One recently bereaved family leaves a bell on their coffee table Christmas Day. Whenever someone remembers the loved one, they ring the bell.
A little girl who lost her brother puts his picture on top of the tree as the family's own "Christmas angel."
Some people light a candle and place it next to the dead person's picture on the mantelpiece, where the light glows all day.
Finding ways to cope with a death in the family is especially hard during the holidays, and not just for the first year, said Betty Asplund, director of the Hospice of the Chesapeake in Millersville.
"You expect the first holiday without the person to be different, but the second holiday kind of creeps up on you before you know it," Ms. Asplund said. "People haven't prepared. We find that the 'success' of coping -- if you want to call it that -- depends on making a plan before the holiday, making decisions ahead of time."
The hospice is a nonprofit organization that supports a family through a terminal illness and for up to 15 months after the family member dies.
The Millersville-based group also is offering holiday counseling from now through the third week of January. Two bereavement support groups meet twice a week, or people can call the vTC hospice at 987-2003 for an appointment, Ms. Asplund said.
"People can come in for one-on-one counseling, although we're not open Christmas Day," she said.
Bereavement holiday support tries to help families make deliberate choices.
For example, bereaved families must decide whether to maintain their usual holiday traditions.
For some, retaining traditions can be more painful than changing the routine, but other people find tradition comforting.
"Some people think they have to choose either pain or change," Ms. Asplund said. "But you can accept the pain, or you can change just for one year. If you always had the dinner and did all the cooking at your house, maybe you should go to a child's house."
Another decision is how to send Christmas or Hanukkah greetings. Receiving cards from people who don't know about the death of a spouse, perhaps addressed to both spouses, can be painful. Ms. Asplund suggests sending cards early, with a little note explaining the death.
"That way when you get cards, maybe they'll contain some comforting words," she said.
"What works depends on the individual, but people need to realize they can't get away from their hearts. You have to admit your life has been changed. No holiday will be the same ever again. The deceased is going to be there in your mind, whether you talk about them out loud or not."
Some people will take trips and change their whole scenery. That's fine, as long as they are prepared to still experience grief and know how to cope with it, Ms. Asplund said.
"If you shove pain inside and put on a happy holiday face, you can create more stress for yourself," she said.
Most hospices in the country offer bereavement support as a part of their services to families of dying patients, but three years ago Anne Arundel's hospice expanded its bereavement program into a large center, which has gained national attention.
The Millersville-based center provides trained social workers and a library and holds bereavement sessions for families and children in cases of suicide, homicide, accident or terminal illness.
More Americans are turning to a hospice than ever before, according to a data from the National Hospice Organization.
The number of people served by hospices around the country increased 17 percent from 1992 to 1992; locally, the numbers increased by 29 percent.
Ms. Asplund, who is certified in bereavement support by the Association for Death Education and Counseling, said her expertise comes from her experience losing her husband many years ago.
The year after he died, she and her children hung his stocking at Christmas.
Each person wrote down a memory and put it in the stocking, and at 6 p.m., the family took down the stocking and read the memories.
"It brought him into the day, but in a very positive way. We had laughter on the day we thought would be sad," she said.