Guest author Danielle Roberts at wordsthatcomfort
 
There are a lot of different things that can trigger grief, such as losing a loved one or beloved pet, losing a job, and even deciding to leave a cherished family home. It’s a feeling that will affect almost everyone at some point in their lifetime. Luckily, for seniors on Medicare experiencing a level of grief and feeling the need to seek professional help, Medicare is there.

Medicare Coverage of Mental Health

For those enrolled in Medicare, Original Medicare Part B provides coverage for mental health care services. This is because Medicare Part B is responsible for outpatient services. Some of those services include:

Annual Depression Screening

Medicare Part B provides coverage for a depression screening once annually. The depression screening covered by Medicare is a test that detects whether the beneficiary is at risk for depression. Medicare beneficiaries should get their depression screenings done by doctors who accept Medicare assignment to ensure they don't owe anything for their screening, and the screening must be done in a primary care setting.

Psychotherapy

Medicare ​Part B covers individual psychotherapy for those in need of it. Psychotherapy is the type of mental care that grief counseling normally falls under. Beneficiaries also get the option of therapy in a group setting if they prefer. Medicare Part B will even cover family counseling for family members of a beneficiary who is on hospice care to help them prepare for the loss of their loved one.

Coverage Rules

Medicare has a set of rules, requirements and conditions that must be met before it provides coverage for mental health care and grief counseling. Medicare allows the following types of medical professionals to provide mental health services:

• Clinical nurse specialists
• Clinical social workers
• Clinical psychologists
• Physician assistants
• Nurse practitioners
• Psychiatrists

Medicare also requires the medical professional to accept Medicare assignment for mental health visits to be covered. If the provider doesn’t accept Medicare assignment, the visit won’t be covered. Accepting Medicare assignment means the provider agrees to charge no more than Medicare’s approved price for the service.

Medicare will cover mental health services provided in the following settings:

• Community mental health center
• Hospital outpatient department
• Doctor’s office

Grief is an emotion that sometimes requires professional help from a medical provider. If a beneficiary needs such help as a senior, Medicare provides coverage for such care. Be sure to carefully review your benefits before pursuing mental health care to ensure that all requirements and conditions are met for Medicare’s standards.
 
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​A friend sent an email with sad news. A young family she socialized with was bereaved. The dad died unexpectedly from a heart attack and she didn’t know what to do. Should she call? And if she did, what should she say?

In troubling times, it can be hard to know what to do. Do you call or respect one’s privacy and give friends time to cope? Do you send an email and offer assistance? And if you do reach out and are rebuffed, do you back off or try again?

It’s always appropriate to reach out and offer assistance, but be specific. Do they need help in picking someone up from the airport, a meal, errands, or someone to stay with the children?

​One of the kindest things you can do for the bereaved is to show up. Offer to visit for a short time. Enter the home, turn your cell phone off, and store your belongings. Then pay attention and listen. You can offer to help, but let your friend guide the way. If it’s a chore or errand, step in. If it’s company they need, sit quietly and be present. Your active presence is what is needed most, right now and in the weeks and months ahead. 

Robbie Miller Kaplan is an author who writes from a unique perspective as a mother who has lost two children. She has written How to Say It When You Don't Know What to Say, a guide to help readers communicate effectively when those they care about experience loss, now at a reduced price for e-books for "Illness & Death," "Suicide," "Miscarriage," "Death of a Child," "Death of a Stillborn or Newborn Baby," "Pet Loss," "Caregiver Responsibilities," "Divorce" and "Job Loss." All titles are in Amazon's Kindle Store.
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​​photo credit: <a href="http://www.flickr.com/photos/89165847@N00/16057342786">Teacher and Student 35 Years On</a> via <a href="http://photopin.com">photopin</a> <a href="https://creativecommons.org/licenses/by-sa/2.0/">(license)</a>

I learned to be comfortable with the bereaved because at a young age, I was the bereaved. I witnessed firsthand how young friends, their parents, my neighbors, teachers, school officials, relatives, and family friends treated and interacted with me upon learning of my father's death.

And yet it was my mom who taught me how to comfort the bereaved. She connected by phone, cooked a meal, visited the bereaved, and continued to help long past when others ceased to call. It was her model that I emulated and used to teach my own children: death is a part of life and the bereaved need our support.

