Grief Processes in the Elderly

  • Jul 26, 2021
click fraud protection
Grief Processes in the Elderly

This article from PsicologíaOnline, aims to analyze and conceptualize the relationship between the grieving process and the elderly, that is to say: analyze the processes of grief in the elderly.

In addition, it was deepened how the individual lives this process at this stage of his life. It is assumed that this event will cause a change in the individual, which is characterized in a certain way; and it will provoke a normal or pathological reaction in him. The article also includes a small conceptual investigation to verify the passage through these stages. To conclude this article, possible solutions or interventions are proposed so that this process is developed favorably.

You may also like: Processes of Grief Facing Significant Losses

Index

  1. Introduction
  2. Theoretical framework
  3. Grieving process
  4. Grief and melancholy
  5. Duel in the old man

Introduction.

This article wants to investigate how the senescent lives the grieving process, paying special attention to the process experienced by the death of the spouse. This is because we will all reach that age and it will be inevitable that sooner or later we will lose our partner, being the highest probability that this occurs at this stage of life, adulthood late. In addition, the vast majority of us have suffered the loss of one or both grandparents, and this has led us to want to go a little deeper into this topic.

In summary, our work will focus on being able to conceptualize the grieving process in the elderly from different perspectives. Paying special attention to the issue of widowhood, in how the loss of the spouse is experienced taking what is raised by different authors. As well, how the old man's life is reorganized after the loss.

Theoretical framework.

Grief can be defined as the state of thought, feeling and activity that occurs as a result of the loss of a loved person or thing associated with physical and emotional symptoms. In other words, it is an emotional reaction to loss. The latter is psychologically traumatic to the same extent as a wound or burn, which is why it is always painful. It takes time and a process to return to the normal balance that is what constitutes the grieving process (Society of Palliative Care Experts)

Grieving process.

The grieving process is It begins immediately after or in the months following the death of a loved one. The period of time or duration varies from person to person (Villena), not always the same, and varies depending on the degree of impact at the time of loss, by the individual's personality, and by the internal and external memories that are possessed of the person deceased. In addition to being determined by the identity and role of the deceased person, by the age and sex of the person who suffered the loss, for the causes and circumstances in which it occurred, and for the social and psychological circumstances that affect the survivor.

Like any process, the duel goes through stages which have been defined by different authors. In general, everyone agrees that the duel takes place in four dynamic stages, the The first stage is called "Impact and Perplexity or Shock". This stage begins when we are faced with the news of death. It can last from minutes, days and up to six months. It tries to defend against the impact of the news. The old man faces a reality that he cannot understand and that captures his full attention, so the consolation will not be well received. He is the one who must verify and confront reality. Nor should you overprotect him and not force him to do activities that he does not want, nor should you leave him in complete rest for a long time. On the other hand, he experiences feelings of grief and pain, disbelief and confusion. He also has poor or excessive appetite disorders, as well as nausea and insomnia.

The second stage is called "Rage and Guilt"; there is intense anguish, accompanied by emotional disorder. Death has already been accepted as a real event. The old man begins a search process for who is no longer there and begins to express his feelings for him. A third stage would be that of "Disruption of the World, Despair and Withdrawal". This stage can last up to two years. Grief and crying intensify. Feelings of guilt, resentment, loneliness, longing and self-reproach arise. The elderly feel anger which keeps them resentful and prevents them from readapting to the new reality and they have behaviors or behaviors that are not considered. He dreams of the deceased, withdraws socially, constant sighs, hyperactivity and frequents the same places as the deceased. He presents physical sensations, such as an empty stomach, chest or throat straps, hypersensitivity to noise, depersonalization experiences, a choking sensation, and a dry mouth. Also thoughts of concern, presence of the deceased, visual and auditory hallucinations. Do not wait for the old man to change his behavior or repress his sadness, on the contrary, you have to allow him to grieve, so that he is able to cope with feelings of pain and sadness.

