5. Reflection on who you have been and who
you are.
What do you see? A life lived with
integrity or despair.
Each has lived a full life of
accomplishments and failures.
When you are able to embrace it all, you
have found WISDOM.
6. Do you reap what you sow?
Attachment dimensions are associated with
current and future care-giving, care-
receiving, and perception of carer burden
Four main styles identified with adults:
Secure
Anxious-preoccupied
Dismissive-avoidant
Fearful-avoidant
Investigators tend to describe the core principles of
attachment theory in light of their own theoretical interests
7. Attachment avoidance was associated
negatively with adult children’s future
care and positively with burden
Contrastingly, attachment anxiety was
positively associated with older parent’s
seeking support, perception of burden,
and intention to seek further support
8. Willingness to seek future care predicted
by anxiety
Fear of abandonment and other
characteristics of attachment anxiety
Anxious individuals’ need for validation and
reassurance, and extreme reliance on others
prompts seeking high levels of care and
excessive demands
Anxious older parents may be aware of the
effects of their insecurity
RESEARCH IN THIS AREA IS STILL IN ITS INFANCY
13. Complicated Grief: Those significantly
and functionally impaired by prolonged
grief symptoms for at least one month
after six months of bereavement.
Chronic Grief: Different from normal
grief by feelings of hopelessness, loss of
meaning and/or belief systems, intense
preoccupation and longing for a lost
loved one or situation, apathy, a
lingering sense of disbelief about the loss,
avoidance of situations or thoughts that
are reminders of the loss.
14. Dysfunctional Grieving is a maladaptive
emotional and behavioral response to
loss. It is in contrast to adaptive or
normal grieving, which progressively
moves the bereaved toward healing.
Prolonged Grief Disorder refers to a
syndrome consisting of a distinct set of
symptoms following the death of a loved
one that are so prolonged and intense
that they exceed the expectably wide
range of individual and cultural
variability.
15. At times it feels as if aging is about nothing
but loss
Health
Physical function
Friends and family move
Kids go away to college
Mental Capacity
Chronic Pain
Loss of energy
Spousal death
Death of friends, family, siblings
Depleted income
16. Dementia too often becomes the final major
issue. Insecure attachment affects the ability
to elicit help from caregivers.
17. When we choose to surround
ourselves with lives even more
temporary than our own, it is a
fragile circle, easily breached.
18. • Feel productive, useful, and needed
• Engage actively in life in order to meet
their needs
• Feel companionship and closeness that
provides security, protection, and support
• Because of the responsibility, we take
better care of ourselves
• Feel touched physically and emotionally
• Someone to communicate with
• Feel unconditional love
19. You can never do a kindness too soon
because you never know when it will
be too late…Ralph Waldo Emerson
20. In some ways, separation seems almost a
“rite of passage”
At almost every major crossroads,
separation of some kind takes place
Sometimes it seems an opportunity to
redefine yourself
For the mature adult, it can be
devastating and lead to ANXIETY!
21.
22.
23. Mature adults make up 12% of population and
account for 18% of suicides
Some feel this is under-reported by 40% as
silent suicides are not counted
High rate of completion
because they use firearms,
hanging and drowning
26. Loss of interest
Cutting back social interaction, self-care, and
grooming
Going off diets and prescriptions
Feeling hopeless, worthless
Putting affairs in order, giving things away, or
making changes in wills
Stock-piling medication or obtaining other
lethal means
Preoccupation with death
27. Be tender with the young, compassionate with the aged, tolerant of the weak,
because someday in your life you will be all of these.
~George Washington Carver~
28. May your golden years be truly golden
May you always find compassion
May you always have someone to love
May the road rise up to meet you and the wind
be ever at your back
Embrace your life, complete with
accomplishments and failures, and know true
wisdom
Sharon J. Kernen, Ph.D.
kershar@comcast.net
505-263-8055
Editor's Notes
INTRODUCE SELF
Born Erik Salomsen, German-American developmental psychologist and psychanalyst.
Never earned a bachelor’s degree yet served as a professor at Harvard and Yale. He was certified by the Vienna Psychoanalytic Institute, encouraged by Anna Freud, who noted his sensitivity to children. Identity was one of his own greatest concerns
Erikson’s stages of psychosocial development was produced in collaboration with Joan Erikson, his wife. It’s a psychoanalytic theory identifying eight stages through which a healthy individual passes from infancy to late adulthood. Each stage unfolds according to a natural scheme and ecological and cultural upbringing. Each stage presents new challenges to master and it builds on successful completion of earlier stages. Mastery of one stage is not required to advance to the next stage. The outcome is not permanent and modified by later experiences. Each stage characterized by a psychosocial crisis of two conflicting forces and if successfully reconciled, the individual emerges with the corresponding virtue. The first mentioned attribute is favored.
