NURS09179 - Loss of Independence and the Role of Helpers

This report examines the multifaceted challenges individuals face when experiencing a loss of independence, particularly focusing on elderly individuals. It delves into the physical, mental, and social losses associated with diminished independence, highlighting issues like bad falls, chronic pain, and societal behaviors. The report distinguishes between normal and complicated grief reactions, outlining symptoms such as depression, anxiety, and post-traumatic stress disorder. Furthermore, it emphasizes the crucial roles of physiotherapists, psychotherapists/grief counselors, and family/friends in providing support and care. Physiotherapists aid in regaining physical abilities, psychotherapists offer emotional support, and family/friends provide essential practical and emotional assistance, all contributing to improving the individual's well-being and coping mechanisms. Desklib provides access to similar reports and solved assignments for students.

Running head: SUPPORTING PEOPLE FACING LOSS
Supporting People Facing Loss
Name of the Student
Name of the University
Author note

1SUPPORTING PEOPLE FACING LOSS
Table of Contents
Introduction......................................................................................................................................2
Discussion........................................................................................................................................2
Issues associated with loss of Independence...............................................................................2
Normal grief reactions due to loss of independence....................................................................4
Complicated grief reactions due to loss of independence...........................................................5
Role of the three helpers..............................................................................................................8
Help from physiotherapists......................................................................................................8
Help from Psychotherapist or Grief Councilor......................................................................10
Family and Friends................................................................................................................11
Conclusion.....................................................................................................................................12
Reference List................................................................................................................................13

2SUPPORTING PEOPLE FACING LOSS
Introduction
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.
Discussion
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

3SUPPORTING PEOPLE FACING LOSS
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

4SUPPORTING PEOPLE FACING LOSS
well as perform daily activities enhance the dependency of an individual on other’s
assistance. This dependency may give rise to various issues like 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

5SUPPORTING PEOPLE FACING LOSS
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.

6SUPPORTING PEOPLE FACING LOSS
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

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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

8SUPPORTING PEOPLE FACING LOSS
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.
Role of the three helpers
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.

9SUPPORTING PEOPLE FACING LOSS
 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:

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 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.

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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.
 Patience