Yaşlılıkta yas

Yaşlılara özgü yas reaksiyonu üzerine bir gözden geçirme oluşturmak için Medline’da ilgili anahtar sözcükler (elderly, older adults, geriatric, bereavement, complicated grief) ile tarama yapıldı. Yaşlılık kayıpların görece daha çok yaşandığı ve bunun sonucunda yas reaksiyonunun daha sık ortaya çıkabileceği bir yaşam dönemidir. Buna karşın yasa karşı normal olarak verilen tepkiler diğer yaş gruplarından büyük farklılıklar göstermemektedir. Çalışmalar depresif yas belirtilerinin bir iki yıl içinde etkisini kaybettiğini göstermektedir. Ancak yaşlılarda yas reaksiyonu genellikle tamamen ortadan kaybolmaz. “Kurtulamazsınız sadece alışırsınız.” yaygın olarak kabul edilen bir önermedir. Komplikasyon olarak baskılanmış yasın yaşlılarda daha fazla görüldüğü bildirilmiştir. Hiper-trofik yas ve kronik yasın ise yaşlılarda daha az sıklıkta görüldüğü bildirilmiştir. Tıbbi komplikasyonların yaşlılarda daha sık olduğu gösterilmiştir. Sağlık sistemini kullanma, somatik belirtilerden ve kötü sağlıktan yakınma yaşlı dullarda daha sıktır. Özellikle alkol sorunu olan dulların, alkol sigara ve diğer maddeleri daha çok kullanmaya eğilim gösterdikleri bildirilmiştir. Ayrıca mortalitenin de yaşlı yas tutanlarda daha fazla olduğu gösterilmiştir. Kayıp öncesi depresyon varlığı, kayıp öncesi kötü ruhsal ve fiziksel sağlık, intihar gibi travmatik kayıplar, ilk günlerdeki aşırı reaksiyon, ekonomik sorunlar ve stres düzeyi, erkek dulların fazladan kayıplar yaşaması majör depresyon için risk etkenleri olarak görülürken, sosyal desteğin koruyucu etkisi gösterilmiştir. Majör depresyonun DSM-IV ölçütlerini karşılamayan hastalar için komplike yas ölçütleri önerilmiştir. Bu gözden geçirmede yas tedavisinin ana ilkelerinden kısaca söz edilmiştir.

Anahtar Kelimeler:

Yas, Yaşlı, Keder

Grief reaction in elderly

We searched related keywords in the Medline (elderly, older adults, geriatric, bereavement, complicated grief) to review the literature on grief reaction of elderly. Getting older brings up losses. As a result of this, grief reaction may occur more often. Normal grief reactions are not much different than the ones given by other age groups. It is reported that depressive symptoms of grief disappear in one or two years. However, grief reaction never ends completely in the elderly. “You can not get rid of, just get used to it” is a commonly used statement. Inhibited grief is seen more often in the elderly. Hypertrophic grief and chronic grief are seen less frequent in the elderly. Medical complications are more frequent in older adults. In older widows, utilization of health services, complaints of somatic symptoms and poor health are more often than the younger ones. Widows experiencing problems with alcohol use in the past display a tendency to increase the amount of alcohol use, cigarette smoking and use of other substances. Mortality is also higher in the grieving elderly. While presence of depression prior to loss, poor psychological and physical health, traumatic losses such as suicide, excessive reaction within days of loss, financial problems and level of stress, more than one loss for widowers are shown as risk factors for major depression, social support is a protective factor. For patients who do not fulfill major depression criteria for DSM-IV, complicated grief criteria was proposed. Besides, principles of treatment of grief reaction were reviewed shortly.

Keywords:

Bereavement, Aged, Grief,

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