Occasionally, there is a story in the news about an elderly couple that has been married over 60 years who die simultaneously hand in hand. It always melts my heart when I hear about that, the ultimate act of love. I have already informed my husband that is the way I want us to go. Certainly dying together spares the remaining spouse from the pain and suffering of losing a longtime companion. What happens to the very old when they are left behind?
The loss of a spouse can impact us profoundly at any times in our lives. On the Holmes and Rahe Stress Scale, loss of a spouse is rated as the most stressful event.  Losing a lifetime companion when elderly can be devastating. The spouse who survives is also likely to be coping with the loss of friends and family members. There are additional issues with their own declining health and the loss of physical abilities; diminished sight, hearing, stamina as well as the loss of independence. The challenges the remaining spouse has to face can be daunting.
Overwhelmed and stricken by grief, the elderly may ignore their own needs. They may have problems with self-care, sleeping, eating, and taking their medication. The result can be the intensification of physical and psychological problems. Their resilience is compromised. It is often said that the remaining spouse could die quickly after their spouse’s death. It is referred to as the “widowhood effect.” Research conducted by Carey, et.al. found that there is an increase chance of dying for the elderly after a spouses’ death in the first three months following the loss. This is often referred to as the “widowhood effect.” During this time, the chances increase of a cardiovascular event.  The survivor may also be susceptible to “broken heart syndrome” or stress induced cardiomyopathy. The two events are different but can both be lethal.
Stress alters our immune system, at any age. The grieving elderly are already more likely to have a compromised immune system. This makes them even more susceptible to infectious diseases. If already in poor health, the chances of death tend to increase. It has also been found that widows and widowers tend to exhibit more cognitive decline than those who have not lost a spouse. 
The emotions of grief are ageless. The surviving spouse experiences sadness, guilt, anger, anxiety and often despairs. They frequently feel they have lost their purpose in life as well as their love. Another important aspect of losing a spouse is that the survivor has lost their best friend and social contacts. It is often hard for the elderly to reach out for help even with family members.
As bleak as it all sounds, it appears that the simple act of being involved with the elderly bereaved can literally make the difference between life and death. Research by Infurna and Luthar (2017), on resiliency after the loss of a spouse, states that “The strongest predictors of resilient trajectories were continued engagement in everyday life activities and in social relationships followed by anticipation that people would comfort them in times of distress.” In Shin’s research on cognitive decline in the elderly bereaved, it was found that “having a high level of education or at least one living sibling appeared to protect against the decline associated with widowhood.” Interestingly, research by Bookwala found that “those who received emotional support from relatives had poorer health than those who received support from friends.” It appears that what is most important is some form of social contact.
There are a number of ways that we can help the elderly. We can be sure that they have frequent vision and hearing tests so they do not become shut off from the world. Many bereaved elderly become afraid to leave the house due to these deficits. They often also have a fear of falling. Assisting them in getting a cane or walker is another way of helping them become more mobile. It is important to encourage them to take good care of themselves in mourning. They should get enough sleep, eat right and take their medications. It is also beneficial for the elderly to be involved in an activity that provides them with a sense of purpose. Helping them to connect with a social group or charitable organization would help them to feel better about themselves as well as providing social contact. They should be encouraged to participate in some form of physical activity such as, swimming, aquarobic classes, chair yoga or other light exercise.
Just because one half of an elderly couple dies does not mean that the other need follow close behind. Becoming more aware of the challenges they face can help prepare us to help them. With care and attention, it is possible to reduce their loneliness and extend their lives.