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Mitigating the Existential Suffering of Older People Transitioning Through Loss and Grief: Understanding the Liberating Influence of Compassionate Care

Year 2021, Volume: 4 Issue: 2, 19 - 30, 31.12.2021
https://doi.org/10.51819/jaltc.2021.1063724

Abstract

Later life is seen as the forerunner to multiple transitions involving loss and grief that have implications for the health and well-being status of older people. Common transitional challenges in later life involve bereavement, retirement, and relocation, including losses relating to the aging process per se. In essence, life-related transitions in later life present a range of possibilities for growth or decline in developmental capacities. This critical commentary draws attention to the need for awareness among health professionals and family caregivers to understand the potential for a disconnect of empathy and compassion from the existential loss and grief experiences of people in later life. A case is made for healthcare workers to explore the aging process more carefully and thoughtfully, with particular attention to the relationship of compassionate care to the existential aspects of loss and grief in later life. Shortfalls in the healthcare system are shown to hinder or endanger the provision of a high-quality, compassionate care culture for older people. It is suggested that any serious psychology of aging requires improved depths of study and understanding surrounding the existential dimensions of loss, grief, and bereavement.

References

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  • Aronson, L. (2019). Elderhood: Redefining aging, transforming medicine, reimagining life. Bloomsbury Publishing USA.
  • Baars, J. (2012). Aging and the Art of Living. JHU Press.
  • Baruch, V. (2004). Self care for therapists: Prevention of compassion fatigue and burnout. Psychotherapy in Australia, 10(4).
  • Basseches, M., & Gruber, H. E. (1984). Dialectical thinking and adult development. Ablex Pub. Corp.
  • Batson, C. D., Eklund, J. H., Chermok, V. L., Hoyt, J. L., & Ortiz, B. G. (2007). An additional antecedent of empathic concern: valuing the welfare of the person in need. Journal of Personality and Social Psychology, 93(1), 65-74. https://doi.org/10.1037/0022-3514.93.1.65
  • Birren, J. E., & Lanum, J. C. (1991). Metaphors of psychology and aging. In G. M. Kenyon, J. E. Birren, & J. J. F. Schroots (Eds.), Metaphors of Aging in Science and the Humanities (pp. 103-129). Springer Pub.
  • Boston, P., Bruce, A., & Schreiber, R. (2011). Existential suffering in the palliative care setting: an integrated literature review. Journal of Pain and Symptom Management, 41(3), 604-618. https://doi.org/10.1016/j.jpainsymman.2010.05.010
  • Bourgeois-Guérin, V., Millette, V., & Lachance, J. (2021). Communication and Silence Surrounding the Experience of Bereavement of Older Adults Living in Seniors’ Residences. Journal of Humanistic Psychology. https://doi.org/10.1177/0022167821995352
  • Brandtstädter, J., & Greve, W. (1994). The Aging Self: Stabilizing and Protective Processes. Developmental Review, 14(1), 52-80. https://doi.org/10.1006/drev.1994.1003
  • Bray, L., O'Brien, M. R., Kirton, J., Zubairu, K., & Christiansen, A. (2014). The role of professional education in developing compassionate practitioners: a mixed methods study exploring the perceptions xof health professionals and pre-registration students. Nurse Education Today, 34(3), 480-486. https://doi.org/10.1016/j.nedt.2013.06.017
  • Cheston, R., & Christopher, G. (2019). Confronting the existential threat of dementia: An exploration into emotion regulation. Springer.
