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Talking about Illness & Loss:
The St. Francis Grief Communication Program

For some 20 years, the St. Francis Center has provided training, information, and counseling on illness, loss, and grief. The Washington, D.C.-based nonsectarian organization works with local hospices, nursing homes, hospitals, schools, and employers to make individuals more comfortable with issues surrounding death and bereavement.

The Center focuses on helping people suffering with long-term or terminal illnesses; grief and bereavement following a death; and the effect of terminal or long-term illnesses on family members or caregivers.

Living with an Illness

"People with long-term illnesses experience a whole series of losses," says Center Executive Director Paul Tschudi. They lose their dignity, they lose their mobility, they lose their physical appearance, and they lose their independence. "What we try to do is help them along the way with each of those losses." The goal is to help them change their mindset: rather than dying of an illness, they are living with an illness.

St. Francis has 14 professional counselors who specialize in grief bereavement and helping people live with life-challenging illnesses such as AIDS or cancer. The Center has counseling programs for adults, families, and children. They have a special program for persons with HIV/AIDS or those who are involved with someone affected by the virus. They also send 80 trained volunteers into the community to support patients, caregivers, and family members; they visit homes, hospices, and nursing homes. They'll follow a person throughout the course of their illness; if he or she becomes homebound, a counselor will go to the home or the hospice to see how they are doing.

The Art of Condolence

They also raise the topic in businesses and schools. "We'll talk to anybody who will listen about what this grief and bereavement thing is . . . the more honest we are in talking about it the better off we are," says Tschudi. He admits that a seminar on death and dying does not exactly ignite the working lunch crowd. "Death is one of those issues that human beings don't necessarily feel like we want to know about before it happens." But the Center has found a way around that resistance by injecting business-speak into their luncheon headliners and calling them "The Art of Condolence."

One hundred years ago, most people died in their homes. The family was present and the children were exposed to illness, death, and bereavement. Tschudi says that, as a culture, "we've grown away from that." Older people don't live with their families for the most part and are often in a nursing home or hospital when they die. Part of what St. Francis' counselors hope to convey is that grieving is something that everyone goes through. "It's almost like we're helping to normalize it for them," says Tschudi.

Time to Heal

Many people he's encountered feel like they've gone off the deep end after the death of a loved one. They can't concentrate, they find themselves crying uncontrollably without cause, and they can't get enjoyment out of life. "We've built a culture where everything is supposed to be a quick fix. You get three days off for bereavement leave and are expected to jump back into work, yet your entire life has changed."

Tschudi says that it generally takes about a year before most people can begin to readjust to life without the person they lost. Every milestone -- a birthday, an anniversary, a holiday -- is a hurdle. "Each time those come up, people revisit grief and loss," he says. For many people, he adds, "it's a long process."

Tschudi says his organization isn't trying to force the issue of death and dying down people's throats if they aren't interested. But he has found that as people open up and talk about these issues there is a real bonding experience that occurs. It makes sense, he says. "Death is a universal experience . . . even for people who haven't experienced [a loss] yet, there is something almost reassuring to find out that there are people who do get through it."

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