After your loved one dies, you may wonder if you’re alone in your grief. The answer is no. Hospice support continues for at least 13 months after death, offering grief counseling, support groups, and compassionate guidance as you navigate loss.
The end of hospice care for your loved one is not the end of your relationship with hospice. Medicare requires all hospice agencies to provide bereavement services to families for a minimum of 13 months following a patient’s death. This support recognizes a fundamental truth: hospice cares for the entire family unit, not just the patient.
In this comprehensive guide, you’ll learn what hospice bereavement support includes, the 13-month timeline and what happens during each phase, different types of grief support available, Oklahoma-specific grief resources in Tulsa, Oklahoma City, and rural areas, when to seek additional help beyond hospice, and how to support children and other family members through grief.
Grief has no timeline, and there’s no right way to grieve. This guide will help you understand the support available as you honor your loved one’s memory and find your path forward.
Quick Answer: What is Hospice Bereavement Support?
Hospice bereavement support provides free grief counseling for at least 13 months after a patient’s death. Services include phone support, individual counseling, support groups, educational materials, and help navigating holidays and anniversaries. All hospice families receive bereavement services at no cost, regardless of how long their loved one was in hospice care.
What is Hospice Bereavement Support?
Definition and Purpose
Hospice bereavement support is the continuation of hospice care focused on the family after a patient’s death. It’s a Medicare requirement that all hospice agencies must provide for at least 13 months following a death. This support helps families navigate grief, adjust to loss, and find a new normal.
The program recognizes that hospice cares for the family unit, not just the patient. When your loved one dies, your need for support doesn’t end. In many ways, it intensifies. Bereavement services provide the guidance, compassion, and resources you need during one of life’s most difficult transitions.
There is no additional cost for bereavement services. They’re included as part of the hospice benefit, whether your loved one was in hospice care for one day or one year.
Who Receives Bereavement Support?
Hospice bereavement support is available to all family members and close friends of hospice patients. There’s no limit on the number of people who can receive support. This includes:
- Spouses and life partners
- Adult children losing a parent
- Parents who have lost an adult child
- Grandchildren and extended family
- Close caregivers and chosen family members
- Children and teenagers in the family
The services are available even if your loved one was only in hospice briefly, for days or weeks. The length of hospice enrollment doesn’t affect your eligibility for bereavement support.
How Long Does Bereavement Support Last?
Medicare requires a minimum of 13 months of bereavement support starting from the date of death. Many Oklahoma hospices offer support beyond this requirement, particularly through ongoing support groups or alumni programs.
The intensity of support is typically highest in the first 3-6 months when grief is most acute. However, hospice recognizes that grief continues long after, which is why the 13-month timeline covers the first full year of “firsts” without your loved one.
Participation is completely optional. You choose the level of engagement that feels right for you. Some families need intensive support with individual counseling and regular support group attendance. Others prefer occasional phone check-ins and educational materials. Both approaches are valid.
Types of Bereavement Support Offered
Individual Grief Counseling
One-on-one sessions with a grief counselor or hospice social worker provide personalized support tailored to your unique grief experience. These sessions are available in-person, by phone, or via video call, depending on your preference and location.
There’s no set number of sessions. The frequency and duration are based on your needs. Conversations are confidential and judgment-free. You can discuss anything: the intense sadness, the anger, the relief you might feel, the guilt, or the numbness. All emotions are welcomed and validated.
Individual counseling is particularly helpful if you’re experiencing complicated grief, struggling with specific aspects of loss, or need privacy to process difficult emotions.
Bereavement Support Groups
Support groups bring together people experiencing similar types of loss. Hospices often offer groups specific to losing a spouse, losing a parent, or losing a child. Groups typically meet monthly or bi-weekly and are facilitated by trained grief counselors.
There’s something powerful about being in a room with people who truly understand. You don’t have to explain why you’re crying over a random song on the radio. They get it. Support groups reduce the isolation of grief and help you feel less alone in your pain.
Many Oklahoma hospices offer both virtual and in-person group options. You can participate from home if that feels more comfortable, or attend in-person if you value face-to-face connection.
Phone and Text Support
Regular check-in calls from your bereavement coordinator provide consistent connection throughout the 13 months. These brief calls (typically 10-20 minutes) allow you to share how you’re doing, ask questions, and receive reassurance.
Some hospices offer 24/7 grief support lines for moments when grief feels overwhelming and you need to talk to someone who understands. While not all hospices provide round-the-clock access, many have after-hours crisis support available.
Increasingly, hospices are offering text support for younger family members who may prefer this communication method. A quick text saying “today is really hard” can connect you with immediate compassionate response.
Educational Materials and Resources
Hospices provide comprehensive grief education through materials mailed to your home. These typically include grief guides explaining what to expect in early grief, booklets on specific topics like navigating holidays without your loved one, supporting grieving children, or managing difficult emotions, reading recommendations for books that offer comfort and guidance, and access to online grief resources and videos.
