TABLE III. Brief

Grief Questionaire for screening for Complicated Grief. This copyrighted instrument is reprinted with permission from Katherine Shear, MD. In later life, PD184352 ic50 losses commonly include spouses, siblings, and peers, and less commonly adult children and grand children, the latter of which are generally perceived as unnatural and unfair. Spousal loss may have followed a lengthy illness in which the care-giving burden may have been exhausting Inhibitors,research,lifescience,medical and the death a welcomed relief from terrible suffering but also might be a possible nidus for guilty rumination over admitting to having thoughts that they sometimes hoped for the death to occur in order to relieve their burden of care, thoughts they now consider be overly Inhibitors,research,lifescience,medical selfish in retrospect. Couples who have aged successfully as a unit of shared responsibility for each other sometimes find that being alone without their partner’s contribution can feel overwhelming, with either the perception they can no longer cope in the same way and are

therefore Inhibitors,research,lifescience,medical forced to accept help from other sources or possibly a move to an alternative living arrangement; or alternatively, the perception that their life is now empty without the caregiving role that organized their whole daily routine. A marital relationship that is mutually satisfying over a long period is viewed by some grievers with gratitude for lasting as long as it did. Finding new sources of support, however, can run the gamut from greater reliance on children, friends, religious institutions, or supportive environs such as life-care communities as well as hired help and potential Inhibitors,research,lifescience,medical new romantic relationships. Remarriage

is protective against depression for widowers, but not necessarily widows, and older survivors of losses through death sometimes conclude that too many complications would arise from remarriage as the multiple allegiances Inhibitors,research,lifescience,medical to each respective extended family are too cumbersome. A sustained romantic friendship is often chosen over remarriage or cohabitation in these cases. Increasing medical burden, disability, and cognitive impairment can occur within a large age range but all are more likely to accumulate with advancing age and thus the necessity of greater dependence on others can complicate the grieving process and further lead to demoralization or depression. Case vignette: recognizing and treating complicated grief in late life CG and its treatment are Calpain best illustrated with the case vignette of Sophia, age 72, whose husband of 52 years had died 9 months earlier after an acute illness. He had been well up to 2 days prior to death, and they had imminent travel plans until the point his illness turned grave with complications. Sophia was shocked that her husband, a prominent local businessman, had died so suddenly. She said she felt like “someone had cut her in two with a saw.