Loss and Grief in Old Age
What is a “good death?”
A good death is ‘one that is free from avoidable distress and suffering, for patients, family, and caregivers; in general accord with the patients’ and families’ wishes; and reasonably consistent with clinical, cultural, and ethical standards.’ (Meier et al., 2016).
Describe your aging journey including direct and secondary losses and how they impact the dying process
Direct losses are those that come from the death of a loved one. As a person ages, they may lose their spouse or child. The loss of a sibling is also a primary loss. The primary losses can lead to a person becoming depressed and lonely. Some elderly patients may become suicidal after the loss of a spouse. Secondary losses, on the other hand, can result from direct loss or other sources (Hooyman et al., 2015). Examples include loss of support that the deceased loved one provided, loss of expectations, dreams and loss; and loss of roles where the roles that the deceased loved one performed have to be performed by the surviving (Walter & McCoyd, 2015).
Both the direct and indirect losses impact the dying process. When a person is lonely and unsure of the future, they may also desire to die. For example, suppose a person had made plans for the future, such as taking a trip to some holiday destination. In that case, the widow/widower may lose all interest in traveling after burying their spouse. Additionally, a person can die of broken heart syndrome. A broken heart syndrome resembles a heart attack and is characterized by sudden pain in the chest. Stress-induced cardiomyopathy, or takotsubo cardiomyopathy, is caused by a temporary enlargement of the heart and failure to pump well while the remainder of the heart continues to function normally or with contractions that are more forceful (Peters et al., 2015). A patient I attended to presented to the clinic with a broken heart, and after a series of differential diagnoses, he was treated. He later revealed that he had not gotten over the death of his only son. His son was involved in a workplace accident, and even with much prayer, faith, and hope from his father, he died 16 days after the accident. The patient was finding it hard to understand why God would allow his son to die even after all the prayers he had made to God.
I am a person that is close to my loved ones, and I have gone through some losses though not direct. I believe that I would more than likely be impacted by a broken heart syndrome if, for some reason, I lost my child. I am emotionally and mentally wired to believe that my child will bury me when I am at a good old age; I do not expect to bury my child. If it happens any other way, I will definitely lose any desire to live. I may not be suicidal, but I will definitely want to die sooner.
Is end-of-life care an appropriate personal selection and what is the impact of that choice on you and those you care for?
I would want end-of-life care primarily for my loved one’s sake. I would not want them to see me suffering; therefore, I would take the option to die in as much comfort as possible. I would want palliative care to be holistic, where spiritual, social, and psychological support is availed. I would do this for my family because I would want them to be at peace with my imminent death. However, I would want the end-of-life care to be availed for a short time, perhaps 4-6 months, to my death because of cost issues. When it becomes obvious that I will die and the time left to live is spelled out, I would consider palliative care. End-of-life care is traumatizing to the family and costly as well. My aim is to live a ‘normal’ life as much as I would. When my body can no longer take the impact of the illness, I will begin entering the nether land. I believe doing this will help my family ease into the reality of my death and help them have more pleasant memories of me as a person who lived through (rather than suffered through) to the very end.
References
Hooyman, N. R., Kawamoto, K. Y., & Kiyak, H. A. (2015). Aging Matters.
Peters, M. N., George, P., & Irimpen, A. M. (2015). The broken heart syndrome: Takotsubo cardiomyopathy. Trends in cardiovascular medicine, 25(4), 351-357.
Walter, C. A., & McCoyd, J. L. (2015). Grief and loss across the lifespan: A biopsychosocial perspective. Springer publishing company.
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Question 
LOSS AND GRIEF IN OLD AGE
As stated in the text, grief is a natural reaction to loss and loss is an inevitable part of being human.
Loss and Grief in Old Age
Many older people must deal with the cumulative effect of losses created by lifelong inequities as a result of their age, race, social class, sexual orientation, gender, or ability. In addition, ageist assumptions may mean that family members and health care providers presume that loss in old age is “not a big deal,” and devalue older adults’ grief. As individuals proceed with their aging journey, they are more likely to experience multiple layers of loss – some from positive life changes and others with negative impacts that the individual has no control over. Loss and grief faced by older adults can involve the death of partners, family members and friends but the inevitable loss is approaching one’s own death and the dying process. Understanding resources and choices available can have a definitive impact on this process.
Module 9 Objectives: At the end of this module, the student will be able to:
1. Differentiate the types of losses that older adults may experience
1b. List common non-death related losses in old age
2. Enumerate how the death of loved ones affects the well-being of older adults
3. Identify different end-of-life care options
3b. Discuss palliative care, hospice, and the “right to die” legislation
Module 9 Resources / Materials :
1. Textbook reading: Chapter 9 Loss and Grief in Old Age
2. Videos:
Write 2 double-spaced pages reflecting on the following case/scenario:
It is often noted that as we age, we look to a “good death.” Reflecting on your reading of Chapter 9 – what is a “good death?” Describe your aging journey including direct and secondary losses and how they impact the dying process. Is end-of-life care an appropriate personal selection and what is the impact of that choice on you and those you care for? Tie all concepts together in your narrative being helped by Chapter 9 readings, your life experience, and your research (use 2 outside resources, including the personal communication with an older adult).