Seniors and Grief – by Jackie Waters

According to the AARP, 40 percent of all women, and 13 percent of all men over the age of 65 are widowed. It’s difficult to watch someone you love grieve the loss of a spouse, but there are things you can do to help. It helps to begin with learning what grief is and isn’t, and understanding the special challenges seniors face after the death of their best friend and/or life partner.

After loss

Death brings many complicated emotions that can be difficult to handle despite age and experience. There has been extensive research over the past few decades on the topic of grief. This information can serve as a starting place for understanding how the process develops. Ultimately, mourning is a personal experience and there is no instruction book or timeline to follow. The most important thing to remember when a loved one is grieving is there will be good days and bad days. It takes time to adjust to such a big change, and even longer to fully accept it. Cynthia Oliver of the Good Grief Center for Bereavement Support notes that grief is not simply an event with a set starting point and definite end date. Seniors who have lost a loved one are often experience with and effected by other forms of loss, long before their spouse or partner’s life actually ended. By this age, many have lost important members of their friendship circle and wake up every morning with a rapidly dwindling support network. In addition to grieving, people over the age of 65 may be trying to come to terms with their own mortality.

A long and winding road

The Kubler-Ross model has defined five stages of grief: denial, anger, bargaining, depression, and acceptance. Recent studies have shown that these stages don’t play out in a linear fashion, as previously believed. Most people feel different emotions throughout the course of their grief, often at the same time. Typically, the anger and depression stages are the most noticeable, although there is pain throughout the process.

According to Toni Bisconti, a psychologist at the University of Akron, those grieving tend to oscillate between stages. Keeping this in mind will prove helpful while caring for your loved one. It is worth pointing out that he or she won't simply "get over" the loss. The feeling of anguish will lessen over time, but never fully dissipate. Upon reaching acceptance, emotions become manageable but waves of sadness and anger may creep in long after the day a spouse died.

A study by Clinical Psychologist George A. Bonanno of Columbia University found that for about half of the study’s elderly participants, grief subsided substantially over the course of six months. Other research studies suggest that it takes a full two years to return to a satisfactory quality of life. One thing that is not contested, is that recovery is bolstered by the amount of familial and social support received by the surviving spouse.

Back on track

The National Institute on Aging says there are several ways to help a grieving senior remain on a healthy trajectory after a loss. These include:
● Encouraging a balanced diet by offering to bring food once or twice a week
● Spending time with them and encouraging social activities
● Helping them find a grief support group and offering to drive them to meetings
● Discouraging any major life changes until they have had time to mourn
● Watching for signs of depression, drug use (which is surprisingly common among older adults), and deteriorating health, and intervening if necessary
Remember, while you cannot eliminate feelings of sadness, you can help combat loneliness, encourage positive behaviors, and keep an eye on their activities for signs of internal troubles. With your support, your loved one will have a better chance of reclaiming their life, and finishing out their Golden Years with a whole and happy heart.

Jackie Waters is a mother of four boys, and lives on a farm in Oregon. She is passionate about providing a healthy and happy home for her family, and aims to provide advice for others on how to do the same with her site:Hyper-Tidy.com

Hospice vs Palliative Care

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It is often difficult for patients to understand the difference between hospice care and palliative care. Each distinction has several levels, which can add to the confusion. Many patients and family members are perplexed by how charges are billed or paid for by private insurance and the Medicare Hospice Benefit. Palliative Care is treatment that relieves suffering and improves quality of life for people of any age and at any stage in a serious illness, whether that illness is curable, chronic, or life-threatening. Treatments are paid for in same way you would pay for regular medical service. Medicare, Medicaid, and most insurance plans cover all or part of the services provided.

Hospice care is palliative in nature, but patients no longer receive curative treatments for their underlying disease. The focus is on comfort. A doctor has to certify that the patient is expected to have a life expectancy of six months or less, under "normal conditions".  It is difficult to account for the strength of the human spirit, and the exact date of death, just like the exact date of birth, is uncertain.

There is a specific Medicare Hospice Benefit, which has a per diem rate that covers treatment, services, and equipment. The first two benefit periods last 90 days, then an unlimited amount of 60 day benefit periods follow.  The hospice team reviews the patient's medical history following set clinical guidelines. If it looks as if the patient is still near the end of life, they are approved for recertification. If they have improved, they may be discharged back into palliative care.

