10 Older Adults 271
and try to maintain their health. Once again, this requires a reworking of
identity as one learns to live with an unfamiliar body and a new set of
impairments or challenges.
Breast cancer brings new losses to older women. Older women’s rates
of breast cancer rise every 5 years and their chance of dying as a result of
breast cancer is also higher (Komen, 2015). Breast cancer can represent a loss
of beauty and sexual attractiveness as well as a loss of health. Once again, the
cumulative losses may challenge women’s ability to cope, yet many are able to
approach their diagnosis with grace if not equanimity.
Some older adults bring strong personal capacities to their confrontation
with loss. They have learned how to reappraise negative events to find some-
thing positive in them. Some use humor as a way of coping with losses and
indignities (Lurie & Monahan, 2015). Others struggle with chronic disease in a
more negative way and are unable to integrate the loss of their previous state
of health.
A chronic illness like Alzheimer’s disease may have a more challeng-
ing impact than a disease like cancer. Alzheimer’s entails ambiguous loss
(Boss, 1999) as the person is still physically present, but psychologically
absent in that they are no longer quite the same person. It seems prema-
ture for a spouse/partner to grieve in socially sanctioned ways because this
would remove the hope of the return of the patient to the partner’s life;
yet on one level the spouse/partner knows that the spouse/partner will
never return. Long-term ambiguity can create a sense of loss of identity and
mastery, leading to helplessness and hopelessness in the family system and
within the partner/primary caregiver’s life. Dementia progresses to the
point where intimacy and recognition cease. This can be especially pain-
ful. Those involved with care of Alzheimer’s patients are at greater risk of
strain, depression, physical problems, and have less time for leisure and
for other family members (Schultz et al., 2003). The caregiver (usually the
partner) of an Alzheimer’s patient must continually redefine and reinterpret
the relationship with the loved one. This in itself is stressful. Caregiver sup-
port groups decrease the isolation experienced by the caregiver and validate
caregivers’ concerns. Respite care is another support vital to caregivers’
well-being over time. Although often funded by home care agencies hoping
for business, online support has allowed caregivers with Internet access to
receive support while remaining home and available to their loved one (see
http://www.caregiveraction.org; http://www.caregiverstress.com; http://www.medicare.gov/
campaigns/caregiver/caregiver.html)
Typical and Maturational Losses
Loss of Home/Relocation
As adults age, the immediate home environment becomes more important
because: (a) older adults have limited mobility and spend more time at home;
(b) home becomes the place where aging bodies need the comfort of familiar
spaces and where functional abilities are not taxed (Oswald & Wahl, 2005);
and (c) the home and surrounding neighborhood may represent a lifetime of
