270 Grief and Loss Across the Lifespan
One qualitative study with older adults who had attempted suicide
(Bonnewyn et al., 2014) found that respondents reported that life loss events
were so overwhelming that they undermined the foundations of their lives.
For the older adult respondents, life after loss was not worth living. The
respondents felt intense loneliness, alienation, and disconnection, and had a
tendency to isolate themselves before their suicide. The free floating anxiety
(trembling, shaking, breathing difficulties) symptoms reported by these older
adults in the weeks prior to their suicide attempts are corroborated by other
research (Liu & Chiu, 2009). Bonnewyn et al.’s respondents “found it unimagi-
nable to integrate the loss and loneliness into the previously constructed story
of their lives for the remaining time they had left” (Bonnewyn et al., 2014,
p. 617). The findings from this study suggest that health professionals should
be mindful of sleep deprivation, physical complaints, feelings of anxiety, and
exhaustion in their older adult patients.
Suicide is also a major concern among U.S. veterans, who are at higher
risk for suicide than nonveterans despite efforts to identify them (Braden,
Overholser, Fisher, & Ridley, 2015). Veterans often deny suicidal ideation, and
it appears that assessing the presence or absence of life meaning (having a
framework or set of goals for life and feeling a sense of fulfillment) may be a
better indicator of whether a veteran is at risk for suicide (Braden et al., 2015).
Veterans have admitted minimizing/denying suicidal thoughts to providers
due to feelings of shame, concern about the consequences of revealing sui-
cidal thoughts, and a belief that such thoughts should be kept private (Ganzini
et al., 2013). At the end of this chapter, Findley’s case presentation of Wesley is
a good example of how a sensitive, skilled professional can intervene with an
older veteran to target his posttraumatic stress disorder (PTSD) and depres-
sion. Knowledge of military culture and its stoicism and privacy are critical
features of work with this population.
Making sense of loss and difficult life situations can lead to meaning-
making; conversely, an inability to make sense of these experiences can lead to
depression and increased psychological distress. Even so, meaning-making is
notoriously idiosyncratic and difficult to define. Many meanings are ascribed
to meaning-making (Park, 2010). Various meaning-making interventions have
been shown to help older adults with dementia (Mackinlay & Trevitt, 2010),
advanced cancer patients (Breitbart et al., 2010), and general psychotherapy
patients (Adler, Harmeling, & Walder-Biesanz, 2013). These interventions seem
likely to help bereaved older adults and depressed veterans avoid suicide.Nondeath Losses
Coping With Chronic Life-Threatening Illness
Older adults commonly live with a chronic/life-threatening illness or dis-
ability. For many, the degenerative aspects of aging (bone loss, arthritis, etc.)
have taken hold. Movement and social interactions become more challeng-
ing. Many older adults can move beyond these losses and create new reali-
ties for themselves. Well-being (Carstensen, 2015) and a sense of integrity
and engagement (Sachs, 2015) are possible for elders who keep involved