Companion Care conducts specialized trainings for their caregivers every month focusing on acquiring new skills and understanding clients’ needs. At the most recent training, our guest speaker was Dr. Mary A. Johnson, author of A Caregiver’s Guide: Insights into the Later Years. This book is filled with wisdom gained from her real life experiences as both a professional counselor and manager of several retirement communities. Sharing her personal stories with the Companion Care caregivers and managers helped those in attendance understand a variety of ways to support the seniors in their care.

One of the topics Dr. Johnson discussed was understanding secondary losses and the changes which result. Secondary losses are changes brought about as a result of primary losses and apply to so many facets that a circular cycle results.

What are some secondary losses? A major one is the loss of physical abilities. These can be caused by changes in health, disease or accident, and/or loss of memory. An example would be someone who was once a long distance runner who now has severe arthritis in both knees and can no longer walk without pain, let alone run. Think about the activities that you enjoy and how you would feel if you were no longer able to do them.

A loss of a role, or a part we play in life, can cause grief. For example, if a spouse or partner dies we are no longer a wife or husband or part of a couple. The ring may still be worn after a spouse’s death but the marriage role is no longer a part of who that person is. Retirement often also means the loss of a role. If someone worked for 40 years as a machinist but now has retired from that career, is he still a machinist? Or is he a “former machinist”? Retirement can affect a person’s perception of himself, especially if he is grieving the loss of his role.

Loss of financial status is regretfully common among seniors. Status may be affected by the loss of a spouse or partner, changes in health, or retirement. Many survivors do not know anything about their financial situation as part of a couple. Balancing a checkbook may be totally foreign to someone who was dependent on their spouse to handle all their financial affairs. They may have no idea what kinds of investments have been arranged. The resulting feelings of inadequacy may affect their self-esteem as well as their financial status. Some survivors are shocked to find they are deeply in debt, particularly if their spouse racked up a lot of bills for medical care prior to their passing.

Another common loss is the loss of ability to drive. This can result from changes in health or loss of memory. This loss has been shown by some studies to be more devastating than the death of a spouse. The day when the car keys are taken away marks the day the person loses their independence and freedom to go where they please. Changes in cognitive function is yet another challenge encountered in many forms of dementia.

These are just a few of the losses that may affect the elderly. Many of them encompass various types of loss of control. When a person feels they do not have control over their own lives they may become verbally abusive in an attempt to exert control over others. Dr. Johnson recommends that families and caregivers look for ways that their family member/client can have control in some areas. This is even more important in the case of individuals who are developing dementia because they are losing control of their thinking processes.

Coping with loss and the accompanying grief takes energy, often energy that elders no longer possess. Some people have a greater degree of resiliency than others and can cope more easily, but multiple losses take their toll on even the most resilient. One of the most supportive things family and friends can do is to be patient and understanding of loved ones who are looking for ways to cope with multiple layers of loss in their life.