EFFECTS OF LIFE TRANSITIONS
Posted by recep on March 26th, 2009For most elderly persons, late life is a period of transition and adjustment to loss. Transitions include retirement, relocation, and bereavement following the death of a spouse, family members, or friends.
Retirement: Frequently, retirement is the first major transition faced by older persons. About 33% of retirees have difficulty adjusting to certain aspects of retirement, such as reduced income and altered social role and entitlements. Individual circumstances surrounding retirement decisions influence the severity of adjustment problems. Some persons choose to retire and look forward to quitting unpleasant work; others are forced to retire because of health reasons or job loss. These factors help explain the different effects retirement has on retirees’ physical and mental health. Appropriate preparation for retirement and counseling for families and retirees who experience difficulties ameliorate many problems.
Relocation: A person or family may experience several transitions in residences in later years, including the sale of the family home and a move to smaller quarters, a move into senior-citizen or retirement housing to minimize the burden of upkeep, and finally a move into a nursing home. Some experts contend that such moves produce relocation trauma; however, recent studies find little or no evidence of increased mortality or other markers of such trauma. Physical and mental status are significant predictors of relocation adjustment. Those who respond poorly to a move are more likely to be men, living alone, socially isolated, poor, and depressed.
However, two factors mediate the stress of moving—the degree of perceived control over the move and the degree of predictability of the new environment. Families should be encouraged to acquaint the older person with the new setting well in advance of moving. For the cogni-tively impaired elderly, a move away from familiar surroundings may trigger a substantial increase in functional dependence and disruptive behavior. Awareness of the increased vulnerability of a demented elder may help families and staff cope during the adjustment period.
Bereavement: A complex phenomenon, bereavement changes many aspects of the elderly person’s life. Loss of companionship is accompanied by a decline in social interaction and a change in social status. The loss of a spouse has different effects on men and women. In the 2-yr period following the death of a spouse, men tend to have higher mortality rates than women. On the other hand, elderly men are much more likely to remarry after the death of a spouse.
Health care workers should be alert to symptoms of stress and depression during the grieving period. A hasty attempt to treat sadness with antidepressant drugs should be avoided because of their potential interference with the process,of grieving and adjustment. On the other hand, counseling and supportive services, such as widow-to-widow groups, may ease difficult transitions and facilitate adjustments to new roles and life circumstances. Prolonged and pathologic grief usually requires psychiatric evaluation and treatment.