  • Christiansen, A., O'Brien, M. R., Kirton, J. A., Zubairu, K., & Bray, L. (2015). Delivering compassionate care: the enablers and barriers. British Journal of Nursing, 24(16), 833-837. https://doi.org/10.12968/bjon.2015.24.16.833
  • Cohen, S., von Meding, D., & Abukhalaf, A. (2021). Successful Pandemic and Disaster Mental Health Preparedness Requires Widespread Community Collaboration. Academia Letters.
  • Cole-King, A., & Gilbert, P. (2011). Compassionate care: the theory and the reality. Journal of Holistic Healthcare, 8(3).
  • Croxall, J. (2016). Bereavement Support in Later Life: An Emerging Social Problem for the Twenty-First Century. In L. Foster & K. Woodthorpe (Eds.), Death and Social Policy in Challenging Times (pp. 131-149). Palgrave Macmillan UK. https://doi.org/10.1057/9781137484901_8
  • Davidson, W. (1991). Metaphors of health and aging: Geriatrics as metaphor. In G. M. Kenyon, J. E. Birren, & J. J. F. Schroots (Eds.), Metaphors of Aging in Science and the Humanities (pp. 173-184). Springer Publishing.
  • de Hennezel, M. (2011). The Warmth of the Heart Prevents Your Body From Rusting: Ageing Without Growing Old. Pan Macmillan.
  • de Lange, F. (2021). Suffering from or in Old Age? The Existential Gravity of Ageing. Journal of Population Ageing, 14(3), 357-371. https://doi.org/10.1007/s12062-021-09334-6
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  • Eklund, J. H., & Meranius, M. S. (2021). Toward a consensus on the nature of empathy: A review of reviews. Patient Education and Counseling, 104(2), 300-307.
  • Erikson, E. H., Erikson, J. M., & Kivnick, H. Q. (1994). Vital Involvement in Old Age: The Experience of Old Age in Our Time. WW Norton & Company.
  • Evans, E., Hyde, M., Davies, J., Moffatt, S., O'Brien, N., & Windle, G. (2019). Navigating later life transitions: An evaluation of emotional and psychological interventions.
  • Farran, C. J. (1997). Theoretical perspectives concerning positive aspects of caring for elderly persons with dementia: stress/adaptation and existentialism. Gerontologist, 37(2), 250-256. https://doi.org/10.1093/geront/37.2.250
  • Firestein, S. K. (1989). Special features of grief reactions with reproductive catastrophe. Loss, Grief & Care, 3(3-4), 37-45.
  • Fonseca, J. d. (2011). Ageing-Towards-Death. Existential Analysis: Journal of the Society for Existential Analysis, 22(2).
  • Forte, A. L., Hill, M., Pazder, R., & Feudtner, C. (2004). Bereavement care interventions: a systematic review. BMC Palliative Care, 3(1), 3. https://doi.org/10.1186/1472-684X-3-3
  • Fung, H. H., Siu, C. M., Choy, W. C., & McBride-Chang, C. (2005). Meaning of grandparenthood: Do concerns about time and mortality matter? Ageing International, 30(2), 122-146.
  • Gawande, A. (2014). Being mortal: Medicine and what matters in the end. Metropolitan Books.
  • Gierck, M. (2018). Take your time to really hear others. The Age, 30.
  • Goveas, J. S., & Shear, M. K. (2020). Grief and the COVID-19 Pandemic in Older Adults. American Journal of Geriatric Psychiatry, 28(10), 1119-1125. https://doi.org/10.1016/j.jagp.2020.06.021
  • Grenier, A., & Phillipson, C. (2013). Rethinking agency in late life: Structural and interpretive approaches. Ageing, meaning and social structure. Connecting critical and humanistic gerontology, 55-79.
  • Hashim, S. M., Eng, T. C., Tohit, N., & Wahab, S. (2013). Bereavement in the elderly: the role of primary care. Ment Health Fam Med, 10(3), 159-162. https://www.ncbi.nlm.nih.gov/pubmed/24427183
  • Hildon, Z., Smith, G., Netuveli, G., & Blane, D. (2008). Understanding adversity and resilience at older ages. Sociology of Health and Illness, 30(5), 726-740.
