These questions are asked about 800,000 time a year to the bereaved spouses who have just lost a loved one, it happens to people of all ages but some of the people it hits hardest are the elderly. In the social aspect of life women are superior they make most of the social contacts while engaged in the bonds of marriage. The annual incidence of spousal loss through death has been estimated to be 1. 6% for elderly men and 3. 0% for elderly women (Murrell SA, Himmelfarb S 1989).
It is the 1. of the aged that is hit hardest by the loss of a spouse. A study by Harris (1993) noted four types of male caregivers to women afflicted with Alzheimers disease; The Worker, The Labor of Love, Sense of Duty, At the Crossroads. Although these women were not dead they were unable to interact in the social forum. This study depicted the lives of these men as ones of servitude and compassion to their wives but an empty and lonely social life. The first group that was examined was The Worker.
This group oriented to their new caregiver role by modeling the role after their work role, so that caregiving became for them a new work identity. Instead of being an accountant or salesman they are now a caregiver. These men change their lives in order to care for their wives. This task to them is not a question of why but one of how. Some of the husbands in this group set up mini offices in their homes in order to keep track of medical expenses and set up schedules for caring for their wives. The man that was interviewed for this study had set up an office in his house.
He was a self made man whos only mind set in life was one of business and, to him, it only made sense to treat this responsibility as a job. Mr. H is the primary care giver of his wife and at present he receives no outside services. I am the laundress, cook shopper, podiatrist I keep my phone right here on my desk and daily keep after Medicare, Blue Cross to make sure they follow up. He has been married to his wife for 54 years and he has only one child who left home. Their contact with their daughter is usually by phone and is infrequent.
Mr. H is only one of the four perspectives of the socially isolated elderly male caregiver. When people marry they share a love that lasts each of them their entire lifetime. For the men who fit into the Labor of love criteria their acts are not driven by responsibility but are done as expressions of the love they feel for their spouse. Each (of these men) looked at his wife now and saw her as she was when he married her(Harris, 1993). Even though these men love their wives dearly they are still susceptible to stress; this stress can at times be debilitating.
The men in each model require a little support from outside services. Mr. N, who has been married to his wife for fifty years, fit into the category of the Labor of Love and has become sensitive to the needs of his wife and is willing to do anything for her, but at times he needs time for himself. He calls in a nurse to look after his wife he says that he does this when he is about to break. These outside resources are almost a necessity in todays fast paced world. The demands placed upon the individual are massive almost too much to handle.
In this study most of the men fell into the group called the Sense of Duty . For these men the women the loved are a responsibility it is not as if they dont care for their wives it in fact is the opposite they care for their wives too much to let anybody else care for them. It is a duty that is a necessity because they would demand the same. Why do I do it? It goes back to my basic philosophy. This is part of life, and she would have done the same thing for me(Harris, 1993).
This was said by Mr. P a retired NASA employee he has been married for 50 years and for the past months his wife has steadily declined to the final stages of Alzheimers disease. Although the man who was interviewed for this study lived in a home containing three generations he was the sole provider of assistance to his wife. The last words quoted by this man sum up the caregiving role of sense of duty; I will never abandon her. (Harris, 1993)These men after a period of time feel as if only they can give the attention and personalized services that their wives need.
The time when a caregiver is most helpless is when the issue of caregiving first rises; the men who fell in to this category had never had to deal with caring for the person who looked after them. As Harris (1993) noted These men are usually the new caregivers whose wives are in the early stages of the disease. These men were most often in crisis. For these men every problem they face is a new one they do not know what they are supposed to be doing and they also dont know haw to do the tasks that are necessary in the early stages of the disease.
This group is one of the highest subscribers of outside help. It is not because they do not care for their wives it is because they do not know how to care for them. Mr. K was interviewed during a time of high stress, his wifes condition had just worsened and he had not formulated a plan to care for her. He still loves her but he is confused throughout the interview he kept repeating Heres the dilemma; I have to start making arrangements. I have to deal with it. It is so frustrating, she is so young. These typologies and common themes were derived from fifteen interviews.
To better demonstrate the experience the role of a male care giver commonalties within the groups need to be recognized. Although this framework covers some of the spectrum of caregiver behavior it would not be safe to say that it is the mold to be fit into. One of the greatest dangers in life is being frozen into rigid roles that limit ones self development and self expression. (Buttler, 1970). The men in these groups all expressed the need to express themselves; they felt as if they had no one to talk to or help available.
Perhaps men in their seventh and eight decades no longer have the powerful motivational bonds for continuity and interaction that accompany career/job and a wife and children who depend upon them, and – maybe- need to admit their new reality and deal with it. (Gryzack, 1999) When a situation arises and help is needed only a small amount of people can be counted upon to provide assistance. The average active social network is between sixteen and fifty people (Wegner, 1989) and of those people approximately only one third can be counted upon for assistance.
On average that is about five to seven people who are almost always family members. Within social support groups there are three criteria to be examined size and density, linkages, and content and composition. Size in a social support group is just that, it is the number of people in the group. Density is the amount of people in the group who are known to each other. An example of a high-density group is a network made up of those involved with one particular elderly person, since the majority of the members live in close proximity to one and other.
A study by Wellman (Wegner, 1989) showed that groups of high density are well integrated, small in numbers, with powerful linkages within them which provides ample emotional support, which is dependable. Small dense networks have the flaw of hindering knowledge because there is a propensity for the group to avoid seeking formal services. If a person is in a social support network that large in number with a weaker linkage then that person resides in a low-density grouping. Within a low density group there are abundant opportunities to receive material goods and tangible resources but emotional support is low.
