What it is: Grief is a response to loss and it can affect all parts of a person’s life.
Bereavement is the period of grieving experienced by family and friends in response to the death of someone close to them. A family includes people (and pets) identified by the person as family.
Why it matters: Feelings of grief and loss can affect a person’s physical health or mental wellbeing. For some people grief is experienced acutely, but with lessening impact on usual routines and behaviours over time. For others, it can be prolonged, tending towards depression or complicated grief. Observation and assessment by nurses are important and ensure people receive help when needed.
What I need to know: Grief and bereavement are natural responses to loss. In older people approaching end-of-life, anticipatory grief can sometimes be experienced, or as a response to changes in living arrangements and capacity to engage in usual daily activities.
The range of losses that might be experienced by older people includes loss of:
- the ability to do things that they used to enjoy
- independence
- control or ‘having their say’ in care or activities
- things that are familiar especially when moving from home into residential aged care
- a spouse, partner, close relative, friend, or pet.
Everyone grieves in their own way; there is no right or wrong way or time to grieve.
Having social support networks including family, visitor volunteers, or pastoral care may help.
Complicated or prolonged grief is extremely disabling, and should be escalated. Psychologists, pastoral and spiritual counselors or allied health professionals e.g. music therapists, may be able to assist. Medication may also be recommended in these instances.
Actions
The person may not need answers or advice; listening to them may give the greatest comfort. Use phrases such as ‘I can see you are having a tough time just now or ‘You don’t seem yourself at the moment, would you like to talk about it?’ and then take time to listen to their response.
Signs of grief to look for in older people include:
- crying or difficulty in expressing sadness
- anger
- anxiety or worry
- a change in eating habits
- losing interest in family, friends, or hobbies
- difficulty in sleeping, concentrating, or making decisions.
Let the older person know that grieving is a natural response to loss and respect cultural differences in grieving.
Spend time with the person in a gentle and unhurried way. Offer them and their family the opportunity to talk.
Talking with a GP, counsellor, or pastoral care worker may help.
Current evidence does not support systematic screening of all people recently bereaved but should be considered for those with persistent signs and symptoms of complicated or prolonged grief.