Monday, April 5, 2010

Psychological Aspects of Surviving Death of Adult Child

Death of an Adult Child

As with the death of an infant, parental grief over the death of an adult child is often overlooked. Attention is focused on the child’s spouse and family. People seem to forget that the adult, despite of his/her age, was still a child to his parents.

Because your relationship with your adult children is different from that with your younger children, or from when the older children themselves were younger, you can expect to see differences in your grief experience when your adult child dies. As your children mature, there is less physical, hands-on caretaking and more offering of advice and sharing of mutual interests. The relationship becomes more equal. Many describe it as one of being friends, of having a connection marked by reciprocity and equal access to power and resources.  Depending on your age and that of your child, role reversals or dependency shifts may have already begun, with your child now caring for you. While your earlier parental nurturance is not forgotten, the maturing of your child adds new facets to the relationship that bring up specific bereavement issues if this child dies.

 In the past, few parents lived long enough to see their children become adults. Parents would have been dead by the time their fifty-year-old son died suddenly from a massive heart attack. Now, with longer life spans and improved medical technology, there are an increasing number of parents whose adult children die.

 It may be particularly difficult for you to see your child robbed of reaping the fruits of his labors.  You  have  witnessed  your  child’s  struggle  for  education  and  job  security,  and  now  all  of  this  has come to naught with his death. It can bring an acute and angry sense of unfairness.

 It may be even harder on you to see the responsibilities left unattended with the death of your child.  The  children  left  fatherless,  the  company  without  its  director,  the  projects  that  will  remain incomplete — all illustrate your child’s absence. You may particularly regret any unfinished business you had with him.  You are likely to be deeply disturbed by all this.  The incompleteness of your child’s life can leave you with a gaping void.

 You can expect that you and your spouse will grieve more similarly following the death of an adult child  than  you  would  following  the  death  of  a  younger  child.  In one study, this type of loss was found to precipitate the most severe grief of all for fathers, while mothers remained at similarly high grief intensities for children of all ages. Your grief is profound; your sense of meaning crumbles. For many,  the  stability  of  life  is  gone  completely  after  an  adult  child  dies.
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 Acknowledging the Death

You may find that you are unable to believe the death has occurred. After all, your child has been reared successfully through more dangerous times. This is supposed to be the time in your life when you can let down your guard and relax. Your job has been accomplished successfully: You have protected your child, and now he can protect himself.  However, the death of your adult child viciously points out the fallacy of any parents ever being able to feel truly secure. It makes no sense:  infants die of Sudden Infant Death Syndrome; young children succumb to cancer; adolescents drink, drive recklessly, and die in automobile accidents.  Why should someone who has survived all of this, die before his natural life expectancy is reached?

It also may be difficult for you to accept the reality of the loss if your child was living outside your home. There is no dramatic absence to signal to you that the death has occurred. For instance, if you have become accustomed to your child’s living away in another state, it may be hard for you to grasp the fact that he is not still alive there. He left at other times, but he always returned. Consequently, the holidays may be particularly bad for you, as these are the times at which you may finally realize that your child is dead. He will not be coming home as he always did.

Because there is not the expectation of seeing your child on a daily basis, it may take a long time before you feel that your child’s loss is permanent and know that he has, in fact, died. However, although your intellectual acceptance of your child’s death may be hard, your emotional adjustment may be relatively easier than it would have been had he still been living with you. You don’t have to live with daily reminders of his absence.

Effects of Age on Your Grief

The developmental issues that you confront as an aging parent of an adult child can complicate your bereavement. You may be experiencing personal losses, such as retirement, widowhood, failing health, or midlife crises. These may lead you to feel that you have lost control, a feeling which is made worse by the death. Often, witnessing the pain of your child’s family and being unable to do anything about it can exacerbate your own pain. How can you answer your grandchild’s question “Why didn’t you die instead of my daddy?  You are so much older,” when it is the precise question with which you yourself struggle?

Another problem is that, depending on your age and the opportunities available to you, you may have diminished strength, abilities, and options for reinvestment of your emotional energies following the death of your child.  You probably are unable to have more children.  You may be retired, without the diversion of work.  Physical difficulties may restrict you; for instance, your eyesight may be so poor that you cannot read, or you may no longer be mobile enough to visit with others. You might not have enough energy to do something active to change the conditions that contributed to your child’s death, such as raising money for cancer research.

You may be concerned about having to assume caretaking duties for your grandchildren at a time when you yourself are emotionally or physically depleted. While some bereaved parents are able to manage this successfully, others cannot. If you are unwilling or unable to do so, you may have to contend with your own guilt or others’ reactions.

Depending on your circumstances, you may suffer from the absence of a support system to nurture you and help you with your grief. This is especially true in retirement communities and similar situations in which friends and neighbors never knew your child. They do not know how to react to your loss because they can see no observable changes in your life and did not know your child well, if at all. You also already may have lost a number of your friends and relatives through illness, relocation, or death.

