Transcript: Grief Kind podcast series 2, episode 3 with Dr Amir Khan

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[00:00:15] Clover Stroud: Hello, and welcome to the second series of Grief Kind; a podcast by Sue Ryder, which helps you to support friends and loved ones going through one of the toughest times of their lives. I'm Clover Stroud and in each episode, I'll be talking to someone who, like me, has experienced grief firsthand, and who can talk about the support they received. Hopefully, each conversation will empower you to be Grief Kind, to avoid clamming up and give your friends and family the love and support they need.

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[00:00:51] Clover: In this episode, I'm joined by GP Dr Amir Khan. Amir's dad, Farouk, died after a long illness when Amir was 26. In this interview, Amir explains how his complex relationship with his dad influenced and still influences his grieving. He also describes how Muslim customs affected his grieving journey, from having hundreds of people in the house to suddenly being the only male in the family. Amir has some great advice for those struggling with bereavement, and I really enjoyed this conversation. I hope you enjoy listening.

Hi, Amir. Welcome to Grief Kind. It's lovely to have you on here.

[00:01:36] Dr Amir Khan: Hi, Clover. Thank you for having me.

[00:01:38] Clover: Well, I'm sure this is going to be a very interesting conversation because you've got two different experiences or perspectives of grief and we'll talk about your experiences as a GP slightly later on but first of all, I'd really like to talk about your dad, Farouk, who died 22 years ago when you were 26 years old. Can you tell me a bit about him? What was he like?

[00:02:02] Dr Amir: Yeah. I mean, I grew up in a very kind of traditional South Asian working-class family, so we're a very big family. I've got six sisters, I was the only boy, and my dad was a bus driver, and my mom worked her way up, actually. She came over from Pakistan, and she couldn't speak English, didn't have a job, and then learned English and trained in lots of different kinds of jobs, went from being a cleaner to eventually becoming a social worker before she retired.

But my dad was, I guess, typical in South Asian families in that, he was quite a strong, opinionated man. And the relationship he had with his children was very much focused around this traditional male role model, I guess. He went out to work, he came home and expected dinner, I guess, on the table. It was odd. It was odd, you know, we’re talking many years ago, and it was a bit of ‘children must be seen and not heard’, so as much as I loved him, we didn't have that very strong bond together.

I'll be honest, it wasn't the best relationship between father and son, but nor was it terrible. It was as expected, I think, for him in that South Asian culture back in the '80s and early '90s. And I wonder whether those kind of complex relationships, when you don't have that really strong bond that you really want with your dad, when you do lose them, it makes it more complex, the loss, I think. And kind of you're grieving not just the loss of the relative, but the loss of the potential that that relationship could have been. And you know you're always hoping that it'll get better, I guess, and you never have that opportunity for that to happen. So I guess there was that as well.

[00:03:40] Clover: Yeah, so do you feel like you were left with some kind of what-ifs and a kind of greater longing for him or for a closeness with him a bit?

[00:03:47] Dr Amir: Yeah, I think I was. I think I was always waiting for our relationship to turn into that perfect father-son relationship and waiting for that moment to occur. He got ill when I was very young, and he was medically retired fairly early on. So, as well as the loss, we had a long period of about just over 10 years of him having very severe heart failure, which meant he wasn't very mobile around the house without becoming short of breath and quite unwell. So we went through that phase of being his carer before he passed away, so we never had the opportunity to get that relationship, I think. You know we went from that very strict father-son relationship of traditional Asian values to caring for him, to losing him, and so it was quite a complex relationship.

And I'll be honest with you, Clover, I don't dwell on it too much because I have lots of unanswered questions that I don't think I'll ever have the answers for. So it’s, in a way, I feel like it's best just left alone. So this is the most I've talked about it in a long time.

