Friday, July 13, 2007

Dealing with death and loss as we grow older





I would like to start first with the definitions of Grief and Loss:


Grief – The normal process of reacting to a loss.  The loss may be physical (such as a death), social (such as a divorce), or occupational (such as a job).


Loss – The disappearance of something cherished, such as a person, possession or property.


Now, I would like to explore the typical symptoms of grief.  I don’t want to make you go to the beginning of my blogs, so we’ll just go over some of the basics.  Grief can affect our behavior, thoughts, emotions and bodies.  Often there are more than one symptom experienced in each category and often there are symptoms experienced in all categories at the same time.  Some symptoms that we can experience, especially as an older person:


Behavioral:  Sleeplessness, loss of appetite, crying, nightmares, sighing, listlessness, absent mindedness, social withdrawal and extreme quietness.


Cognitive:  Inability to concentrate, difficulty making a decision, self-destructive thoughts, low self-image, preoccupation, confusion and disbelief.


Emotional:  Anger, guilt, sadness, depression, helplessness, fear, loneliness and anxiety.


Physical:  Headaches, fatigue, shortness of breath, increased illness, empty feeling in body, tightness in chest, muscle weakness and stomachaches.


Next, let’s look at the types of losses we can experience in our lives as we grow older.


Death:  As we grow older, the deaths of loved ones become inevitable.  Often death can occur in the natural order of things, such as a pet may die or a parent may die, but many times death does not follow the natural order of things and we may experience the death of a spouse, a sibling or a friend.


Independence:  As life changes around us, we may find that we have to make decisions that will alter our ability to stay living in an independent nature.  Our families may take on the role of decision maker in regard to our finances, healthcare and environmental living conditions. 


Health:  It’s a fact of life that as we grow older, our health may deteriorate as well.  We may begin to have achy joints, arthritis, osteoporosis, diabetes, high blood pressure, etc.  We may find that as a result of these health changes we are no longer able to perform at the level we used to.


Energy:  Often our energy levels are not as high as they were in our younger days.  We find we often have to take breaks to catch our breath, or rest due to fatigue.  We might also find that we can not stay active for as long as we were able to before.


Appearance:  I know, this is vain – but it’s a human fact of life that most of us are in a constant battle against wrinkles and graying, thinning hair.  As the signs of aging become physically evident, we find ourselves struggling to accept the fact that we have no control over this aging business.


Home:  When we can no longer stay in our home due to failing health, or perhaps due to the death of a spouse and finances no longer enable us to stay in the home, we are forced to sell our home and move.  The move may be to a smaller condo or apartment, or even a step-facility where we have to downsize considerably and leave a place that holds so many memories. 


Finances:  There are times when our failing health costs us tremendous amounts of money in doctors’ visits, medications or perhaps surgeries.  We may not have the same medical insurance we used to and have exorbitant out of pocket expenses.  Perhaps our financial planning wasn’t up to snuff and we find our retirement funds dwindling due to high cost of living and other unexpected expenses.  Or we may find ourselves in a stressful financial situation due to the death of a spouse who was the main bread-winner in the family. 


Spiritual:  When we experience losses of any kind, we may find ourselves experiencing a spiritual crisis.  That loss of faith that we used to rely on – believe in, can leave us in a very lonely place.


Retirement:  Many individuals have a very hard time in retirement.  Traditionally, it is looked upon with anticipation and enjoyment, waiting for the day to finally come when we can realize all of our dreams and plans.  We often plan to occupy our time with all the hobbies that we wanted to do and never found the time while employed, or plan extensive travel plans with our spouses to enjoy some quality time now that there are no familial or career pressures.  However, the reality is that we may find a lot of time on our hands and we may not know how to fill it and find ourselves questioning our self-worth and productivity.  This is a time where statistics show that depression can be high and relationships can become quite stressed.


What happened to those symptoms of grief that we were talking about?  I didn’t forget – I would like you to reflect on these types of losses I just described and imagine how you would feel, or think about how you have felt, when experiencing these losses.  Write down the words that come to mind when you think about the deaths in your life, your independence, health, your energy levels, appearance, your home, finances, spirituality and your retirement, if applicable.  For me, I think of fear, anxiety, sadness, frustration, anger, depression and doubt.  Take this list of words and go back to the symptoms of grief – notice anything?  You don’t have to experience a loss just through death to experience some of these symptoms of grief.  It is described as “as we grow older, we experience little losses or ‘little deaths.’”  Before I go on about this new concept of “little deaths” let’s take a look a look at the types of death we could experience. 


