Transitioning to Residential Aged Care: Loss and Grief
Published: 13 May 2021
What do you think of when you hear the words ‘loss’ and ‘grief’?
For many people, the first thought that comes to mind is probably death.
Despite this, there are in reality many types of loss, one of those being the loss of a way of life (Beyond Blue 2014), which may relate to changing jobs, retiring, moving away or other life events significant to the individual (Healthdirect 2020).
One such life event that has increasingly been found to cause feelings of grief is the transition from home to residential aged care (Zizzo et al. 2020). These feelings of grief may affect the older adult themselves, their loved ones and carers, and possibly even staff (GriefLink 2021).
With that in mind, how can we better support residents and their families when a loved one enters aged care?
What are Loss and Grief?
Firstly, let’s define what exactly the terms loss and grief mean.
Grief is a natural emotional reaction to the loss of someone or something important. It’s an individual experience that affects every person differently and may be expressed in a variety of ways (Healthdirect 2020).
People experiencing grief may feel emotions such as:
Why Might Transitioning to Aged Care Cause Loss and Grief?
Transitioning into residential aged care is a major life event that can be difficult and stressful for an older person and their carers or loved ones, especially if the change has come about due to a medical issue and there is limited time to make a decision (Relationships Australia Victoria 2017).
It’s important to note that the adjustment to aged care doesn’t only occur during the move itself; it’s a gradual process that begins long before the physical transition and continues after the client has entered the facility (Alzheimer’s Australia NSW 2012; BaptistCare 2014).
In some cases, it might even take 6 to 12 months for a client to fully adjust to their new environment (Relationships Australia Victoria 2017).
It’s estimated that over 50% of older adults living in residential aged care experience depression and/or anxiety, compared to 10% of older adults overall. Furthermore, less than half of that 50% enter residential aged care with pre-existing mental illness (Rossi 2017).
Specific reasons why older adults may experience grief when transitioning into aged care include:
Reduction in physical health
The transition to communal living
Loss or dispersal of valued belongings
Loss of independence, dignity and identity
Loss of social connections
Loss of valued routines
Loss of the comfort and familiarity of their home
Feelings of homelessness and helplessness
Reduced decision-making ability
Lack of privacy
Having negative perceptions of aged care facilities
Fear of being forgotten by loved ones
Fear of not being heard
Fear of the unknown
Fear of being mistreated
Fear of living with people who have dementia
The realisation that this may be the place where they die
Fear and anxiety about the future and death
Self-reflection or guilt about the quality of the life they have lived in the past
Doubts about whether they have made the right choice
Rushed admission into aged care due to a short decision-making period
Language barriers between staff and CALD clients.
(Aged Care Awareness 2014; Meaningful Ageing Australia 2016; Relationships Australia Victoria 2017; GriefLink 2021; HelloCare 2017; Alzheimer’s Australia NSW 2012)
Family members or carers may also experience grief during this transition for a variety of reasons, including:
Feelings of guilt for placing their loved one into residential aged care and ‘abandoning’ them
Feelings of sadness and frustration that they are no longer able to take care of their loved one
Feelings of shame that they have ‘failed at their responsibilities’
Feelings of resentment from other family members who do not agree with the decision to place their loved one into aged care, which may lead to arguments and impaired relationships
Feelings of disconnect and loneliness when their loved one is no longer in their full-time care
Loss of their caring routine
Anxiety about handing over responsibility to aged care staff
Loss of their primary care role (particularly for spouses)
Fear that their loved one will not receive compassionate and high-quality care
Watching their loved one experience distress when transitioning
Loss of an imagined future
Loss of their relationship with their loved one as it used to be
Loss of companionship
Loss of their loved one’s former self (in the case of clients with dementia)
Having conversations about end-of-life and death.
(GriefLink 2021; Alzheimer’s Australia NSW 2012)
Who is at Increased Risk of Experiencing Grief When Transitioning to Aged Care?
Some older adults have additional needs that may make it harder for them to adjust to residential aged care. These people include:
Zizzo, G, Mackenzie, C, Irizarry, C & Goodwin-Smith, I 2020, ‘Loss and Grief: The Experience of Transition to Residential Aged Care’, Australian Journal of Social Issues, vol. 55, no. 4, viewed 22 April 2021, https://onlinelibrary.wiley.com/doi/10.1002/ajs4.105
Test Your Knowledge
Question 1 of 3
Which of the following behaviours may suggest that a client is experiencing grief?
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