[00:04:47] Clover: [chuckles] I'm interested as well. Because my mother, my mother had a very bad accident before she died, and she was very, very ill with brain damage for 22 years, and she was actually looked after beautifully in a Sue Ryder care home. And I always thought that that might prepare me for her death when it happened in her 70s. But do you think the fact that your father had been ill for a few years, do you feel as though that did prepare you, or do you think that we're ever really ready for the moment of losing somebody?

[00:05:17] Dr Amir: Certainly for me, it was the length of illness. I think, you know, when it first-- Because he had a really big heart attack, and then he became very unwell after that with heart failure. And we were told that his prognosis wasn't great, and so we were prepared really early on for it, but then it was quite a protracted illness in that it went on for almost over a decade. I think you kind of get used to the level of illness during that time, and you no longer prepare because you just- that's your new normal.

And I wonder whether it was the same for you. Because it went on for so long, you're prepared in the early stages, and then you kind of get used to it and you're not prepared anymore. So when it happened, even though he had the long illness with the heart failure, and in the end he had respiratory failure as well, but in the end, it felt very sudden. Because one morning, he kind of just tried to get out of bed to go to the bathroom, and then he had another heart attack and that was that, really.

It felt sudden, but I guess when you look at it objectively, it probably wasn't that sudden. So I don't think you can ever be prepared for it. I don't think you can.

[00:06:22] Clover: I agree with you. I think it's always, always a shock, and my experience with mom certainly bears that out. So you're away at university yet to qualify as a GP when he died. Can you tell me a little bit about the immediate aftermath of his death, and maybe about some of the traditions and rituals of a Muslim funeral and grieving process, and what was useful or, what was difficult about it as well?

[00:06:51] Dr Amir: The sudden death of him kind of made me immediately the man of the house. Which was unusual because I wasn't living at home, but I suddenly was thrust upon with these responsibilities. And my sister rang me and said, "Come home," which I did, obviously, because my dad passed away.

And actually what had happened, you know, he passed away-- He was still for resuscitation, so they tried to resuscitate him in the ambulance, and then took him to A&E and tried to resuscitate him there. And, some people may well have experienced this, but I think for the sake of my mom and my sisters who accompanied him to the hospital, they do resuscitate for a period of time so the relatives can see that every effort has been made to try and get him back. They had seen all of that, and I think that was quite traumatic for them. So by the time I arrived, that bit was already done, and my mom and my sisters were in the relatives' room.

And I was asked-- He was still in A&E Resus in one of the cubicles. As I got there, the nurse was pulling out the lines and taking off the stickers and all of that kind of stuff. And it was kind of a surreal experience because I feel like I missed that part where, you now,-- I don't know. I felt like maybe if I was at home, maybe I could have done something, being a medic, but also then I got there and everybody had already been through that bit, so I was on my own in Resus.

There's a part of you when you're a clinical, I guess, you can look at it from a clinical point of view and say, "Okay, so these things need to happen. The Resus needs to happen, the stickers need to come off, the cannula lines need to come out." He was still intubated at that point and that needs to come off.

And the nurse was doing all of this as I was coming into the room, and she asked if I'd like her to stop while I say goodbye almost, I guess. And I think I kind of went into doctor mode there, I go, "No, no, no, you do your job." And in a way, I regret that because I feel like that was a very private moment between me and my father, and I didn't have the guts to say to her, I think, which is, "Just leave me alone for a minute." It's just one of those things. And so that was, that was that.

Then with a Muslim funeral, the tradition is you have to bury your dead within 24 hours of them dying. Often that's complicated if we don't know the cause of death and there has to be a post-mortem. With this, my dad had a known health condition, and we knew what he died from. However, it was really tricky. Because he died in hospital, it was in the evening, none of the doctors there could do the death certificate, so you then rely on the GP the following morning to do the death certificate.

And this is so important. I work in Bradford now, and, you know, we have a large Muslim community. And I understand the importance, first-hand from that, but also going forward, of the need to have the burial within 24 hours from a religious point of view. The purpose of that is to help with the grieving process. Anyone who's lost someone will know, actually, there is a sense of closure after the funeral. There's still the grieving, but there's a door that can be closed after the funeral and you can get on with other things. That's the purpose of the quickness of these funerals.

