Counseling Older Adults with Dementia Who are Dealing with Death: Innovative Interventions for Practitioners

Abstract

As individuals age, they deal with an increasing number of emotional, physical, and environmental losses. One loss older adults encounter is their own and others' deaths. Older adults with dementia may face greater difficulty in understanding and dealing with death-related issues because of cognitive and memory changes. Little literature exists to guide the practice of grief counseling with this population. Thus, two innovative approaches-spaced retrieval and group buddies-will be presented as ways to help individuals with dementia deal with issues around death. Two case studies are presented to demonstrate the preliminary usefulness of these techniques with clients.

Constructing Couples’ Stories: Narrative Practice Insights from a Dyadic Dementia Intervention

“…On the one hand, interventions with the spouses or caregivers of people with memory loss aim to prepare caregivers for issues such as managing problem behaviors, resolving family conflict, and reducing feelings of burden (Hepburn et al 2001; Mittelman et al 1995; Whitlatch et al 2006). On the other hand, clinical interventions with the person who has memory loss aim to address issues such as improving coping strategies or coping with loss (Kasl-Godley and Gatz 2000; Lewis and Trzinski 2006). Interventions with the person with memory loss often focus explicitly on issues of identity, aiming to help people with memory loss affirm their personhood, share their stories with others and explore their changing identity (Beard 2004; Caldwell 2005; Ryan et al 2009; Young 2010).…”

The mourning process of older people with dementia who lost their spouse

“…, Rentz et al . , Grief & Myran ); professional caregivers were puzzled by how to treat the bereaved people with dementia, as neither guidelines nor educational and training programmes existed (Lewis & Trzinski , Gataric et al . ); people with dementia had difficulty encoding and storing memories regarding their spouse's loss, causing them to keep re‐experiencing their grief owing to cognitive impairment (Grief & Myran , Watanabe & Suwa ); people with dementia needed support by a psychologist or a psychotherapist and medication (Grief & Myran , Johansson & Grimby ).…”

“…In contrast, little is known about the mourning process of bereaved people with dementia and this has resulted in there being no guidelines concerning grief care for them (Rentz et al . , Lewis & Trzinski , Gataric et al . ).…”

“…However, there has been little focus on bereaved people with dementia (Grief & Myran 2006, Gataric et al 2010, Watanabe & Suwa 2015. Such studies' findings have included the following: people with dementia developed unusual delusions following the death of their spouse, which led family caregivers to decide to relocate them to a nursing home, (Herrmann & Grek 1988, Venneri et al 2000, Rentz et al 2004, Grief & Myran 2006; professional caregivers were puzzled by how to treat the bereaved people with dementia, as neither guidelines nor educational and training programmes existed (Lewis & Trzinski 2006, Gataric et al 2010; people with dementia had difficulty encoding and storing memories regarding their spouse's loss, causing them to keep reexperiencing their grief owing to cognitive impairment (Grief & Myran 2006, Watanabe & Suwa 2015; people with dementia needed support by a psychologist or a psychotherapist and medication (Grief & Myran 2006, Johansson & Grimby 2013. Worden (2010) describes the mourning process as the bereaved going back and forth over four tasks to overcome grief.…”

Challenging Aspects of Bereavement and Grief in Older Adults with Dementia: A Case Series and Clinical Considerations

“…Professional caregivers need to recognize and respond to the PWD's fears and anxieties about their illness and issues of death [18,33]. Care staffs need to be wary about using PWD's cognitive impairment to excuse their own difficulties in dealing with PWD's feelings of anxieties and uncertainties during the period of bereavement.…”