Bereavement in the elderly: spouse interaction as a modifying variable.

The purpose of this study in bereavement adaptation of the elderly was twofold. First, the pre-terminal interaction between spouses was classified into two categories, closure and non-closure, by means of an index developed from a review of the literature. This index quantified the type and extent of interaction between spouses when one spouse was dying. Second, the group of survivors who attained closure was compared to those who did not attain closure in certain aspects of bereavement adaptation at two months after the death of the spouse. The critical utilized were based on previously reported bereavement-related feelings and behaviors noted in other bereaved populations. The survivor's perception of stressfulness of their spouse's death and their perceived coping ability was also compared between the two groups. Closure had an affect on the intensity and frequency of feeling and behaviors. In achieving closure, survivors had a chance to exercise certain behaviors which, in turn, paralleled certain feelings. This initiated the mitigation process pre-terminally, which modified intense stimuli otherwise experienced during bereavement. This investigations result illustrated this. The repetitious review of the spouse's death, talking to and looking for the spouse became frustrating behavior that the survivor attempted to buffer by avoiding reminders of the spouse and keeping busy. These behaviors related to feeling of disbelief, confusion, being dazed and irritable due to the nature of the disorientation with which the survivor was trying to cope. The closure variable significantly contributed to the modification of these bewildering symptoms when their frequency or intensity was high. Nursing; implications of this study were addressed to the three areas of research, practice, and education.