Family matters | Loved ones loss can trigger complicated grief

I am a 54-year-old woman trying to support my mom, whose long-term partner died at age 80. I am concerned about how she will be impacted by this. What can I expect? What can I do to be helpful? Will this grief ever resolve? — J.R., Pleasanton

I am so sorry to hear that your mom lost her partner. She must feel so distressed and overwhelmed. Your mother is fortunate to have your presence and caring as an integral part of her support system.

It’s pretty astounding to think about the fact that about 2.5 million people die in the U.S. each year. Bereavement, especially spousal loss, is disproportionately experienced by older adults.

Grief is a multifaceted experience and process that changes over time and may take on different forms from loss to loss. Your mom’s reaction to her world may be altered permanently by her loved one’s death. On the other hand, grief can also be an avenue for change and growth. Each person’s grief is unique and doesn’t follow a prescribed pattern, trajectory, or time frame. In losing her life-long partner, your mother’s life has changed dramatically. If she was a caregiver, she may have also lost her important daily role.

Although older adults in general experience the death of loved ones at a higher frequency than younger adults, we cannot assume that this frequency establishes their readiness or ability to grieve successfully. In our ageist society, we often hear that older people are “used to people dying.” This robs older adults of the validation of experiencing the same depth of grief and fearfulness about death as younger people do.

Emotions related to grief are also very specific to each person. Immediately after the death and in the days to follow, many people feel numb or want to pull away from others. Others express sadness, guilt or even relief. Some physical responses may include insomnia, appetite issues and lethargy. The depth and intensity of these reactions are affected by many factors, including one’s relationship to the deceased, and the time and manner of death. As your mother tries to adapt to life without her partner, she may oscillate between confronting and reflecting on these feelings and then setting them aside.

Bereavement can also be a major stressor that triggers the onset of physical or mental health problems, including major depression and complicated grief. Unresolved complicated grief can be detrimental to overall health and can impact quality of life in older adults.

Complicated grief is the high end of the grief spectrum in both intensity and duration. There is no clear line between regular grief and complicated grief, but it may be complicated grief  if a person is unable to resume normal activities by about 14 months after the death of the loved one. This type of grief is marked by repetitive, intrusive and excessive yearning for the deceased, accompanied by severe emotional spells. There may be pervasive feelings of numbness toward others, loneliness, emptiness, meaninglessness, regret and difficulty acknowledging the death.

According to Dr. Katherine Shear, director of the Center for Complicated Grief at the Columbia University School of Social Work, signs of complicated grief include the bereaved person blaming him- or herself for the death of the loved one and avoiding doing things or going places they shared. These feelings interrupt the natural healing process that gets most people beyond acute grief. About 9 percent of bereaved older women will suffer from complicated grief. Sometimes the grief resolves on its own, but if it’s not treated, it can lead to serious health problems. Complicated grief is an under-recognized public health problem that probably affects millions of people in the United States, many of them elderly.

Because complicated grief is not the same as an anxiety disorder or depression, the treatment differs. Treatment for complicated grief uses techniques that facilitate natural mourning by focusing on loss and restoration.

Nothing can take the pain or grief away, but there are ways to support your mother through the grief process and help her restore hope. Some important tips are to acknowledge the loss with your mom, use the deceased person’s name in conversations, validate her feelings of pain, and, most of all, continue to be a good listener. You will be a healing presence.

You can also create opportunities for your mother to share memories in ways that involve her friends and family. For example, spending time together creating journals, family photograph albums, and oral histories will help honor her partner’s memory. Practical help is also needed and is very important. You can initiate this type of help by offering to run errands and pick up needed items at the grocery store.

It’s hard to determine at this point how your mother’s grief will progress. There are many variables, including culture, cumulative losses, her sense of belonging, community and her health. Social support, including loving assistance from you, her friends and other family members will most likely prevent your mother from developing complicated grief. When your mom is ready, she can seek additional support from her spiritual community or a therapist who specializes in death and loss in later life.

Rita Clancy, LCSW, is the director of adult services at Jewish Family & Children’s Services of the East Bay. Her columns appear regularly in J.’s Seniors supplements. Have questions about your aging parents? Email rclancy@jfcs-eastbay.org or call (510) 558-7800, ext. 257.

 

Rita Clancy

Rita Clancy, LCSW, is the director of adult services at Jewish Family & Community Services of the East Bay. Have questions about your aging parents? Email rclancy@jfcs-eastbay.org or call (510) 558-7800, ext. 257.