These materials help normalize the grief experience and provide practical guidance for challenges you may not have anticipated. Many families find comfort in reading that what they’re experiencing is normal, even when it feels anything but normal.
Special Event Support
Throughout the year, hospices offer programming to support families during difficult times. This might include memorial services and annual remembrance ceremonies where families gather to honor loved ones, holiday grief workshops before Thanksgiving, Christmas, or Mother’s/Father’s Day, grief camps for children during summer or school breaks, candle-lighting ceremonies on special dates, and anniversary support as you approach the one-year mark.
These events acknowledge that certain days are harder than others. They provide community and structure during times when grief might feel particularly intense.
Spiritual and Religious Support
For those who want spiritual support, hospice chaplains are available to visit, pray with you, or explore questions of faith and meaning in the context of loss. Chaplains can help connect you with faith communities or provide support during moments of spiritual crisis.
It’s important to note that spiritual support doesn’t require religious affiliation. Many hospices offer non-religious spiritual support for those exploring meaning, purpose, and existential questions outside a faith framework.
The 13-Month Bereavement Timeline: What to Expect
Immediate Support (First 24-72 Hours After Death)
Within 24 hours of your loved one’s death, you’ll receive a condolence call from the hospice team. This call serves multiple purposes: expressing sympathy and acknowledging your loss, offering practical guidance about what to do next, providing information about funeral planning if needed, sharing resources for any children in the family, and explaining the bereavement services that will be available.
This early contact reassures you that even though your loved one has died, you haven’t lost your hospice support system.
Early Grief (Weeks 1-4)
Around two weeks after the death, you’ll receive a second follow-up call checking on how you’re doing. During this time, you’ll also be mailed a grief packet containing resources, information about upcoming support groups, and details about bereavement services.
Many hospices offer a bereavement orientation session, either in-person or virtual, where you can learn about all available supports and meet the bereavement team.
The first few weeks are often characterized by shock and numbness. You’re navigating practical tasks like the funeral, thank-you notes, and estate matters while in a fog. The hospice team provides guidance on handling these responsibilities while grieving and reassures you that difficulty concentrating and making decisions is completely normal.
Months 1-3: Funeral is Over, Reality Sets In
Many people find that grief actually intensifies after the funeral when everyone goes home and regular life is supposed to resume. The shock begins to wear off, and the full weight of the loss settles in.
This is typically when hospice support groups begin. These provide critical community during a phase when friends and family may be moving on while you’re just beginning to process the reality of loss.
During this time, you’ll experience many “firsts”: the first Sunday without them at church, the first grocery trip alone, the first time someone asks how you are and you realize you have to explain they died. The hospice team helps you navigate these painful firsts and validates that grief may feel worse, not better, as time passes.
Months 4-6: The Long Middle
This phase is often the hardest. The initial support from friends and family has faded. People may expect you to “be over it” or at least “doing better.” But grief doesn’t follow anyone else’s timeline.
The hospice bereavement team provides crucial support when others stop checking in. They help you navigate returning to work while grieving, handling social situations where people don’t know what to say, managing well-meaning but hurtful comments, and finding moments of peace amid the ongoing sadness.
This is also when many people make important decisions about belongings, living arrangements, or life changes. The hospice team can provide guidance on timing these decisions and avoiding choices made in acute grief that you might regret later.
Months 7-13: Holidays, Anniversaries, and Finding New Normal
The second half of the bereavement timeline focuses on supporting you through the first full cycle of holidays and anniversaries without your loved one. This includes Thanksgiving, Christmas, and New Year celebrations, the first anniversary of their death, the first spring, summer, and fall experiencing seasons without them, and their birthday and other significant dates.
The hospice team helps you prepare for these difficult milestones. They offer guidance on creating new traditions, modifying old ones, or skipping celebrations altogether if that feels right. There’s no “should” about how to handle holidays. You do what works for you.
During this phase, many people begin finding moments of genuine peace or even joy. The hospice team gives you permission to experience these positive emotions without guilt. Laughing at a memory or enjoying a beautiful day doesn’t mean you’ve forgotten or stopped loving your person. It means you’re finding your way forward.
After 13 Months: Transitioning Support
The Medicare-required bereavement period ends at 13 months, but many Oklahoma hospices offer continued support beyond this. Some maintain alumni support groups that continue indefinitely. Others provide transition planning to other community grief resources if you need ongoing help.
You’ll receive communication about the conclusion of the formal bereavement period and information about any continuing resources. The hospice team reminds you that while their formal support is ending, grief continues, and other support is available if needed.
Oklahoma-Specific Bereavement Resources
Tulsa Area Grief Support
The Tulsa area offers numerous bereavement resources beyond hospice:
Live Well Hospice provides 13-month bereavement services for all families, including those who weren’t patients. They offer ongoing support groups open to the community.
Seasons Hospice offers free grief counseling and community grief support groups, even for families who didn’t use their hospice services.
