Donna Wilson is a professor in the Faculty of Nursing at University of Alberta in Edmonton. Her program of research focuses on health services and health policy, primarily in relation to aging and end-of-life care. She has conducted or been involved in studies on grief and bereavement, ageism, social isolation and many more topics.
This summer, she and her team released the results of a study that found humor to be both a grief trigger and a coping mechanism for grief.
Have a listen as Donna and I dig into more subjects than grief and humor, including what a good death is and why it’s OK if all you do for a grieving friend is show up with a casserole.
Good morning, Donna Wilson, how are you today?
I’m fine. Thank you. Glad to talk to you.
I’m so excited to chat with you about your history and the research you’re doing on grief and humor. Why don’t we get started by having you tell us a little about yourself and how you attached yourself to this subject.
So Terrific. Well, thanks. And I should probably say, I grew up on a farm, where we had a small number of pets, but we had a lot of animals, some of whom were ill. And then we tried to help them but certainly death was a reality on a farm.
I became a nurse and have been a nurse for a number of years working in hospitals and nursing homes and other places. And you certainly do help a lot of dying or people who see death quite a lot, actually. In fact, I think nurses are at the bedside of many, many deaths, whether it’s now in the home or in hospital or nursing home.
And you begin to realize, you know, how the person who’s passing away needs support and reassurance and some basic care and sometimes pain medications, and you know, they have a difficult death.
But it’s the people that are left behind with the grief … you know, the family caregivers that know what a huge gap this is going to be. This their beloved mother, father, sister, child and whatever. Then you also realize that there’s some people that, you know, they haven’t had a good relationship, perhaps with their mom or their sister or whatever but they have the opportunity at the deathbed to come and make up and say, “Yes, we had some differences, but I love you.” And “I really cared for you,” or “I’m sorry, we live so far apart, that I didn’t get to see you as much as I should have. But you’re still family, and I really care about you. And I’m here for you.”
So I got to see some wonderful deathbed chats. And you start to kind of realize, what an important time this is, and how wonderful it is, when you have some awareness that the end is coming. And as compared to, you know, sudden deaths where you know, “oh, my goodness, he had a heart attack, and God, nobody realized what was happening.”
So as my research career kind of took off, I was interested in older people. And most people who passed away were older. And so then I got into, you know, are we looking after older people? Well, when they’re on their deathbed or when they’re dying, where are they dying? And who is there and what can we do to have good deaths and what is a good death and what’s a bad death?
Then I started getting really interested in grief because I realized there were very few researchers doing anything about grief and that in fact, there’s anticipatory grief. You know, this older person is getting ill and will perhaps pass away in the next year or month or week or whatever.
But also then the grief that happens after the death, at the time of the death and then afterwards. And so one of the very surprising studies that we did recently — my team of students and a few colleagues — was looking at grief triggers. Because you really have solid, heavy grief for a number of days after a meaningful death of a loved person, or even if an animal dies. But then after that, for even years of time, you can have your grief triggered, and you can have very serious waves of grief or grief episodes, when something reminds you of the person who was gone.
And so that was one of the studies that ended up getting quite a bit of attention. I’m glad that it has, because everybody expects that you’re going to feel really sad for a few days, if your mum or spouse or whatever dies, but they don’t realize that the grief actually goes on for a number of years. And there’s certain periods or certain things like an anniversary or their birthday, or something that reminds you of that person that you have a very major wave of grief that can last for a while.
And we don’t necessarily ever get over grief. Do we? We learn to live with it.
Yeah. Yeah, absolutely. And the sad thing is most of the general public, they have not had a really serious grief episode. And so they sort of think, well, of course you’re going to be sad for three days, and then we’ll be fine. Just go back to work, you know, find a new husband or wife. I mean, it’s been a whole year since he’s been gone. Come on now, you know, don’t get depressed, go and see a doctor and get on sleeping pills and psych pills. Because there’s something wrong with you.
We’ve don’t know a lot about grief. So that’s why I’m happy to be doing this series of studies on grief … to normalize it in many ways. And to, you know, learn what is normal and how do you help people who are grieving? What can you expect when somebody is grieving? Because you’re right, you can live with grief for the rest of your life.
Yeah, we’ve really taken grief and tucked it into a box as a society, haven’t we? And that is really at the core of why there isn’t enough research done on it too. Am I right? Because we don’t want to have to deal with it. It’s an icky subject.
