Presentation on theme: "31 st Annual Arkansas Aging Conference October 26-28, 2011 Hot Springs Convention Center Sponsored by: Arkansas Association of Area Agencies on Aging Arkansas."— Presentation transcript:
31 st Annual Arkansas Aging Conference October 26-28, 2011 Hot Springs Convention Center Sponsored by: Arkansas Association of Area Agencies on Aging Arkansas Department of Human Services Division of Aging & Adult Services
Statistics Older adults – 65 and over - represent 12% of the population in United States (U.S. Census Bureau, July 2003) Adults – 65 and over – experience an average of 17 death losses in their lifetime (Losses of Expected Lifetime in the U.S. Max Planck Institute for Demographic Research)
The Face of Grief Female Age 65 and over Losses can include spouse, parents, grandparents, siblings, children, extended relatives, other significant persons Living alone or in long-term care Has multiple health problems Limited resources Dependent upon others for assistance
Each death loss demands acknowledgement because: The loss causes significant emotional and physical pain Losses are a “forever” event Death ends a life, it does not end a relationship Death changes our relationship with the person who has died from one of physical presence to one of memory If loss is left unattended, it can lead to depression and/or other mental health issues
Death losses are normal life experiences that incur highly negative emotions. Death losses are life’s greatest challenge. Older adults experience death losses plus the compounded impact of cumulative loss. Grief and mourning is our society’s last taboo. Significant shortage of grief counselors, educational programs and support opportunities. “When a parent dies, you lose your past; when a child dies, you lose your future; and when a spouse dies, you lose your identity.” Anonymous
Considerations for Older Adults and Death Losses Losses occur over a span of years Losses include: spouses, parents, grandparents, siblings, friends, children, extended relatives, other loved ones Most losses are not dealt with beyond funeral service Professionals working with older adults need to consider peripheral losses such as age, decline in health, loss of independence, financial dependency, and long term futures and: –Imperative need to grieve losses –Critical need to actively mourn losses –Requirement to deal with overwhelming and ongoing losses –Need to begin the healing process to reconcile losses into life by: - remembering the person who has died - telling the story - honoring the lives of those who have died “We begin healing our lives when we ask our shadow to lunch.” - John Donne
Older adults with multiple death losses need to know: It is not their fault for difficulties with their coping skills They must seek help for all their losses, regardless of when they occurred The differences between grief and mourning To recognize the need to find their own via dolorosa They must seek a safe place to share their feelings That each person’s grief journey is as unique as their fingerprint And, finally, healing from grief takes time and hard work
First things first……….. What is the difference between grief and mourning?
What is grief? Definition: Deep mental anguish, as that arising from bereavement; a source of deep mental anguish; annoyance or frustration; trouble or difficulty. Grief is completely subjective while being completely universal.
What is mourning? Definition: To feel or express grief or sorrow; to show grief for a death by conventional signs as by wearing black clothes; to make a low, indistinct, mournful sound; to feel or express deep regret; to grieve over; to utter sorrowfully. Mourning is completely subjective and varies greatly dependent upon many factors.
What are the differences between grief and mourning? Grief is what we feel immediately on the inside; what we will continue to feel in our hearts. Mourning is our behaviors and actions; the outward display of our feelings. Grief is in your heart and mind; mourning is what you show to the world.
Why differences between grief and mourning are important for a person who has experienced multiple losses. Grief is immediate and cannot be denied. It is readily accepted by others but only for a short time. Grief is the initial wound that occurs with loss. Mourning begins later, if at all. By accepting losses, embracing their new reality, exploring new feelings, understanding they are not going crazy, learning that loss affects all areas of their life, knowing that they need to nurture themselves, reaching out for help, and seeking ways to reconcile the loss into their changed reality; all of these are ways to achieve “real” mourning. Things we do vs. what we feel. IMPORTANT: If mourning is not achieved, the initial wounds of grief remain as a festering, gaping hole in our hearts.