  • Hillman, J. (2012). The Force of Character: And the Lasting Life. Ballantine Books.
  • Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., Veloski, J., & Gonnella, J. S. (2009). The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic Medicine, 84(9), 1182-1191.
  • Ishikawa, R. Z. (2020). I may never see the ocean again: Loss and grief among older adults during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S85.
  • Ivancovich, D. A., & Wong, T. (2008). The role of existential and spiritual coping in anticipatory grief. Existential and spiritual issues in death attitudes, 209-233.
  • Laceulle, H. (2013). Self-realisation and ageing: A spiritual perspective. Ageing, meaning and social structure. Connecting critical and humanistic gerontology, 97-118.
  • Langle, A. (2001). Old age from an existential-analytical perspective. Psychological Reports, 89(2), 211-215. https://doi.org/10.2466/pr0.2001.89.2.211
  • Längle, A., & Probst, C. (2000). Existential questions of the elderly. INTERNATIONAL MEDICAL JOURNAL-TOKYO-, 7(3), 193-196.
  • Lathrop, D. (2017). Disenfranchised Grief and Physician Burnout. Annals of Family Medicine, 15(4), 375-378. https://doi.org/10.1370/afm.2074
  • Malouf, D. (2002). A great escape. Age (Dordr), 31.
  • Mannion, R. (2014). Enabling compassionate healthcare: perils, prospects and perspectives. Int J Health Policy Manag, 2(3), 115-117. https://doi.org/10.15171/ijhpm.2014.34
  • Moody, H. (2009). From successful aging to conscious aging. In J. Sokolovsky (Ed.), The Cultural Context of Aging: Worldwide Perspectives (3 ed., pp. 55–68). Praeger Publishers/Greenwood Publishing Group.
  • Morris, T. (2020). The Existential Dimension to Aging. Perspectives in Biology and Medicine, 63(1), 195-206. https://doi.org/10.1353/pbm.2020.0014
  • Mutter, J. (2018). Neglected in the House of Medicine. The Hedgehog Review, 20(3), 46-57.
  • Neimeyer, R. A., Holland, J. M., Currier, J. M., & Mehta, T. (2008). Meaning reconstruction in later life: Toward a cognitive-constructivist approach to grief therapy. In Handbook of behavioral and cognitive therapies with older adults (pp. 264-277). Springer.
  • O'Connor, P. A. (1988). Understanding the Mid-Life Crisis. Pan MacMillan.
  • Olay, C. (2020). Self-interpreting Language Animal: Charles Taylor’s Anthropology. In Life After Literature (pp. 117-135). Springer.
  • Olsson, C. (2021, 2021, September 16). It’s Inhuman To Deny People Proper Grieving. Herald Sun (Opinion).
  • Palmer, L., Nystrom, M., Carlsson, G., Gillsjo, C., Eriksson, I., & Dalheim-Englund, A. C. (2020). The intertwining of reconciliation and displacement: a lifeworld hermeneutic study of older adults' perceptions of the finality of life. Int J Qual Stud Health Well-being, 15(1), 1799588. https://doi.org/10.1080/17482631.2020.1799588
  • Palmér, L., Nyström, M., Carlsson, G., Gillsjö, C., Eriksson, I., & Dalheim-Englund, A.-C. (2019). The meaning of growing old: A lifeworld hermeneutic study on existential matters during the third age of life. Healthy Aging Research, 8(2), 1-7.
  • Parkes, C. M. (1988). Bereavement as a Psychosocial Transition: Processes of Adaptation to Change. Journal of Social Issues, 44(3), 53-65. https://doi.org/10.1111/j.1540-4560.1988.tb02076.x
  • Peterson, J. B. (2018). 12 rules for life: An antidote to chaos. Penguin UK.
  • Ramsey, P. (1970). The patient as person: explorations in medical ethics.
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Year 2021, Volume: 4 Issue: 2, 19 - 30, 31.12.2021
https://doi.org/10.51819/jaltc.2021.1063724