You’ve seen one hospice, you’ve seen them all. Or…

...have you? Ask most folks who work in hospice and palliative care and they will say, “You’ve seen one hospice, you’ve seen one hospice”.

Elderly woman and her daughterThere are more than 3,200 hospices today with different working models – some are independent, others are non-profit agencies. Profit hospice companies are often part of hospitals or health systems. According to the National Hospice and Palliative Care Organization, their patient population is grossly underserved. They estimate that only one in three patients who could benefit from hospice services are actually receiving care.

In 2011, approximately 47 percent (or 1,059,000 patients) died in the US receiving hospice care at the end of lives. That is less than the percentage of people in this country who have written instructions or advance directives for their end-of-life care, such as a living will, a health care power of attorney, or a do not resuscitate (DNR) order. Despite the fact that it has been more than 50 years since Elizabeth Kübler-Ross wrote her groundbreaking work, On Death and Dying, Americans are very reluctant to talk to their aging parents about end-of-life decisions. Research shows parents are more willing to talk with their children about safe sex and drugs than about their own end-of-life decisions.

 

Ten Easy Ways to Reduce Stress for Caregivers of Hospice Patients:

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You have faced the reality that your loved one is not going to get better. While you are not giving up hope, you have made the decision to change the focus from trying to find a cure, to obtaining maximum comfort and a higher quality of life for the time they have left. This act can relieve a great deal of the decision-making stress. Being the primary caregiver for someone brings other forms of stress, and grieving the daily losses can be overwhelming. So keep this list handy, and remember caregiving means taking care of yourself as well as your loved one.

  1. Breathe! Most people employ only the top half of their lungs, robbing the internal organs of precious oxygen. Take a few minutes at the start of every hour to focus on your breath and consciously fill your belly full of air when you inhale.
  2. Check in with your body! A good posture aligns the spine and increases the abilities of the central nervous system. This means your organs (including your brain) function better and you become less fatigued.
  3. Drink water. Many people walk around dehydrated because of our love affair with caffeine, which actually dries you out more. By drinking caffeinated beverages you add to your fatigue, so you want more caffeine. Caffeine is an addictive drug often added to soft drinks, which because of their corrosive nature, have been shown to leach calcium from your body. Drinking enough water is sometimes all it takes to increase energy, decrease joint pain, and rejuvenate your skin.
  4. Take a break. Set a timer so at the end of every hour you take a three to five minute break (you deserve it). Studies show that people who take regular breaks actually work more efficiently overall.
  5. Stretch. Every 15 to 20 minutes, try checking in with your body. Freeze your frame and look at yourself. Are you in a truly comfortable position? If not, stand, stretch, breathe (and don’t forget to bend at the knees, not at the waist).
  6. Go for a walk. We are not meant to be sedentary. Our bodies were created for movement and they crave it. A 20-minute walk just one time a day has been proven to significantly reduce depression. According to the Mayo Clinic, prolonged sitting liked to obesity and metabolic syndrome. http://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sitting/faq-20058005
  7. Get some body work. Acupuncture, massage therapy, acupressure, reflexology can all release toxins from your body and help you feel rejuvenated. If you can’t leave or don’t want to have someone else treat you, go to http://www.holdmegently.com/ . They have a self-treatment booklet on hospice acupressure points. You can download for a fraction of the price of a regular massage, and use it to treat yourself and the person you are caregiving.
  8. Rub your hands together briskly and hold them over your eyes. We take in the majority of our information through our eyes. Pollen, sun glare, reading, looking at computer and phone screens, and pollution add to eye strain. Having regular exams, wearing sunglasses, and giving your eyes regular mini-breaks will help reduce their stress. Cucumber slices applied on top of closed eyelids at the end of the day are refreshing, and help combat inflammation.
  9. Put up relaxing images where you can see them regularly. This can be a conscious reminder of a person, place or thing that gives you a sense of comfort. Thinking about, or seeing baby animals or humans can produce oxytocin, serotonin, and prolactin - the "love" or "feel good" hormones. Some people make mini collages with multiple images and affirmations like, “Everything is fine” or, “I am safe and life is good”.
  10. Go to the bathroom and run cold water over the inside of your wrists for 30 to 60 seconds. In Chinese medicine this is known as ‘cooling the pulses’, and is particularly good any time you feel distressed. It has been known to lower the blood pressure, and it gives you some quiet place to escape and let your trouble go down the drain.