Anxiety and depression in the elderly may occur for various reasons, but illness or personal loss is found to be essential triggers which are termed to be the risk factors for older people. This article is going to discuss the loss of loved ones which is felt by the elderly. Bereavement is a situation of having suffered a loss whereas grief is a natural response to pain. Grieving is a collective experience in adults aged sixty years and above, and it is a concern to primary care physicians (Shear, Ghesquiere, & Glickman, 2014). Loss of a loved one usually causes acute grief characterized by yearning and longing, frequent thoughts of the deceased as well as decreased interest in ongoing activities which can cause depression.
Grief follows a sequence of phases that comprises of initial shock or denial which later causes anger. Acceptance occurs before the resolution of pain, but sometimes mourning can persist long after decision should have happened and thus, becomes abnormal. Therefore, it is significant for the older people to visit the physicians more often whenever they are faced with the parting of a loved one. In most cases, acute grief naturally evolves into a state of cohesive grief where the mourner is in a position to re-engage with everyday activities as well as find interest or fun. Thus, it is seen that majority of the people can handle their grief without intervention whereby as a few percentage are not.
However, research shows that seven percent of the bereaved older adults will develop the mental health condition of complicated grief. According to physicians, it is essential to recognize bereavement-related diseases in older adults during its early stages (Hashim, et al., 2013). They require optimizing support as well as available resources before and throughout the bereavement period to lessen the encumbrance and misery of the family members. Therefore, in understanding the importance of this risk factor will help the elderly age successfully since they will be in the ability to access the right doctors to help them overcome the depression and anxiety during the bereavement period.
Moreover, several studies were carried out to examine how many people suffer from the loss of the loved ones. According to (Ghesquiere, Shear & Duan, 2013), a various method such as Changing Lives of Older Couples (CLOC) was used to identify the grief of the elderly of their spouses. The research surveyed 1532 married couples from the Detroit Standard Metropolitan Statistical Area using 2-stage area probability sampling. Face-to-face interviews were conducted from nineteen eighty-seven June to nineteen eighty-eight April. Husbands were required to be sixty-five years or older. A total of three hundred and thirty-five respondents lost a spouse during the last five years of the study of whom two hundred and sixty-three participated in at least one follow-up interview conducted at six months, 18 months and 48 months after their spouse's death.
The CLOC data were collected before the recognition of the complicated grief as a clinical entity. In identifying complicated pain, a positive subsample in the CLOC questionnaire was employed that roughly corresponded to the suggested complicated grief criteria set. The results showed that only about 60% of this distressed sample of widowed older adults reported using any of the three standard grief supports within six months of their loss. This suggested that there may be a gap between the need for services and their use. Also, research proposed that older adults seeking bereavement support from their doctors may not get the support they require and that the more efficient option considered should be the grief-specific services.
According to (Newson. et al., 2011), the Rotterdam study was carried out to examine the elderly in bereavement. The research evaluated five thousand, seven hundred and forty-one adults. Complicated grief was assessed with a 17- item inventory of complicated grief. Results showed that prevalence within the general population was 4.8%. This was reported by 1089 participants whereby two hundred and seventy-seven (25.4%) were diagnosed with complicated grief. Inflated anxieties, as well as depression rates, were documented in people with complicated grief but a majority of the people remained free from co-morbidity.
Moreover, time since bereavement and relationship to deceased more so when the source was a spouse or a child were predictive of complicated grief. The research discovered that individuals with complicated grief were older and had a lower level of education and more cognitive impairment. Therefore, these findings highlight the need for prevention, diagnosis as well as treatment options for older adults with complicated grief and recognition of complicated pain as a distinct diagnosis.
Moreover, adults may or may not have the capacity to improve their resilience and interventions may be useful. In the intervention process, it is essential to avoid the scattergun approach. People involved in the aspect of resistance must identify the attributes that are most needed for improvement of the elderly during the bereavement period. In doing so, they must observe and listen to the elders. Moreover, the descriptions of their experiences of resilience are fundamental to the work that follows. Old people are experts of their life histories and their knowledge, opinions, beliefs as well as conscious must prefigure any attempt to adjust their behavior (Wagnild & Collins, 2009). A plan should be developed with the patient that extends their positive experiences of resilience. Thus, individuals, as well as the community, are required to aid the elderly in resistance whenever encountered by the loss of their loved ones.
On the other hand, the primary care physician plays a vital role in preventing, identifying as well as managing abnormal grief especially in high-risk of the elderly (Hashim, et al., 2013). They require being prepared and develop ways to identify those at risk of bereavement-related problems such as depression. In resilience in the loss of the loved ones, primary care physicians are essential since they assess family members before they experience an imminent loss especially the first year after grief. Assessment should comprise identifying the needs of family members, either in the form of financial aid, bereavement support or counseling.
Moreover, having identified deprivation as a risk factor, more work needs to be done in older adults. In handling, the elderly during the time of grief it is important to note that the aged people are also affected by the loss more immensely, and they should be handled with much care. Treatment should be enhanced to those patients as well as counseling during the mourning period especially if the loss is that of a loved one such as a husband, a wife or a child. Therefore, when such cure is emphasized it will help in the resilience of the elderly when facing the loss of the loved ones.
Ghesquiere, A., Shear, K. & Duan, N. (11 March, 2013). Outcomes of Bereavement Care Among Widowed Older Adults With Complicated Grief and Depression. Retried from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3961004/Hashim, et al.(2013). Bereavement in the elderly: the role of primary care. Retried from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3822663/
Newson, et al.(2011). The prevalence and characteristics of complicated grief in older adults. Retried from: https://www.sciencedirect.com/science/article/pii/S0165032711000759
Shear, K., Ghesquiere, A. & Glickman, K.(2014). Bereavement and Complicated Grief. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3855369/
Wagnild, G., & Collins, J. (2009). Assessing Resilience. Journal Of Psychosocial Nursing And Mental Health Services, 47(12), 28-33. http://dx.doi.org/10.3928/02793695-20091103-01
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