GriefShare Groups meet at churches throughout Tulsa, including First United Methodist Church, LifeChurch, and other congregations. These 13-week support groups use Christian perspective on grief.
Tulsa Community College occasionally offers grief support groups and workshops through their continuing education department.
Private Grief Counselors in Tulsa who accept SoonerCare include licensed professional counselors and clinical social workers specializing in grief and loss. Contact SoonerCare at 1-800-987-7767 for a provider directory.
Oklahoma City Area Resources
Oklahoma City and surrounding metro areas provide comprehensive bereavement support:
Open Arms Initiative offers free grief and loss counseling for individuals and families in the Oklahoma City metro. They specialize in trauma and complicated grief.
Integris Hospice provides bereavement programs including support groups, memorial services, and educational workshops open to the community.
Oklahoma City Area Support Groups (non-hospice affiliated) meet at various locations including community centers, libraries, and churches.
Children’s Grief Camps in the OKC metro include summer camps and weekend programs specifically designed for bereaved children and teens.
OU Health provides grief counseling referrals through their palliative care and supportive oncology programs.
Rural Oklahoma Telehealth Grief Support
For families in rural Oklahoma where in-person resources may be limited:
Oklahoma State Department of Mental Health and Substance Abuse Services offers statewide grief support through contracted providers, many of whom provide telehealth services. Call 1-800-522-9054 for information.
SoonerCare Telehealth Mental Health Coverage includes grief counseling via video or phone. All SoonerCare members have access to mental health services including bereavement counseling. Contact SoonerCare at 1-800-987-7767.
National Grief Support Lines accessible from anywhere in Oklahoma include the National Hospice Helpline (1-800-658-8898) and Crisis Text Line (text HELLO to 741741).
Online Grief Support Groups eliminate the need for travel. Many hospices and grief organizations offer virtual support groups you can join from home, regardless of your location in Oklahoma.
Hospice Phone Support for rural families often includes regular check-in calls and 24/7 crisis support, recognizing that in-person visits may be challenging due to distance.
Oklahoma Crisis and Mental Health Resources
If grief becomes overwhelming or you need immediate support:
Oklahoma Crisis Hotline: 1-800-273-8255 (National Suicide Prevention Lifeline, serving Oklahoma with local crisis counselors)
SoonerCare Mental Health Provider Search: Visit oklahoma.gov/ohca or call 1-800-987-7767 to find grief therapists in your area who accept SoonerCare.
Oklahoma Department of Mental Health and Substance Abuse Services: Provides statewide mental health services including grief counseling. Call 1-800-522-9054 or visit oklahoma.gov/odmhsas.
Grief Support for Veterans: The VA Oklahoma City Healthcare System (405-456-1000) and VA Tulsa Healthcare System (918-577-3000) offer bereavement counseling for veterans and veteran family members.
Supporting Different Family Members Through Grief
Spouse or Life Partner Grief
Losing a spouse is one of life’s most profound losses. You lose not just the person but your identity as “we.” The grief encompasses multiple losses: companionship, shared history, future dreams, practical partnership, and often financial stability.
Common challenges include navigating the shift from “we” to “I” in your identity, managing practical tasks they handled (finances, home maintenance, cooking), intense loneliness, particularly at night and weekends, decisions about wedding rings, changing relationship status, and social changes (couple friends may drift away), and when or if to consider dating again (there’s no timeline for this).
“Widow fog” is a real phenomenon where grieving spouses experience difficulty concentrating, making decisions, and remembering things. This typically improves over time but can be frightening when you’re experiencing it. Hospice bereavement counselors can reassure you this is normal and temporary.
Many widowed people find comfort in continuing to talk to their deceased spouse. This isn’t denial or dysfunction. It’s a way of maintaining connection. There’s no right time to stop.
Adult Children Losing a Parent
Losing a parent as an adult brings unique challenges. You’re often managing estate matters, belongings, and family dynamics while grieving. Sibling conflict can emerge over inheritance, possessions, or even whose grief is “worse.”
You lose your “person”: Who do you call with good news? Who understands your entire history? For many people, a parent was that irreplaceable source of unconditional support.
If you were a caregiver, you may experience role reversal grief. You cared for the person who once cared for you. That shift, and its end, can be particularly painful.
“Sandwich generation” grief affects adult children caring for their own children while grieving a parent. You’re supporting your kids through their grandparent’s death while managing your own loss. This can feel overwhelming.
Parents Losing an Adult Child
Losing a child at any age defies the natural order. Parents aren’t supposed to outlive their children. This “wrong order” grief is often especially intense and may require support beyond the standard 13-month bereavement period.
Oklahoma resources for bereaved parents include The Compassionate Friends, which has chapters in Oklahoma City and Tulsa. These peer support groups specifically serve parents, grandparents, and siblings grieving the death of a child of any age.
Many parents experience isolation as friends and family struggle to know how to offer support. The grief can strain marriages as partners grieve differently. Hospice bereavement counselors can provide couples counseling focused on navigating this loss together.
