Cultural Awareness: Impact Of Loss Of Independence On Individuals

Develop a Cultural Awareness of the impact of loss on a range of people.

Loss of independence may be defined as a condition when an individual is unable to perform his daily activities without the help of another includes. Daily activities are referred to activities like visiting the washroom, having a bath, preparing food or feeding oneself. The rate of loss of independence is found to be higher in elderly individuals since human being tends to lose physical capabilities with age. According to the survey, 36.3 percent of the total number of elderly people in Australia has lost their independence due to various physical as well as neurological issues (Berian et al. 2016). Loss of independence imposes a highly negative impact on both physical as well as psychological well being of an individual. This specific loss often leads to intense grief resulting in depression, social isolation and development of lack of interest in daily activities. In this report, the chief issues suffered by individuals due to loss of independence and the consequences of those issues will be discussed. Along with that, discussion on both normal as well as complicated grief responses of an individual who is going through the loss of independence will be performed in this report. Apart from that, this report will also include the role of 3 relevant helpers and the type of help they can provide to the individual who is suffering from the specific loss.

Issues associated with loss of Independence

Diminished independence has the potential to impose a negative impact on both physical as well as the Psychological health of an individual. Especially when it comes to the elderly individual, loss of independence is a highly crucial risk that enhances their vulnerability (Pedone et al. 2015). The loss of independence, especially in case of elderly people can be classified into three factors namely, physical losses, mental losses and social losses. Physical and mental losses include:

• Unable to perform daily activities
• Facing difficulty in climbing stairs
• Unable to do minor jobs
• Unable to travel without the help of a helper
• Visionary as well as hearing issues
• Lower control over emotions
• Lower physical energy
• Lack of memory

Social losses due to diminished independence are as follows:

• Inability in attaining social gathering due to losing the ability of self-feeding
• Inability in participating in sport activities
• Inability in visiting desired places

All these factors result in social isolation that eventually leads to depression.

 Some of the chief reasons for diminished independence in an individual are as follows:

• Bad Falls: According to researchers, a fall leading to major injuries can be considered as one of the major reasons behind the loss of independence (Tappenden et al. 2012). Bad fall often leads to disability which snatches away the independence of an individual to perform his or her own activities independently. The decline in the ability to move as well as perform daily activities enhance the dependency of an individual on other’s assistance. This dependency may give rise to various issueslike grief, depression, and social isolation. Moreover, according to researchers, people suffering from lack of independence often suffer from lack of self-confidence (Pedone et al. 2015). The percentage of individuals suffering from loss of independence due to bad fall is higher in the elderly individual compared to that of youth (Wu et al. 2015). Diminished body strength due to old age is considered to be the most crucial reason behind this high percentage.
• Chronic pain: Another issue associated with loss of independence is chronic pain. Majority of seniors are found to lose their physical independence due to chronic pain. Chronic pain also leads to depression and enhance carelessness in undergoing proper medical care in elderly people. These, in turn, worsen the pain making both the physical as well as the psychological condition of the service user more vulnerable.
• The behavior of the Society: The behavior of the society is another issue that imposes an impact on the loss of independence.  When it comes to the independence of elderly people, it is crucial to have a tough conversation with aging parents restrict their movement for their own benefit. However, it has been observed that in the majority of cases

Normal grief reactions due to loss of independence

The term normal grief response refers to the psychological sufferings of an individual due to a specific loss, which though extremely painful, disruptive and consuming, is usually tolerable. Uncomplicated grief is usually self-limited and does not require formal treatment. When it comes to grief due to loss of independence, the victim is generally found to be suffering from normal grief in the initial stages (Kersting et al. 2013). The fact that they were independent for a prolonged period of time in life and have suddenly lost the capacity to perform basic day to day activities by their own and hence is entirely dependent on another person, starts bothering the individual. Initially, loss of independence, especially in elderly adults, triggers a number of emotions that include anger, fear, guilt, confusion and depression.

