As we age we become more frequently exposed to loss and grieving becomes more apparent. For the elderly population losses are more prevalent, forcing many of them to have to cope with disappointment, sadness, and uncertainty. Grieving can be complicated when the elder’s resilience is challenged by extraneous events that further compound the loss. Older people can become vulnerable to depression and many elderly consider suicide as a means to cope with their grieving.
There are many losses that the elderly may encounter: spousal/conjugal, siblings, friends, children, physical and cognitive functions, self esteem, roles, autonomy, home, job, finances, community status, intimacy, objects and pets.
There is a strong correlation between attachment and loss. The degree of attachment and the type of loss can affect how the elder copes.
For instance, loss of a pet can be a monumental experience. The attachment to the pet is intense for many elderly, particularly if they live alone. The elder may substitute the pet for the other losses that are often encountered later in life. The pet fills the void the elder experiences because of social isolation from family, friends, and even the community.
To further compound the problem, the elder may become depressed, anxious, and even suicidal. There is a high incidence of suicide among the elderly and many behavioral scientists are discovering that it is more common for the older person to commit suicide than the younger person.
For example, the 1995 Merck Manual for Geriatrics reported that suicide was 70% more common in white males aged 75 to 84 than the white males aged 18 and 24. The U.S. Suicide Statistics reported in 2005 that the 65+ population represented 14.7% of the total deaths attributed to suicide. On the other hand in that same year the 15-24 population represented 10% of the total suicides in the United States. Given that the older population is comparatively smaller to other populations, the rate of suicide in the elderly is a cause for concern.
Moreover, many elderly resort to substance abuse to cope with loss. In fact, substance abuse is becoming more problematic in the elder community.
Consequently, experiencing a loss for the elderly can be very stressful. If the elder is unable to resolve the sadness around the loss, he/she may experience what is known as complicated patterns of grieving. Complicated grief can lead to years of emotional suffering and turmoil. Therefore, it is important for the caregiver to recognize the grief surrounding the elder’s experience with a loss.
There are many steps a caregiver can take to help the elder through the grieving process. The caregiver should never minimize the loss no matter how trivial he/she perceives it to be.
It is important to help the elder embrace the loss by giving him/her the opportunity to verbalize the feelings associated with the loss. Encourage the elder to give meaning to the loss.
In other words by asking the elder how his/her life has changed because of the loss will validate what the elder is experiencing. In essence, validating the loss shows the elder that the caregiver understands the value of the loss. Allowing the elder to talk about the loss provides a forum for the elder to respond to the loss in a healthy manner. How the elder responds to the loss is at the core of allowing the elder to take control.
The elder’s attitude is also critical. A healthy outlook will help the elder seek other methods to compensate for the loss. Perhaps, the elder who has lost a pet might replace it with taking up an activity that will help alleviate some of the loneliness, yearning, and pining for the pet. The elder who is no longer able to work may take up volunteer work. The elder who has loss of income may want to take a course on how to live on a fixed income by using a budget.
There are three proactive steps the caregiver can take to help the elder gain insight to understanding the loss: awareness, acceptance, and action.
Awareness grants permission to acknowledge that indeed a loss has occurred.
Acceptance of the loss provides a feeling of gratification, eliminating conflicting feelings that clash because the elder is unsure how to come to terms with the problem.
Action allows the elder to move beyond the loss and replace it by putting something back into his/her life. For instance, many compensatory behaviors often can provide a sense of empowerment, increase self-esteem, strengthen resiliency, and promote optimism. By replacing the loss with something different can also help the elder reach a feeling of successful aging. For instance, the grieving widow may find solace by getting involved in a community program such as the senior center, engaging in activities that can enhance her life.
In summary, understanding that grief and bereavement for the elderly is different from other populations is essential so as to avoid illness and premature death. As caregivers, we need to be able to identify elderly losses, look for unresolved grief, and complicated patterns of grief. Furthermore, the ability of the caregiver to acknowledge the loss that the elderly is experiencing provides a caring and supportive environment.
It is also important for the elder to ultimately achieve closure around the loss. The caregiver needs to be empathetic towards the elder in order for the elder to move beyond the loss.
Finally, the caregiver and the elder can enter into a bonding relationship which will bring them closer together; thus, the elder knows that he/she does not have to go it alone.