Abstract

References

  • Adams, J. D., Hayes, J., & Hopson, B. (1977). Transitions: Understanding and Managing Personal Change. Martin Robertson.
  • Aronson, L. (2019). Elderhood: Redefining aging, transforming medicine, reimagining life. Bloomsbury Publishing USA.
  • Baars, J. (2012). Aging and the Art of Living. JHU Press.
  • Baruch, V. (2004). Self care for therapists: Prevention of compassion fatigue and burnout. Psychotherapy in Australia, 10(4).
  • Basseches, M., & Gruber, H. E. (1984). Dialectical thinking and adult development. Ablex Pub. Corp.
  • Batson, C. D., Eklund, J. H., Chermok, V. L., Hoyt, J. L., & Ortiz, B. G. (2007). An additional antecedent of empathic concern: valuing the welfare of the person in need. Journal of Personality and Social Psychology, 93(1), 65-74. https://doi.org/10.1037/0022-3514.93.1.65
  • Birren, J. E., & Lanum, J. C. (1991). Metaphors of psychology and aging. In G. M. Kenyon, J. E. Birren, & J. J. F. Schroots (Eds.), Metaphors of Aging in Science and the Humanities (pp. 103-129). Springer Pub.
  • Boston, P., Bruce, A., & Schreiber, R. (2011). Existential suffering in the palliative care setting: an integrated literature review. Journal of Pain and Symptom Management, 41(3), 604-618. https://doi.org/10.1016/j.jpainsymman.2010.05.010
  • Bourgeois-Guérin, V., Millette, V., & Lachance, J. (2021). Communication and Silence Surrounding the Experience of Bereavement of Older Adults Living in Seniors’ Residences. Journal of Humanistic Psychology. https://doi.org/10.1177/0022167821995352
  • Brandtstädter, J., & Greve, W. (1994). The Aging Self: Stabilizing and Protective Processes. Developmental Review, 14(1), 52-80. https://doi.org/10.1006/drev.1994.1003
  • Bray, L., O'Brien, M. R., Kirton, J., Zubairu, K., & Christiansen, A. (2014). The role of professional education in developing compassionate practitioners: a mixed methods study exploring the perceptions xof health professionals and pre-registration students. Nurse Education Today, 34(3), 480-486. https://doi.org/10.1016/j.nedt.2013.06.017
  • Cheston, R., & Christopher, G. (2019). Confronting the existential threat of dementia: An exploration into emotion regulation. Springer.
  • Christiansen, A., O'Brien, M. R., Kirton, J. A., Zubairu, K., & Bray, L. (2015). Delivering compassionate care: the enablers and barriers. British Journal of Nursing, 24(16), 833-837. https://doi.org/10.12968/bjon.2015.24.16.833
  • Cohen, S., von Meding, D., & Abukhalaf, A. (2021). Successful Pandemic and Disaster Mental Health Preparedness Requires Widespread Community Collaboration. Academia Letters.
  • Cole-King, A., & Gilbert, P. (2011). Compassionate care: the theory and the reality. Journal of Holistic Healthcare, 8(3).
  • Croxall, J. (2016). Bereavement Support in Later Life: An Emerging Social Problem for the Twenty-First Century. In L. Foster & K. Woodthorpe (Eds.), Death and Social Policy in Challenging Times (pp. 131-149). Palgrave Macmillan UK. https://doi.org/10.1057/9781137484901_8
  • Davidson, W. (1991). Metaphors of health and aging: Geriatrics as metaphor. In G. M. Kenyon, J. E. Birren, & J. J. F. Schroots (Eds.), Metaphors of Aging in Science and the Humanities (pp. 173-184). Springer Publishing.
  • de Hennezel, M. (2011). The Warmth of the Heart Prevents Your Body From Rusting: Ageing Without Growing Old. Pan Macmillan.
  • de Lange, F. (2021). Suffering from or in Old Age? The Existential Gravity of Ageing. Journal of Population Ageing, 14(3), 357-371. https://doi.org/10.1007/s12062-021-09334-6
  • Dewar, B. (2013). Cultivating compassionate care. .are. Nursing Standard, 27(34), 48-55; quiz 56. https://doi.org/10.7748/ns2013.04.27.34.48.e7460
  • Dohmen, J. (2013). My own life: ethics, ageing and lifestyle. Ageing, meaning and social structure. Connecting critical and humanistic gerontology, 31-54.
