Grief counselor offers ideas for dealing with male grief

Here are some common misconceptions

True or false: If a male caregiver/family member doesn't show any emotion, then he is coping well with his grief over his loved one's dying.

The answer is "false." This is a common misconception among some hospice workers and the public when it comes to dealing with male caregivers, family members, and patients.

"There are a lot of ways to grieve that don't have anything to do with crying or showing emotion," says Keith A. McDaniel, MFT, CT, a grief counselor with the FirstHealth Hospice and Palliative Care of Pinehurst, NC. People handle grief according to how they learned to express their feelings and emotions growing up, McDaniel says.

"I'm in my early 50s, and people in my generation didn't have fathers who knew how to share feelings and emotions because their fathers didn't," McDaniel says. "If our fathers didn't know how to share feelings and emotions, then it's difficult for the sons to know how to do that, and it's a re-learning experience."

McDaniel saw his own father cry only twice.

"If you think about it with kids, when they get into athletics, the coach will say, 'Shake it off, you're okay,' and so we're conditioned to have that stiff stance and stuff our emotions," he adds.

This type of emotional conditioning has a lasting influence and doesn't dissolve at the end of life.

"So then as an older male when we have a traumatic event occur, we don't have the tools to express those emotions," McDaniel says. "It's okay to be angry, but it's not okay to be sad."

The key is for hospice professionals to offer male patients and family members an action-oriented way to express their grief, he says. For example, a hospice could invite men to participate in a volunteer session of fixing or making something because men sometimes can work through their grief by working with their hands, McDaniel says.

"Men typically are doers, and they'll get involved in things that allow them to work with their hands," he explains. "One man created an urn for his wife's ashes in his workshop." Making or creating something is a way of expressing grief without outward emotions, McDaniel says.

Exercise, such as golf and walking, also can be good strategies for dealing with grief, and hospice counselors can encourage men to return to their favorite exercise past time, he says. Hospices also could provide male-only support groups, although it can be difficult to get men to show up, he notes.

"We've had as many as five men come to a support group meeting, and these have been older men," McDaniel says. "It's very powerful when you have five or six men expressing their grief and crying with other men."

While it took a great deal of encouragement to fill the support group, once the men began to attend the meetings, they opened up and began to share their feelings, he adds.

Another strategy for working with grieving men is for nurses and social workers to sit back and not push them to open up, McDaniel suggests. By just being with them, practicing being a presence in their lives, the hospice workers might earn their trust.

"Just be there and talk about what they like to do, like what their hobbies are and those kinds of things, as opposed to trying to get directly to how they feel about their illness," McDaniel says.

Men also might be open to journaling.

"I think journaling is wonderful," McDaniel says. "The other thing is I deal a lot with dreams. I always ask the bereaved person if he has had any dreams about the loved one or dreams in general."

Men usually are not hesitant to talk about their dreams, McDaniel says.

Hospices might offer men massages and other types of therapeutic interventions, he says.

"I learned after my dad died to get massages, because I knew the grief would get stuck in my body and massages help to keep the grief flowing," McDaniel says. After a loved one has died while in hospice care, the husband or caregiver might need to get away for a while.

"One man after he lost his wife said, 'I don't know why, but I think I need to go to the coast,'" McDaniel recalls. "So he took a week to spend it alone traveling and just reflecting and keeping a journal." When the man returned, he said the time away had made all the difference.

"One man, while his wife was dying, would go to Wal-Mart or somewhere like that, once a week and he'd buy a fishing lure — one at a time," McDaniel says. "He collected these lures during the time of his wife's illness, and then when she died, he knew he needed to go out and fish for a week."

"The main thing to keep in mind is that everyone grieves differently," McDaniel says. "Just because your father is not showing emotions does not mean he's not grieving." Hospices can encourage men to attend support groups or inquire about grief services by distributing fliers and mailings, as well as by contacting men directly, he suggests.

"You can say, 'We're having a men's group, and we'd like you to come,'" McDaniel says.

"I think often times that men are looking for ways to express or deal with their grief, but they don't know what's out there, and they don't know that there are counselors who deal with grief," McDaniel says. "When you start to get enough men to come in, they'll start telling their buddies that it's okay."