[Providing grief counseling to a major depressive elderly widower: a nurse's experience]

The death of a spouse is both a major loss and a tremendous life stressor for the partner left behind. Such has been shown to be particularly hard on the elderly. This article describes a nurse's experience caring for an elderly patient suffering from major depression resulting from the death of his wife. While providing nursing care to the client, the author, employing holistic nursing assessment, identified a reciprocal influence between his depressive symptoms and grief reaction. In applying the Inventory of Complicated Grief to ascertain grief reaction intensity to help the client discern between major depressive symptoms and grief reaction, the author found that the client (1) could not accept the loss of his wife, (2) had difficulty adjusting to life after his wife's death, and (3) faced a tense and distant relationship with his son. Such resulted in suicidal ideation and planning and feelings of loneliness, helplessness, hopelessness and incapability, which triggered major depression and a complicated grief reaction. Therefore, the author applied grief counseling to help the client accept the loss of his spouse, communicate his grief, overcome the difficult adjustment to life after his spouse's death, bid farewell to his wife, and establish new relationships. Such counseling gradually helped the client accept the inevitability of death and his wife's passing. To help the client establish new relationships under existing circumstances of negligible external support systems, the author encouraged the client to establish a new relationship with himself and integrate the old-age stage of life cycle naturally into his daily routine. Based on this care experience, we recommend psychiatric nurses assess cautiously the loss experience and grief reaction in elderly widowers under their care in order to provide timely grief counseling intervention to help the client pass quickly through the grieving phase and free him or her from the haze of depression.