State of Grief Survey

  • State of Grief Survey

    Thank you for taking part in this important survey to gauge the state of grief in the Omaha area and surrounding areas in Nebraska.

  • Findings of this survey will be included in the annual State of Grief Report created by the Collective for Hope in Omaha, Nebraska. The Collective for Hope (CFH) is a grief center that provides groups, counseling, activities, and community for those experiencing grief.

  • We expect this survey to take 5 to 10 minutes to complete. Responses will be analyzed collectively by Collective for Hope and individuals will remain anonymous. The CFH team will then provide an annual report to the public using your invaluable feedback.

  • This survey will ask you questions about death and grief, which may be activating or cause intense feelings. If you are looking for a space to honor your loss, click below to access our free services.

  • By clicking the button to begin the survey below, you are giving your consent to participate in this survey. If you do not wish to participate for any reason, please click the exit survey link below.

  • Visit Collective for Hope: www.collectiveforhope.org

  • Demographics

    By disclosing the following demographics, you are helping us apply for grants/funding that keep our programs free and/or accessible to everyone regardless of their ability to pay. Your personal information is kept confidential and is not reported alongside the details shared in this section. Thank you for whatever information you are comfortable sharing for this purpose.
  • Are you...
  • What is the highest level of school you have completed or the highest degree you have received?
  • What is your ethnicity?
  • In what county do you live?
  • Please select all that apply to you. You will be asked to answer questions about each of the experiences you select. If you are uncomfortable sharing about any one of these, do not select that choice.*

  • Death Information

  • People often experience multiple bereavements during their lifetime. Please indicate if you have lost any of the following:
  • Which loss had the most profound impact on your life?

  • Please consider your experience with the death of a person you selected in the previous question, the death that affected you most. Respond to these questions about that particular death.
  • How long ago did your loved one die?
  • How did your person die?
  • Were you the main caregiver for your person?
  • Were you present when your person died?
  • Would you have liked to be there?
  • Anticipatory grief is when you have feelings of grief before the person has died. You may feel worried about the future and how you will cope without them, or sad or angry about their illness and its effect on your life. Did you experience anticipatory grief?
  • Did the death change your living situation?
  • Did you have any dependents at the time of the death? A dependent is a person who relies on you for support, often financial or material (e.g., children).
  • Did your dependent(s) have a relationship with the person who died?

  • Grief Information

    The following questions are about your experience with grief. Please continue to answer these questions about the death that you identified impacted you most. This survey defines grief and bereavement as the intense emotional, physical, and psychological response to a significant death loss.
  • What was the single most important source of support for you in coping with your bereavement?
  • Have you sought grief-specific services to help you cope with your grief (e.g., grief counseling, grief groups, grief camp)? Remember to only consider the death you identified as most impactful.
  • Why did you not receive grief services?
  • In the past week, how often have you yearned for the deceased?
  • In the past week, how often have you felt guilty or angry about your loss?
  • In the past week, how often have you felt sad or emotionally numb?
  • Have these grief experiences caused problems in personal, family, social, educational, occupational, or other important areas of your life?
  • How much are you having trouble acknowledging the death of your person?
  • How much are you having images or thoughts of your person when they died, or other thoughts about the death that really bother you?
  • Are there things you used to do when your person was alive that you don't feel comfortable doing anymore, or that you avoid? Like going somewhere you went with them, or doing things you used to enjoy together? Or avoiding looking at pictures or talking about them? How much are you avoiding these things?
  • How much are you feeling cut off or distant from other people since your person died, even people you used to be close to like family or friends?

  • Secondary Death

    In this survey, we use the term Secondary Death to refer to secondary stress that may arise when you care for someone who is experiencing grief. Even though you did not “directly” lose someone, watching someone you care go through grief about can affect your emotions as well.
  • Please indicate your relationship to the person who experienced a grief loss, with which in the aftermath you helped care for them.

  • When caring for the person who experienced a death loss, did you ever experience any of the following?
  • I felt emotionally numb.
  • My heart started pounding when I thought about my relationship with this person.
  • It seemed as if I was reliving the loss(es) experienced by this person.
  • I had trouble sleeping.
  • I felt discouraged about the future.
  • Reminders of my relationship with this person upsets me.
  • I had little interest in being around others.
  • I felt jumpy.
  • I was less active than usual.
  • I thought about my relationship with this person when I didn't intend to.
  • I had trouble concentrating.
  • I avoided people, places, or things that reminded me of my relationship with this person.
  • I had disturbing dreams about my relationship with this person.
  • I was easily annoyed.
  • I expected something bad to happen.
  • I noticed gaps in my memory about time with this person.

  • Ambiguous Loss

    Ambiguous loss is when someone is physically out of your life but still psychologically present to you (a severed relationship, divorce, incarceration, military deployment, missing persons, etc). It can be a physical presence with psychological absence (Alzheimer’s disease, dementia, traumatic brain injury, etc.) It might also be a homesickness for a home country community to a migrant or a loss of someone you never met, but meant something to your family.
  • Please indicate the type of ambiguous loss that you have experienced.
  • Which loss had the most profound impact on your life? Please think of one person you lost.
  • Please indicate your relationship to the person you lost physically or psychologically.

  • Below, several separation distress reactions are listed. Please indicate how often you have experienced each of these reactions due to the loss of the person identified above in the past month. Note: Some questions refer to the “disappearance” of your person. This is referring to the physical or psychological loss you identified in the previous question.
  • Intrusive thoughts or images related to the person who disappeared.
  • Intense emotional pain, sadness, or pangs of grief.
  • Longing or yearning for the person who disappeared.
  • Avoidance of places, objects, or thoughts that reminded you that the person disappeared.
  • Bitterness or anger related to their disappearance.
  • Moving on (e.g., making new friends, pursuing new interests) was difficult for you.
  • Feeling emotionally numb.
  • Life is unfulfilling or meaningless without them.
  • A significant reduction in social, occupational, or domestic functioning because of their disappearance.
  • Negative thoughts about yourself in relation to the disappearance (e.g., thoughts about self-blame).
  • Feeling alone or detached from other individuals.
  • Feeling it is unreal that they disappeared (physically or psychologically).
  • Intense blame on others because of their physical or psychological loss.
  • A part of you is gone along with the person you lost.
  • Difficulties experiencing positive feelings.
  • Your grief is worse (e.g., more intense, severe and/or longer duration) than for others from your community or culture.
  • Preoccupation with thoughts or images related to the person or disappearance.

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