And it was a Friday night, and the GP was closed on the Saturday and it wasn't open again until the Monday, and we needed the GP to give us the death certificate. So, there was this long weekend which felt like an eternity where we were waiting for the GP to open up on Monday. And that was very stressful for my mom and my sisters, but it was understandable for me, again, being medical. So that was hard. But once we got the death certificate, again being the only boy in the family, I was expected to sort it all out, and at 26, not having done it before, it was really difficult. So, I had to ring the GP in the morning, get the death certificate, which-- Oh my goodness. When patients tell me it's hard to get through to their GPs, I understand, I really do. [chuckles]

In the end, I just went to the surgeon and said, "Please." They were very good and got it to me. Then there's the whole registration of the death. It's slightly different now post-Covid, a lot of it can be done online, but then you made an appointment at the registrar and registered the death. Then once you have the forms after the registry, you could go to the funeral director.

I was of an age when none of my friends' dads or moms, really, had passed away, and so mine was the first. I was trying to get help from my friends, but nobody really knew what to do and how to organize a funeral. Luckily, with the Asian community, there is a million aunties and uncles that you can ask. So it turned a bit into kind of too many cooks spoil the broth, because everybody was then starting to give me advice, and I wasn't quite sure what to do. But once I got to the funeral director, and there's very specific Muslim funeral directors, they just take control of the whole situation. I imagine it's the same for any religious funeral director, they just take control. They get the forms, they sort it all out.

And the burial happened that afternoon. There's so many traditions. So the women are generally at home, and the men are either in a different room at home or at the mosque, and we were at the mosque, and the casket goes to the house first where the women are, so everybody has a look at the body of my father. There's lots of crying, lots and lots of crying. That's part of it, I guess, getting that emotion out.

Because traditionally, and religiously speaking, we're only supposed to grieve for three days in Islam, which I know is really, really prescriptive, and you're supposed to then kind of, right, get on with the rest of your life. But, so, I think that kind of outburst of emotion comes from that three-day process of grieving because you go, "Right, I've only got three days. I've got to get it all out." I think that traditionally comes from there. Obviously, we grieve for much longer than three days, but that I think comes from there.

And then the body comes over to the mosque where the men see it, and you line up, and I didn't-- Again, no idea. So as the son, you stand at the head of the casket, and then everybody else-- I mean, when I say line up, it's a very disorderly line, but everybody lines up and says something to my dad and then says something to me about sorry for your loss. Usually the line is, and this is the line I find really difficult, is, you know, it's God's will. That is always-- They say it, "It's God's will, it's God's will. Never mind, it's God's will." I'm like, "Well, that's not that helpful." [laughs] It's like the least helpful line isn’t it Clover”

[Clover laughs]

"It's God's will," I'm like, "Okay. Does it give me anything one way or another?"

And then once you get past that bit, you go to the-- You have to wash the body. There's a Muslim tradition and it's called a ghusl, where men who are very close to the person who's died, so it's me and my brother-in-laws, would wash the body. And there's a very specific way to do it. The funeral director has a special room where this happens, and my dad was there on a trolley with a cloth over him. And we're being instructed by the funeral director, who's clearly done this a million times over, on how to wash the body. And that feels horrendous, if I'm being honest with you. Because it was a cold metal trolley, he was just lying on it, and you are rolling him over, washing his back, rolling him the other way, washing that way. It’s all, from an emotional point of view, it's really, really tough.

Then it gets worse, though, Clover, because then you actually have to physically get into the grave to bury your father. So you lower the coffin down into the grave, and only the men come to the graveyard, and you lower the coffin down into the grave. And then I had to get into the grave as well. So there's little platforms on the side of the grave where I can step into, and you're given these concrete slabs to place over the coffin and so that goes in.

