Effects of Life Transitions on Older People

Retirement is often the first major transition faced by older people. Its effects on physical and mental health differ from person to person, depending on attitude toward and reason for retiring. About one third of retirees have difficulty adjusting to certain aspects of retirement, such as reduced income and altered social role and entitlements. Some people choose to retire, having looked forward to quitting work. Others are forced to retire (for example, because of health problems or job loss). Appropriate preparation for retirement and counseling for retirees and families who experience difficulties may help. Many employers and community agencies offer retirement planning services.

Relocation may occur several times during old age. For example, people may move to retirement housing with desirable amenities, to smaller quarters to reduce the burden of property upkeep, to a different community for better weather or to be close to family members, to a relative's home, or to a residential care facility. People who respond poorly to relocation are more likely to be living alone, socially isolated, poor, and/or depressed. Men often respond less well than women.

Because of financial, social, and other complications, some older adults feel they must remain in a problematic home or neighborhood despite the desire to relocate. Often, social workers can assist older adults in assessing their options for relocation or home modification.

Much of the stress seems to result from people's feeling they lack control over the move and do not know what to expect in the new environment. For older people who have memory loss, a move away from familiar surroundings may intensify confusion and dependence on others and lead to frustration. Many moves happen suddenly, but even a little preparation can help decrease the stress of relocating. People who are moving should be acquainted with the new setting well in advance, if possible. Touring future surroundings and meeting potential neighbors can be very helpful.

Bereavement affects many aspects of an older person's life. For example, social interaction and companionship decrease, and social status and financial circumstances may change. Older people may experience a decline in their own health after the death of a close family member or friend. The death of a spouse affects men and women differently. In the 2 years after death of a wife, the mortality rate in men tends to increase, especially if the wife's death was unexpected. For women who lose a husband, data are less clear but generally do not indicate an increased mortality rate.

Some sleep disturbance and anxiety are normal in people who are grieving. These effects usually resolve in months without the use of medications. If grief is prolonged or overwhelming, if people become unable or unwilling to carry out even essential daily activities or if they speak of suicide, evaluation and treatment by a doctor are necessary. If the doctor diagnoses depression, people may be referred to a mental health practitioner. At times, antidepressant medications may be helpful.

Screening for depression is an important part of a doctor visit. Caregivers and health care professionals should look for symptoms of depression and be aware that bereaved people are at high risk of suicide and declining health.

Generally, the risk of suicide increases as people age.

In the United States, almost 7 times more older men commit suicide than older women. Rates of death by suicide for older adults are thought to be underestimated because, for example, many deaths due to opioid overdose are not investigated and intentional deaths due to voluntarily not eating and drinking are not documented. Older adults often do not give warnings about suicide and often do not seek mental health treatment. Also, doctors are less likely to offer treatment for depression to older adults than to younger people. Although older adults attempt suicide less often than those in other age groups, they have a much higher rate of dying in the attempt because the following are more likely:

• They use firearms in the attempt.

• They are likely to have more health problems and to be frail.

• They avoid interventions.

• They are less likely to live with other people who might detect and respond to suicide attempts.

Thus, the risk of death by suicide is high among older adults who have suicidal thoughts.

Timely screening for depression and suicidal thoughts is essential. To determine the risk of suicide, health care professionals ask older people who have recently lost a loved one or who seem depressed specific questions about suicidal thoughts.

To help with difficult transitions, older people may need counseling, supportive services (such as the National Widowers Organization), and/or medications for anxiety or depression.

The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

1. Suicide Is Different. This web site provides guidance, tool kits, and coaching to help family members and caregivers support a person with suicidal thoughts and to remain well themselves. Accessed 4/1/23.