A TIME FOR REFLECTIONLifespan: The Final Stage

Presented by Sharon J. Kernen, Ph.D.

I always prefer to believe the best of everybody, it saves so much trouble.

~Rudyard Kipling~

Erik Erikson

1902 to 1994

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Final Stage: Integrity vs. Despair

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.

ATTACHMENT in ELDER YEARS 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

Role Reversal 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

Elderly parent response: 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

Insecurity is painful!

Never look down on anyone, unless you are helping them up.

The Bereaved GRIEF: keen mental suffering or distress

over affliction or loss; sharp sorrow; painful regret;

a cause or occasion of keen distress or sorrow.

It’s not really so simple…. Kübler-Ross Model1) Denial2) Anger3) Bargaining4) Depression5) Acceptance

Variations of Grief 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.

Cont. 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.

LOSSAt 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

Dementia and AttachmentDementia too often becomes the final major issue. Insecure attachment affects the ability to elicit help from caregivers.

Loss of Substitute Family: PetsWhen we choose to surroundourselves with lives even more temporary than our own, it is a fragile circle, easily breached.

Pets encourage us to…• 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

You can never do a kindness too soon because you never know when it willbe too late…Ralph Waldo Emerson

SEPARATION 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!

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Many understand this misery

Elder SUICIDE 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

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Warning Signs 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

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~

Thanks for asking me…. 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.net505-263-8055