Senior Living: Making loss matter in the wake of grief

By David W. Hart, Ph.D.

Contributing writer

The children’s poet, Shel Silverstein, wondered in prose about the existence of happy endings.

He opined: “There are no happy endings. Endings are the saddest part. So just give me a happy middle and a very happy start.”

Silverstein’s poem mirrors many of the observations made by my older adult clients and personal friends: The end of the lifespan isn’t all it’s cracked up to be.

Of all the challenges that make up later adulthood, grief and loss are most frequently cited by seniors as primary instigators of negative states of well-being, including depression, anxiety, apathy, loneliness, substance abuse, and even suicidal tendencies. Which is why it’s important to know what grief is, when it becomes problematic, and how to employ meaning-making tools to better cope with grief over time.

Grief is a signpost of age – the older we are, the more losses we accrue. Endings come more rapidly and we’re called to say goodbye to the people who matter most to us. Losses in other domains, including physical and cognitive impairments, loss of a cherished dream, death of a pet, retirement and losing financial stability are also significant sources of grief. Talk about the possibility of double and triple whammies.

Descriptions and definitions of grief vary but is generally understood as the emotional suffering one feels when something or someone is missing or gone. Grief is a uniquely personal experience and, believe or not, there’s no right or wrong way to grieve. How you grieve depends on many factors, including personality (are you more rational or more feeling); coping style (do you generally make mountains out of mole hills or turn lemons into lemonade); life experience (do you have practice with grief); faith (using scripture and religious lessons to guide your response to grief); and nature of the loss (whether it was sudden and/or traumatic).

Normal grief, which typically lasts up to 3 years, can continue for a lifetime — through major milestones, special occasions, holidays, or each time you’re unable to do what you once were able to. Nearly 20 years after her passing, I still dream of my grandmother waking from Alzheimer’s disease, our relentless conversation about all that’s happened, and the terrifying realization that when I return to reality, the pain of her loss will still be with me. Inevitably, my slumber turns to sobs and my tears gently bring me back to oneness with my grief. The lesson here: Grief may never go away but I make it through my life by coping day-to-day with this significant loss.

That doesn’t mean that grief cannot take a turn for the worse and attempt to consume us. Complicated grief – pain of loss that is so constant and severe that it keeps an individual from resuming his or her life – can become a problem if the intensity of one’s state of mourning fails to subside over time. Complicated grief can include intense denial of a loved one’s death, imagining a loved one is still alive, extreme anger or bitterness, and feeling that life is empty or meaningless. If you’re experiencing any of these symptoms, I encourage you to quickly speak with a trusted member of your healthcare team. You may also reach out to me for direction or more information.

There are several evidence-based strategies to cope with grief and make meaning out of loss, but the single most important approach is to seek out the support of other people. I offer an important caveat here: Look for people who are comfortable with your feelings and limit their unhelpful comments (for example, I know how you feel; look at what you have to be thankful for; he’s in a better place now; and any statement that begins with “you should”). Other coping strategies that may be therapeutic:

• Praying, meditating or going to a place of worship;
• Joining a bereavement support group (there’s an excellent group at Torrance Memorial Medical Center);
• Expressing feelings through journaling, writing a letter stating all the important things that may have never been said, making a scrapbook or photo album celebrating life;
• Getting involved in an organization that was important to your loved one;
• Planting a garden in your loved one’s honor.

Comments to avoid when attempting to comfort the bereaved were previously stated but for those of you who intend to be helpful to your friend or family member grieving a loss, the following is a list of practical modes of assistance:

• Share an enjoyable activity;
• Take care of housework;
• Shop for groceries or run errands;
• Drive them to where they need to go;
• Accompany them on a walk;
• Look after pets;
• Drop off a casserole or other types of food.

This list isn’t exhaustive – just simple suggestions. The point here: We all can play a role in making meaning out of grief, whether we are the bereaved or a shoulder to cry on.

When my grandmother Janice died, our family’s grief was debilitating for many years. After a period of intense mourning subsided, we decided to make meaning of the experience by focusing our work on helping other families navigate the challenges that come with caring for a person with dementia. Each day, in every moment, we honor our loss by making efforts to improve quality of life for the folks we care for. Even writing this column is an avenue toward deeper healing. It turns out that endings, unhappy as Silverstein described them to be, may have the potential to be meaningful too.

In solidarity, with you, the reader.

David Hart, Ph.D., is the director of clinical services at Always Best Care Senior Services in Torrance and is a faculty member in the Department of Counseling at California State University, Fullerton.  Hart, founding chair and member of the South Bay Dementia Education Consortium, specializes in working with older adults with dementia and their families. For more information, go to alwaysbestcaresouthbay.com or contact him at dhart@abc-seniors.com or at (310) 792-8666.