And the fourth and last stage is called "Restructuring the world, Reorganization and Healing." The restructuring can take up to two years. The elderly person becomes aware of the loss, accepts the void and incorporates it as a present absence. Peace and sense of life reappear, and emotions and feelings fade. He feels the warmth of those around him again. He begins to have a more realistic view of the lost being.

There is talk of elaboration of mourning when the loss has already been accepted and remembering does not cause pain.or. Openly expressing the grief that one feels is something natural and desirable, and is a good psychological outlet in terms of the elaboration of the recently lived grief.

For its part, the grieving process has tasks which must be completed to trigger a good development of it. You must accept the reality of the loss, then suffer emotional pain and pain, and then adjust to the environment without the missing person in the sense of building a new life stable and satisfactory, and finally remove the emotional energy of the deceased reducing it towards other relationships in the sense of recovering the ability to love in a more sense large.

If we now characterize pathological grief occurs when the tasks of the process have not been lived and completed. Abnormal grief can present itself in a number of ways, ranging from delayed grief or absence, even a very intense and prolonged grief, which can even be associated with suicidal behaviors or symptoms psychotic. These elderly people show signs of grief in a serious and delayed way. Here the problem is asking why the patient is unable to overcome the loss. There are different explanations for this. On the one hand, a strong dependency can be seen due to the old man's attachment to his deceased spouse.

Or the elderly person does not maintain a close relationship with another member of the family to whom to transfer some of the ties that linked him to his spouse. As it is also likely that previous pathological grief relationships, if any, have been ambivalent. As a result of this type of grief, depression can be triggered, which in the elderly can be fatal. This is determined by the personality of the old man as well as by his vital history. This type of depression affects the central organ, endocrine and immune systems, paralyzing the continuous growth process and the intellect. In addition, there is a decline in the functioning of the body, deterioration of physical functions, low defenses, which can be easy prey for any disease. There is alteration of some neurotransmitters such as serotonin, norepinephrine and dopamine.

The mood suffers and the elderly are constantly tired. Loss of physical health can lead to low self-esteem, increased dependency, and decreased mobility. It is important in this case to bear in mind that the elderly man who lives a pathological grief will give us some signs of alert, such as loss of energy, feeling old, anedonia or loss of desire to enjoy. As well as it can also present insomnia, decreased appetite and measurable weight loss. It is common for them to have thoughts of death, a strong social withdrawal, some kind of guilt, a change in mood, as well as physical pain and complaints about their health.

Grief Processes in the Elderly - Grief Process

Grief and melancholy.

Grief and melancholy are reactions to loss. Freud takes the word 'duel' in its two meanings: as pain ('dolere') and as combat between two ('duelum'), since the duel implies a combat painful between two: on the one hand the self that refuses to leave its places of satisfaction, and on the other the reality principle that insists on the lost.

Freud wonders why grief is painfulIn this regard, he points out that in it we can find three affects: anguish, which is the reaction to danger, and it appears suddenly, triggering the duel. Then the pain that is the displeasure produced by an accumulation of an unprocessed amount.

The pain of grief is in a overload of representations of the lost object taking into account that the ego is sensitive to everything that brings a memory of the lost object. Then that overload must be released little by little, and the pain subsides. In addition, the pain also comes because the lost object no longer loves us anymore. And sadness appears at the end of this painful work, when the lost is registered as such, going to integrate the past.

Then the self feels liberated and invests a new object, through the process of substitution. This mechanism raises two issues: a substitution as a consequence of a primary repression, since something that pre-existed is substituted. And each duel inevitably summons previous duels, that is, there is an unworkable remainder in each duel, which would return by repetition in other duels. We can say then that grief is, as a general rule, the reaction to the loss of a loved one or significant object.

Melancholy, meanwhile, Freud singles it out in the mood for a deeply hurt uneasiness, a cancellation of interest in the outside world, the loss of the capacity to love, the inhibition of all productivity and a reduction in the feeling of self that manifests itself in self-reproaches and self-denigration and is extreme to a delirious punishment. The reality check has shown that the loved object no longer exists, and from it now emanates the exhortation to remove all libido from its links with that object. An understandable reluctance is opposed to this; It is universally observed that man does not willingly abandon a libidinal position, not even when his substitute already appears.

