Bereavement and the elderly: a critical review with implications for nursing practice and research

Loss is a common occurrence in the lives of the elderly. One of the most profound losses is the death of a spouse. Yet, infrequent and predictable as this event is for older adults, we know very little about the grieving process or the resolution of grief among this age group. For nurses who care for older clients an understanding of loss and bereavement is important in order to provide appropriate and timely support. In this paper the nature of grief and bereavement behaviour is discussed beginning with the earliest empirical work done in 1930 and including a synopsis of six major variations of grief. A comprehensive review and critique of current investigations provides the basis for suggesting that, because of flaws in conceptualization and design, there are substantial limits on the relevance of existing knowledge of grief for an understanding of this phenomenon among the aged bereaved. A beginning theoretical integration and discussion of key concepts related to bereavement and the elderly is provided. This discussion is summarized in a proposed model. This paper concludes with suggestions for nursing research and practice.