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Cry for help
Grief support for older Australians is lacking .
Katrin Gerber interviewed by Eleanor Campbell
Grief is a universal response to a significant loss or death of a loved one , but for some , the chronic physical and emotional symptoms of mourning can persist for years .
A new survey of 633 bereaved older adults found that 21 per cent met the criteria for a persistent complex bereavement disorder ( PCBD ), yet only 14 per cent had received help from a GP . Study lead Dr Katrin Gerber , a NARI Research Fellow and Honorary Fellow at the University of Melbourne , joined Aged Care Insite to speak about complicated grief and why older people aren ’ t being offered enough quality resources to cope .
ACI : Can you tell us what prolonged grief is , and why is it commonly found in older people ? KG : Grief is a very normal response to a significant loss . But sometimes , signs of grief remain severe and impairing for a longer period of time , and that can really impact a person ’ s ability to function . This is what we call prolonged grief , or persistent complex bereavement disorder .
This can include things like a pervasive longing or yearning for the deceased , a persistent preoccupation with thoughts or memories of the deceased , intense emotional pain like anger , sadness ,
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numbness , and also difficulty accepting the death or difficulty reengaging with day to day life . This intense form of grief can cause a considerable impairment in the person ’ s functioning , their ability to work , engage in social or personal activities .
To diagnose prolonged grief , these symptoms need to last for longer than 6 to 12 months . We recently did a nationwide survey of 633 bereaved older adults , and we found that 21 per cent met the criteria for prolonged grief even years after a significant bereavement . This is more than double what we see in the general adult population .
Some of the reasons why older people may struggle with prolonged grief are , firstly , they are often encountering what ’ s called the bereavement overload : multiple deaths of close family members and friends over a short period of time . And this accumulation of losses can really have a compounding effect on their physical and mental health .
Secondly , some older people also have fewer social support networks or social engagement that could help them through this really difficult time . And thirdly , I think many older people are very reluctant to seek professional help after a bereavement that could prevent them from potentially developing prolonged grief later on .
How did the older adults in the survey talk about how their grief affected their daily lives ? Grief can manifest itself in very different ways . Some of the psychological signs of grief that people spoke about include very intense emotions , like shock , anger , tearfulness , apathy or guilt . But there were also some positive emotions in grief , like gratitude for the time that you had with the person , love , acceptance , sometimes even relief .
What was interesting in our study was that , particularly for older people , they ’ re often presented with physical manifestations of grief , like changes in appetites , sleep , changes in self-care or physical pain . Increased substance use was often an issue after a bereavement . And in its most extreme form , grief was associated with higher mortality rates . Suicidal thoughts are a real concern because we know men over the age of 85 especially have the highest suicide rates among all age groups .
Many people also spoke about older family members dying within a short time of one another . There ’ s evidence that the stress of a significant bereavement can affect people ’ s cardiovascular system , causing the onset of a new condition or the worsening of an existing one . That could potentially lead to an early death , especially if you have a lot of preexisting medical conditions .
Do you think with an experience like COVID that this will be a growing issue in the future ? Absolutely . I think COVID has directly impacted how we die and grieve through lockdowns , visitor restrictions , limits on public gatherings such as funerals , and the fact that people are more often faced with death .