Yeah. Because it brings up death and dying, you know, things that are pretty scary for some people and for a large proportion of people there’s quite a bit of death anxiety out there. You know, that’s been fairly well studied. But yeah, it’s an uncomfortable subject and, you know, it can be uncomfortable talking to someone who’s grieving.
What do you say? There isn’t sort of, you know, I mean, 100 years ago, when death was much more common, where a man and a woman who married would expect to have eight children and three may die. And their sisters and brothers would die with accidents and infections and war and what have you. People were a lot more in tune to grief and death and dying because it was sort of inevitable, but then antibiotics came along and health care came along.
We all think we’re going to live to be 100 now. But really, we just don’t even think about death and dying, when it’s not a reality for us. Most of us, you know, we have parents who haven’t passed away yet. And no sisters or brothers have ever passed away, no friends have passed away.
So we actually have very little experience now with death, dying and grief. I guess it’s understandable in a way, why we are so uncomfortable being around grieving people or even knowing what to do when we are grieving ourselves.
And that includes even when your beloved pet dies or they’re suffering and you get euthanasia done. So we can grieve not just for people but for beloved pets and horses. A lot of people have a wonderful horse. And when that horse dies, there is terrible grief, people really suffer from grief.
Detracting from your study about humor for a moment, you also did a study on older women and losing their companion animals and the impact that has had on those women. What did you see? And how did those women in your — I believe there were 12 elderly women in your study — how did they process the grief of their dog or their pets dying?
One of the sad parts of that study was finding out that most of them went home and in enormous loss, that pet isn’t there in the house, greeting them anymore and sitting on their lap and what have you and they couldn’t tell anyone about it because they felt that they wouldn’t get comforted.
And they would get bad advice, or the “oh, well you know, it was just a pet or just a cat,” and “they’ll get another one.”
They knew that that’s the kind of reaction that they would get. And so they didn’t talk to anybody. They didn’t put out anything on social media, because they didn’t want to have to deal with calls or responses.
Well, you know, it was just a dog or whatever.
They were very, very, very selective on who they would talk to in a few days. They might have a really good friend that they thought would be sympathetic, and they would phone that friend and say, “you know, I had to put Blackie down on Friday, because her cancer was incurable or she suddenly got really ill. The kidneys failed, and she was suffering and I had to put her down.”
So they grieved alone. That was the sad part, a lot of those older women, and they were older women living alone except for this pet. And they really grieved alone, they grieved hard and they grieved long.
It was a loss in many, many ways. This was their companion, their daily companion that they interacted with and cared for, and that cared for them too. And that was gone.
They were alone in the world because they couldn’t talk about their grief, because it was “just a pet.”
Yeah, with my own mom, my dad died in 1996. And all of the kids were gone at this point, I believe, and they had a dog together. That dog became my mother’s — for lack of a better word — replacement husband, you know, and when that dog died, she was devastated and she never lost her attachment to that dog just as she never lost her attachment to my father.
That really is part of grief, I think, is coming to some kind of state at some point where you still love those people and those animals and everything and then being able to kind of live on.
Many people never remarry; many people never get another pet again; or they might get a different pet. Again, because it’s such a strong bond, even after death.
Whether that’s healthy or not, it depends on the person. Some people can be very lonely living alone and at some point getting a good friend you can do things with. Even if you don’t marry that person, or getting a replacement — and it’s never a replacement — but a new animal.
Because we are social beings. The pandemic taught us how damaging it was when we’re locked away in our homes and you can’t interact with people. And during the pandemic, the things I miss the most was hugs.
My family is a huggy, very touchy people. And we just stopped hugging and touching and on top of the visiting, boy was that isolating. I started to realize how much I missed being around people. And the hugs.
We always greeted with a hug and said goodbye with a hug and if someone was sad, we would hug.
We’re social beings and so our family or friends or our companion animals are extremely important to our health and our well-being, much more important than a job and other things that we spend so much time on.
To hell with work. I’m going to stay home and cuddle my dog all day.
Yeah, it pays the bills, but it doesn’t always make you feel good.
One of the women in your study was traveling. And the person who was watching her pet for her made the decision while she was traveling to put her pet down. How traumatic must that have been for that woman. She couldn’t even make that decision herself. It was made for her.
Yeah, yeah. Along that line, how difficult that must have been. The worst deaths, for humans, if a spouse dies, or whatever, are the sudden, unexpected deaths, where you don’t get an opportunity to say goodbye, tell them you love them, give them that last hug, be at the bedside, make sure that they’re comfortable, the pillow is OK and they’re too hot or not too cold or whatever.