On the other hand, you probably have had to cope with other traumas and bereavements in your life. If you successfully resolved these losses, you know that grief can be managed and survived.  This is an important realization to have in your grief. In this regard, age and experience can be positive factors for parents who lose older children.

Social Exclusion

As mentioned earlier, a major problem for bereaved parents of adult children is that they tend to be excluded from the concern of others. Much of the focus of attention is on the child’s spouse and children. Not only does this leave you with a lack of validation for your unique loss, but it may also mean that you are omitted from important activities following your child's death that could help you cope with the loss. For example, while your adult child’s spouse and children would certainly be invited to a ceremony in which a scholarship is given in his name, it would not be uncommon for you to be overlooked and not included. The focus simply is not on you, as it would be if your child were a youngster.

There is also a curious social phenomenon in which older individuals are expected to be less grieved by death. Some people assume that previous loss has made you immune to grief, or that advancing age means that you are comfortable with death because you are closer to it. These assumptions are not necessarily valid, and frequently the opposite is true. The older bereaved parent can be in an extremely vulnerable position.

Sometimes you may feel that you should suppress your own grief out of your concern for your spouse or your child’s spouse and children; other times, others will place this expectation on you. In either case, it will not be helpful.
 
Everyone has the right and need to grieve this loss.

Lack of Control

One of the major issues for any parent whose adult child dies is your significant lack of control. This stems from having less contact with any decision-making power over your children once they are adults. This is normal, but it can become a problem when you review your child’s life, the events of his death, or funeral or memorial service decisions.

It is very probable that you were not actively involved in your child’s last days or in his life in general. This may have been the result of emotional or geographical distance, or may have reflected your child’s desire to keep you only peripherally involved for your or his own protection. You may feel more intense guilt if you fail to appreciate the fact that increased independence, with its resulting psychological and geographical distance, is a normal part of a relationship with any adult child. Sometimes you may regret the independence you granted your child, as if you magically could have protected him from harm. Although it is untrue, this can fuel your anger, depression, and marital stress. On the other hand, you may be grateful that your child had the opportunity to achieve independence and enjoy his adulthood before he died.

If you were not involved actively in your child’s daily life, you may have been precluded from participating in your child’s care if he died from an illness. Thus you lost out on the benefits that such participation could have brought. In addition, if your child had been maintaining a lifestyle or making medical treatment decisions of which you did not approve, you may be left with feelings of ambivalence, anger, disappointment, and guilt.

Decreased control and lack of everyday contact may mean that you must struggle with incomplete information as you attempt to understand the circumstances that preceded your child’s death. Your questions may not all be answered, which will make it harder for you to resolve your grief. You may have to deal with your concerns about your child’s emotional and physical state, your worries as to whether everything possible had been done to prevent his death, and your anxieties about whether all his needs had been met. If you feel that there were problems prior to the death with which you could have helped, you may have additional difficulties. You may be angry with your child’s family if you think they failed to provide your child with the type of environment or care you would have wanted.

Another issue that may affect your bereavement is your limited control over the decisions regarding funerals and funerary rituals. Most often your child’s spouse makes these decisions, frequently influenced by her own parents and friends. You may be forced to endure rituals that are distasteful to you or suffer the absence of those that would be helpful and meaningful to you. For example, one set of parents was exceptionally offended by the fact that their child did not have a religious ceremony and that his body was cremated. This was not only upsetting to them in terms of their values, but it also contradicted their image of their child. To them he was a ten-year-old altar boy who strictly practiced his Catholic faith. They did not know him as the adult who had fallen away from his former religion and who had on many occasions expressed a desire not to have a religious service at his funeral.  Parents in this situation are quite distressed.  They cry, “I can make no decisions, yet he was my flesh and blood!”

On the other hand, it is possible that instead of feeling a desire for control, you may be relieved that you are no longer responsible for your child.  This does not signify a lack of love but rather a normal surrendering of parental duties.

Secondary Losses

In addition to losing your adult child, you may be suffering a number of secondary losses. If as a consequence of your own aging your social world was diminishing, the loss of a child who occupied numerous roles will be felt in many more ways. Where a role reversal or dependency shift had begun, you may have become dependent on your child in a number of ways —financially, psychologically, socially, or physically.  If you feel anger over your unmet dependency needs stemming from your child’s death, you may feel guilty. Practical problems such as social isolation, financial instability, and unmet responsibilities around your home or business may have developed.

Even if your child was not caring for you at the time of his death, you have lost someone who would have taken care of you in the future. You must deal with serious questions about your physical, emotional, and financial livelihood. You also may have been deprived of a source of comfort at a time in your life when you needed it.

You may feel that the death of your adult child has robbed you of a source of status and pride. If you were accorded particular respect because of your child’s position or accomplishments —perhaps he was a star athlete, a rabbi, a lawyer — you may lose social status with his death. If this status was one of the main supports of your self-esteem, this symbolic loss also will have to be grieved.