Secure: corresponds to secure in children
Anxious-preoccupied: corresponds to anxious-ambivalent in children
However, dismissive-avoidant style and earful-avoidant style are distinct in adults and correspond to single avoidant style in children
As aging parents decline in health, their vulnerability becomes more evident to children and felt security is no longer achieved through recollections of the attachment figure. The adult child then engages in helping behavior as a form of proximity maintenance to experience felt security. Caregiving delays the loss of the parent for as long as possible. Children’s consideration of future needs of older parents was associated with attachment. As the Karantzas study hypothesized, avoidance was positively related to burden and negatively related to willingness to provide future care. Low attachment avoidance maintains the perception of attachments figures as loving and caring and provides comfort in offering future care. Avoidant individuals do not know how to respond with empathy and concern. Attachment anxiety unrelated to children’s current and future caregiving
This results in recipients concern with burdening of care-giver and opt not to disclose their needs. However, in order to combat feelings of low self worth and the constant need for validation, highly anxious older parents may oblige their children to fulfill caregiving responsibilities. It is suggested that parents and children may hold different attachment concerns yielding differences in the seeking and provision of care. Results suggest that attachment dimensions affect caregiving and care receiving differently. Older adults with attachments insecurities may not respond well or seek care if avoidant, whereas those who are highly anxious may feel that they never receive sufficient care
No family or friends left
Trying to live on a fixed income results in disregarding good healthcare and nutrition
Fertile ground for despondency and hopelessness
Before we had always had a future, but what is it now?
The human spirit has the capacity to grieve any loss and grief can take so many different forms
Left unnoticed and unaddressed may result in self-destruction
Attachment behavior is marked in infancy but it will often emerge under life stress at any time. Bereavement has been identified as the MAJOR stressor in terms of mental and physical health.
Denial: the diagnosis is mistaken
Anger: How can this happen to me?
Bargaining: extended life in exchange for a reformed lifestyle
Depression: Recognition of own mortality…why go on?
Acceptance: Embrace mortality or inevitable
Importance of distinguishing the different types from the standpoint of differing treatments and possibility of mislabeling as depression.
Insecure attachment is a risk factor for a complex grief reaction.
Avoidant individuals need help expressing feelings about loss.
Those who are preoccupied (anxious/ambivalent) cannot stop grieving and need help restructuring their view of self in order to recover coping capacity.
What have you observed in how clients manage grief?
Health issues may come at any age but will become more debilitating with age…diabetes….always possible depression with chronic conditions
Our physical architecture is not really designed to live this long and wear out (oxidation) takes it toll on skeleton and organs
We live in a dynamic society where everything seems to be on the move. Seems like there will always be new surroundings to acclimate.
We strive to help our kids grow, progress, and recognize their potential. To do so, they must eventually leave the nest (at lease you hope they do and stay away.
None can escape age-related decline, but we can strategize ways to hang on to as much as possible…new learning, exercise, socializing
Chronic pain also seems inevitable, another matter of the structure unable to hold up to the prolonged stress….arthritis
If you could only keep up with those grandkids and their constant noise and chaos wouldn’t drive you nuts
We are all too aware that one in the partnership will someday no longer be there
We miss those who have gone on and left us behind to wonder….when?
The baby boomers are among the fortunate who are probably best prepared for retirement.
ANSWERS: Think ahead and prevent as much as you can. Make preparations to alleviate that stress for your children and you will gain peace of mind. MOST OF ALL….Assess your losses and strategize what you can do to take the place of the activities you can no longer do. Maintain a healthy social support system. Friends can be replaced.
If you are still strong and motivated keep working or start a new career.
Secure caregivers are able to identify the underlying emotional needs of their patients and respond flexibly.
Insecure counterparts focus on overt behavioral expressions. The avoidant caregiver will tend to withdraw while the anxiously attached become over-involved
Dementia is recognized as a condition that invariably produces fear and anxiety, especially in an unfamiliar environment. They will hate it regardless of how kind and invested the caregivers are.
The “stranger experiment” has been done with dementia patients resulting in crying, looking after (absent family member), running after, calling after the attachment figure. The presence of strangers to the person with dementia causes the person to feel permanently unsafe.
A loss that is difficult at any age but particularly for mature adults, whose most consistent experience is loss.
Feeling deprived of so much, it is no wonder that older individuals develop meaningful relationships with their pets. Attachments that are significant and enduring, and meet a whole range of physical and emotional needs.
Caring for a pet gives them something to live for and get out of bed every day
One suggestion: a parrot will probably live longer than you.
20% of the elderly report symptoms of anxiety arising from physical problems or medication effects:
For example: breathing problems, irregular heartbeats, or tremors. Additionally over half of elderly persons with severe depression also meet criteria for GAD.
Elderly people deal with significant life-changes, with threats to their independent functioning and with major losses when they are least equipped to handle them. This often leads to anxiety.
Help through relaxation techniques, psychotherapy and medications.
Gaius Plinius Secundus (AD 23 – August 25, AD 79), better known as Pliny the Elder (/ˈplɪni/), was a Roman author, naturalist, and natural philosopher, as well as naval and army commander of the early Roman Empire, and personal friend of the emperor Vespasian. Pliny the Elder died on August 25, AD 79, while attempting the rescue by ship of a friend and his family from the eruption of Mount Vesuvius in Stabiae that had just destroyed the cities of Pompeii and Herculaneum.[2] The prevailing wind caused by the sixth and largest pyroclastic surge of the eruption would not allow his ship to leave the shore and Pliny probably died during this event.[3]
Silent suicides: overdoses, self-starvation or dehydration and “accidents”
John and driving
Risk factors:
Increasing age
White male
Divorced
Major psychiatric disorder
Misuse of alcohol
Medical illness
Family discord
Finances
Physical disability
Unrelieved pain
Loss
Grief
The public sees depression and suicide as a normal aspect of aging