And the same thing goes for our pets, our companion animals. So in that case, yes, that was a really, really tough death for her because she was away. And you can only guess that you hope that the right decision was made.
You know that, in fact, it was suffering and it was time to put the animal to sleep.
But still, you’re not there to know that animal that loved you that was bonded with you, that will be comforted, as it’s laying there in pain and as it’s getting an injection to, to stop its heart and stop its breathing. So that would be a horrific death. And it was for that individual.
Just like when we hear that a best friend had a heart attack or a husband or mother or father and we think, oh, my you haven’t talked to them for a week or two or months or I haven’t visited Mum because I moved far away. And I haven’t seen her for two years, I’ve talked to her on the phone but my goodness, I didn’t get an opportunity to be there and say those important things and catch up and all the rest of it.
So sudden deaths are the hardest ones. Because we have no warning. I’m starting to realize — looking historically, at death and dying — how important the deathbed is to be there. Death is coming and you have an opportunity to say the things you need to say. You have a responsibility to be there to make sure the dying person is comforted, that they’re dying a good death.
So there’s a lot that that we could talk about grief and how important it is and how we need more research on it, but we just need to talk about it too. It touches us. It’s very, very, it’s very, very meaningful.
I just recently learned that hearing is the last sentence we lose before we die. And I hadn’t seen my mom in five years, talked to her on the phone of course because she lived in Nova Scotia. And my brothers were with her because they live closer. And I I had thought about having them hold the phone up to her head so I could say goodbye. She was unconscious for two days after I found her. But I was overcome by this feeling that no, that’s silly. She can’t hear me she she’s not nothing is going to happen. But now what I’ve learned hearing is the last sense you lose. I beg people to get that phone held up if you can.
That is such a good idea. Families now tend to scatter all around the globe. And you don’t schedule death, you don’t say it’s going to happen on Wednesday so you’ve got three days to get here. It just doesn’t work that way. And people have busy lives and during the pandemic, it was difficult to catch a flight places. It still is. So it can be really hard to get back.
But you’re absolutely right, having a phone conversation, Zoom, whatever you can set up, it would be very good. Because there’s two important things happening: You need to feel good about yourself that you were there in one way or another, even if it is your thoughts but you also want to know that they’re OK and that they hear you. Not everybody wants to be there at the deathbed.
I had a fantastic grandmother, which is probably why I study aging and worked with older people most of my life. She got to be very elderly and when we knew she was failing, that it’ll be sometime soon, I went to visit her, and then they said, she’s really quite bad, you better come.
I knew as a nurse she probably wouldn’t live until the next morning. And I thought, you know, do I want to be here. And I didn’t want to be. I had a new baby, and I just wanted to go home. I had said my goodbyes, and she was just resting comfortably. She and her daughter had a special relationship and I felt like I would be in their way. They wanted to be together at the end. So I drove home to be with my daughter, my little infant daughter.
I don’t regret that. So part of it again is doing things that you’re going to feel comfortable with, that you feel was OK, or the best under the circumstances or whatever. And then of course, family, you’re concerned about them? Are they? You know, are they OK, so? So I think it’s a wonderful idea talking to people on the phone. Absolutely. Zoom calls. Why not? You know, zoom? Why not? Because what it is hard to get together. We live so far apart now.
Now circling back to the study about humor. It feels to me sometimes, when I’m doing these podcast interviews, awkward to be laughing because we’re talking about serious subject matter. But at the same time, we need humor as a healing tool as well, don’t we? Because, and you mention this in your study, that it isn’t just a trigger for waves of grief to occur, but it can be a healing tool as well. Can you talk about that for a little bit?
Wonderful. Yeah, thanks. So just the background, we were doing this grief trigger study, what triggers grief and what people do about it. And some of them said, “Well, you know, my sister who died, she would just tell outrageous stories and we would just laugh and laugh and laugh. And now when I hear a story that I think, ‘gee, I’d love to tell her’ and then I remember, she’s gone and I would get a wave of grief.”
Or “gee, that was just such a funny TV show. I would have loved to talk with her about it. But it reminds me of her.” So you get a wave of grief. So grief, humor could be a real grief trigger.
But then we started to talk to people about well, what do you do about your grief? And they said, well, I go and I find cartoons and I deliberately watch TV shows that are funny, and I watch movies that are really funny. And I visit funny friends and because it makes me feel better. It gives me a break from my grief. So I can actually rest. Like I’m feeling so sad and so lonely. I’m grieving so hard. It gives me even just a moment or two hours where I don’t have to think about my grief. That was wonderful for people.