According to researchers, in the majority of cases, when an individual lost physical independence, fear is the first response that takes place (Rikli and Jones 2013). The individual becomes frightened of his or her vulnerability and becomes aware of the fact that they will not be able to manage their own life completely by themselves. Majority of people gets dependent on their close friends as well as family to be always available to them and help out themselves with their daily activities. The feeling of anger originates when an individual with diminished independence feel helpless and at times, result in violent acts performed by that individual. The feeling of guilt originates when the individual regrets for bothering another person to help him or she performs her daily activities. Moreover the refusal of friends as well as family to help elderly adults with diminished independence often makes them feel that they are a burden to the family which enhances the feel of guilt. This emotion often results in self-blaming and depression. Depression resulting from normal grief usually lasts for a time span of few hours to 1 week. In spite of the fact that normal grief is tolerable and does not require immediate medical attention, uncomplicated grief, if not given major attention, in its initial stage can result in major depression which has the potential to dramatically interfere the function as well as the quality of life.  

Issues associated with loss of Independence

Complicated grief reactions due to loss of independence

Normal grief if not handled with appropriate care  often leads to major grief-related depression which imposes a highly negative impact on both physical as well as the psychological well-being of individual who is suffering from loss of independence. Uncompleted grief if not given proper attention takes the form of completed grief which can be highly fatal for the victim of the mentioned loss, especially for elderly adults. Unlike uncomplicated grief, complicated grief requires medical attention along with the cooperation of the near and dear ones of the individual who is suffering from the loss of independence. According to researchers the most common complicated grief reactions that are evidenced in individual suffering from diminished independence includes depression, anxiety, suicidal thoughts, post-traumatic disorder and physical illness (Walter and McCoyd 2015). Depression is considered to be the most common expression of an individual who is grieving. According to researchers, sudden loss of independence is more likely to give major depression compared to individuals who have gradually lost their independence over a prolonged period of time (Doka 2013). Depression in an elderly adult due to diminished independence leads to social isolation and lack of communication with family members. Other symptoms of depression associated with complicated grief include numbness and lack of attachment with daily life, a constant feeling of bitterness, lack of trust in others, developing the feeling that life no longer holds purpose or meaning, unjustified agitation and irritability, inability to enjoy life or think positively.

Another complicated response associated with the loss of independence is anxiety. A person suffering from complicated grief develops anxiety that lasts longer than expected and has developed intensity that interferes with the daily functioning of life. Not only is that anxiety in case of diminished independence associated with an extreme feeling of guiltiness. Disruptive anxiety results in more complicated grief response that includes

• Making an individual feel like they have lost the control over their emotions and providing them with a feeling of overwhelming fear (Doka 2013)
• Excessive anxiety in an individual with diminished independence, especially the elderly adult often experience triggering of physical symptoms like an anxiety attack or heart attack. During an anxiety attack, individuals feel intense terror, chest pain and tightness, difficulty in breathing, dizziness, rapid heartbeat, shaking of body and sweating.

Apart from hampering psychological wellbeing of the individual, complicated grief due to loss of independence also results in several types of physical illness as being discussed below.

• Complicated grief results in stress and weakness of the immune system which in turn makes an individual more prone to aches, pains and illness (Brown2012).
• Elderly people with chronic medical conditions may suffer from reoccurrence or worsening while undergoing depression or anxiety due to diminished independence.

Physical illness along with psychological issues like depression and anxiety has the potential to give birth to suicidal thoughts. The feeling of dependence and ignorance from friends and family members results in the development of the feelings that there remains no purpose in life. An individual who has been depressed or has had thoughts of suicide before may be vulnerable to having suicidal thoughts while grieving. Suicidal thoughts being highly fatal to require immediate medical attention Along with attention from near and dear ones.

The percentage of individuals with diminished independence suffering from the post-traumatic disorder is much higher in case of sudden loss of independence compared to individuals who have gradually lost their independence (Marzona et al. 2012). People who have suddenly lost their independence due to major accidents are more likely to suffer from post-traumatic disorder (PTSD). PTSD can be defined as an intense emotion or psychological response to a highly disturbing traumatic experience such as physical or sexual assault, accident, war, natural disaster or death. The responses of individuals suffering from the post-traumatic disorder are as follows:

• Painful re-experience of the incident through nightmares while sleeping and flashbacks while awake.
• Emotional numbness and developing an inability to feel as well as express emotion towards family friends and loved ones.
• Developing irritation and anger for unjustified reason resulting in violent act towards oneself or others.