Not everyone feels at ease comforting the bereaved. And if you’re not comfortable, how will you teach your child to be comfortable?

One of the ways to instill compassion in your child is to work on a comforting activity together. This is how my neighbor Susan did it.

Susan and her best friend Abby were pregnant at the same time. Susan’s baby, Lisa, was healthy; Abby’s baby, Beth, wasn’t. Beth was born with a disfiguring congenital defect for which there was no cure or repair and her parents were told that she had only months to live.

Susan and her daughter spent a lot of time with Abby and Beth as well as Abby’s older daughter Sara. When Beth died at age two, she had lived much longer than expected. Susan was a gifted writer and she chose to write the story of Beth’s life. She wanted big sister Sara to know that despite Beth’s disfiguring illness, she was much loved and during her short time on earth, her life was meaningful and she made a difference.

While working on the project, Susan shared what she was doing with her daughter Lisa and Lisa colored the illustrations Susan had drawn. Together, Susan and Lisa presented the book to Abby and Sara. Abby has shared that during the five years since Beth’s death Sara continues to get comfort from the book. She shares it with new friends as it is a comfortable way to tell the story of Beth’s short life and death.

Since Beth’s death, Susan has used her writing talents on several occasions. She has written stories and poems for friends and loved ones who are bereaved. Now, Lisa offers to draw the illustrations. She’s learned firsthand from a compassionate mom how to be compassionate too.

​Robbie Miller Kaplan is an author who writes from a unique perspective as a mother who has lost two children. She has written How to Say It When You Don't Know What to Say, a guide to help readers communicate effectively when those they care about experience loss, now available as e-books for "Illness & Death," "Suicide," "Miscarriage," "Death of a Child," "Death of a Stillborn or Newborn Baby," "Pet Loss," "Caregiver Responsibilities," "Divorce" and "Job Loss." All titles are in Amazon's Kindle Store

Image: stock.xchng/kslyesmith

Copyright Legacy.com  Used with permission

There is no way around it: Grief is painful. It’s hard to experience it yourself and it’s terribly difficult to watch someone you love go through it. But what’s the alternative? 

You can try to medicate your grief, but at some point you have to stop and the pain comes rushing back. Distractions do help, but if you are not grieving your loss, eventually distractions end and you are once again left with the pain. 

So what does work?

It's important to allow yourself to fully mourn your loss so you can ultimately accept it and move on with your life. But that doesn’t mean that you can’t begin to re-enter during the mourning process. In fact, making your way back into the world goes a long way in helping you work through your grief.

Patience and purpose are helpful healers. Activities and deeds, such as work, hobbies, interests, and volunteering are excellent ways to distract while helping the mind refocus. And when you’re in a place where it’s difficult to feel joy, there is satisfaction in accomplishing tasks and joy in helping others.

Transitions are never easy and this is a tough one to make.  Everyone works through grief in their own way and in their own time, so cut yourself or your loved one some slack and go with what works.


Robbie Miller Kaplan is an author who writes from a unique perspective as a mother who has lost two children. She has written How to Say It When You Don't Know What to Say, a guide to help readers communicate effectively when those they care about experience loss, now at a reduced price for e-books for "Illness & Death," "Suicide," "Miscarriage," "Death of a Child," "Death of a Stillborn or Newborn Baby," "Pet Loss," "Caregiver Responsibilities," "Divorce" and "Job Loss." All titles are in Amazon's Kindle Store.
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My mother was a wise woman and a wonderful teacher. While we shared a lifetime of learning, it was not until her death that I realized she forgot one important lesson: She never told me how to live without her.

I’m not alone. Even though the death of a parent is the natural order of things, everyone I know has struggled with the death of a parent. Whether the relationship is a good one or bad, we never seem to be ready to lose them, no matter their age or ours.
 
It was the death of my dearest friend that spurred me to begin thinking of my own death. At the cemetery following my friend’s funeral my daughters asked, “Is this the cemetery where you would like to be buried?” As my husband and I had not had this discussion, it was a good place to start. We chose to respond to our daughters by asking them what they wanted. “Will you visit a grave site?” we asked, and “Do you want us buried in a place where you can come and grieve?”

In the following weeks, I began to explore funeral and burial options and ask myself the hard questions. For instance: What kind of life do I want my children to have when I am no longer with them? I knew that I do not want my children to feel as lost as I did when my own mother died.  

