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Helping the Elderly Cope with Grief

Many of us have lost loved ones to COVID-19, and we have had to deal with the grief we experience. Sadly, the elderly suffered these losses disproportionately, as so many of them have lost a spouse or a sibling—or even a child— who contracted the virus. Each person deals with loss and grief in a different way, but the elderly, in general, have greater difficulty coping with the loss of a loved one than younger people do.

In her book On Death and Dying, the Swiss-born American psychiatrist Elisabeth Kubler-Ross proposed that grieving people go through a series of stages, beginning with denial and anger and progressing through other emotions to the final stage of acceptance. Most bereaved people reach the stage of acceptance eventually and in a reasonable amount of time. However, about 10 percent of those who experience grief are unable to reach resolution and go into what has been termed “complicated grief.”

Like all other age groups, the elderly experience grief in different ways. One study found that some elderly show no outward signs of grief at all, while others respond to their loss with anger and become hostile towards those who are still alive. However, in a large study published in 2011, involving older adults in the Netherlands, about 25 percent of those who were experiencing grief were diagnosed with “complicated grief”—a much higher percentage than that in the general population. The study found that if the elderly person had lost a close family member, such as a spouse or a child, he or she was more likely to experience complicated grief. In addition, the older a person was, the more susceptible he/she to complicated grief.

People suffering from complicated grief have difficulty accepting the reality of their loss; they are unable to allow themselves to experience the pain associated with the loss; hence unable to adjust to the new reality. They minimize the value of the other relationships, those suffering from complicated grief show many of the same signs as those experiencing normal grief. The difference is, while these signs and symptoms diminish and disappear over time with normal grief, in the case of complicated grief they linger and may even become more intense as time goes by, so that the person is in a constant state of heightened mourning. It becomes impossible for them to focus on anything but the death of the loved one. The person becomes obsessed with the objects and possessions of the lost loved one, or, conversely, avoids them strenuously so as not to be reminded of their absence. The person may feel a sense of numbness or hopelessness, or feel detached from the world, with a sense that life is meaningless and without purpose and not worth living, that no one can be trusted. The person may be unable to experience enjoyment or appreciate the positive aspects of the relationship they had with their lost loved one. People suffering from complicated grief have difficulty carrying out their normal routines, and tend to go into isolation, and avoid social activities. These behaviours are, of course, detrimental to the wellbeing of the elderly, who, in the best of times, already have difficulty with aspects of daily living.

The elderly can be screened for complicated grief using the Brief Grief Questionnaire or the Inventory of Complicated Grief. Those diagnosed with complicated grief using these tools can receive grief counselling to assist them with processing their grief in a healthy and productive way and help them to come to terms with their loss so that they can return to their normal lives.