Loss in Later Life

Loss In Later Life

Most literature on grief and loss focuses on bereavement after the death of a loved one. While this focus is extremely important, there are many other losses that occur later in life. Although most people look to later life as a time of leisure and enjoyment of family and friends, many also contend with an increasing number of losses. These losses include social roles, relationships, health, cognition, and functional ability. In some sense, the elderly experience the loss of pieces of themselves.

Physical Health

Two-thirds of older adults report having good to excellent health. Three-quarters report minimal limitations in carrying out activities of daily living (Jette, 1996). Aging involves the decline of many physiological processes, however, and half of people over the age of 85 report various disabilities in their daily activities (Jette). Normal aging includes the following:

  • hearing loss
  • vision loss
  • loss of muscle and bone mass
  • decreased sensitivity to touch, smell, and taste
  • decreased ability to heal from injuries and illnesses
  • slowed metabolism
  • loss of muscle and skin elasticity

Later life is also accompanied by chronic illness and disease for many older adults. Common illnesses of later life include:

  • cardiovascular problems (high blood pressure, high cholesterol, heart disease, congestive heart failure)
  • diabetes
  • osteoporosis, brittle bones, significant ramifications of falling
  • arthritis
  • cancer
  • chronic pain
  • kidney disease

These illnesses and resulting disabilities lead some older adults to stop participation in previously enjoyed physical activities, including sports, gardening, housekeeping, cooking, and even attendance at social or community events and religious services.

Cognitive Functioning

Later life is accompanied by small declines in short-term memory, memory for nonverbal information, speed of information retrieval, and speed of reaction time. Most older adults' daily functioning is not affected by these normal changes. However, a minority will experience dementia, which results in the loss of most cognitive functions

Independence

Physical and cognitive declines leave many older adults dependant on others for household maintenance, activities of daily living, transportation, and (for some) total personal care. Loss of independence is difficult for many and seen by some as tantamount to the end of life as they knew it. The loss of ability to drive a car, in particular, is a major loss of independence that can lead to isolation and depression (Marottoli et al., 1993). Dependence on others can be humiliating and, for some, can have a significant negative impact on an individuals sense of self and self-esteem.

Valued Social Roles

A role is an individuals pattern of activity that occurs within a specific type of social situation. For example, the role of an employee is enacted in the work setting, and includes the tasks that one was hired to do, as well as the formal and informal social rules that govern behavior at work. Valued social rolesare those roles that society has deemed worthy of value, such as employee, parent, teacher, volunteer, student, or friend. These valued roles are in contract to devalued roles that many older adults view themselves as taking on later in life, such as medical patient or care recipient.

The general consensus among early American theorists was that old age is a time for reviewing past experiences and accepting one's life course while shifting away from the larger community (Erickson, Erikson, & Kivnick, 1986; Jung, 1957; Neugarten, 1977). This position assumed that it was a normal, acceptable part of later life to relinquish valued social roles and allow younger generations to step into them. However, roles largely define identity. For example, a woman may think of herself as a mother, a wife, a lawyer, a community advocate, or a friend. These roles provide meaning to her life and shape her sense of self and self-esteem (Wells & Stryker, 1988). Generally, the greater the number of valued roles people view themselves as having, the better they feel and function. Similarly, the greater the number of devalued roles people view themselves as having, the worse they feel and function. It follows, then, that loss of valued roles would have negative consequences for some elses, a phenomenon that has been supported by research. In a study of elderly assisted living facility residents, older adults reported having lost an average of 40 percent of the valued roles they had as younger adults (Emery & Pargament, 2002). This loss was subjectively reported as distressing and was associated with higher levels of depressive symptoms.

What Can You Do?

  • Remember that every person has inherent worth and something to offer.Don't be blinded to an individuals strengths in the face of a loss. Consider, for example, a nursing home resident with multiple sclerosis who had become quadriplegic. Despite her physical losses, she was able to make audio recordings of her life story and favorite recipes to share with her children and grandchildren, thus leaving a legacy to her family
  • Explore individuals' remaining strengths. What can they do? What are they good at? What do they enjoy doing that they are able to do? Mr. Bernstein, for example, was still generally physically healthy, just not agile enough to play handball. He could utilize his training as a carpenter and experience as a handyman to help friends and neighbors with needed tasks around the house. He could also fulfill his wish to spend time outside by helping his wife in the garden.
  • Identify ways they can get involved in the community. Mrs. Kim, a Christian minister, had been in the hospital for weeks with end-stage stomach cancer. She had little strength left and knew that her life was coming to an end. Mrs. Kim remained connected to her congregation by saying prayers and giving blessings to those who wrote and visited her in the hospital. This activity gave her last days meaning.
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The information above is reprinted from Working with Seniors: Health, Financial and Social Issues with permission from Society of Certified Senior Advisors® . Copyright © 2009. All rights reserved. www.csa.us