Parental:  This would follow in the natural order of things, but can still be experienced as a painful loss, particularly if we had a close relationship with our parent.  Also, if we were the primary caregiver for our parent, we may feel the loss more acutely because they were such a big part of our everyday living.


Spousal:  Again, this loss may be felt more acutely if we had a close relationship with our spouse.  Some spouses do everything together and the loss of our spouse leaves us alone and without social support. 


Child:  This is a loss that definitely does not follow in the natural order of things.  This is one of the most painful losses a person can endure. 


Family Member:  This too, can be a loss that does not follow the natural order of things.  This could be a sibling, in-law, cousin, niece and nephew, etc.


Pet:  Although this may be a loss that follows in the natural order of things, just by the nature that we typically outlive our pets, it still can be experienced as a very painful loss.  Particularly if the pet was treated like a child, or if the pet was the sole companion for a person. 


Friend:  The loss of a friend can be very painful.  Particularly if this was our best friend, our only social support or our confidante.  The uncomfortable aspect of losing one of our friends is that it tends to make us face our own mortality. 


The complication we can find ourselves in is when we experience these “little deaths” and then we also experience one of these other types of death.  When someone experiences back to back losses, or has not resolved a loss issue before another one comes along, we can experience complicated grief or mourning.  Symptoms of complicated grief are:  chronic symptoms of grief, exaggerated symptoms of grief, delayed symptoms of grief and masked symptoms of grief.  If you’re not sure if you have complicated grief, you can ask yourself a few questions.


  1. How long have you been feeling the effects of grief?
  2. Are your grief reactions interfering with your activities of daily living?
  3. Did your grief reactions surface after some time has passed since your loss?
  4. Are you experiencing symptoms that you think are NOT related to your loss?


There are other bereavement issues we can face besides complicated grief.  Such as, when we are forced to face our own mortality.  This can be particularly bothersome as we grow older and more friends die.  Often, people find themselves with no friends and no social supports and then begin to wonder why they are still here and what are they supposed to do now.  Facing our own mortality can lead to fear, anxiety and depression. 


As we grow older we also start to question our productivity and generativity.  This simply means that we are not sure how productive we can be anymore and wonder what we could possibly contribute to society.  This line of thinking can lead us to devalue ourselves or fear that society devalues us as well.  We can have low self-esteem, low self-image and this too can lead to anxiety, depression and we may find ourselves withdrawing from the world around us.


Part of devaluation is the thought that we are not valued by the people in our lives.  We feel that we are burdens to our family and as we begin to lose our independence and family takes over more of the decision making for us, we begin “learned helplessness.”  It’s almost as if the fight has left us and we don’t want to cause any more hassles or be any more of a burden than we already are, so we just clam up and go with the flow – whether it’s what we want or not.


Finally, when we start to experience these “little deaths”, actual death, complicated grief and other bereavement issues, these can all lead to “bereavement overload.”  Unless, we can find some good coping strategies, we may go down a dangerous path of depression, decreased health and social isolation.


A good perspective on coping strategies is to think of them as prevention for avoiding bereavement overload.  Firstly, focus on your health.  Are you taking good care of yourself?  Pay attention to your nutrition and exercise (within your capabilities, of course).  Keep regular visits with your doctor, take your prescribed medications, keep track of your blood pressure, cholesterol and blood glucose levels.  Maintain a sense of self.  You have value and you have a lot to contribute to your family, to society and to the world.  You have an important role as an older person.  You have younger generations looking up to you as a role model, as a story teller, as the person to hand down family and cultural information to continue the family legacy. What kind of person do you want to be? What kind of characteristics or ideals would you like to promote?  How do you want to be remembered?  What kind of meaning do you want from your life?  What kind of footprints will you leave behind?  The more active you become physically and mentally, the more you will be able to maintain your independence.  If you have any regrets, now is the time to change things, to make amends.


If you would like more resources, I hope you find the following links helpful:  (1-888-687-2277), 601 E. Street NW, Washington, DC 20049


Remember – “. . . But the greatest of human possibilities remain to the very end of life. . .” By Robert Butler.



Until next week, please be gentle with yourself.




P.S.  If you have found this posting or previous postings helpful, please consider making a donation to The Bereavement Center.  We are a non-profit organization that serves the community, and we operate solely on donations from families, clients and the community.  As always, your donation will be greatly appreciated and acknowledged.

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