They're really heavy, so as well as being emotionally distraught, you're also physically distraught. Because these are huge concrete slabs that about three men have to hold together and they hand to you, and you're alone inside of that grave with your dad, and so place them. And it's a bit like a Tetris puzzle because they've been cut but really awkwardly cut, and you have to piece them together so they fit perfectly. It's all a bit surreal.

Then you're allowed to come out of the grave. And then everybody gets a fistful of dirt and- oh, soil, sorry, and throws that in. Then once everybody's done that, the funeral director and the people who organize the graves will put the rest of the soil on. And then there's a big prayer, and everybody then disperses usually back- it was all back to our house and expects a full meal, Clover. [laughs] so catering has to also be sorted. [laughs]

[00:15:04] Clover: I'm very-- Because it sounds very, very active, and there are lots of very specific traditions and rituals that you have to go through. When my mother died and my sister died two years ago, I actually found planning the funeral and planning hymns and, you know, what she should be buried in, the actual activity of it was useful as a ritual, I suppose, and so that you know what to do. Because in grief, you can be left with a feeling of like, "Well, how do I show my loss, and how do I kind of manifest it other than just walk around in a state?"

Did you find this sort of high level of activity, it's interesting it was done in a few days, was it useful in some way, or was it overwhelming, or was it probably a bit of both, I should think, but learning about those rituals and then carrying them out, was it good for you to go through?

[00:15:56] Dr Amir: It was definitely good for me to go through. Because one thing that just happens, and you know will happen in most cultures but is particularly heightened in the Asian culture, is that you get an influx of people who come to your house. That influx starts at about 7:00 in the morning, you're not even awake, and it goes on until three or four o'clock at night.

And every, so over that weekend where I wasn't doing any of those things, there was knocks on the door, rings on the bell, and every room was full of people, which was great for my mom because she really relied on that community support. Huge. But for me, from a personal point of view, we're talking a couple of hundred people in the house, and you have to have the same conversation over and over again, "How did it happen? Did you not know it was going to happen? Was there anything that could have been done? What did the doctors say?" Blah, blah, blah.

So you have the same conversation over and over again, which I found quite- no, it wasn't hard, but I just found it draining. I was relieved, I guess. Yes, you're right. I was relieved to be able to actually do something else. And that, the mechanics of all of that and actually being told what to do was useful because I didn't have to use my brain for that because people were just telling me what to do. So that, I guess, was really useful.

I think what would have been nice would be to have had a brother who was helping with it all. I think it felt very lonely being the only boy in a funeral which is traditionally done by the men.

[00:17:22] Clover: Yes, yes, I can imagine. Do you feel that in those very, very busy, overwhelming days, you actually had time to grieve, or when do you feel that your grief really started kicking in?

[00:17:35] Dr Amir: I think it was when I went back to university. During that period there, I certainly wasn't able to grieve because you're just making cups of tea, if I'm being honest with you, Clover. [chuckles] Cups of tea, providing lunch, making sure people are fed, making sure my mom was okay. Because you revert back to those traditional gender roles in those situations.

You know, the women were looking after my mom, who was very emotionally distressed, and my sisters who were very emotionally distressed. And there was a lovely community of women in the kitchen who were also making cups of tea and making sure food-- And we get loads of food. That's the other thing. You know, every time someone new arrives, they're not just expecting tea, they're also bringing with them a big curry and lots of rice and naan and rotis, and that kind of thing.

So that's never a problem, but it's just this constant-- I guess you're just constantly talking to people. And so much as that is useful, you're never asked how you're feeling in our community. It's never, "How are you?" It's always, "Tell me what happened." I would try and sneak off to my old bedroom, but you often just get called back down. It wasn't until I was out of that, which I felt very guilty about leaving, but I had to get back, that I thought, "Oh, actually, something major has really happened."

[00:18:54] Clover: Do you feel… It's interesting hearing you talking about this. Do you feel that that big arrival of people in your house and the food and the tea and the conversations, I get a sense that that might have been more useful for your mom and your sisters than it was for you?