That reluctance can reach such intensity that produces an estrangement from reality and a retention of the object by way of a hallucinatory psychosis of desire. The normal thing is that compliance with reality prevails. But the order she issues cannot be carried out immediately. It is executed piece by piece with a great expenditure of investiture time and energy, and meanwhile the existence of the lost object continues in the psychic. Each one of the memories and each one of the expectations in which the libido was tied to the object are closed, over-clothed and in them the detachment of the libido is consumed. In the duel we find that inhibition and lack of interest were fully cleared up by the self-absorbing grief work. In melancholy, the unknown loss will result in a similar inner work and will be responsible for the inhibition that is characteristic of it. Melancholy implies an impossibility to carry out the work of mourning, that is, to lose the object. The melancholy is not necessarily triggered by a real loss and, even if this is the case, the melancholic knows who he lost, but "he does not know what he has lost with him." The important difference with grief is the loss of self-esteem (which is also in grief, because one stops being loved one) to the extent that such loss of self-esteem translates into self-reproach and a subsequent wait for punishment delirious. A delusion of insignificance and a feeling of guilt appear ("I deserve it").

The articulating concept of these relationships is narcissism, even though narcissism alone does not explain melancholy or psychoses in general.

Grief Processes in the Elderly - Grief and melancholy

Duel in the old man.

It is important to bear in mind that at this stage of development the reactions to grief will be more sustained over time, this because the elderly have more difficulties to adapt to the changes. Loss is the predominant theme in the emotional life of the elderly. For the elderly, death not only ends life, but is now more present than ever. Grief in the elderly is similar to that of children, because in old age there is a return to dependency. John Bowlby (1980) argues that this attitude of search or return to dependence is due to the expression of the instinctive response to separation that we observe in childhood. This impulse is not only triggered when we lose the most important attachment figure at any stage of life, but it is specific to human beings. This results in a decreased ability to grieve. The dependence presented by the elderly leads him to develop non-pathological and adaptive behaviors to loss. They also need a security surrogate, as the loss of a loved one threatens this security. However, in other cases, there does not seem to be an attempt to find a substitute, presenting behaviors self-destructive, in an apparent attempt to reunite with the lost person, showing no signs of pain for this lost. The elderly in a dependent condition would seem to be more prepared for his own death than that of the object of his dependence.

Widowhood or widowhood in the elderly

Widowhood at this stage it is accompanied by loneliness, understood as the crisis that occurs due to the loss of loved ones. This is one of the hardest experiences that the senescent faces, the fact of losing the being with whom he has shared a long stage of his life. The role that children play in this situation is important, since it is they who must try to alleviate this loneliness.

During the first year of condolence or grief, the spouse may be depressed, distressed, and even have phobic reactions, which does not fully imply the fact that they are developing a condition pathological.

Another important point to note is the fact that because the life cycle of men is shorter, and they are usually older than their wives, the situation of widowhood is more normal among older women. Which leads to a series of conflicts, not only due to the death of the spouse but also due to the fact of having to face life alone now. If the husband, in this case, has been the main source of livelihood, be it financial, emotional or otherwise, her death usually implies changes in the standard of living. Even waking up takes on another meaning when we realize that there is no one next to us. Widowed women learn to function in their own home without the presence of their husband. They also face numerous stressors that challenge adaptive resources.

You also have sharp fluctuations in your financial resources. Most women feel that the loss of a husband is a loss of emotional support. For their part, widowed men tend to suffer from intense depression after the death of their wives, which translates into the rapid search for a new partner to marry. The widowed person, then, must rebuild an identity whose essential element may have been the married person for most of her adult life. As the psychiatrist Colin Parkes (1972) puts it, “even when the words remain the same, they change their meaning. Family is not what it used to be. Not home, not marriage. "

If we now focus on what life will be like for widows, we will see that, as Helena Lopata (1979) found in her two classical studies conducted on widows over 50 years old in Chicago, United States, who had an average of eleven years in such condition. She concluded that most of the women lived alone. This because they needed independence from their children. She, in turn, discovered that their monthly income had decreased by almost half after the death of the spouse. But what is most striking is that the interviewees stated that their identity as a wife had been essential in their adult life.