Grandchildren and Extended Family
If you’re a grandchild or extended family member, your grief is valid even if your relationship was less close or daily. You may be supporting your own parent through their grief while managing your own loss. This can lead to disenfranchised grief where others minimize your loss because you “weren’t as close.”
Hospice bereavement support is available to extended family members. You don’t need to be immediate family to access support. Your grief matters, regardless of how others perceive your relationship.
Supporting Grieving Children and Teens
How Children Grieve (Ages 5-12)
Children grieve differently than adults. Their grief comes in waves rather than being constant. They may seem fine, playing and laughing, then suddenly become intensely sad. This is normal.
Young children think concretely. They need clear, honest explanations using direct language like “died” rather than euphemisms like “passed away” or “lost.” Phrases like “Grandma is sleeping” can create confusion and fear about sleep.
Play and art become vehicles for grief expression. Children may draw pictures of the deceased, act out the death in play, or create elaborate stories processing their loss. This is healthy grief work.
Behavioral changes to watch for include regression to earlier behaviors (bedwetting, thumb-sucking), changes in eating or sleeping patterns, difficulty concentrating at school, increased clinginess or separation anxiety, aggression or acting out, and physical complaints (stomachaches, headaches) without medical cause.
These behaviors don’t necessarily mean professional therapy is needed. They’re often normal grief responses. However, if behaviors persist beyond several months or significantly interfere with daily functioning, additional support may be helpful.
How Teens Grieve (Ages 13-18)
Teenagers may withdraw emotionally or seem “too mature,” taking on caretaker roles for younger siblings or grieving parents. They may hide their own grief to protect others or to maintain independence.
Peer support becomes critical for teens. They often prefer talking to friends over family. This is normal developmental behavior, not rejection of family support.
Risk of unhealthy coping increases during adolescence. Watch for substance use, risky behaviors, severe withdrawal, failing grades, or self-harm. These require professional intervention beyond hospice bereavement support.
Teens need balance between independence and family connection. They may resist family grief activities but still need to know support is available. Offering without forcing is key.
School support can be valuable. Many schools have counselors trained in grief support. Communicate with your teen’s school about the loss so they can offer appropriate support and understanding if grades or behavior change.
How to Talk to Children About Death
When explaining death to children, use clear, direct words. Say “died” or “dead,” not “passed away,” “lost,” or “went to sleep.” Euphemisms create confusion.
Provide honest, age-appropriate explanations. Young children (5-7) need simple facts: “Grandpa’s body stopped working.” Older children (8-12) can understand more detail about illness or dying process.
Allow questions and re-asking. Children process information slowly. They may ask the same question multiple times or return to questions months later. This is normal.
Normalize their emotions. Let them know it’s okay to feel sad, angry, scared, or even happy sometimes. There’s no wrong way to feel.
Maintain routines while allowing grief. Children need the stability of regular schedules but also space to express grief. Balance structure with flexibility.
Oklahoma Grief Resources for Children
Hospice Children’s Grief Groups: Most Oklahoma hospices offer specialized support groups for children, often using art, play, and age-appropriate activities.
School Counselor Support: Contact your child’s school counselor to ensure they’re aware of the loss and can provide support during the school day.
Camp Carpe Diem: Oklahoma grief camp for children who have experienced the death of a loved one. This overnight camp provides peer support, grief education, and fun in a supportive environment.
Books for Kids About Death: Hospice bereavement coordinators can recommend age-appropriate books. Helpful titles include “The Invisible String” (ages 3-7), “Tear Soup” (ages 8-12), and “The Grieving Teen” (ages 13-18).
When to Seek a Child Therapist: If your child’s grief significantly interferes with daily functioning beyond 3-6 months, consider professional therapy beyond hospice support. Hospice bereavement coordinators can provide referrals to Oklahoma child therapists specializing in grief.
Navigating the Practical Side of Grief
First Holidays Without Them
Holidays magnify grief. The first Thanksgiving, Christmas, Hanukkah, or Easter without your loved one can feel impossible to face. Here’s how hospice bereavement support helps:
Thanksgiving brings decisions about new traditions or honoring old ones. Do you cook their favorite dish? Acknowledge the empty chair? Change everything to avoid pain? All approaches are valid.
Christmas challenges include handling decorations that hold memories, the empty stocking, gift-giving without them, and managing extended family gatherings where their absence is glaring.
Mother’s Day and Father’s Day after losing a parent or spouse are particularly painful. Hospice groups often offer special support sessions before these days.
Their Birthday and Death Anniversary mark difficult milestones. Some families celebrate with remembrance rituals. Others prefer quiet acknowledgment. There’s no right way.
You have permission to skip celebrations, modify traditions, or fully participate. You can leave early if overwhelmed. You can cry through dinner. You can find moments of joy. All of it is okay.
Creating meaningful remembrance rituals helps many families: lighting a candle, sharing favorite memories, donating to causes they cared about, or visiting meaningful places. These rituals honor their memory while allowing grief.
