Helping the Elderly Cope With Loss
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.
Study Finds Working Caregivers Are More Likely to Have Health Issues
Being a caregiver is an incredibly stressful experience and a new study by the MetLife Mature Market Institute has some startling conclusions about its impact. The report examined employees serving as caregivers and found that they are more likely to suffer from health problems like diabetes, high blood pressure and depression than their co-workers.
Some of the key findings in the study include:
- Caregivers have health costs which are 8% higher than people who are not caregivers and cost employers $13.4 billion a year.
- Employees serving as caregivers were more likely to report poor health than their co-workers. For example, 17% of female employees ages 50 and older who were caregivers reported fair or poor health compared to 9% of non-caregivers.
- Employed caregivers find it difficult to take care of their own health care needs and are less likely to get preventive care such as mammograms, annual physicals and preventive health screenings.
A Message From the Founders: What We’re Thankful For
For this Thanksgiving holiday, we have so much to be thankful for.
We thank all of you, the community of eCare Diary caregivers, visitors and partners, who’ve helped make the site a success in such a short period of time. Our mission was to create a centralized place where caregivers could find help, information, and the support they need. John and I developed this site based on our own personal frustrations as caregivers with the hope that future caregivers would never have to go through what we did.
I am thrilled to report that in only 10 weeks since eCare Diary went live, the number of visitors and registered users more than exceeded our expectations. Response to the site has been amazing! We are overwhelmed by the emails offering thanks, support and terrific new ideas.
We are thankful for our experiences as caregivers. It wasn’t a role we expected or wanted. No one wants to watch their parents suffer through long term disease. However, while those were very difficult, sad times, that experience gave us a hard and fast education on long term care. We were exposed to information, resources and communities that lead to the creation of this site.
We are thankful for the loved ones in our lives more than ever. When you’ve suffered loss and death, you appreciate the people in your life in a whole new way. Around the holidays, John thinks about his parents a lot wishing that they were alive to have met our daughter, Avery. Their absence makes me more thankful than ever that my parents are still alive, and I appreciate them more profoundly.
We are thankful for our daughter Avery who just turned 19 months old. She has opened our hearts in ways we never expected. Giving birth to her reminded us of the preciousness and volatility of human life, interestingly similar to what we observe as caregivers.
We are thankful that eCare Diary is becoming a family affair. John’s sister, Polly Whitehorn, recently joined us as Director of Special Events and Outreach. Formerly of the Arthritis Foundation, Polly’s experience and networking has been invaluable in getting the word out about eCare Diary. Susan’s brother, Kevin Kim, has also joined eCare Diary as Web Designer. We are so fortunate to have his talent for developing clean, consumer-friendly designs; he is in the process of redesigning the site for eCare Diary 2.0 coming soon!
We are thankful for many new friends we’ve made and partnerships we’ve formed. Their generosity and assistance have helped propel eCare Diary. We thank and acknowledge them below.
We wish you a very Happy and Healthy Thanksgiving!
Bill Walters, CEO of ALTHA (a hospital trade association), for featuring a 2 page story on eCare Diary in ALTHA’S quarterly newsletter
Denise Brown, creator of Caregiving.com (blog for caregivers), for inviting John to write a 3-part series on his caregiving experiences with his father
Howard Gleckman, author of Caring for Our Parents, for his long term care expertise
Margery Pabst, author of Enrich Your Caregiving Journey, for her caregiving expertise and articles
MarketWatch.com for inviting John to write “Obamacare: Why it’s Different This Time”
Chris Lombardi, of WomensVoicesForChange.org, for publishing my article “Sex in the Workplace: A Caregiver’s Story”
Jason Alba, Founder of JibberJobber.com (a relationship management website for professionals and entrepreneurs), for his advice, constant support, and plugs
Katherine Lewis, of CurrentMom.com (a blog for tech mom entrepreneurs), for publishing my story, “Becoming An Accidental Entrepreneur”
Karla Lightfoot and Stella Grizont, of LadiesWhoLaunch.com (women entrepreneurs website), for promoting the site and connecting me to an amazing community of female entrepreneurs
Jean Levin, founder of Caring From a Distance, for her advice, thoughts and insights.
Facebook Fans & Friends, your thumbs up and support encourage us all the time!
Caregiving in America Today—A True Story
Editor’s Note: eCare Diary is pleased to announce that Michael Chien, co-founder of Head to Toe Care LLC, is a guest blogger today. Head To Toe Care is a free website offering practical tips for home based caregiving. Medical professionals give step-by-step instructions, symptom management, and medical provider interaction tips.
My friend is a registered nurse experienced in hospice and palliative care. This is her story. Her father is a retired Air Force colonel—he served as a commander in three wars and assumed the responsibility to care for his troops. He still has this responsibility.
Last Saturday evening, she received a frantic call from her father that one of his “troops” needed assistance. They rushed over to the condo of his friend, a retired officer and doctor. He had been discharged from the hospital after a 7 day stay which included ICU care. He was discharged to his “home” which is a condo in the independent living section of a life care community. He had been “home” for about 4 hours when another friend happened to stop by for a visit. He found the doctor in a chair, in the living room, with no ability to care for himself, or call for help. There were no sheets on his bed and no clean towels or washcloths. There was nothing to eat or drink within his reach, and no possible way for him to get to the bathroom. Recognizing that the needs of the doctor were far beyond his abilities, the friend managed to place the doctor on the sheet less bed and telephoned my father for help.
