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Loss and Bereavement for People With Cognitive Disabilities

Loss and Bereavement for People With Cognitive Disabilities

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In Kohelet we read, “Everything has an appointed season, and there is a time for every matter under the heaven. A time to give birth and a time to die; a time to plant and a time to uproot that which is planted.

When a person with a cognitive, developmental and/or psychiatric disability loses someone close to him/ her, they may not understand this idea that G‑d provides an order to life. In fact, the lack of understanding creates many experiencesPeople come and go of loss for them throughout their lives. People come and go: friends one year are different the next year, siblings and relatives live at home and then move out, beloved grandparents, aunts and uncles, and parents are with them for much of their lives, and then they are no longer. For many, the absence of a physical presence is difficult to understand. So, like all of us, they will try to communicate their feelings of loss in the ways they know best. Some may behave in ways that demonstrate their sadness or anger, others may withdraw and avoid, while others may refuse to cooperate with daily routines because the important person who was part of that routine is now absent. Each reaction will be unique to the individual, as will be the ways s/he lets us know what s/he is feeling and thinking.

We all find personal ways to cope with loss. Our Jewish tradition provides us with customs which support and guide us through these difficult times. In order to assist people with cognitive, developmental and psychiatric disabilities, it is helpful to understand some of the ways that all of us deal with loss. Coping mechanisms that many of us rely upon at these times are denial or disbelief that the person is really gone, disorganization or dependence on others because of the acute absence of someone on whom one has been so reliant, and/or intellectualization or rationalization of the person’s death or absence. These approaches enable us to gradually accept the loss at the pace that works best for us. For people with cognitive, developmental or psychiatric disabilities, the nature of their disability may interfere with their ability to rely on these approaches to acceptance. Nonetheless, there will be evidence of their efforts to do so.

Emotionally, we are likely to move through feelings of anger and resentment, guilt, fear and anxiety, and loneliness and depression until we begin to accept the loss in ourDiagnoses do not define emotions lives. Then we may feel relief and recovery from the initial period of profound emotional turmoil. People with cognitive, developmental and/or psychiatric disabilities will feel these emotions, too. It is important to remember that their diagnoses do not define their emotions, although it may impact how they express them and what they express.

When we teach children how to safely cross the street, we tell them to Stop, Look and Listen. When we support people with disabilities adjusting to loss, we should:

Stop ourselves from assuming what or how they may feel or react and

Look for indications of their understanding and experience of the loss. Then

Listen to what they say or demonstrate is their need for support and respond in the way that best facilitates adjustment.

An inability to communicate directly may result in behavioral expressions of these feelings. It is important to be patient with oneself and our loved ones as we traverse this process together. Belief in G‑d brings us comfort. Those who may lack the cognitive capacity to believe as we do, will rely upon us and our beliefs as their sources of consolation and solace.

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