Normal grief reactions due to loss of independence

Help from physiotherapists

Physiotherapy can be highly beneficial for individuals suffering from loss of independence. The chief goal of a physiotherapist is to maintain the independence of an individual through treatment, as much as possible. In the following paragraph ways by which a physiotherapist can help an individual who is suffering from loss of independence has been discussed.

• Physiotherapy helps the healthcare user to independently perform daily indoor activities like taking food or brushing teeth (Walters 2013).
• An individual who is gaining back his independence through physiotherapy feel highly confident which helps him to cope up with depression.
• Physiotherapy reduces the development of anxiety which had developed due to loss of independence
• A physiotherapist helps the healthcare service user to regain his strength so that he can continue his daily activities more independently.
• Another advantage of undergoing physiotherapy is that it reduces the risk of injury from both indoor as well as outdoor activities ensuring that the individual can maintain his independence.

The role of a physiotherapist is to provide advice as well as necessary treatment to the healthcare service user. The major advices given to a healthcare service user suffering from loss of independence are:

• Advising ways to deal with difficulties while performing both indoor as well as outdoor activities
• Advice for reducing the risk of bad falls (Marzona et al. 2012)
• Advice on how to treat the pain or which operation to undergo for preventing loss of a specific organ
• Advice on the what physical activity is appropriate for a specific organ and what should be the amount of term to execute the activity
• Advice about any equipment and adaptations to the home that would help in recovery from the disability

There exists a huge range of physiotherapy treatment that has the potential to help individuals who have lost their independence. The chief treatments that are provided to healthcare service users to gain back their independence are as follows:

• Upper body strengthening exercises (Berian et al. 2016)
• Active and passive stretching for the upper limb
• Upper body mobility exercises
• Balance and coordination work
• Provision of necessary equipment that will be needed for performing daily activities at home.
• Usage of preventive measures within home if necessary.
• Help to provide aids for your loss of independence to make you feel less anxious.

Help from Psychotherapist or Grief Counsellor

Grief counseling can be defined as the form of psychotherapy that helps individuals to cope up with grief or mourning that has taken place due to death of near or loved ones or major life changes like loss of impendence, divorce or job loss. According to grief counselors, individuals react to their loss on the basis of their culture (Volkan and Zintl 2015). While some people prefer to withdraw themselves from the society as well as from their friends, family and relatives, some individual show anger and become violent to cope up with their grief. Considering the fact that majority of people who have lost their dependence, suffers from various psychological issues including depression, anxiety and post-traumatic disorder, it is crucial for them to undergo grief counseling as it facilitates expression of emotion as well as thoughts about loss including their feelings of anxiousness, sorrow, guiltiness and loneliness. A grief counselor helps his healthcare service user in accepting his loss through conversation. During counseling grief councilors makes the healthcare service users aware of the five stages of rebuilding one's life after a major loss. They teach the patient to accept her or her loss and adapt it in the day to day life. Adapting brings order back into daily life and attain stability.

However, the concept of grief therapy is different from grief counseling. While grief counseling is used to treat healthcare users suffering from non-complicated grief, grief therapy is used to treat patients with complicated grief issues. Unlike grief counseling, grief therapy includes putting the healthcare service user under medication (Pedone et al. 2015). The goal of grief therapy is to identify and solve the psychological and emotional problems which appeared as a consequence. Individuals undergoing grief therapy are prescribed medicines which help them keep their anxiety and depression in control. Apart from that regular counseling is done with them in order to prevent the re-occurrence of grief. Ofcourse during grief counseling as well as grief therapy, the participation of both friends and family is highly crucial to bring back the bereaved into a normal lifestyle.