[00:19:11] Dr Amir: Certainly. I welcomed it because I know it was useful for my mom. Because every time, I used to say to her-- Because I thought, "God, if I'm getting overwhelmed by this, surely she is." I'd say to her, I said, "Mom, should I just say to people give us a break for an hour or so, or don't come around today?" She was like, "Absolutely not," and she goes, "That's not what we do."

And then every time someone would come, I think my mom found it really useful. It was a bit bizarre, actually, if I'm being honest. I don't want to make it sound funny. But it was all a bit odd, but every time a new person would arrive, it would like flick another switch on my mom and she would start wailing again and telling the whole story again. I thought, "Well, that looks horrendous for her," but in the end, I realized that actually that was really helpful for her to be able to tell it from her point of view and get that support from everyone each time.

[00:19:57] Clover: So you went back to university, and what was your life like at that point? How did you cope, and how did your feelings show themselves at that time?

[00:20:06] Dr Amir: Yes, so I wasn't a student at that point. I went back to Liverpool, which was my university city. I was a junior doctor in the hospital at that point, so I hadn't quite started my GP training. I told my consultant who was my boss at the time what had happened, and he was very understanding. You've just got to crack on with work and when you're in the hospitals, you have to just get on with it. And interestingly, I was doing care of the elderly, so you deal with bereavement and grief and the conversations around grief.

[00:20:31] Clover: So you must find yourself having to support people who are grieving a lot of the time now. What's the kind of-- Is there any advice, I suppose, that you can offer to people? People always say, "Oh, you know, I don't know what to say." I think that's a really, really common feeling. And when you're grieving, you can as a result feel very lonely, I suppose, as though the world that you're in is on its own. What have you learned as a GP as a way of supporting people who've just lost somebody very close?

[00:21:03] Dr Amir: I think it's very difficult to say the wrong thing. Saying less is best, I would say, and not worrying so much about what you have to say. Because it's often, you just have to ask a very open question, which is what I tend to do with my patients or anyone I know who's lost someone. That question just has to be something really simple like, "How are you coping?" Or, "How are you feeling?" Followed by, "What can I do to help?" I think is a really good question.

And from our point of view as a GP, that kind of, "How are you coping?" Opens up doors because they know we have that relationship, it's all confidential, so they can tell us things that perhaps they can't tell anyone else. And that can relate to their emotional state, but also their physical state if they're not sleeping and that kind of thing.

And then "What can I do to help?" Can mean different things to different people. For some of my patients, it might be they need a note for time off work, or they need something in the short term to help them sleep. But if you're not their GP, just asking what you can do to help might be a case of, "Well, actually, just come and see me more often or ring me more often," or something like that would be useful.

But I think those are the two most common questions I like to ask, and just let them talk. Because often, as I experienced, they might go through the mechanics of what happened leading up to the death of their loved one, but nobody's asking them how they're feeling and how they're coping. And the other thing I would say, I guess-- Because I've worked at this surgery here now for nearly 12 years, so I feel like I know my patients really well.

Even if it's been 6 or 12 months down the line, still ask those questions because it never goes away. It never goes away, and saying things like, "Time will help," and da, da, da, da, I'm not sure is very useful. Time may change a little bit about how you're feeling, but it doesn't take away the feelings. And so, asking regularly, not all the time so you're pestering them, but asking at regular intervals, even going into the future, I think is really important.

[00:23:05] Clover: Yes, so the conversation continues. I'm also interested, by the way, in which, and I don't know whether this is possible as a GP, but talking about death in our lives every day is an important thing to do. I've got five children, and I talk about it with my kids a lot. Do you think that we would be better at grieving and we would be better equipped, I suppose, when it came to the death of people that we love if we had discussed it more openly beforehand?