Handling Their Belongings
There’s no timeline for clearing out a deceased loved one’s belongings. Some people need to quickly remove reminders. Others find comfort in keeping things unchanged for months or years. Both are normal.
When you’re ready, keep what brings comfort and donate what doesn’t. Many families find meaning in redistributing items to family members who will treasure them.
Specific items carry intense emotional weight: wedding rings (some people wear them forever, others remove them when ready), clothing (the scent of them may linger in favorite shirts), collections or hobbies (train sets, quilting supplies, tools), and photos and personal items.
Storage is a valid option. If you’re not ready to decide, box things up and store them. You can make decisions later when grief isn’t so acute.
Social Media and Digital Grief
The digital age adds new dimensions to grief:
Memorializing Facebook Accounts: Facebook allows you to memorialize a deceased person’s profile, preventing login but preserving their page as a place for friends to share memories. Visit facebook.com/help for instructions.
Birthday Reminders and “Memories”: These automated notifications can be painful. You can adjust notification settings or request accounts be removed.
Online Grief Communities: Many people find support in grief-specific online forums and Facebook groups. These can provide 24/7 connection with others who understand.
Sharing Grief vs. Privacy: There’s no right amount to share publicly about your grief. Some find comfort in posting memories and thoughts. Others prefer privacy. Do what feels right for you.
Unsubscribing from Their Email and Accounts: This practical task can be emotionally difficult. You might continue receiving emails addressed to them for months. Unsubscribing can feel like erasing them. Take this slowly, at your own pace.
Well-Meaning But Hurtful Comments
People often say things intended to comfort that actually sting:
“They’re in a better place” can hurt because you want them here, not in a “better place.”
“At least they’re not suffering” minimizes your loss. Yes, their suffering ended. Your suffering is just beginning.
“You’re so strong” feels like pressure to hold it together when you want permission to fall apart.
“Time heals all wounds” implies there’s a timeline for grief. There isn’t. Grief doesn’t end; it changes.
Scripts for responding:
- “I know you mean well, but that’s not comforting right now.”
- “Thank you for caring. What I really need is just someone to listen.”
- “I appreciate that you want to help. The best help is just being present.”
Setting boundaries is okay. You don’t owe anyone a particular grief performance.
Making Decisions in Early Grief
Avoid major life changes for 6-12 months if possible. Don’t sell the house, move across country, quit your job, or start a serious relationship immediately after loss. “Widow fog” (or griever fog) affects judgment and decision-making.
Major decisions you can’t wait on (finances, estate matters, dependent care) should be made with help from trusted friends, family, or professionals who can provide objective perspective.
Protect yourself from financial pressure or scams. Unfortunately, grieving people are sometimes targeted by predatory financial schemes or pushy family members. Hospice social workers can help you identify and resist pressure to make quick decisions.
Normal Grief vs When to Seek Additional Help
What “Normal” Grief Looks Like
Grief has an incredibly wide range of normal expressions. All of the following are common and expected:
Emotions: Intense sadness, anger, relief, guilt, numbness, anxiety, longing, despair, or feeling nothing at all.
Physical Sensations: Feeling their presence or “seeing” them briefly, hearing their voice, smelling their scent, chest tightness or heartache (literal physical pain from grief), and exhaustion or insomnia.
Behaviors: Talking to them or about them constantly, keeping their things exactly as they were, avoiding all reminders of them, losing track of time, difficulty concentrating and making decisions, and changes in eating (too much or too little) and sleeping patterns.
Waves of Intense Grief: Grief isn’t constant. It comes in waves. You might be fine, then suddenly overwhelmed. Triggers can be obvious (a song) or inexplicable.
All of these are normal. You’re not “doing grief wrong” if you’re not crying constantly or if you are. You’re not broken if you feel relief or numbness. There’s no right way to grieve.
Red Flags for Complicated Grief
While grief has a wide range of normal, certain signs suggest you may be experiencing complicated grief or Prolonged Grief Disorder (PGD), a diagnosis recognized by the American Psychiatric Association:
Intense grief that doesn’t ease after 6-12 months. While grief continues indefinitely, most people experience some easing of intense symptoms over time. If pain remains as acute at one year as it was at one week, additional support may help.
Inability to accept the death. Most people eventually reach some acceptance. If you’re still deeply in denial months later (not just wishing it wasn’t true, but truly unable to believe they died), this may be complicated grief.
Intrusive thoughts about the death. Replaying the death over and over, ruminating on what you could have done differently, or being unable to think about anything else suggests complicated grief.
Numbness or feeling “frozen.” Some numbness is normal early in grief. But if you feel emotionally frozen for many months, unable to access any feelings, this warrants additional support.
Avoiding all reminders. While some avoidance is normal, completely avoiding anything that reminds you of them (refusing to talk about them, removing all photos, avoiding places you went together) can prevent grief processing.