And so, my family began a series of discussions on a topic that one daughter calls, “The sad stuff.” Whatever it might be called, I am undeterred. There are decisions to be made on cremation services, niches versus cemetery plots, and the merits of a variety of burial/funeral fees. Our talks gravitate towards my wishes should my spouse survive me to thoughts and feelings about a range of topics. I want my daughters to understand and embrace that life should be lived without regret. And to accept that the world will continue and so will they, even when I am no longer by their side.
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There never is a good time to talk about death and yet I have seen the chaotic aftermath when the topic is avoided and feelings are left unsaid. I have chosen a different route for my family. My children now know how I feel and they will not be left with a burden of decisions to ponder when I am gone. It’s also freed up my mind to better embrace and enjoy the rest of my life.  


Robbie Miller Kaplan is an author who writes from a unique perspective as a mother who has lost two children. She has written How to Say It When You Don't Know What to Say, a guide to help readers communicate effectively when those they care about experience loss, now available as e-books for "Illness & Death," "Suicide," "Miscarriage," "Death of a Child," "Death of a Stillborn or Newborn Baby," "Pet Loss," "Caregiver Responsibilities," "Divorce" and "Job Loss." All titles are in Amazon's Kindle Store

Photo AnaRusso via photopin

Copyright www.legacy.com  Used with permission

It’s not uncommon for the bereaved to feel regret. While anyone bereaved can feel regret, children and young adults can be particularly vulnerable. They have less experience with life and death and have yet to understand how fragile life can be. Regret is a deep sadness over what we perceive as missed opportunity and it’s the last thing we want to feel when a loved one dies.

Prince William and Prince Harry disclosed their regret that they cut short their final phone call with their beloved mother, Princess Diana, just hours before she was died in a car accident in Paris. Prince Harry shared: “I can’t necessarily remember what I said, but all I do remember is regretting for the rest of my life how short the phone call was.” Prince William and Prince Harry were just boys at the time. How could they have possibly known that this would be their last chance to speak with their mother?

As a child, I had regrets too. My father fought cancer for five years and died when I was eleven. I was too young to understand that my father could die and I was unable to remember the last time I said, “I love you.” Not wishing to repeat this “regret,” or any other for that matter, I made it my mission to express my feelings openly. No one I cared about would ever need to wonder how I felt. While my mother was alive, I made every effort to demonstrate how much she was cherished and ended every conversation by telling her I loved her. I continue to do the same for every precious relationship in my life.

How can we know that a visit, phone conversation, or connection with a friend or loved one will be our last? We can’t. What we can do is accept life’s frailties, taking advantage of opportunities to build and maintain meaningful relationships.

Our loved ones would not be happy if we tied their memory to regret. Instead, make their legacy a personal mission to live your life to the fullest. 

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Robbie Miller Kaplan is an author who writes from a unique perspective as a mother who has lost two children. She has written How to Say It When You Don't Know What to Say, a guide to help readers communicate effectively when those they care about experience loss, now available as e-books for "Illness & Death," "Suicide," "Miscarriage," "Death of a Child," "Death of a Stillborn or Newborn Baby," "Pet Loss," "Caregiver Responsibilities," "Divorce" and "Job Loss." All titles are in Amazon's Kindle Store

Copyright legacy.com  Used with permission
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Photo: I've Had a Few, But Then Again, Too Few To Mention via photopin

With families settled all over the country, even the world, it can be difficult to come together to mourn a death. That’s what happened to a friend when her nephew died in Alaska. Her immediate family was spread out on both coasts and a funeral in Alaska was logistically impossible. Her nephew’s death was a devastating loss to my friend, her husband, and their children. Their inability to attend funeral rituals left them without any sense of closure.

What can grieving families and friends do when many members are geographically scattered?

