The geriatric orphan is described as an elderly person with no close friends nor survivor or family members who are available to provide emotional support. He or she has had significant others and lost them to death, distance or fractured relationships. This individual has not, however, desired to be alone. The researcher, Boyack suggests, “It is imperative to establish a surrogate network, assist the individual through their grief, resolve any unfinished business and seek appropriate resources for maintenance in the community as long as desired and able.” However for some, it can be a welcome relief to be among others in a congregate or institutional setting despite a commonly held belief against residing in a nursing facility or setting.
As we observe this individual we begin to understand the three Rs that define the tasks of aging as identified by the researcher, Cynthia Kelly. They are “accepting reality, fulfilling responsibility, and exercising rights.”
Realty has to do with accepting one’s capacities in the health, social and financial realm.
Responsibility includes planning for one’s survivors and for making the best choices regarding the remainder of life.
Rights include exercising the right to move at one’s own pace, the right to privacy, and the right to respect.
The geriatric orphan’s plight is often compounded by the loneliness of living alone. Loneliness for all intent and purpose can be an amorphous state of longing and feelings of isolation.
There is little information on the effects of living alone as it pertains to survival and satisfaction. Males who live alone or with someone other than a spouse are thought to be at a disadvantage in terms of survival, while it seems to make less difference to women. Both sexes are equally affected by income, race, physical activity and employment, but these are variable effects. The researcher, Moustakas sees loneliness “as a condition of human life that sustains, extends and deepens humanity.” In a recent research study on loneliness it was claimed that “loneliness is evidence of the capacity to love. The degree of attachment is directly correlated with the felt loss when detachment occurs.”
Florence Nightingale reflected on the fact that pets are an excellent companion for the elderly person who is living with a long term illness and with feelings of unrelenting loneliness. Studies concerning the value of a pet that lives with an isolated aged individual began appearing with popular literature around the 1980s. One reason for an old person to own a pet is companionship and what that pet can bring to the relationship.
For those who care for an elder, here are several questions that can be asked that would aid in a clearer understanding and reason for that loneliness:
- Does the elderly individual reply when spoken to?
- Does the elderly individual appear anxious, withdrawn, apathetic, or even hostile as demonstrated in the body language?
- Is he/she unable to articulate their personal needs?
- Is he/she eager for visitors but becomes distressed when they leave?
As a Registered Professional Nurse who has worked and cared for the aged, I urge the caregivers of a geriatric orphan, whether at home or in a facility, to become familiar with a technique known as verbal intervention. Here are several suggested interventional approaches.
- Ask whether the patient feels lonely daily.
- Devote time with the individual by either sitting quietly or open with a mutually shared conversation.
- Inform the person when you will be available to talk again. However keep your appointment as promised.
- Engage him/her with informal discussion pertaining to their feelings, with the purpose of obtaining insight into what the individual is sensing.
- Don’t expect an immediate response with that first intervention.
- When asking these questions consider the emotional trauma they may cause.
- Never force a response brought on by a question which may cause anger.
Here is a final thought. Alice, an elderly nursing home resident once framed it in the following manner. “Loneliness is a devastating illness, more so than physical illness and can be fatal. Some people can overcome a little, but the older the individual is, the more hazardous the loneliness becomes. A hug or touch is so important.”
Here then is a quotable quote that succinctly expresses a healthier direction for those who live with the pain brought on by an emotional reaction.
“Hope never abandons you, you abandon it.” Anon.