes time. There is little we can say to ease the pain. Comments like, "It was for the best," or, "It was God's will," may sound trivial or offer little comfort. Probing for details will seem insensitive and intrusive. Simply express your sadness and support. Attentively listening is one of the most thoughtful ways to help.

Participate in the memorial

Attending visitations, funerals, or sitting Shiva are all ways that you can show support, even if the family's religious or cultural background is different from your own. Flowers or memorials sent as contributions demonstrate your concern. Because each individual and each culture is different, it is always best to ask family or friends what the most appropriate action might be.

Offer tangible help

Grievers may find it difficult to sort out what they need, or they may be embarrassed to ask. Rather than simply asking if there is anything you can do, offer specific assistance. Helping with a project at work, bringing a meal, or offering to babysit are tangible ways to show you care.

Be understanding

For no obvious reason, Mark had a horrible day at work. When he returned home and discussed it with his wife, she reminded him that it was the second anniversary of his father's death.

Grieving is a long process. Even after the funeral, survivors still struggle with their grief. It takes time to return to former patterns of work and relationships. The support of co-workers and supervisors is critical, although be aware that some people grieve very privately and may not share too much.

When a Co-Worker Dies

Supervisors and co-workers may have to deal with the death of an employee. The employee may die at home, or the person may die at work, perhaps because of a heart attack or stroke. Such losses may be especially difficult because you not only have to deal with the loss but with a renewed sense of your own vulnerability and mortality.

Deaths that are work-related may be especially troubling. These deaths may be unwanted reminders of any dangers that exist within your work environment. Such deaths can leave you grieving as well as feeling unsafe.

In addition to earlier suggestions, a few other ideas may help supervisors and coworkers respond in a sensitive and compassionate way.

Share information

When a death occurs, share information with other workers about what has happened and what plans are being made. When possible, check such information with the family so that their wishes are respected.

Plan memorials together

It may be appropriate to do something at the workplace to commemorate the loss. But plan these memorials with others.

In our company, a committee made the decision to cancel the holiday party and donate the proceedings to a scholarship fund in Clara's honor. But many of us who had worked more closely with her had looked forward to the party, one of her favorite events, as an opportunity to come together and celebrate her memory with the company.

Sensitively deal with personal effects

In cleaning out lockers, desks, or offices, be sensitive about personal effects. Even when the family asks you to dispose of them it may be helpful to keep them around for a while, should they reconsider their decision.

Acknowledge the loss

Recognize that employees who work closely with one another or have had longstanding relationships may be experiencing grief more deeply than a new employee.

Consider professional intervention

When death occurs at work, especially when it is work-related, it can have powerful effects on the workplace. Professional crisis teams can assist workplaces in appropriately responding to the loss.

Getting Help

While it is difficult to deal with situations involving illness and loss, you do not have to face these situations alone. Your local hospice or mental health agency, as well as your Employee Assistance Program, can be of help.

Written by Kenneth J. Doka, PhD, senior consultant, HFA. Special thanks to Dr. William Lamers and Marcia Lattanzi-Licht for their insights and suggestions.