1. Hold a memorial service in another part of the country for friends and loved ones unable to attend the funeral. That’s what my family did when my mother died. My mother’s funeral was in California. My immediate family, local relatives, and friends who did not travel to the West coast for the funeral were able to share their loss, cherish my mother’s memory, and support me at a memorial service in my home.
2. Conduct an online memorial with your family via Skype or another form of group chat. Plan ahead with readings, stories, or photos, anything that will help family members interact, grieve, and feel some sense of closure.
3. Organize an event when you will all be together to remember and honor your loved one. You can plant a tree in their memory, all helping in the selection and planting. Or, you can be creative and make a donation to a place the deceased loved that is accessible for you to visit, such as having a plaque added to a bench in their memory at a favorite park or a tree planted in a public space.
4. Create an online scrapbook together using Shutterfly, Snapfish, or another online photo service. Use the same login so each member can add their personal photos and journal memorable stories and anecdotes. When you have completed the album, purchase a copy for each family member.
5. Choose an annual way for the family to honor your loved one when you are together that ties into your loved one’s passion, whether it is education, clean communities, or feeding the hungry.
6. Designate a day for all of you to light a memorial candle, either on the anniversary of their death or their birthday.

Do not allow distance to come between you and your grief. Look beyond traditional mourning rituals to find a strategy that helps you and your family grieve.


Adapted from Legacy.com.  Used with permission

There seem to be no conversational boundaries when it comes to death. The bereaved are often subjected to inappropriate comments and questions that can shock, hurt, or leave us speechless. We are often left wondering, how can friends, family, colleagues, neighbors, and even acquaintances say or ask that?

It can be especially stressful when someone you truly care about hurts you. A week after my mother died a friend inquired, “Do you think she knew she was going to die?” I hadn’t pondered that question, but after our conversation, I could think of little else. And as much as the question pained me, I never told my friend; I did not want to lose her friendship.

I’m not alone. It is very hard to articulate your feelings when mourning a loss and even harder to do it tactfully. Sometimes it is not just inappropriate conversation; there are people who just cannot understand our loss or our pattern of grief. It can become too difficult for them or us to continue the relationship while we mourn our loss. It is not uncommon for the bereaved to distance themselves or walk away from some friendships.
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So, how can you handle inappropriate comments or questions?

• For starters it can be helpful to understand that most people genuinely feel sadness for you but, they just do not know what to say. Maybe they have never experienced a death so they have no way to put it into context. In their discomfort, something inappropriate pops out.
• If someone makes you uncomfortable, remove yourself. If you are on the phone say, “I hear someone at the door” or “Another call is coming in.” If you are in person say, “It’s good to see you” and then exit. Or, “I have some other business to attend to.”
• You can always draw a boundary and say, “I’m not prepared to discuss this.”  Most people will back off but, it takes a lot of energy to deal with difficult questions and energy is what most bereaved lack.
• Most important, surround yourself with supportive and understanding people while giving yourself the time and space to heal. There will always be understanding people who do know what to say and do, so gravitate to them.

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Robbie Miller Kaplan is an author who writes from a unique perspective as a mother who has lost two children. She has written How to Say It When You Don't Know What to Say, a guide to help readers communicate effectively when those they care about experience loss, available in ebooks for "Illness & Death," "Suicide," "Miscarriage," "Death of a Child," "Death of a Stillborn or Newborn Baby," "Pet Loss," "Caregiver Responsibilities," "Divorce" and "Job Loss." All titles are in Amazon's Kindle Store.


Couple in a park photo via photopin (license)

copyright Legacy.com  Used with permission

A reader asks, “How can I help my friend who is deep in grief over the death of her sister and at times takes her anger out on me?”

It takes understanding to be supportive of someone both heartbroken and angry while grieving their loss. But, this is what good friends do. You can help a friend deal with their grief in any of the following ways:

1. Physical activity is a wonderful way to channel anger and refocus. You and your friend might make a date to take a weekly walk together in the evening or sign up for an exercise class together. You might need to arrange to pick her up to make sure it happens.

2. Sometimes the best way to help heal is to help others. When you can't seem to help yourself, seeing how your efforts can make a difference in someone else's life is very uplifting. Volunteering can be a wonderful distraction.

3. Your friend might need more than you to discuss her grief. Is there a community or religious organization that has a support group? You can do an online search to see what’s available in your area. Even if your friend is not a member of a specific faith, they might be very willing to have her attend.
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Everyone grieves in their own way and in their own time and mourning a loss is exhausting. If you are patient with your friend, in time she will be able to more fully participate in your relationship. 

photo credit: <a href="http://www.flickr.com/photos/70838083@N07/10501280313">George Washington Bridge</a> via <a href="http://photopin.com">photopin</a> <a href="https://creativecommons.org/licenses/by-nd/2.0/">(license)</a>