Some African Americans may not express grief openly to non-family members. They may appear stoic. Grief and loss are more likely to be expressed at the funeral in the presence of family and close friends. For some, a custom of singing and praying over the open casket of the deceased during the funeral may encourage family members to grieve and show strong emotion. One less common emotional custom is falling out which is manifested by collapse and an inability to see or speak. This response is a traditional way to grieve openly.
Service delivery issues. Traditionally, it is appropriate for providers to address African American family members formally, using Mr. and Mrs. with the last name. Not using the last name may be seen by some as a sign of disrespect. Providers need not be African American to reach out to African American families. One strategy for reaching out to a family is to ask about their faith foundation, beliefs, and practices. A provider who is not familiar with those customs can say, “I am not familiar with your faith, but how can I help you?” Sincerity is what is essential, and a willingness to want to learn about the family’s traditions. Providers should be there for the family, respect their customs, and reassure them no one is there to impose certain beliefs.
Care providers must not make assumptions about a person’s grief based on failure to show emotion. The example that follows shows how a person’s stoic grief reaction was misunderstood.
A bereavement counselor learned that a young mother had suffered a stillbirth while the counselor was away. The mother had not taken a picture of her baby or mementos. She signed out of the hospital without even spending the night. The mother stated she did not want a funeral for the baby. Staff commented the mother did not seem upset and must not really care about losing the baby. A few months later, the young woman called to pick up the photo and mementos. She met the counselor and started sobbing. The mother said she wanted a funeral for her baby, but could not have one. Her grandmother died of cancer the same day her baby died. Her own mother had been taking care of the grandmother during her long illness. The young woman felt it was not right to ask her mother for help with the baby’s funeral while her mother also was planning her own mother’s funeral. She left the hospital to go home to help with the grandmother’s funeral. She believed that God would have to take care of her baby.
In summary, African Americans comprise a diverse group of people. Their grief reac- tions are influenced by a broad array of historical, religious, traditional, and cultural factors. Individuals vary according to their faith foundation, geographic location, edu- cational preparation, economic level, gender, role expectations, and family customs. A service provider can reach out to bereaved African Americans by asking about their beliefs and traditions, preferences and desires, and by being open and responsive to what the family members say.
VOICES FROM THE COMMUNITY: CROSS CULTURAL EXPRESSIONS OF GRIEF AT THE LOSS OF AN INFANT
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