Losing a loved one to a prolonged illness can be an exhausting and frustrating experience. Although there is not the abrupt sense of loss associated with homicide or accidental death, the months leading up to the death of a loved one in hospice can be incredibly difficult. After their passing, the family and friends of the deceased are not simply released from the pain of the experience, but are rather left to face the grieving process knowing there is nothing left that can be done. They may still experience the anger, sadness and fear associated with all forms of grief even though they have anticipated the death for some time. One issue that may arise is the question of whether the decisions made by the caregiver were the right ones after all. Throughout the process of a long illness, there are many choices that must be made without full knowledge of their effects. While the caregiver may have done what they felt was best at the time, such decisions do not always hold up to later scrutiny. In hindsight, the caregiver or other family members may feel angry or guilty that a more appropriate course of action was not taken. Such situations may be replayed in the mind and may lead to a painfully acute sense of regret. All involved parties may feel helpless that there is no way to rectify the consequences of such decisions following the death. Another issue present in hospice is that caregiving is difficult for all involved. Even the patient, accustomed to caring for themselves, may feel angry or embarrassed by having to share the most intimate of tasks with another. In such a vulnerable situation, tension may lead to flared tempers and bursts of anger that can create haunting and unpleasant memories for the survivor. Additionally, because caregiving is an extremely consuming position, the caregiver may feel lonely or useless following the death as what had become one of the main purposes of their life is no longer relevant. As with all grief, talking is one of the most effective activities in helping a survivor accept the death of their loved one. Although grieving for a loved one following a prolonged illness can be a difficult and complex time, it is important to acknowledge the reality of the situation; that we are human and cannot expect ourselves to be perfect. Understanding this can help us forgive ourselves for things that we or others view as mistakes. It is also important to realize that each end marks a beginning and that once we have learned how to manage the pain, we can learn and grow from coping with our loved one's passing. Grief is often episodic and may seem harder some days than others, even if we think we have finally let go. This does not mean that we will never be happy; enjoying the small things (perhaps a favorite book or food) can help us remember that there are pleasant things about life in addition to the things that may be difficult. For more information: http://www.hospicefoundation.org http://www.hospicenet.org