Every now and then we read in the newspaper or see on TV an article about an older person who has done something remarkable–skydiving, a marathon, or turning 100 and still driving. It demonstrates that people can have fulfilling and remarkable lives up to very advanced years. Whereas this is true, at the same time as one ages loss becomes part of one’s life. This month Elder Voice talks about aging and loss.
For many people a first major loss as they age is retirement. It can offer an array of opportunity, but it is also the letting go of a major part of one’s identity. When asked what we do for a living, we don’t usually answer, ” I do plumbing,” or ” I do doctoring.” We say, “I am a …” identifying ourselves by our career.This is especially true for men whose sense of self is closely tied to their employment.
A second major loss is often the loss of a spouse. Not only is this also a shift in identity (I am a husband, I am a wife” ) it also entails a major re-organization in people’s lives–financially, socially, and emotionally. It is a complicated process that some people find extremely difficult to manage.
Giving up one’s license, voluntarily or not, is another loss. This too engenders a shift in identity–people see themselves as losing their independence. Out culture values independence strongly. It’s loss has an impact on how a person feels about him or herself.
Continuing as we age, a fourth major loss often occurs when someone moves from their home, one that that they may have had for fifty years or more. It is the loss of safety and comfort, the place of memories and securities. Similar to a career, people often see themselves reflected in their things and their home. Leaving one’s home is like losing a part of the self. If someone moves to a seniors residence, not only is there the loss of self, feelings of loss of independence also arise.
Loss continues and occurs in many other areas as well. There is the loss of mobility that may lead to someone needing a walker or a cane. As someone reaches their eighties or nineties they often have lost most or all of their friends. There may be the loss or impairment of continence. Vision, hearing, taste, and sometimes smell may also decline, impacting the ability to socialize or enjoy food.
As someone ages, there is the loss of siblings, cousins, or other family members. It is a profoundly lonely experience to be “the last one” of the family or close friends one has grown up with. There is no one left who participated in our history or with whom we can say ” remember when we….”
Finally, as one gets older, there is often the loss of health and strength which may be accompanied by chronic pain, the loss or changes in cognition such as dementia. These are frightening and frustrating and can lead people to feel helpless and hopeless.
With loss comes grief, which is often hidden by an older person who may not want to be seen as complaining, weak or vulnerable. With some of the losses, such as continence or mobility, there may be also be shame and embarrassment. Because of this, it is not talked about or acknowledged and conditions that could perhaps be treated may not be.
How do we help someone with loss? How do we respond?
The most important thing is to be aware of the meaning of the losses that someone is experiencing. For instance, having to use a walker is not just about using a walker–it is also about the meaning of using a walker. Caregivers, professionals and family must be sensitive to the fact that loss can lead to changes in how someone feels about themselves. They must understand the profound loneliness that comes from being “the last one.” They must understand that grief may be accompanied by shame or regret.
Talk to someone about what they are going through or how they are feeling, as opposed to trying to talk them into or out of it. Ask what it is like to have a certain experience. It doesn’t help to say “well we can drive you,” or “you can afford a taxi” when someone feels they are losing control of their life. If you want to point out those things, wait until after you have heard what it is like for them; until after you have said, “it’s really hard for you to have to make such a big change in your life, isn’t it?” You can ask if they feel some shame or regret. Often, people need an “invitation” to start talking. This is the use of empathy and listening.
In terms of health, we can encourage and help people to eat well, socialize, and exercise. Exercise especially gives people a sense of well being through the release of endorphins in the brain, increases their strength and mobility, and helps maintain and improve overall body functions. All of these assist in fighting helplessness because people are doing something to help themselves.
We cannot give people back what they have lost, of course. But often people can balance their losses. In some respects this is what is meant by successful aging: finding or retaining meaning, purpose and passion in life. Meaning, purpose and passion are different for different people. For some, it may be volunteering or playing bridge, for some it may be skydiving, or running a marathon, for others maybe finding a companion. Whatever it may be, it is something which helps people see themselves in a positive way and value themselves, and allows them to feel loved or valued.
If loss or grief become overwhelming, a person should be seeking counselling and seeing their physician. Signs of depression include withdrawal, loss of appetite,irritability and anger, changes in sleep patterns. Suicide is a risk for older people, and being suicidal may go unrecognized. Although it may be frightening, you can ask someone if they are feeling so low that they are considering harming themselves. You will not “trigger” someone to do this by asking them about it and you may save their life.
One of the services offered by Diamond Geriatrics is professional counselling to families or seniors concerned with loss, grief, and depression. We can also help with the practical issues that come with aging. It is often part of how we help when we planing and making moves to seniors housing. Call us for an assessment.