When they arrived, what they found was heart wrenching. Not only was the hospital gown saturated with urine and feces, there was evidence of old as well as new urine and feces through out the small condo. It took them two hours to see to his basic needs of bathing, nutrition, making the bed, positioning him comfortably and cleaning the condo as best we could. The colonel is a smart and capable man. He had insight to know that he could not have cared for his friend alone. With her directions, he was able to learn and participate in simple care giving for his friend.
Sadly, this story is not unique. This scenario is happening all the time. People are being sent home from various health care facilities (hospitals, rehab centers, etc.) While care needs are evident, there is little if any communication to achieve a seamless transition between the needs of the patient from the outpatient setting to the inpatient setting, and then back to the “home” setting. With “real” discharge planning—this situation could have been avoided. A paid caregiver could have been hired as there were no family members available because the family lived out of state. When there are no funds to pay for a hired caregiver, than it is up to family members and friends to see to caregiving needs. However, the family needs to be instructed on how to provide care.
This type of caregiving information is vital for families and friends. This will ensure that those who need care can maintain their dignity and get the care that they deserve.
Three Toughest Challenges I Faced As A Caregiver
Editors Note: In honor of National Family Caregivers Month I will be doing a 3 part series on my caregiving experience. It will be cross posted at Caregiving.com and LosingourParents.com.
Becoming a caregiver is an unplanned experience since we never know when or where it will occur. It creates many challenges in terms of day to day care and the emotional needs of the patient and caregiver. When I was caring for my father who suffered from Parkinson’s disease I faced many challenges and will discuss the three toughest ones.
Allowing My Father to Be Independent While Convincing Him He Needed Help
Parkinson’s is a degenerative disease so when my father was initially diagnosed the medications addressed many of the symptoms permitting him to live independently. However, as the disease started to take its toll on his body and the medications were less effective, it became harder and harder for him to live without help. He started to fall, had trouble making meals for himself, dressing himself and bathing himself.
Caregiver News for Sunday November 8, 2009
Healthcare Reform Passes House of Representatives – A bill to reform the US healthcare system passed the House of Representatives by a vote of 220-215. The bill includes a requirement that all people have health insurance, eliminates denial of coverage for pre-existing conditions, and provides a new regulatory structure for the health insurance industry.
Flu Facts for Patients for Dementia – The Alzheimer Foundation issued a list of tips for patients with dementia and the flu. One of the most important things is to look out for both Swine Flu and regular flu since both viruses will also be of concern this winter.
More Evidence That Alzheimer’s Is Hereditary – A Dutch study has found that about 60% of the risk on contracting the disease is based on genetics. A gene called apolipoprotein E is believed to be the cause. People with a variant called APOE e4 are more likely to develop Alzheimer’s than those without it.
Discovery of New Protein Offers Hope for Parkinson’s Patients – Scientists at Iowa State University have discovered the presence of protein kinase-C, a dopamine killer. In people suffering from Parkinson's Disease the brain cells producing dopamine die. It is hoped that knowing what causes these cells to die will lead to a cure.
It’s National Family Caregivers Month – President Obama has declared November Family Caregivers Month to recognize the extraordinary work of this group of people
Caregiver News Roundup Sunday November 1, 2009
Geriatric Care Managers: What They Are and How They Help
Today I attended a conference for professional geriatric care managers (GCMs) in New York City. I had an idea of who they are and what they do, but admittedly, wasn’t one hundred percent clear. Interestingly, I learned today that many people don’t know who they are or that their service even exists. Today I got my education and would like to share it with you.
Who & What
GCMs are professionals who conduct in-depth assessments of elderly clients to identify solutions and suggest a customized care plan. Their knowledge, experience and network can help families navigate the complex system of eldercare. They can assist with a wide range of topics:
Financing care (long term care insurance, Medicare, Medicaid)
Placement in care facilities (such as adult daycare, nursing homes, assisted living facilities)
Finding home care agencies
Home living space and design
GCMs can also serve as a third party when families are having trouble discussing care planning amongst themselves. They can guide the conversation and even help families through conflicts.
How an Ailing Parent Can Become a “Ward of the State”
I’m relieved to be home. I just returned from a trip to California where we went to visit my grandfather. He was in the hospital early September because he refused to eat and became dangerously weak. He was released after a few days once his health improved and got his strength back. Since he is 90 years old and has dementia, John and I thought we should pay him a visit while he is still lucid and can recognize us.
The visit was emotionally exhausting and tense. You see, the care of my grandfather since his diagnosis with dementia caused a deep rift in my family. His 3 children fought bitterly for custody of him and ultimately my paternal uncle won conservatorship. Conservatorship is when a judge decides that a person cannot take care of themselves and chooses a person or organization, the “conservator,” to be in charge of their care.
This all happened 3 years ago. My grandfather was living independently in New York City until several incidents such as a major car accident, declining health, and going after my father with a knife made the family realize he could no longer live alone. Begrudgingly, he sold his home of over 40 years and moved to California to live with my paternal aunt until another living arrangement could be made.