Psychotherapeutic Treatment

As a way of treating the normal grieving process from therapy Sports should be encouraged as well as establishing new relationships and doing other activities outside the daily routine. More specifically, psychotherapeutic treatment should aim to favor the review of the personal relationship with the deceased, help the patient to express pain and anguish, to recognize cognitive, affective and behavioral alterations secondary to the mourning, as well as finding an intrapsychic representation of the deceased to avoid interpretations with a lot of burden of conflict. In addition, it must enhance the patient's adaptation mechanisms, it must allow transfer, and finally, should facilitate the transmission of the deceased's dependency to other sources of gratification when necessary.

If we now focus on the treatment to face the pain of depression in the elderly caused by pathological grief, the Pharmacological treatment will be to administer drugs to the elderly in small doses that act on serotonin and norepinephrine. And therapeutic treatment is often difficult as they are constantly reminiscing about the loss. The family, a priest or the services of an organization can help to reestablish a bridge with the outside world. For this reason, it is important that the therapist maintains contact with family members. in order to know how the loss affected at the family level and so that they know the situation of the elderly, and thus be a support and a company.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Grief Processes in the Elderly, we recommend that you enter our category of Emotions.

Bibliography

  • American Psychological Association (2001). The 5th edition of APA’s Publication Manual (online).
  • Maple, H.. Contreras, P.. Gutiérrez, B.. La vejez (online).
  • Belsky, J. (1999). Psychology of aging. Madrid: Auditorium.
  • Bowlby, J. (1999). Affective bonds: Development and loss training (3rd Ed.). Madrid: Morata.
  • Concha, A.. Sepúlveda, M.. Olivares, L. (2000). Social networks in the elderly (online).
  • Florenzano, R. (1993). On the road of life. Santiago: Editorial Universitaria
  • Greenspan, S. & Pollock, G.. (1987). volume VI Late Adulthood. The course of life
    (pp. 69-111) Madison: International Universities Press.
  • Hall, E.. Hoffman, L.. Paris, S.. (1996). Developmental Psychology Today (6th Ed.). Madrid: Mc Graw Hill.
  • López, C. (1973). About life and death. Madrid: Rialp S.A.
  • Machado, L. Psychological grief and sexuality (online).
  • Mahaluf, J.. Happiness from loss and grief. In Teleduc, Directorate of distance education (Ed), Basic Gerontology: Complementary readings
    (pp. 118-132). Santiago: Catholic University of Chile Editions.
  • Martínez, J.A.. Normal aging, mental disorders and general principles of psychiatric assistance (online).
  • Milagros, M. (2001). Aging and psychological changes (online).
  • Papalia, E. & Wendkos, J. (1997). Death and mourning. In Human Development
    (pp. 632-658). Bogotá: Mc Graw Hill.
  • Ramos, F. & Sánchez, J.. Old age and his grandchildren. (online).
  • Remplein, H. (1971). Treatise on Evolutionary Psychology (3rd Ed.). Barcelona: Labor S.A.
  • Rodero, M.A.. The third age (online).
  • Sárquis, C. (1993). Introduction to the study of the human couple (2nd Ed.).
    Santiago: Catholic University of Chile Editions
  • Simonsen, E. (1998, July). The penalties of old age. Que Pasa Magazine, 1421, 42-44.
  • Palliative Care Expert Society. The duel (online)
  • Third age (online).
  • University of Chile (2001). Journal of psychology (volume X, nº1). Santiago.
  • Zegers, B. (2002). Psychology of aging, Teaching document nº36. Santiago: University of the Andes.
  • Villena, J. El duel (online).
  • Zegers, B. (1992). Assessment of affective life. In P. Marin (Ed), New time for the elderly: an interdisciplinary approach (pp. 118-132). Santiago: Catholic University of Chile Editions.
instagram viewer