Wednesday, November 5, 2003

Traumatic grief among the elderly

Grief is a natural part of bereavement. However, for as many as 4.8 million Americans each year, it can result in an increased risk of physical ailments such as heart disease and hypertension. Especially among the elderly, traumatic grief-mourning which is abnormal and unhealthy-can also lead to sleep and nutritional disorders, major depression and substance abuse.

An estimated 16 million people are bereaved of a close friend or family member annually in the U.S. Most of these people experience moderate to intense grief at the loss; this is normal and healthy. However, for a significant minority, this ordinary mourning turns into debilitating traumatic, or complicated, grief. This is especially common in widowed men. Sufferers of traumatic grief typically display certain signs of unhealthy mourning from two to six months after the death:

• Difficulty accepting the death.

• Recurrent, intense grief and a feeling that otherwise memory of the deceased would be lost forever.

• Disturbing and intrusive images of the deceased and particularly the death itself.

• Avoiding social situations or activities associated with the deceased.

• Difficulty letting go of personal effects, photographs and other reminders.

• Reveries that interfere with day-to-day functioning.

“Our data showed that approximately 15 percent of recently bereaved elders suffered major depression,” said Carolyn L. Turvey, Ph.D., assistant professor of psychiatry at the University of Iowa’s Carver College of Medicine. Dr. Turvey reported the results of her study at a recent medical symposium sponsored by the Alderwoods Group, Inc. for the Society for the Advancement of Bereavement Management. “The rate of depression in the newly bereaved was nearly twice as high as the rate for married elders. Clinicians should screen everyone who has suffered loss of a spouse for depression.”

So how can doctors and hospice personnel deal with patients’ grief? The Society for Advancement of Bereavement Management says the old ways are often the best: traditional mourning rituals can help mourners feel grounded. In addition, they legitimize emotional and physical expression and validate people's feelings, providing a means of release that doesn’t violate personal or cultural conditioning.

It is important that doctors help families and older people in particular cope with and move past their grief because many studies show that the bereaved are at higher risk for increased morbidity and mortality following a loss. One service therapists can provide is to help design rituals that are meaningful to them. This can be an enormous gift doctors can give patients and their families. To learn more, go to www.sabm-agr.com.

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