260 Grief and Loss Across the Lifespan
Objectives
After reading this chapter the reader will be able to:■ Understand the variety of losses that may occur in older adulthood and
how they differ from adult losses in other life phases.
■ Describe how the developmental tasks of older adulthood influence how an
older adult might cope with grief and loss.
■ Explain how theories of loss/grief/bereavement influence practice with
older adults.Developmental Crisis: Integrity Versus Despair
In this text, older adults are defined as those 70 and older. Although some
authors separate early and later older adulthood, we focus on the years after
midlife’s focus on generativity, grappling with mortality, and work life end-
ings have been accomplished. As noted in Chapter 9, reinvention and retire-
ment span the years between late midlife and early older adulthood. Older
adults typically have completed the transition from a focus on work life to a
focus on relationships and health.
Recently, Emanuel (2014) provoked controversy with an essay entitled
“Why I hope to die at 75.” His premise is that older adults live longer by
enduring greater illness rather than longer, healthier lives. He prefers to die
while still vigorous. Soon after, the inimitable Sachs (2015), at 81, shared how
his recent terminal cancer diagnosis gave him “sudden clear focus and per-
spective,” leaving him unwilling to put time into inessential activities and
focused on the relationships and activities that give him pleasure. These two
men exemplify different approaches to the fact that older adults are confronted
with opportunities for growth and development as well as many stressors,
risks, and forces (biological, psychological, and social) that can disrupt growth.
Older adults confront more physical losses (health) and social stressors (losses
of friends, homes, family members, etc.) than individuals in other life phases.
Even so, research shows that older adults most often feel a strong sense of
well-being (Carstensen, 2015). It seems that when older adults can focus on the
relationships that are important to them and continue to find purpose in life,
their sense of well-being is maintained through the challenges of aging.Biological Development
Older adulthood brings obvious physical changes including sensory losses
in hearing, eyesight, sense of smell and taste, and joint degeneration.
Chronic diseases, such as heart disease, cancer, osteoarthritis, strokes, and
diabetes, are all common in older adulthood. Cognitive changes are com-
mon: reaction time, short-term memory, and verbal processing all show
some decline, yet for individuals who have remained physically and cogni-
tively active, these declines are less pronounced and brain plasticity remains
(Erickson, Gildengers, & Butters, 2013). Memory issues tend to relate more