  • Duggleby, W. D., Penz, K. L., Goodridge, D. M., Wilson, D. M., Leipert, B. D., Berry, P. H., Keall, S. R., & Justice, C. J. (2010). The transition experience of rural older persons with advanced cancer and their families: a grounded theory study. BMC Palliative Care, 9(1), 5. https://doi.org/10.1186/1472-684X-9-5
  • Eklund, J. H., & Meranius, M. S. (2021). Toward a consensus on the nature of empathy: A review of reviews. Patient Education and Counseling, 104(2), 300-307.
  • Erikson, E. H., Erikson, J. M., & Kivnick, H. Q. (1994). Vital Involvement in Old Age: The Experience of Old Age in Our Time. WW Norton & Company.
  • Evans, E., Hyde, M., Davies, J., Moffatt, S., O'Brien, N., & Windle, G. (2019). Navigating later life transitions: An evaluation of emotional and psychological interventions.
  • Farran, C. J. (1997). Theoretical perspectives concerning positive aspects of caring for elderly persons with dementia: stress/adaptation and existentialism. Gerontologist, 37(2), 250-256. https://doi.org/10.1093/geront/37.2.250
  • Firestein, S. K. (1989). Special features of grief reactions with reproductive catastrophe. Loss, Grief & Care, 3(3-4), 37-45.
  • Fonseca, J. d. (2011). Ageing-Towards-Death. Existential Analysis: Journal of the Society for Existential Analysis, 22(2).
  • Forte, A. L., Hill, M., Pazder, R., & Feudtner, C. (2004). Bereavement care interventions: a systematic review. BMC Palliative Care, 3(1), 3. https://doi.org/10.1186/1472-684X-3-3
  • Fung, H. H., Siu, C. M., Choy, W. C., & McBride-Chang, C. (2005). Meaning of grandparenthood: Do concerns about time and mortality matter? Ageing International, 30(2), 122-146.
  • Gawande, A. (2014). Being mortal: Medicine and what matters in the end. Metropolitan Books.
  • Gierck, M. (2018). Take your time to really hear others. The Age, 30.
  • Goveas, J. S., & Shear, M. K. (2020). Grief and the COVID-19 Pandemic in Older Adults. American Journal of Geriatric Psychiatry, 28(10), 1119-1125. https://doi.org/10.1016/j.jagp.2020.06.021
  • Grenier, A., & Phillipson, C. (2013). Rethinking agency in late life: Structural and interpretive approaches. Ageing, meaning and social structure. Connecting critical and humanistic gerontology, 55-79.
  • Hashim, S. M., Eng, T. C., Tohit, N., & Wahab, S. (2013). Bereavement in the elderly: the role of primary care. Ment Health Fam Med, 10(3), 159-162. https://www.ncbi.nlm.nih.gov/pubmed/24427183
  • Hildon, Z., Smith, G., Netuveli, G., & Blane, D. (2008). Understanding adversity and resilience at older ages. Sociology of Health and Illness, 30(5), 726-740.
  • Hillman, J. (2012). The Force of Character: And the Lasting Life. Ballantine Books.
  • Hojat, M., Vergare, M. J., Maxwell, K., Brainard, G., Herrine, S. K., Isenberg, G. A., Veloski, J., & Gonnella, J. S. (2009). The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic Medicine, 84(9), 1182-1191.
  • Ishikawa, R. Z. (2020). I may never see the ocean again: Loss and grief among older adults during the COVID-19 pandemic. Psychological Trauma: Theory, Research, Practice, and Policy, 12(S1), S85.
  • Ivancovich, D. A., & Wong, T. (2008). The role of existential and spiritual coping in anticipatory grief. Existential and spiritual issues in death attitudes, 209-233.
  • Laceulle, H. (2013). Self-realisation and ageing: A spiritual perspective. Ageing, meaning and social structure. Connecting critical and humanistic gerontology, 97-118.
  • Langle, A. (2001). Old age from an existential-analytical perspective. Psychological Reports, 89(2), 211-215. https://doi.org/10.2466/pr0.2001.89.2.211
  • Längle, A., & Probst, C. (2000). Existential questions of the elderly. INTERNATIONAL MEDICAL JOURNAL-TOKYO-, 7(3), 193-196.