Why addressing grief issues is so important after loss. Loss affects a person emotionally, physically, mentally, psychologically, socially, cognitively, financially, spiritually Loss can lead to depression, suicidal thoughts, and other mental health issues Loss alters our identity Loss changes our reality Loss challenges our personal belief systems Most of us have few coping skills to deal with loss Loss goes mostly unaddressed and can impact self-esteem, self-worth and values. Loss needs to be addressed just as any other life event (illness, accidents, aging process, mental health issues).
Why target older adults and address their multiple grief issues? Recent loss/past losses/multiple losses May be experiencing anticipatory grief May be experiencing depression or other mental health issues Medical/other problems that may compound grief issues May have little or no support system Rising incidence of senior suicides Mental health issues for seniors becoming a growing problem Growing concerns for those experiencing isolation, social withdrawal or “late life loneliness” “Layered” losses that have not been addressed (previous loss) Altered self-identities Need validation, significance and to be valued Need opportunities to be heard, tell the story, remember Their need to honor their loved ones who have died
Where professionals can identify older adults who have grief issues. Area Agency on Aging organizations Senior Centers Organized group activities Case Management personnel Physicians, nursing staff Medical facilities Rehab hospitals, clinics Spiritual leaders/Churches Concerned family and friends
When do we approach older adults identified as experiencing grief issues? Obvious loss of a loved one Experiencing any signs of depression Noticeable changes in personality Self-isolation, withdrawal Obvious physical changes Noticeable lack of participation in activities Displays profound sadness Reluctance to talk freely (common for older adults) Displays unusual characteristics When assessments/intakes reveal recent loss or past losses/multiple losses
What expertise older adults need at this time: Warm acknowledgement that their loss is important and significant Acknowledgement of how their life is now different in many ways Safe place to talk, share and recall memories Nonjudgmental allowance of feelings and memories, thoughts and behaviors (not just for a brief period of time) Your trust Your acceptance to allow their natural responses Your sensitivity and warmth Your patience in giving them time and space Your empathy, allowing them to know you want to help Grief counseling and education opportunities Opportunity to learn coping techniques for loss and ways to honor their loved ones Hope…….so they can overcome their challenges and rebuild their lives
What EAAAA offers seniors who have grief issues: Agency offers ongoing grief education and counseling through: 1.Grief workshop - 12-week workshop teaching nationally known 10 touchstones of companioning bereaved persons. (Wolfelt) 2.Bi-monthly grief support group meeting. 3.Planned activities - grief memory walk, opportunities that will facilitate the person’s need to honor their loved ones. 4.Personnel is trained in grief education/counseling/facilitation with ongoing programs.
What can be offered to your older adults? Grief education and counseling by trained professionals Referral to appropriate professionals (if complicated grief is present) Development of programs where seniors can share with others who have experienced loss (informal or formal) Groups or activities where meaningful dialogue and actions can occur Provide creative outlets for “reaching out to others” Opportunity for honoring their lost loved ones, such as meditation, reflection, journey workshops, etc.
Outcomes of successful grief issue identification: Acknowledgement of loss increases feelings of significance, value, self-worth, validation of their emotions, being a part of things, feeling understood A place to go with their grief, opportunities to creatively work through the difficult process of reconciliation Motivation to address other physical needs Creating a new way of “caring” that is not currently readily available, if at all Happier, better adjusted individual
In closing - “ When we honestly ask ourselves which persons in our lives mean the most to us, we often find that it is those who, instead of giving much advice, solutions or cures….have chosen rather to share our pain and touch our wounds with a gentle, tender hand….who can be silent with us in a moment of confusion or despair….who can stay with us in an hour of grief and bereavement….who can tolerate not knowing, not curing, not healing….and face with us the reality of our powerlessness….that is a friend who cares.” - Fr. Henri Nouwen
The Face of Grief: How Death Losses Affect Older Adults Dedication In Loving Memory Mildred J. Pearson August 1930 – March 2000