And some people said, hey, send me your jokes. Tell me your jokes. I need jokes. I need humor in my life.
But the interesting thing is grieving people use humor sometimes to tell everybody, I’m OK. Yeah, I’m sending you a joke so don’t worry about me, I’m surviving, I will survive this. And maybe I kind of want to help you a little bit too, because I know you’re grieving as well. But I know you’re worried about me and I don’t want you to worry about me. This is tough, but I’ll get through it. I’ll survive.
These grief triggers, humor was just one of those totally unexpected findings, and how common it was used, most people use humor for themselves to make them feel better, and also to make other people around them feel better. But not everybody was that same way.
It resonated with me, because at my mom’s funeral in February, it was the first time in a couple of years that my three brothers and I were together because we live separately across North America. And, you know, we gravitate to telling stories and making each other laugh. And whether it was a distraction from the grief we were all enduring or just the natural part of the MacIsaacs being in the same room together again. It felt so good to not be crying. But at the same time, the laughter can last for five minutes and then the tears can come again. And then the laughter …
Yeah, you can still have joy of being together with beloved family members that you don’t see so often. The Irish have a custom really of having fun at funerals. You go to a funeral with your best jokes, and we’re going to tell humorous stories about the person who died. You know”, everybody come up and tell a story about John, who passed away,” and they’re all laughing.
It’s interesting. There’s different cultural customs, but one of the interesting things looking at humor is every single country, every religious group, every custom, every group of people has always used some kind of humor. Humor is important to them. It’s part of our DNA almost, you know, and so why wouldn’t humor be OK at a funeral, and afterwards?
I remember the one person said, “Hey, look, my husband only died a year ago. I don’t want jokes. He told jokes, but I don’t want jokes told around me. I don’t want people to try and make me laugh or whatever. I’m doing the job of grieving. I’m not supposed to be happy. I’m supposed to be sad.”
So you do have to be careful about humor. Not every family goes for it. Not every person feels it’s appropriate. But the vast majority of people appreciate humor, use humor, and it’s very healing. It is really important.
We are Irish, Irish-Scottish … I mean, we’re Atlantic Canadians, so it’s natural. And I did sit in the funeral home at my mother’s week and think, man, if some stranger walked in here, they wouldn’t know they’re at a wake. They’d think they were at a standup comedy show.
Absolutely, yeah, that’s normal. That’s totally normal, especially for your family and that cultural group. Totally. And that’s wonderfully healing. That’s part of what you do at a funeral.
There are a lot of dichotomies when it comes to life, there is birth and there is death, and there is, you know, joy and there is sadnes. Which also means that laughter and tears can coexist, as well. Right?
Absolutely. Or they can follow each other very quickly. And I mean, let’s face it, sometimes you laugh until you cry.
We cry at weddings, we laugh at funerals. It’s a natural existence of life, isn’t it?
Absolutely. Yeah. And how wonderful that we have those expressions and people can read those expressions.
We see so little death and dying and grief now that we’ve lost a lot of the customs, and we kind of don’t know what’s the right thing to do, and we’re kind of awkward. So this is why, if you’re grieving, tell people if you want jokes, you know, lead the way, make it possible for people to make grief normal, to say “Hey, anybody have a good joke about this person who’s in the coffin, please come up and tell us, because he loved a good joke. Let’s enjoy our time together and let’s celebrate the life of that person. Let’s celebrate what they were like.”
That extends naturally to our pets, too, because they bring us so much joy. They don’t get to do it for our entire lifetimes, but their entire lifetimes are so much about bringing us joy and happiness and comfort.
Definitely. They’re bonded with us. We’re their world.
What’s next in grief study for you, Donna?
Well, currently, I’m doing a study of family caregivers who are looking after very old family members who are starting to need help. And I’m studying anticipatory grief now. Because while you’re helping your mom and dad or older spouse, who never used to need any help, now they’re starting to need a bit of help, and then a bit more and a bit more and a bit more, and you know the end is coming.
And yet, you’re still actively involved, and you’re trying to lift their spirits and be normal around them but you’re grieving, you start grieving, because you know the end is coming. And they know the end is coming as well.
So I’m studying anticipatory grief now, because it’s, you know, how do you live with knowing that someone’s 94 or 104 or 85, and they’ve got a really bad heart. How do you help somebody help and be normal around these beloved family members but you’re all grieving. It’s sort of — like they say, the horse on the dining room table — sometimes they don’t talk about it, it’s there, but they don’t talk about it. And that’s a lot of death, dying and grief we don’t talk about, we’ll just kind of ignore it.
