The grief of families and friends after a voluntary assisted death
When a life ends through Voluntary Assisted Dying (VAD), family members and friends left behind may experience grief complicated by the circumstances of their loved one’s death. Even when we know the end of life is approaching, it’s still hard to prepare for the death of someone we love. Those involved in the process of VAD require a specific kind of resilience they may not have needed to find previously.
Family and friends may talk about how grateful and relieved they feel knowing their loved one was able to end their suffering on their own terms; but like any death, when a life ends through VAD, there may be complicated emotions. The complexities of grieving after a voluntary assisted death aren’t always understood.
It was hard. On the one hand, I was so grateful Dad didn’t suffer, but I also feel angry that he chose to leave us.”
Looking after a person with a life-limiting illness can be stressful, and those doing the caring might find themselves questioning or forgetting things or experiencing physical symptoms before the loss happens - this is common in what’s known as anticipatory grief.
Sometimes grief can make people feel powerless, especially when it’s hidden and not publicly acknowledged by others. There’s a sensitivity around VAD because of the legal and ethical issues surrounding it, so family members might be at an increased risk of experiencing what’s known as disenfranchised grief. This is where their grief may not be acknowledged or socially supported. This can negatively impact their mental health, such as increased loneliness, shame or anxiety.
I listened to what was important to Mum, and that helps because I can return to that when questions arise”.
Family members can experience a range of emotions before or after a person has died from VAD. They might feel sadness mixed with guilt, or anxiety complicated with relief, sometimes gratitude, or deep sorrow. People describe sleeping poorly, thinking constantly about what happened, and feeling powerless or in denial after being involved somehow in a process that might have seemed too quick and surreal. Grief can be ambiguous, and ‘holding’ intense emotions such as despair and relief can be difficult for our minds and hearts to understand.
Despite the complexities, most grieving people want to be heard, seen and understood, and we don’t need special techniques or strategies to make a difference. Spending time with people who can listen, empathise and be present will help.
It can be useful to reach out to others who’ve shared the experience - if you feel comfortable and if the other person is open to talking about how it was for them.
Some other things that might help include:
- Taking care of yourself and doing things that ‘fill you up’ - for example, reading, exercising, being quiet and taking time for yourself, sleeping, and eating nutritious food.
- Talking to friends and family and sharing experiences with others who understand.
- Asking for help when you need it.
- Practising self-compassion, such as talking to yourself kindly, being mindful and understanding that adversity is part of being human. You can learn more about this at self-compassion.org
- Practising your spirituality, culture, or religion. This might be meditation, prayer, yoga, or attending a place of worship.
- Using helpful resources or attending a support group in your area. You can find more information about VAD and support through Go Gentle Australia.
- Connecting with Grief Australia and other support services if you need bereavement support. You can talk to one of Grief Australia's friendly intake workers on 1800 642 066.
*This information was compiled in consultation with Grief Australia, a leading voice on grief and a global leader in providing evidence-informed grief counselling and education services. Established in 1996, Grief Australia is a government-funded not-for-profit organisation that supports grieving Australians through advocacy, research and evidence-informed practice and education.
Other useful links
Dying with Dignity Victoria: Pre and post-VAD support groups
Queensland Health: Support for family, friends, and carers during voluntary assisted dying
Western Australia Health: End of life care - supporting someone through the VAD process