[00:23:34] Dr Amir: Yes, I do. I think you know it's tricky with children, isn't it? You've got to be age-appropriate with the conversations that you have, but I think it is important to have those conversations. And it's certainly happening in our family with our nephews and nieces. What generally happens in the Asian culture again is when someone does pass away, you do bring the children to the house of the bereft, of the family members, and you do take them to the funeral because there's a real importance.

I don't think my dad did this to me, which is probably why I felt so lost, but you're supposed to show them the ways and get them to you know sit quietly when it's important to sit quietly, ask the questions when it's important to ask the questions so they get to see all of that. And I think that should run through all cultures, really, so when things happen, yes, there's the emotional impact that death has and you know no amount of seeing it happen to other people prepares you really for it to happen to yourself, but at least you understand it better.

[00:24:28] Clover: Yes. And does your GP train… Are doctors actually trained to deal with grief? Is it part of your training?

[00:24:35] Dr Amir: Yes, it is. So we do a palliative care. It sounds a bit clinical, but we've called it a module and also-- I'm a trainer now, so I've got GP trainees. And  what we ensure that they do as part of their final year of training is take the lead in a palliative care case, really. So we'll give them a patient, with us overseeing, who is sadly end of life, and you know we're trying to make their death as good a death as possible and they're dying at home. So we connect them with our GP trainee, and so they will follow that patient all the way through from when we say, "Okay, this is now a palliative patient," and that could be quite a long time too if they do then die.

So they get that experience, not just with the patient, but with the family members as well. So we ensure they take a lead role in that with us overseeing it.

[00:25:25] Clover: I'm really interested by you using the phrase good death as well. Because my sister died very young, she was 46. And she, you know that was terrible, but she did have a very-- Her passing was a very beautiful experience. You know we were all with her. It was very connected as a family and very loving and gentle. Do you think we can do more culturally to prepare for our own deaths? I'm not talking about the conversations we might have around death, but actually to prepare for death in some way?

[00:25:55] Dr Amir: Yes. I think culturally, for sure, I think we've got to be open about conversations around what we expect in death, what we would like in our own death. In our culture, we're really not allowed to talk about that because it's a way of tempting fate and actually asking for death almost. And it's really sad because you then-- It's really hard.

Because I work in Bradford, and again we're very lucky in that we have a very diverse population, and you see the stark differences in the support that is needed or asked for, I should say, between the different cultures. So often with Caucasian people, the idea of GPs or district nurses and palliative care nurses coming into their homes isn't that alien and after the right level of explanation in our roles, it's very accepted.

What I found with the South Asian culture is that they're very protective over their dying relatives, and there's all sorts of questions around the medication, which is absolutely right when we're trying to keep people comfortable and ensure they have those good deaths. Because those conversations have never really taken place while that person wasn't on an end of life or a care for the dying pathway, then those conversations are brand new to these people.

And it's a real stark difference to what they perceive healthcare professionals' roles to be, which is to prolong life at all cost and to make people better. And that isn’t, you know the role of healthcare professionals really change in palliative care. It's about managing symptoms, ensuring people have as good a death as we can manage. And that's a real shift in cultural conversations, and often that causes them to close ranks a little bit and say, "Well, actually, we don't need you to come in because we can manage them, and we can make them more comfortable," just often with the power of prayer and love and just being there for them. Which is really important, but isn't necessarily the same thing that we're offering. It's really, really hard.

[00:28:01] Clover: So would you advise me, definitely, to reach out to people even if they are from completely different cultures and you feel you know you feel anxious about, but just communicate, be human, I suppose?

[00:28:11] Dr Amir: Honestly, the only complaints we've had from families is when we haven't done that. You know we never have a complaint saying, "Someone came and said the wrong thing." The complaint is always, "No one ever came." And so my advice is go and ask the questions, explain what your role is. You can even say this is your first time dealing with someone who is dying from this culture and you want to get it right. I think that is perfectly fine to say and it helps them understand your, you know, what you can do, what you can offer, but also how they can support you as much as you can support them. Like I say, the complaints tend to be from lack of action rather than being proactive.