  • Lathrop, D. (2017). Disenfranchised Grief and Physician Burnout. Annals of Family Medicine, 15(4), 375-378. https://doi.org/10.1370/afm.2074
  • Malouf, D. (2002). A great escape. Age (Dordr), 31.
  • Mannion, R. (2014). Enabling compassionate healthcare: perils, prospects and perspectives. Int J Health Policy Manag, 2(3), 115-117. https://doi.org/10.15171/ijhpm.2014.34
  • Moody, H. (2009). From successful aging to conscious aging. In J. Sokolovsky (Ed.), The Cultural Context of Aging: Worldwide Perspectives (3 ed., pp. 55–68). Praeger Publishers/Greenwood Publishing Group.
  • Morris, T. (2020). The Existential Dimension to Aging. Perspectives in Biology and Medicine, 63(1), 195-206. https://doi.org/10.1353/pbm.2020.0014
  • Mutter, J. (2018). Neglected in the House of Medicine. The Hedgehog Review, 20(3), 46-57.
  • Neimeyer, R. A., Holland, J. M., Currier, J. M., & Mehta, T. (2008). Meaning reconstruction in later life: Toward a cognitive-constructivist approach to grief therapy. In Handbook of behavioral and cognitive therapies with older adults (pp. 264-277). Springer.
  • O'Connor, P. A. (1988). Understanding the Mid-Life Crisis. Pan MacMillan.
  • Olay, C. (2020). Self-interpreting Language Animal: Charles Taylor’s Anthropology. In Life After Literature (pp. 117-135). Springer.
  • Olsson, C. (2021, 2021, September 16). It’s Inhuman To Deny People Proper Grieving. Herald Sun (Opinion).
  • Palmer, L., Nystrom, M., Carlsson, G., Gillsjo, C., Eriksson, I., & Dalheim-Englund, A. C. (2020). The intertwining of reconciliation and displacement: a lifeworld hermeneutic study of older adults' perceptions of the finality of life. Int J Qual Stud Health Well-being, 15(1), 1799588. https://doi.org/10.1080/17482631.2020.1799588
  • Palmér, L., Nyström, M., Carlsson, G., Gillsjö, C., Eriksson, I., & Dalheim-Englund, A.-C. (2019). The meaning of growing old: A lifeworld hermeneutic study on existential matters during the third age of life. Healthy Aging Research, 8(2), 1-7.
  • Parkes, C. M. (1988). Bereavement as a Psychosocial Transition: Processes of Adaptation to Change. Journal of Social Issues, 44(3), 53-65. https://doi.org/10.1111/j.1540-4560.1988.tb02076.x
  • Peterson, J. B. (2018). 12 rules for life: An antidote to chaos. Penguin UK.
  • Ramsey, P. (1970). The patient as person: explorations in medical ethics.
  • Riedl, M., Mantovan, F., & Them, C. (2013). Being a nursing home resident: A challenge to one's identity. Nursing Research and Practice, 2013.
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Details

Primary Language English
Subjects Geriatrics and Gerontology
Journal Section Articles
Authors

Terence Seedsman 0000-0002-6594-3742

Publication Date December 31, 2021
Acceptance Date December 31, 2021
Published in Issue Year 2021 Volume: 4 Issue: 2

Cite

APA Seedsman, T. (2021). Mitigating the Existential Suffering of Older People Transitioning Through Loss and Grief: Understanding the Liberating Influence of Compassionate Care. Journal of Aging and Long-Term Care, 4(2), 19-30. https://doi.org/10.51819/jaltc.2021.1063724

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The National and Applied Gerontology Association (NASAG) is a leading non-profit organization in Türkiye that promotes healthy and productive aging via evidence-based research. The utilization of multidisciplinary and interdisciplinary research in gerontology is crucial in integrating research, practice, and policy, given the need for evidence-based programming to improve the quality of life in old age. As an advocate for social action for older people, the NASAG is particularly concerned that public policies are strongly and genuinely focused on supporting and protecting the most vulnerable, marginalized, or disadvantaged older people.

The NASAG has been a member of the International Association of Gerontology and Geriatrics (IAGG) since 2007.