“Right after her death, it seemed as if I went into a trance. Martha was so much a part of my life. Now it’s almost six months and I am still tortured by memories of her, particularly when I am around the house and come across some of her personal things. All of her clothes are still in the house, as are her mementos. I keep them there to remind myself of how lucky I was to have had a woman like that...Losing her has made me realize that there are still parts of myself that I don’t understand.” (Liebermann, M. (1996) Doors close, Doors Open, New York: C.P. Putnams’s Sons, page 184).
Death is what we usually equate with loss and grief. Grief is the term used for the emotional response to a loss that a person has experienced. However, there are many types of losses that one can experience that are just as tragic and devastating to a person, young or old. These losses include: the loss of ones home when moving to a retirement facility, the loss of friends who move away, the loss of ones professional identity upon retirement or even the loss of ones’ role such as mother when becoming an ‘empty nester’. People of all ages can feel the effects of grieving and loss.
One notable point about grief, is that it can have a cumulative effect. This is why many older adults can suffer the effects of loss and grieving so profoundly. Older adults are particularly vulnerable to loss and the complications of grief. When you consider the above mentioned losses in addition to the loss of senses and physical ability, the effect on ones mental health and well being can be staggering.
Experts including Erich Lindemann (1944) , William Worden (1991) and Teresa Rando (1992-1993) have tried to identify and quantify various stages and phases of grief and loss. Often called ‘task theories’, they attempt to outline the grieving process one must go through in order to return to a meaningful and functional life. Understanding normal stages can help both professionals and lay persons alike assist loved ones through the grieving process.
Generally speaking, the experts suggest that a person should:
1. Accept the loss, 2. Work through the pain, 3. Make adjustments to life without the person or loss.
While this is good advice, the reality is when one is in emotional pain, seeing the way through is often impossible. Although there are many good books and pamphlets, encouraging someone who is in the grieving process to read and comprehend the message is next to impossible.
I have worked with many families; elders and children alike in grief support groups here in Jacksonville and in St. Augustine, and the pain and despair that people can feel is overwhelming at times. Often family members and friends who want to help, do not know what to do. Below are a few tips or ideas that may assist you and your family when you go through losses in your life.
Tips for the grieving persons family and friends
Spend time with the grieving person. Try to remind the person that you are there if they need you. Don’t expect them to act like their ‘old selves’ at this time. Let them just be who they feel like, without feeling like they need to be strong for everyone else. The best of friends cannot really change the elders situation. You cannot change history, you cannot restore the loss. What you can do is to remind the person of your dedication to them.
Don’t pretend to have all of the answers. You may know someone that always feels like they have to give an answer when spoken to...you may feel like that yourself in an uncomfortable situation. Sometimes just allowing someone to talk through their feelings is enough. Sometimes it has to be enough. Often there are no answers.
I remember working with a family who was trying to help their newly widowed mother adjust to moving into an Assisted Living facility. They seldom mentioned the status of the mothers’ home - which was for sale, they seldom mentioned their father, who had passed away seven months earlier, and usually talked about trivial topics and superficial issues.
When I spent time with the elder, she said that she desperately wanted to talk of her home and husband, even though it made her feel sad and she usually cried. She stated her children never spoke about things that mattered to her. When I spoke to the children, they reported avoiding sad subjects because they did not want their mother to cry and feel sad! They stated that she had to stay where she was, and the whole discussion was futile and upsetting to the mother.
Talk about sad subjects...don’t always wait for the elder to bring up the topic. Often we feel that if we do not mention sad subjects to those in pain, we are sparing them the pain. In actuality, we may be adding to their pain, as they may need to talk and express their feelings. My feeling is that widowed spouses and those grieving are thinking of their loved ones and losses anyway. Bringing up subjects into everyday conversation only shows people that we care for them.
Watch for undiagnosed complicated grief. Many older adults often go without seeking any kind of emotional assistance. Having grown up in an era that was not accepting of mental distress and therapeutic support systems; afraid of being labeled ‘crazy’, they deny needing help. Often elders will report to their physician ambiguous symptoms, aches, or pains, as this physical pain is more acceptable. For this reason, diagnosis for grief and its’ complications can be very difficult. Prolonged reactions to grief and depression can lead to more physician maladies. Untreated, these overwhelming feelings can lead to suicide risk. It is a fact that the suicide rate for older adults is three times that of the general population.
Don’t lie or offer false hope to the grieving person. I feel that you should be as truthful as possible to the grieving person. Even if there is some dementia and confusion, the truth is usually the best policy. In addition, it is not good to offer false hope about future changes or options, if the options are not probable. For instance, if an elder is having difficulty accepting the loss of their home and subsequent move to a retirement home, it would not be wise to convince them that the move is temporary, if it is not. People need to accept the loss and move on if possible. A loss can not be accepted if it is not seen as final.
Look to the past for predicted outcomes. I am a firm believer that people don’t change. Look to your family history to see how pain and loss was dealt with in the past. If you are looking for a possible prediction for grief and loss reactions, think to the elders history. Although the past is not a perfect predictor of ones reactions, it may assist the family in preparation. Chances are that you may gather some valuable information.
In spite of everything I’ve stated, sometimes avoidance is the best policy! If you are dealing with an elder that is not reasonable - in the true sense of the word - don’t try to confront or clarify. There may be many reasons that someone is not able to reason or grow through their pain. If your elder has a mental incapacity because of their health, if they have a history of poor coping skills, or have historically dealt with pain in unhealthy ways, now is not the time for family therapy or confrontation. Perhaps your physician can offer help with medication. Let your elder verbalize their feelings and offer the best support that you are able.
Tips for the Grieving person:
Feel the Pain. I know this sounds somewhat corny, but it is easier to move through the phases of grieving when denial is not the goal. Try not to avoid the issue if you are able to deal with it. Many times we pass up opportunities to experience pain and the growth that can accompany it.
Avoid grief delaying options. If you have recently experienced losses in your life, take some time for yourself to see if there is something you can learn. Avoid alcohol or drugs if possible. Most experts agree that one needs to work through their pain eventually. Dulling the senses may only delay the grief work.
Ask for and accept help from others. Often asking for help is difficult. Look around at your friends and support systems in your life. Try to match your needs with your friends natural gifts. Don’t expect everyone to understand what you are going through. In fact, most will not truly understand. This may be the time to rekindle old friendships or reunite with your church or family.
Seek professional help. Sometimes it may be necessary to get help from someone outside of your circle of friends. Talk with your physician. A combination of an anti-depressant coupled with talk therapy, may be able to help you get past your pain.
Remember that loss can be very painful and it is something that no one chooses to go through, but as in most things that require hard work, the benefits and growth can be great. Take time for yourself; allowing yourself to have good days and bad days. Grieve at your own pace and remember that time is on your side. Robert Schuller, always the eternal optimist once said, “Never look at what you have lost, rather at what you have left”.