University of Iowa Health Science Relations and
Kathleen C. Buckwalter MA, PhD
Professor of Nursing/Internal Medicine/Psychiatry
First Published: November 2000
Last Revised: December 2003
Peer Review Status: Internally Peer Reviewed

Coping with loss can be difficult for anyone, but the elderly may have a particularly difficult time because they may have lost so much. "Elders may face the losses of physical health, a loved one, and a role such as a profession," says Kathleen C. Buckwalter, professor of nursing at the University of Iowa College of Nursing. Buckwalter advises caregivers--family members or health care professionals--to learn to understand the impact of loss on elderly people.

"The elderly are less likely to cope as well as young people because of the added years of meaning behind the loss, and the fewer years with which to move on," says Buckwalter, a specialist in gerontology, the study of the process of aging and problems of the elderly.

Losses can have multiple ramifications--psychological and social, as well as physical--and may not conform to a younger person's expectations. For example, the loss of a driver's license due to physical or mental health can gravely affect an older person's self-esteem, sense of responsibility, and independence, Buckwalter says. "The symbolic meaning is broader than just losing the license," she says. Buckwalter suggests that the caregiver of a person who should no longer drive give a reason such as, "the car doesn't work anymore," instead of saying "you're not a safe driver anymore."

Similarly, the loss of a family home due to the move to a nursing home can symbolize to older people that they are no longer able to care for themselves. "We need to honor decision-making for these people--give them a sense of choice and mastery over their environment and lives," Buckwalter says. "For example, instead of telling someone that his or her niece is coming at a specific hour, ask what time he or she would like the niece to come visit."

"When the loved one enters the nursing home, a sense of meaningfulness for family members still at home may be lost," Buckwalter says. She suggests nursing home staff members work with family members to make the transition smoother.

Some losses for the elderly can be prevented or made less stressful. Buckwalter adds. Loss of eyesight due to glaucoma can be prevented through regular screenings. Loss of the work role due to retirement-- and the identity crisis that may accompany retirement--can be eased through pre-retirement counseling, activity planning, and volunteer work. Loss of bone strength may be combatted by exercise, calcium intake, selected medication, and a bone density exam after age 50.

Many losses are predictable, Buckwalter says, and caregivers can help the adjustment go smoothly. "Ask them what they feel about the loss. It's really important to hear them out and honor their emotions, no matter what they are feeling. Listening offers direct comfort and support."

For more information about easing loss, talk to your health care provider.