[00:28:49] Clover: That's very, very interesting. Just going back to your dad, how has your grief changed? Obviously, it's been you know it’s been quite a while now. How do you grieve? Do you mark moments in the year? And how do you sort of feel about grief and how you manage it at this later stage in your life?

[00:29:07] Dr Amir: It's still complicated, I think. You know I still haven't quite got to grips with our relationship, and I find myself-- It sounds really odd, but when I see a really good father-son relationship, I find myself getting quite emotional. I feel like I've been bereft of that more than anything else. I feel like I'm not a very emotional kind of person, but that's the one thing that really gets me emotional.

To be honest with you, Clover, I don't feel like I've come to terms with it as well as I should have done, and I haven't taken the time to kind of interpret that, but I'm okay with that, I think. I think I'm okay with it. I accept the fact that, can you ever really come to terms with losing someone, and then having that complex relationship, will you ever really be okay with it? I'm not sure you will be. I certainly am not, and that's all right. I've come to accept that it's going to be imperfect forever, I think, is probably the best way to describe it.

[00:30:01] Clover: What about your mom and your sisters, do you support them? How are they doing?

[00:30:06] Dr Amir: They're fine, they're good. We do talk about dad every now and again, and his grave is really close to our surgery, actually, which makes it easy for me to visit. It's very important that we visit the grave on a regular basis. That's again part of our tradition, and so I will go every Friday because that's our religious day, and I will also go on things like Eid, which is our kind of religious festival days and that kind of thing. And I'm there most the way through summer and autumn because there's lots of plants on his grave, and I'm a big gardener, so I've turned it into a mini garden, which is quite therapeutic to tend to it a lot through the summer period.

[00:30:43] Clover: Just last of all, this podcast is about supporting people who are bereaved. So for anybody listening to this, what advice would you offer to them? If they you know are supporting someone who's lost somebody very close to them, what kind of advice would you offer about what to say, what to do, or just how to handle it in the most sensitive way?

[00:31:04] Dr Amir: I think being there is the most important thing, and asking about how they're feeling, how they're coping, what you can do to help. Those are the three big questions that I would like to have been asked when my dad passed away, and those are the questions I ask my patients when they have lost loved ones. And don't feel like you have to do all the talking or fill all the gaps. Silence is often good in those situations for you both to reflect on. Let them do the talking, not in a pressured way and you know not feeling like they have to fill in the gaps either, but just let them talk when they feel comfortable.

And remember, it's not just-- You don't ask them on the day of the person passing away or a week later or two weeks, keep asking them. Because I think it's hard for people who have lost loved ones; after a year or so, they feel like they should have got over it. So you asking them how they are and saying it's okay not to be okay about the loss of a loved one is also a good way in. And if a year has passed and you haven't spoken to someone about their lost loved one, do it today because it will make a big difference.

[00:32:07] Clover: I think that's such good advice, that it's a long process that's always  there, and offering some kind of friendship or camaraderie or love support is always a lovely thing as a human being, really, isn't it? We all need it. It's been really so interesting talking to you. Thank you very, very much, Amir. I've really found it an incredibly interesting conversation, and I'm really, really grateful. Thank you so much.

[00:32:31] Dr Amir: Thank you. Like I said, Clover, I think that's the most I've ever spoken about my dad's death, so it's been an experience, a positive experience for me as well.

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[00:32:41] Clover: Grief is different for everybody. There's no one-size-fits-all approach, but you don't need a degree in counselling to help a loved one who's grieving. It is about the personal support you can offer, which should always be led by what feels right for the grieving person. The most important thing is to ensure that no one has to go through it alone.

To get more information on how to help grieving friends and relatives, go to sueryder.org/griefkindpodcast. And don't forget to follow us on your favourite podcast app to get the next episode as soon as it's ready. I'm Clover Stroud. Grief Kind is a Bengo Media production for Sue Ryder.

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