According to Wagner (1989) social networks in the west are loosely knit, despite this most of the people in the group have ties to either, or both, family and friends. What that member of the social support group does is what he or she is to the person receiving help. Linkage is the levels upon which one person knows anther, there are two types of linkages a multiplex linkage and uniplex linkage. A uniplex link, for example, would be a cousin who is only known as just that, a cousin, and a multiplex link would be a cousin, shopper, laundress, and a source of transport.
Multiplex relationships are extremely dependent, they are found in relationships that are highly reciprocal. Multiple linkages are stronger, the support network of the elderly is constructed of several highly multiplex relationships and a border of less multiplex relationships. These ties are capable only if the person is in good physical and mental health, because the multiplex relationship is based upon the exchange of tangible objects and emotional support.
In this society linkages tend to be more beneficial for the party who requests help more often, they tend to be one sided. When a person is physically incapacitated they tend to solicit help more often, this help usually comes from family members. Family aid is requested in the necessary circumstance of sickness. The family members who respond to the call for help are for the most part within the nuclear family, a son or daughter, brother or sister. Their help is generally reliable. With increasing age / or dependency, more reliance on the family develops.
A study by Wenger showed that there are five categories that are identified as social networks: Local integrated , Local self-contained, Wider-community-focused, ocal family dependent, and private restricted support networks. The two most defenseless groups; local self -contained and private restricted networks, are represented heavily by widowed men. Support networks not only show the amount of support one receives but they also shed light upon the lifestyle one leads. The Local integrated support network involves family, friends, and the surrounding community.
Those who fall into this group are either currently involved in a community activity or have recently completed one. Due to their activities their linkages are usually multiplex and their networks usually dense. The members of this group have a highly active support network consisting of friends, family, and neighbors. They rarely relied upon social services unless their condition was debilitating. Those who are more likely to enter into assisted living are the people who fit under the heading of local self-contained support network. These are the people who are content with being solitary.
They lead privatized lifestyles they neither expect nor demand help from outside sources during atypical times of need, i. e. food shopping, laundering, or basic transportation. When asked to participate in community functions they played a passive, low key role. The role played by family members in the life of a person in the self contained network is minimal. People within the study had no support from their family members. Their social network density was extremely low they relied on their neighbors for the most assistance because they focused on a household orientation.
In contrast to the self contained support network the people in the wider community based network focused upon whom was around them. This group takes advantage of local organizations as well as neighbors and other members of the community. The linkage of their support networks are remarkably complex multiplex relationships. For the most part these networks are found in areas that are highly populated with retirees. Independence was jealously protected, but help was accepted when they decided that it was necessary(Wegner, 1989).
Those who do not have the luxury to decide whether or not they need assistance are the people who fall under the heading of the local family support network. The people in this group relies on family members for most of their needs, emotional and otherwise. The linkage of this network is remarkably high due to the low number of people caring for the individual and the proximity of those individuals performing that care. The people in this category are the most dependent. For some there is no one to be dependent upon. The lives of the people who fall under the heading of private restricted networks are one of forced independence.
In some instances they have out lived their cohorts in others they have out lived their children. Their social contacts are almost absolutely nonexistent, their networks are sparse and linkages are few and far between. Their support comes from outside sources such as meals on wheels or contracted domestic help. These people are the most vulnerable to social isolation. Although these people are not active in the social world they still are part of a family. What if one were to lose that companionship, if they were to be isolated from the one closest to them a husband of thirty years or a devoted wife of twenty-five years?
No one ever told me that grief felt so much like fear. I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep swallowing (C. S. Lewis 1961). There are five phases of guilt alarm and panic, searching, mitigation, anger, guilt and depression, and acceptance and reorganization. The phases of grief not only carry psychological burdens but also causes a lot of somatic stress. In the first stage, although there is no stage theory for grief, if alarm and panic bereavement is a time of high physical stress the initial response is fight or flight.
They sometimes suffer from feelings of panic, restlessness, and irritability. The impact of grief can lead to actual physical change such as loss of weight, digestive disturbances, headaches, and muscle aches and pains. As well as feelings of anxiety the bereaved person may keep sighing or loosing his or her concentration. They may drop normal personal hygiene routines and even at times feel guilty for feeling pleasure. They keep rehashing the events that led up to the deaths of their spouses. To ease the pain of grieving the survivor maintains a feeling that the deceased person is somehow nearby.
It is also common for the bereft to dream about their dead spouse. The loss of this spouse is more than just the loss of a partner it is the loss of a part of ones self. The person who recently lost a loved one will at times avoid people or places that remind them of their lost loved one. The grieving person is a sea of emotion ebbing from sheer and utter depression to flowing rage. Anger is a natural part of grief. Anger, irritability, and bitterness are usually associated with early grieving. These feelings tend to give way to a pervasive depression that is riddled with questions of how could this happen?
Why did it have to be her? It is common to want to find a place to lay blame even if that place is within that person. Everything in life is temporary, even life itself is temporary. The feelings of alarm, searching, mitigation, and anger are also just temporary the only loss that is grieved for is the loss of the role that one played, i. e. daughter, son, husband, wife, mother, father. Almost everything about us is based upon the roles we play in everyday life and when a major character is lost that sends the rest of the roles into upheaval.