Feeling life isn’t worth living. Passive thoughts like “I wish I had died too” are common. Active suicidal thoughts (“I’m making a plan to die”) require immediate professional help.
Signs of Depression Beyond Grief
Grief and depression can overlap, but clinical depression requires treatment beyond bereavement support:
Persistent feelings of worthlessness or hopelessness beyond sadness about the loss.
No moments of peace or respite from pain. In normal grief, there are moments of peace, distraction, even laughter. In depression, there’s no relief.
Inability to function in daily life for extended periods. Missing work for weeks, unable to care for children, not eating or bathing for days.
Thoughts of suicide or self-harm. This requires immediate professional intervention. Call the Oklahoma Crisis Hotline (1-800-273-8255) or text HELLO to 741741.
Substance abuse to numb pain. Using alcohol, drugs, or medications to avoid feeling grief can lead to addiction and complicated grief.
Withdrawal from all relationships and activities. Some withdrawal is normal. Complete isolation for months is concerning.
When Hospice Bereavement Isn’t Enough
Hospice bereavement support is excellent for normal grief. However, certain situations require specialized professional therapy:
Complicated grief or trauma. If the death was traumatic (suicide, violence, sudden death), you may need trauma-specific therapy like EMDR (Eye Movement Desensitization and Reprocessing) or CPT (Cognitive Processing Therapy).
Pre-existing mental health conditions worsened by loss. If you had depression, anxiety, or PTSD before the death, grief may exacerbate these conditions. You may need psychiatric care and medication management beyond what hospice provides.
Suicidal thoughts. This requires immediate professional intervention beyond bereavement support.
Need for specialized therapy. Some grief situations benefit from specialized approaches hospice bereavement counselors may not provide.
If you need support beyond hospice, your bereavement coordinator can help assess your needs and provide appropriate referrals.
Oklahoma Mental Health Resources
SoonerCare Mental Health Provider Directory: If you have SoonerCare (Oklahoma Medicaid), mental health services including grief therapy are covered. Visit oklahoma.gov/ohca or call 1-800-987-7767 for a provider directory.
Private Grief Therapists in Tulsa and Oklahoma City: Licensed professional counselors (LPC) and clinical social workers (LCSW) specializing in grief are available throughout Oklahoma. Ask for referrals from your hospice bereavement coordinator.
Oklahoma Department of Mental Health and Substance Abuse Services: Provides statewide mental health services including grief counseling. Call 1-800-522-9054 or visit oklahoma.gov/odmhsas.
Sliding Scale Counseling Options: Many private therapists offer reduced-fee sessions based on income. Community mental health centers throughout Oklahoma provide affordable counseling.
Grief-Specific Therapists: Seek therapists who specialize in grief and bereavement, not general counselors. Grief is a specialized area requiring specific training.
Online Therapy Options: For rural Oklahomans or those who prefer virtual care, platforms like BetterHelp, Talkspace, or Oklahoma-based telehealth providers offer grief counseling via video or phone.
Cultural and Religious Considerations in Grief
Faith and Grief
Different religious traditions have specific practices around death and mourning:
Christian grief perspectives in Oklahoma vary by denomination. Some emphasize hope in reunion in heaven. Others focus on lament and honest expression of pain. Hospice chaplains can support both approaches.
Native American grief traditions are diverse across Oklahoma’s many tribes. Some tribes have specific mourning practices, rituals, and timeframes. Hospice bereavement support respects these cultural practices.
Latino/Hispanic cultural mourning practices often include multi-generational family involvement, specific prayers and rituals (novenas, rosaries), and extended periods of mourning dress or memorial observances.
When you’re angry at God, this is a common spiritual crisis in grief. Many people question their faith, feel abandoned by God, or rage at the unfairness. This doesn’t mean your faith is lost. It means you’re wrestling with profound questions. Hospice chaplains are trained to support people through spiritual crisis without judgment.
Finding (or not finding) meaning in loss is a deeply personal journey. Some people find comfort in believing the death had meaning or purpose. Others never find meaning and that’s okay too. There’s no requirement to find silver linings in devastating loss.
Cultural Differences in Grieving
Latino/Hispanic communities often express grief more openly with outward displays of emotion encouraged. Extended family involvement in mourning is common. Food and gathering together hold important roles in supporting bereaved families.
Asian American grief expressions vary by specific culture but often include ancestor veneration, specific mourning periods, and practices around burial and remembrance. Some Asian cultures emphasize restraint in emotional expression, which doesn’t mean grief is less intense.
African American funeral and grief traditions often include elaborate funeral services celebrating the deceased’s life, church community support, and specific cultural practices around death and remembrance.
LGBTQ+ grief and chosen family acknowledges that legal family may not be who you’re closest to. Hospice bereavement support is available to chosen family, partners, and close friends regardless of legal relationships.
Military and veteran family grief carries unique challenges including potential combat-related loss, frequent relocations affecting support networks, and military funeral traditions. VA medical centers in Oklahoma City and Tulsa offer specialized bereavement support for veteran families.
