• Constructive Conversations about Loss and Grief by Felicia Juntunen

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    November 18, 2025 /  Basics, Difficult Conversations

    By Felicia Juntunen, Director of Care Management at Elder Care Management

    “No one has taught us how to act or what to say when someone dies. More important, no one has taught us what it feels like to grieve. We don’t know how to heal the hurt created by grief or how to live with it.”- Barbara Karnes, RN,

    My Friend, I Care: The Grief Experience

    As Aging Life Care Professionals, our work and service to aging individuals and their families frequently intersect with experiences of loss and the grief that accompanies it. We recognize the profound and varied impact grief has- on our clients, their families, and ourselves- and remain committed to fostering healthy coping and resilience following loss.

    Discussions about death and grief are often among the most challenging we encounter. As Barbara Karnes observes, few of us have been taught how to respond to death or how to grieve. By deepening our understanding of the nature of grief- its expressions, complexities, and effects- we can better facilitate constructive conversations that honor individual experiences and support the healing process.

    Understanding the Dimensions of Grief

    Grief is both universal and deeply personal. It is not confined to emotional pain alone but influences all aspects of human well-being:

    • Emotional: sadness, anger, guilt, relief, anxiety, loneliness
    • Cognitive: difficulty concentrating, decision-making challenges
    • Behavioral: withdrawal, restlessness, or disruption of daily routines
    • Social: isolation or diminished engagement with others
    • Physical: sleep disturbance, appetite change, chest / stomach discomfort
    • Spiritual: loss or renewal of faith, questioning meaning and purpose

    It is also important to recognize anticipatory grief- the process of mourning a loss before it occurs. This experience is quite common among caregivers, particularly those supporting loved ones with progressive conditions such as dementia. Anticipatory grief is often complex, as individuals navigate the dual experience of holding on while beginning to let go.

    The commonly referenced stages of grief- denial, bargaining, depression, anger, and acceptance– represent potential emotional responses rather than a prescribed sequence. Grief is not linear, and there is no uniform progression. Each individual’s journey is unique and influenced by their personal, relational, and cultural context.

    Facilitating Constructive Conversations About Grief

    Supporting individuals and families through grief requires sensitivity, patience, and a willingness to engage in authentic dialogue. Conversations about loss can evolve into meaningful opportunities for connection when guided by three key principles:

    • Pace: Acknowledge that each person’s grief journey is distinct. Healing unfolds over time and cannot be rushed or standardized.
    • Presence: Offer genuine presence without an agenda. Simply being with someone in their grief- listening attentively and empathetically- can be deeply comforting.
    • Permission: Provide opportunities for individuals to speak about their loved one, to share stories, and to express the full range of emotions associated with grief. Encourage healthy outlets for expression and connection to supportive resources.

    Sources of Support

    Encouraging individuals to access support can greatly enhance their ability to cope and adapt following a loss. Helpful resources may include:

    • Family members and close friends
    • Hospice bereavement and aftercare services
    • Faith-based or spiritual communities
    • Peer and community support groups
    • Licensed grief counselors or therapists

    Moving Forward

    “Healing the wound of grief is allowing ourselves to feel the pain, to recognize ‘I’m missing her,’ to cry, to experience the intensity of the moment and then to move on. We wipe our eyes, dust ourselves off and move forward into living the day. We know the pain will come again. It will be felt and experienced again. We will move forward again, and on and on.”- Barbara Karnes, RN

    Grief is an evolving process rather than an endpoint. Through compassion, understanding, and open communication, Aging Life Care Professionals can play a vital role in helping individuals and families navigate loss while continuing to find meaning, purpose, and connection in life.

     

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  • Constructive Conversations: From Curative to Comfort Focused Care by Felicia Juntunen

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    October 21, 2025 /  Basics, Difficult Conversations

    By Felicia Juntunen, Director of Care Management at Elder Care Management

    In previous newsletters, we’ve explored how families can transform challenging discussions into constructive conversations. One of the most sensitive topics in aging families is end-of-life care- a subject many find difficult to approach. As Aging Life Care professionals, we believe that informed families are better equipped to navigate these moments with compassion and clarity.

    Understanding what matters most to the older adult, recognizing the signs of frailty, and knowing what resources are available all contribute to meaningful conversations and supportive decision-making.