And yet there’s a horse on the dining room table. It’s a big thing.
I think one of the things you’re exposing so well by doing these research studies is the lack of service that exists, the lack of support services that exist for people who are in the anticipatory and grieving stages.
Yeah, very much. It’s kind of like, well you’re locked in so why are you grieving? But again, that’s because we have so little experience with death, dying and grief now, because most people do live to be 85. So we don’t have classmates who pass away, good friends who pass away, aunts, uncles, cousins, what have you, and we have such smaller families. I mean, we’re typically quite healthy until old age. So we’ve had the luxury of not worrying about death and dying and grieving, but it means we’re kind of novices at it, and there’s not many services and, and we struggle to say, “Oh, you know, should I should I talk about that or should I just ignore it? Will I hurt the person if I say something when I say the wrong thing?”
So we worry about how we can help people who are grieving. Even anticipatory grieving, because you know that 85-year-old or 95-year-old, they’re not going to live another 10 years, or even they may be gone within one month.
Are we standing on the edge of a sea change when it comes to grief and normalizing it in our society, because I feel like there are a core group of us out there who are trying to get the word out and saying, we’re normal, we’re not, you know, you don’t need to walk on eggshells around us just because we’re grieving. But we also need to be heard, we need to be supported and, and, you know, help us through these stages.
I think the pandemic helped in some ways to really move us a bit forward in terms of normalizing grief and having grief services and, you know, people being more comfortable with grief, because the pandemic really risked a lot of lives and a lot of younger people did die. You know, the 60-year-old or the 80-year-old that you thought would be around for a number of years.
So, I think in some ways, the pandemic has kind of pushed death, dying and grief more into the public eye.
I think the other thing is we got this huge baby boom group, the massive baby boom group who many of them are just caring for their dying parents now. And they’re getting awakened to death, dying and grief, and the grandchildren as well, too. Of course, some baby boomers are already 75 and they’re starting to kind of look ahead and doing wills and maybe starting to talk to families. The reality is mum and dad are gone. I’m next. Oh, it’s my turn.
But I also think we’re starting to get some nice research, research groups and hospice groups, and they are doing good work. If I talk about Ireland, in particular, grief is a big deal in Ireland; their hospices all have grief support groups. They have memorial events where people come together let butterflies go once a year to remember the people who passed.
So some countries are doing quite well, because they’ve had some leaders who have brought grief to the public eye and kept it there. And they’ve started to develop some nice services and supports and ways of being so that you know what to do when somebody’s grieving.
I think we’re getting there, but I don’t see a sea change yet. I think we’ll all just keep hoping to live forever, and never have to deal with grief.
In wrapping up, what, what is the one thing you would advise people who know people in the anticipatory grief and grieving stages to help them?
You know, that’s a wonderful question. Sometimes people don’t really want to have a big conversation about their feelings, and what’s going to happen. But, you know, they can use a casserole, they can use a ride to go and visit mom in the hospital. Because it’s tough when you’re tired and you’re grieving to drive, to the nursing home.
Sometimes concrete support is the best possible thing or to have somebody say, “Look, I know you’re busy visiting your mom or your dad in the nursing home. Can I come over and cut your grass or can I bring some groceries in for you?”
Those are such wonderful ways of support and caring that you don’t have to get into a big discussion about “how are you feeling” then. Because for some people it’s just not the right time to talk. But everybody appreciates what’s behind an offer, a genuine offer to cut your grass or get your groceries in or to pick up the medications from the pharmacist. Or is there some actual way that I can handle it?
And we appreciate that because the last thing we want to do when we want to be visiting mom is to be busy cutting the grass and cleaning the toilets.
We can get pretty busy with daily stuff that needs to be done.
And at work, I’ve done a little bit of work on grief at work. This is where bosses and colleagues need to be able to say, “hey, look, we’ll cover you, if you need to take the day off, go, don’t worry about it.”
Or if you want to go into the staff bathroom and have a little cry or something, go ahead.
That’s real concrete stuff that it is so helpful, because the heart is behind it. You know the person really cares about you, and has some insight into how you’re feeling. So that’s maybe the last tip I would give.
And that’s beautiful. It makes me remember that when we knew we were leaving for Nova Scotia our friends stepped up and said, “Don’t worry about Bella. We’ll take care of her.” That was such a huge weight off my shoulders because I didn’t have to worry about her being boarded or with somebody we didn’t know.
Donna, I’m going to get you to stay on the line so we can say goodbye but I want to thank you so much for this amazing chat.
Lovely, thank you.