Non-Religious Grief Support
Secular grief support groups are available for those who don’t identify with religious frameworks. Many hospice groups are facilitated without religious content.
Humanist and atheist perspectives on loss focus on honoring the person’s memory, the legacy they leave, and finding comfort in relationships and community rather than afterlife beliefs.
Finding meaning without faith framework might include focus on continuing their values, contributing to causes they cared about, or finding purpose in supporting others through similar loss.
Nature-based grief practices include memorial plantings, scattering ashes in meaningful locations, or finding solace in natural settings.
Oklahoma secular grief resources can be found through hospice bereavement programs that offer non-religious options, the Center for Inquiry Oklahoma City, and Grief Beyond Belief online community for secular grievers.
Frequently Asked Questions About Hospice Bereavement
Is hospice bereavement support really free?
Yes, completely free. Bereavement services are included as part of Medicare hospice benefits and are provided at no cost to families for at least 13 months after death. You don’t need insurance or Medicare to receive these services if your loved one was a hospice patient. There are no bills, no copays, no costs.
What if my loved one was only in hospice for a few days?
You still receive the full 13 months of bereavement support. Length of hospice enrollment doesn’t affect bereavement services. Even if your loved one was in hospice for one day, your family qualifies for the complete bereavement program.
Do I have to participate in bereavement support?
No, it’s completely optional. Hospice will reach out and offer support, but you can decline or participate as much or as little as you want. Some families need intensive support with individual counseling and regular support group attendance. Others prefer minimal contact. Both are okay. You’re in control.
Can my children receive grief counseling through hospice?
Yes. Most hospices offer specialized children’s grief support including age-appropriate counseling, activity-based grief groups, and grief camps. Children of all ages can participate. Hospice bereavement counselors are trained in childhood grief and can provide resources specific to different developmental stages.
What happens after the 13 months ends?
Many hospices continue to offer support groups and resources beyond 13 months. Your bereavement coordinator will help you transition to other community resources if you need ongoing support. Some hospices have alumni groups for long-term connection. If you need continued professional therapy, your coordinator can provide referrals to Oklahoma mental health providers.
I’m not good at talking about my feelings. Will I be forced to share in groups?
No one will force you to share. Many support groups allow you to listen without talking. Some people attend for months before they feel comfortable sharing. Others never share and find comfort just being present with others who understand. Individual counseling might be more comfortable than groups. You can also receive support through phone calls and written materials. There’s no requirement to verbally process your grief if that’s not your style.
What if I didn’t get along with the person who died?
Complicated relationships create complicated grief. Feeling relief, guilt, or ambivalent emotions is common when the relationship was difficult. Hospice bereavement counselors are trained to support all types of grief. Your grief is valid even if the relationship was difficult, even if you feel relief, even if you’re angry at them. These complex emotions are normal and nothing to be ashamed of.
How do I know if I need more help than hospice can provide?
If you’re experiencing suicidal thoughts, unable to function in daily life for months, or grief feels traumatic and frozen (not processing or easing at all), you may need specialized therapy beyond bereavement support. Signs include persistent thoughts of self-harm, inability to care for yourself or dependents, substance abuse to numb pain, or no improvement in intense symptoms after 6-12 months. Your hospice counselor can help you assess and refer to appropriate mental health professionals in Oklahoma.
Can I get bereavement support if we didn’t use hospice?
Hospice bereavement services are only for families of hospice patients. However, many community resources offer grief support to anyone: churches and faith communities often offer GriefShare or other grief support groups, community centers and libraries sometimes host grief groups, private counselors specialize in grief therapy (may be covered by insurance), and some hospices offer community grief groups for a small fee open to anyone. Your local hospice may also be able to refer you to appropriate community resources even if you weren’t a hospice family.
What if I feel guilty that I feel relieved they died?
Relief is an extremely common and normal emotion after a long illness. It doesn’t mean you didn’t love them. It means you’re relieved their suffering ended. It means you’re relieved that the intensity of caregiving is over. It means you’re relieved they’re at peace. Many caregivers feel guilty about relief, creating a cycle of guilt about relief and relief about their death. This is something bereavement counselors help with often. Your feelings of relief are valid and nothing to be ashamed of.
Real Stories: Oklahoma Families and Bereavement Support
Susan’s Journey Through First Year (Tulsa)
Susan lost her husband of 42 years to lung cancer. She describes the first months: “I didn’t know how I’d survive. We’d been together since I was 19. Who was I without him? The hospice bereavement counselor called me every two weeks for the first three months. I didn’t always want to talk. Sometimes I’d cry through the whole call. Sometimes I was numb and had nothing to say. But knowing someone cared meant everything.
The first Christmas was devastating. I couldn’t imagine celebrating without him. The hospice grief support group helped me plan how to handle it. I decided to keep some traditions like attending Christmas Eve service and making his mother’s fudge recipe. But I skipped the big family gathering. I went to my daughter’s house for a quiet dinner instead. That felt manageable.