    From Curative to Comfort Care: Asking the Right Questions

    Changes in medical technology and cultural attitudes have reshaped how families think about health care and end-of-life decisions. It’s essential to ask questions that help clarify the older adult’s values and goals:

    • Will medical procedures prolong life at the expense of quality?
    • Is the goal to live longer- or to live better?

    Early conversations about personal preferences help guide families later, especially if they’re called upon to make decisions on behalf of their loved one. Care managers emphasize the importance of documenting preferences through advance directives, designating a decision-maker, and ensuring that person understands the older adult’s wishes.

    Recognizing Frailty: A Signal to Reassess Care

    Families often wonder when it’s time to shift the approach to care. Frailty is a key indicator. Aging Life Care professionals frequently work with individuals in their 80s and 90s, helping families assess whether medical interventions will truly benefit their loved one.

    Signs of increasing frailty include:

    • Sleeping more than being awake
    • Difficulty rising from a chair
    • Moderate to advanced dementia
    • Trouble swallowing and significant weight loss

    When frailty is present, the likelihood of recovery from surgery or invasive procedures diminishes. In these cases, care managers often encourage families to speak with medical providers about adjusting goals and being selective with the care they pursue.

    Understanding Support Options: Palliative and Hospice Care

    Early awareness of supportive care options helps families prepare for transitions when the focus shifts from prolonging life to preserving comfort and dignity.

    Palliative care provides relief from symptoms and stress at any stage of a serious illness. It can be delivered alongside curative treatments and is often provided through clinic visits, virtual care, or occasional home visits.

    Hospice care is designed for individuals with a life expectancy of six months or less. It focuses on comfort rather than cure and is delivered by an interdisciplinary team that addresses physical, emotional, and spiritual needs. Hospice care is available 24/7 and can be provided wherever the patient resides.

    Building a Foundation for Constructive Conversations

    Families can foster more compassionate and informed end-of-life discussions by:

    • Understanding the older adult’s preferences
    • Recognizing the impact of frailty
    • Becoming familiar with palliative and hospice care resources

    These strategies help families make decisions that honor their loved one’s values and promote dignity in care.

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  • Facing the Difficult Subject of Living Choices

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    July 27, 2016 /  Difficult Conversations

    Facing the Difficult Subject of Living Choices Many families want to avoid talking about end-of-life matters. This is understandable, as it’s a weighty subject with a variety of emotions attached to it. Parents feel resistant to the idea that they are closer to facing this. Children and other relatives are saddened and worried by what the future holds for their loved one. However, it’s a conversation that can’t be sidestepped. Facing it head on with a frank attitude will help your family come to terms with it sooner.

    One of the first and most important items to address is living choices. You want to have clear plans before there’s a crisis. Consider whether your parent needs minimal assistance, or more intense care for issues like Alzheimer’s and dementia. Naturally, most older ones would still like to stay in their homes. But if they struggle with day-to-day activities and household duties, they might wonder how that will be possible. It’s important to assess the reality.

    Some questions that you will want to discuss with your parents would be, “What challenges do you face? Is it difficult to drive, walk up and down stairs, or access the bathroom? What’s the plan in an emergency?” It’s completely possible that they can continue to live at home. Mom or Dad might require part-time or full-time care to manage this. Sometimes simple changes or adaptations to the home can also make it feasible.

    For those who remain in their home, there’s an abundance of resources that will help. Options include home health aides, housekeeping, meal delivery service, and transportation services. Retirement communities offer many of these services while enabling residents to enjoy independent living.

    For some, living alone is no longer possible. Consider whether or not moving in with you is the right choice. It all depends on the circumstances. You might look into senior housing. Cost plays a primary role, so this needs to be factored in. You might not realize how much your parents value your input. Show care and empathy. Ask questions and genuinely listen to their answers. They absolutely need to be involved in the decision-making process if they’re going to be happy with the end result. Don’t rush this decision! Take your time and think wisely.

    Writing down a list of their wants and needs is helpful. What features would make them more comfortable? What’s essential to their care? This is valuable even if they continue to live at home or choose to live with family members. You’ll need to consider their financial and work situations, and the adjustments that might need to be made in those areas. Bringing on a part-time aide can maintain balance.

    This is a monumental time in both parent’s and children’s lives. Even with a well laid-out plan, nothing’s going to go perfectly. At times, emotions will run high. But through communication, empathy, and understanding, your family can make it through.

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