Family and Friends

While physiotherapy o grief therapy is a significant way to deal with the loss of independence, the most beneficial way to eradicate the grief of an individual due to loss of independence is active participation of his friends and family in his journey to eradicate grief. It is highly crucial for family members to support an individual with diminished independence to deal with their disability (Walters 2013). Considering the fact that providing support to an individual who is losing independence may feel physically and emotionally exhausting at times, it must be remembered by the family members that family support is the most important thing that has the potential to eradicate grief for diminished independence with time. In the following paragraph, the factors that need to be followed by the family members, as well as friends of a bereaved individual, has been discussed.

Complicated grief reactions due to loss of independence

Patience

People who have lost their independence are often found to display anger and lose patience for an unjustified reason (Kersting et al. 2013). In such cases, family members should remember that the origin of these behaviors is their helplessness and thus show patience while dealing with the bereaved individual.

Outdoor activities

Considering the fact that staying at home reduces the scope of engaging with people and elevates the feeling of being confined, friends and family members of the bereaved individual should frequently organize outdoor activities to cheer up the individual (Brown 2012). Being in a touch of nature and loved ones will reduce the development of grief.

Encouraging them to speak their mind

Verbal communication is one of the most effective ways of managing grief. Hence family members must not avoid communication with the individual suffering from loss of independence and instead encourage him to speak his mind.

Conclusion

From the above discussion, it can be concluded that loss of independence can highly affect the physical as well as physiological well being of an individual. The fatality of complicated grief resulting from loss of independence in an individual is much higher than that of the non-complicated grief. However, grief due to diminished independence can be dealt with the help of physiotherapy, grief counseling or therapy and with the help of family and friends. Finally, it can be said that mere treatment or medication does not poses the potential to completely eradicate the issue and hence support of the society along with family members and friends are highly crucial for effective grief management.

Reference List 

Berian, J.R., Mohanty, S., Ko, C.Y., Rosenthal, R.A. and Robinson, T.N., 2016. Association of loss of independence with readmission and death after discharge in older patients after surgical procedures. JAMA surgery, 151(9), pp.e161689-e161689.

Brown, E., 2012. Loss, change and grief: An educational perspective. Routledge.

Doka, K.J. ed., 2013. Living with grief: Children, adolescents and loss. Routledge.

Kersting, A., Dölemeyer, R., Steinig, J., Walter, F., Kroker, K., Baust, K. and Wagner, B., 2013. Brief Internet-based intervention reduces posttraumatic stress and prolonged grief in parents after the loss of a child during pregnancy: a randomized controlled trial. Psychotherapy and psychosomatics, 82(6), pp.372-381.

Marzona, I., O’Donnell, M., Teo, K., Gao, P., Anderson, C., Bosch, J. and Yusuf, S., 2012. Increased risk of cognitive and functional decline in patients with atrial fibrillation: results of the ONTARGET and TRANSCEND studies. Canadian Medical Association Journal, 184(6), pp.E329-E336.

Pedone, C., Costanzo, L., Cesari, M., Bandinelli, S., Ferrucci, L. and Antonelli Incalzi, R., 2015. Are performance measures necessary to predict loss of independence in elderly people?. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 71(1), pp.84-89.

Rikli, R.E. and Jones, C.J., 2013. Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. The Gerontologist, 53(2), pp.255-267.

Tappenden, P., Campbell, F., Rawdin, A., Wong, R. and Kalita, N., 2012. The clinical effectiveness and cost-effectiveness of home-based, nurse-led health promotion for older people: a systematic review. Health technology assessment (Winchester, England), 16(20), p.1.

Volkan, V.D. and Zintl, E., 2015. Life after loss: The lessons of grief. Karnac Books.

Walter, C.A. and McCoyd, J.L., 2015. Grief and loss across the lifespan: A biopsychosocial perspective. Springer publishing company.

Walters, D.A., 2013. Grief and loss: Towards an existential phenomenology of child spirituality. In Children, Spirituality, Loss and Recovery (pp. 89-98). Routledge.

Wu, E., Barnes, D.E., Ackerman, S.L., Lee, J., Chesney, M. and Mehling, W.E., 2015. Preventing Loss of Independence through Exercise (PLIE): qualitative analysis of a clinical trial in older adults with dementia. Aging & mental health, 19(4), pp.353-362