Your relationship to your child’s family may well change with the death. You may lose contact with them. Your child’s spouse may date others, and you may have to cope with the fact that your grandchildren will be raised by another who has taken your own child’s place. You may fear that the family will move away, taking away the last pieces of your child and a beloved in-law as well. The possibility of remarriage, the surviving spouse’s renewed dependence on her own parents, and the family’s increased reliance on others for physical, emotional, and financial support all poignantly highlight the absence of your child. You may fear that your grandchildren will forget their real parent or will not be reared in the way your child would have wanted. As you have little control in this situation, you may feel frustration and loss.

Other secondary losses develop for bereaved parents of adult children, such as the loss of the family business or the family name. Depending on your relationship with your child’s family and/or the existence of other children, you may feel particularly deprived at not having someone to whom you can bequeath important and symbolic heirlooms. You may lose a sense of personal and family continuity and immortality. Or, if you have already given these heirlooms to your child and they are retained by his family, you may have to face the awkward situation of wanting to get them back.

In summary, the relationship between you and your adult child has a number of characteristics that can make that child’s death particularly difficult to address. In addition, your life situation as an older parent frequently complicates your bereavement. The loss of an adult child brings unique issues, problems, and demands that both you and those who seek to help you must recognize.  You will have to accept the limits of your control, realize that decreased contact and increased independence are both natural and normal in a relationship with an adult child, and search for the information you need in order to successfully cope with your child’s death. Finally, although society downplays the importance of your feelings, you will have to make sure that you pay attention to your grief.

Special Family Configurations

When family configurations differ from the two-parent, several-children model, there can be additional difficulties for parents mourning the loss of a child. These are outlined quite briefly here in an attempt to bring out special areas of consideration.

Single Parent

If you are a single parent, you face the incredible burden of trying to take care of yourself and your surviving children alone following the death of your child. You often must make crucial decisions without input and support, and face major events by yourself. Usually there is no one to spell you from your responsibilities, share in your duties, or relieve you from your burdens. You alone are responsible for meeting parental, work, financial, social, and household obligations —and all while you are actively grieving. 

Because you lack another adult with whom to share your grief, you often do not have a sufficient respite from it.  Frequently there is a general lack of support for single parents.  This is not to say that friends and family are not concerned.  However, when you are alone in the middle of the night and need to be held or want to share the pain of grief, you may not have the options of a bereaved parent who is in a relationship with another adult who is available to her.  Or you may not have the energy required to reach out. This particular isolation only increases the normal alienation felt by bereaved parents in general, and underscores the critically important need for special support systems.

As a single parent, you probably lack the person with whom you shared the pregnancy and at least some of the development of the child, as is the case in traditional marriages that survive.  Consequently, you are at a relative deficit when it comes to sharing memories of your child.  Also, because you are alone, if you are having difficulties coping, it may be a while before you come to realize this, since there may not be others to provide you with sufficient feedback. For such reasons it is important for single bereaved parents to have the support of others and to avail themselves of self-help support groups for bereaved parents.

The Remarried Parent

When your child dies, as a remarried parent you may have to deal again with your ex-spouse. If there is bitterness and unfinished business between the two of you, the grief of each can be complicated.  Feelings of guilt and blame that are a normal part of parental bereavement may be worsened in this situation when you two come together again.  Some are able to negotiate this successfully for their own mental health, as well as that of their surviving children. However, this is a situation in which issues are complex. This is especially true if one of you needs to have the support of the other because of the experiences that were shared around that child, and this puts pressure on a current spouse.

As a remarried parent, you also may have to deal with a blended family, and this brings up issues which will need to be confronted. There may be additional step-siblings or half-siblings and other blended family relatives who will be involved in the extended family mourning your child. When there are differences among these individuals, the grief experience can be full of problems. Our society is only just now trying to deal with the difficult task of negotiating blended families in rituals of life, such as weddings, baptisms, and funerals. Regardless of the types of issues presented, the fact that there are more individuals involved in blended families will affect the bereavement experience, for better or for worse.

Loss of an Only Child

When you lose an only child, your parental responsibilities end, as well as your parental gratifications. You must then contend with the total absence of your former identity as a parent.  This is tremendously disorganizing, confusing, and demoralizing. There is intense damage to your sense of self. You may wonder whether or not you can still call yourself a parent.

In addition, you may wonder to whom you will pass on your name and your heirlooms. There is no biological continuation of yourself and your immortality has been taken away.  You will never be a grandparent.  There are no other children for whom you can make a pretense of the holidays, or for whom you can force yourself to go on. Questions arise about who will take care of you and who will come to you on the holidays.

As a parent who loses an only child, you face the same issues as any bereaved parent, but you must do so in a vacuum of the parental role that is taken away with the death of the one child you had.

The death of your child exposes you to the most intense, complicated, and long-lasting grief known to humans. The loss is unlike any other particularly because of the unique aspects of the parent-child relationship, the unrealistic social expectations that accompany it, and the fact that it often robs you of your most important source of support by affecting your spouse as well.  Unfortunately, most people fail to see its critical differences from other losses and don’t understand that what is abnormal in those cases may be quite typical in the parental loss of a child.


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