Other group members shared what worked for them. One woman went on a cruise to avoid the holidays entirely. Another created an elaborate memorial service on Christmas Day. There was no judgment about different approaches. We each did what we needed to do.
By month 13, I wasn’t ‘over it.’ You never are. I still cry sometimes. I still talk to him. But I found I could breathe again. I could laugh without guilt. I could imagine a future, even though it looked different than I’d planned. Hospice grief support didn’t take away the pain, but it walked with me through it. I didn’t have to do it alone.”
Robert Supporting His Children (Muskogee)
Robert’s wife died suddenly from a heart attack, leaving him with three children ages 8, 12, and 15. “I was drowning in my own grief and trying to help my kids. I didn’t know what to say to them. Should I cry in front of them? Should I be strong? I felt like I was failing as both a grieving husband and a father.
Hospice offered a children’s grief group. At first my 15-year-old daughter refused. ‘I’m fine,’ she insisted. But she wasn’t fine. None of us were. Eventually she agreed to go. She needed to talk to other teens who’d lost a parent. She wouldn’t talk to me, but she’d talk to them.
My 8-year-old son did art therapy and play-based grief work. I didn’t even know that existed. He drew pictures of heaven and made memory boxes. The grief counselor explained these were his ways of processing what he couldn’t put into words.
My 12-year-old daughter just wanted to talk. She had so many questions. Is it okay if I don’t cry every day? Does it mean I didn’t love Mom if I laugh with my friends? What if I forget what her voice sounded like? The hospice counselor answered every question with patience.
The bereavement team supported all four of us in different ways tailored to our ages and needs. They taught me how to talk to my kids about death, how to let them see me cry, and when to just be present without trying to fix it. That first year was the hardest of my life. But we survived it together, with help.”
Maria’s Complicated Grief (Oklahoma City)
Maria’s relationship with her mother was difficult. Years of criticism and conflict had strained their relationship. When her mother was dying, Maria provided care out of obligation and some hope for reconciliation that never came.
“I felt guilty that I didn’t cry at the funeral. I felt relieved she was gone, then guilty about the relief. I was angry at her for dying before we could resolve our issues. I was angry at myself for caring that we didn’t resolve things. It was a mess of contradictory feelings.
The hospice bereavement counselor told me complicated relationships create complicated grief. That permission changed everything. I didn’t have to pretend I was devastated by the loss of an idyllic mother-daughter relationship that never existed. I could grieve the relationship we had AND the relationship we’d never have. I could feel relief AND sadness. I could be angry AND love her. All of it was allowed.
I did both individual counseling and a support group through hospice. The support group included other people grieving complicated relationships. We could say things like ‘I’m relieved they’re dead’ without shock or judgment. That permission to be honest was healing.
After 13 months, I transitioned to a private therapist because I needed more work on childhood trauma and family dynamics. But hospice got me started. They helped me understand my grief was valid even though it looked different. I wasn’t a terrible person for feeling relief. I was a human being with complex emotions about a complex relationship.”
Conclusion: You Don’t Have to Grieve Alone
Hospice bereavement support continues for at least 13 months after your loved one’s death, providing free grief counseling, support groups, phone support, and educational resources. This support is available to all family members including children, regardless of how long your loved one was in hospice care.
Oklahoma offers additional grief resources in Tulsa, Oklahoma City, and rural areas including community support groups, mental health counseling, and specialized services for children, veterans, and diverse cultural communities.
Normal grief has a very wide range of expressions. Your grief is valid whether you cry constantly or feel numb, whether you keep their things or clear everything out, whether you talk about them all the time or find it too painful. There’s no right way to grieve.
Professional help is available if grief becomes complicated or depression develops. Your hospice bereavement coordinator can assess your needs and provide appropriate referrals to Oklahoma mental health professionals.
Grief is not something you “get over.” It’s something you learn to carry. The pain changes shape over time. The acute agony eases into softer sadness. The constant crying becomes occasional tears. You don’t forget them or stop loving them. You learn to live with the loss.
You don’t have to do it alone. Hospice bereavement support walks alongside you, offering compassion, resources, and community as you honor your loved one’s memory and find your path forward.
If you’re currently grieving or anticipating the loss of a loved one in hospice, reach out to your hospice bereavement coordinator. If you’re supporting someone who’s grieving, encourage them to accept help. Grief support isn’t weakness. It’s wisdom. It’s accepting that some journeys are too difficult to walk alone.
For Oklahoma families seeking hospice care with comprehensive bereavement support, local hospice agencies serving Tulsa, Oklahoma City, Muskogee, and surrounding communities provide expert end-of-life care and grief support that continues long after death. You are not alone in your grief. Support is available, free of charge, for as long as you need it.
Article reviewed by Jennifer Torres, LCSW, Certified Grief Counselor with 12+ years experience in hospice bereavement services. Ms. Torres specializes in family grief, complicated loss, and children’s bereavement support in Oklahoma.
