Grief is grief, no matter how old the person you lose

I interviewed psychiatric nurse practitioner Ellen Carty, NP, APRN for this story after my mother passed away at the age of 96. I struggled with my feelings of grief and what our culture was telling me about losing a parent later in life. My question to Carty was, why, when someone has been blessed with such a long life and you feel as though that should somehow comfort you, is it still so hard to lose them?

“The loss of a mom is really considered one of the major life events,’ Carty said. “It doesn’t matter how old the mom is.”

If we are lucky, our mothers love us unconditionally, which is hard to find in any other relationships in our lives, she said. “Your mother is at the center of your life,” she said.

Carty assured me that what I was feeling was a natural and healthy response.

“If you find you’re surprised to be feeling this way, it means that you’re a certified human being. Pretending that you’re not missing your mom would really be a disservice to yourself,” she said.

Death of a parent later in life has not been studied extensively, said Carty, who is also certified in family and pediatric care and practices at Cape Cod Hospital. And death, in general, is still a difficult subject for many to talk about.

“There’s a discomfort with it in our society,” she said.

The Swiss psychiatrist Elizabeth Kubler-Ross brought the subject of death and dying and its effects on loved ones to the mainstream, and she developed the five stages of grief. She “raised the bar a little bit,” Carty said. “She planted the seeds, but we’re not there yet.”

When Carty lived and worked in critical care in Hawaii earlier in her career, she encountered many people of Samoan heritage, who tend to be quite spiritual, she said. When someone was seriously ill, “there would be 30, 40, 50 people in a waiting room, coming together, praying together, eating together,” she said. “There was something about that collective mourning that was really helpful to them.”

Memories and Displacement

Part of the reason the death of a parent in older age can be difficult is because we have collected so many memories that can arise at any time, she said.

“The hippocampus is like a big file cabinet in your brain. It stores every single memory you’ve ever had in your lifetime. But most of it we’re not aware of until certain things trigger some of those memories,” she said. “When you think of losing your mom, there are so many threads that can trigger all those memories that go way back to childhood. You can be in a grocery store and hear a song that maybe your mom sang or may have been her favorite song. You can have these overwhelming emotions come over you.”

Another aspect of losing a mother is called “generational placement,” Carty said.

“All of a sudden, the woman who planned Christmas and was at all the events and was at all the weddings, was present for every birth, is no longer there. So, you and your siblings are left trying to figure out how do we do this? How do we do Thanksgiving? Do we have the energy to take charge?”

As a result of this change, we start to examine our own mortality more closely, she said.

“We start thinking about our own health and our own aging process; what matters and what doesn’t.”

Grief Recovery

Carty found a helpful therapy years ago when she was going through a difficult time in her life. Called ‘grief recovery,” it was developed by a man named John James, who started the Grief Recovery Institute more than 30 years ago after the death of his son.

“(James) could not see himself moving forward,” Carty said. “He was ready to commit suicide, and he had a ‘God moment’ and said he knew there were others experiencing the same thing."

"He realized grief is more than the death; it’s the loss of memories, the loss of things we experienced when we were very young, like moving from our first house, when our best friend moved away, the loss of our first animal or there’s a divorce.”

James’ theory was that grief accumulates over time, and when there is a big loss, like a mother, it brings all the other losses forward, she said.

To help people process their grief, James developed a practice that includes creating a timeline of all the losses you have had in your life, big and small. If you find that there is incomplete closure on some of them, you can write letters or make phone calls or do other follow-up things that can complete that part of your life, she said.

“It’s almost like carving out time and saying, ‘Today’s the day I’m going to sit down with a big pad of paper and look at those areas of loss in my life; look at areas that maybe there was something I need to say to mom that I didn’t say. Maybe a goodbye letter of what she meant to me.”

It’s also helpful to have someone to read a letter to, she said. “Someone who can give you time, space and compassion.”

When You Need a Professional

There are times when you may need a professional therapist to help you work through your grief, Carty said.

“If it’s more than six months, and you’re still struggling where it’s affecting your day-to-day life, you’re drinking a little more wine than you should be. These would be signs of depression,” she said.

Another thing that can make grief difficult is if your relationship with the person who has died was complicated and was a relationship you struggled with. A therapist can help you work through this, even when the person is no longer there for you to directly resolve your issues.

Seeing a therapist to help with unresolved grief can help you move forward to be able to enjoy the other relationships in your life, Carty said.

“Mental health does not have to mean something like having schizophrenia. To me, it’s our emotional well-being; it’s how our lives are going, how we’re connecting with our families and our friends, and where we are finding purpose, what’s bringing us joy.”

After talking with Carty, I realized that while I will always miss my mom, the passage of time has helped me replace the sadness with an appreciation of the joy she brought to my life and those around her.

“You never will not miss your mom,” Carty said. “Generally, life gets a little easier and the fond memories will come more often.”