A "Not able to live anymore": Reaction of the grieving process of the elderly dealing with chronic disease


  • Bahtiar Bahtiar Universitas Indonesia
  • Sahar Sahar
  • Junaiti Junaiti
  • Wiarsih Wiarsih
  • Wiwin Wiwin




grieving, chronic illness, elderly, family


Background: Psychological problems have an impact on the elderly with chronic diseases thus affecting health status. Objective: The purpose of this study was to identify the response of the elderly in dealing with chronic diseases. Methods: This study uses a descriptive phenomenology method. The population in this study were elderly who lived in Makassar City and had a chronic disease. This study illustrates the experience of 13 older adults aged 60-78 years who experience chronic disease. Results: A response felt by the elderly with chronic diseases for years, a series of grieving processes. The grieving process felt by the elderly is a psychological reaction from the suffering experienced due to symptoms and complaints of chronic illness. The series of grieving process reactions that are displayed are denial, anger, bargaining, despair, and resignation. Conclusion: The old experience with denial, anger, bargaining during chronic illness is normal. Also, the elderly could experience a desperate reaction during chronic illness due to the prolonged treatment process, and resignation reaction was a sign that the elderly were aware of the disease condition which they experienced. Recommendation: nursing intervention is needed related to grieving issues that include aspects of self, physical, social and spiritual for elderly with chronic illness.

Keyword: grieving, chronic illness, elderly, family


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Abbott, M. W., Wong, S., Giles, L. C., Wong, S., Young, W., & Au, M. (2003). Depression in older Chinese migrants to Auckland.

Allender, J. A., Rector, C., & Warner, K. D. (2014). Community and Public Health Nursing : Promoting the Public’s Health.

Badan Pusat Statistik Indonesia. (2013). Proyeksi Penduduk Indonesia Indonesia Population Projection 2010-2035. Badan Pusat Statistik Indonesia. https://doi.org/2101018

Ballew, S. H., Hannum, S. M., Gaines, J. M., Marx, K. A., & Parrish, J. M. (2012). The Role of Spiritual Experiences and Activities in the Relationship Between Chronic Illness and Psychological Well-Being. Journal of Religion and Health, 51(4), 1386–1396. https://doi.org/10.1007/s10943-011-9498-0

Barlow, M. A., Liu, S. Y., & Wrosch, C. (2015). Chronic Illness and Loneliness in Older Adulthood: The Role of Self-Protective Control Strategies Chronic Illness and Loneliness in Older Adulthood: The Role of Self-Protective Control Strategies. Health Psychology, 34(8), 870–879. https://doi.org/10.1037/hea0000182

Bhamani, M. A., Khan, M. M., Karim, M. S., & Mir, M. U. (2015). Depression and its association with functional status and physical activity in the elderly in Karachi, Pakistan. Asian Journal of Psychiatry, 14(2015), 46–51. https://doi.org/10.1016/j.ajp.2014.12.004

BPS. (2015). statistik penduduk lanjut usia 2014: Hasil Survei Sosial Ekonomi Nasional. Jakarta: Badan Pusat Statistik.

Cable-williams, B., & Wilson, D. (2014). Awareness of impending death for residents of long-term care facilities. International Journal of Older People Nursing. https://doi.org/10.1111/opn.12045

CDC. (2017). Chronic Disease Overview. Retrieved from https://www.cdc.gov/chronicdisease/overview/index.htm

Chiaranai, C., & Chularee, S. (2018). Older people living with chronic illness. Geriatric Nursing, 2. https://doi.org/10.1016/j.gerinurse.2018.02.004

Dinkes Kota Makassar. (2016). Profil Kesehatan Kota Makassar. Retrieved from https://www.google.co.id/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwihwJX_9NnXAhUDhrwKHVj_BR0QFggmMAA&url=http%3A%2F%2Fdinkeskotamakassar.com%2Findex.php%2F2017-02-09-09-30-56%3Fdownload%3D17%3Aprofil-kesehatan-kota-makassar-tahun-

Hood, G., Huber, J., Gustaffson, U., Scambler, S., & Asimakopoulou, K. (2009). ‘ With age comes wisdom almost always too late ’: older adults ’ experiences of T2DM. European Diabetes Nursing, 6(1), 23–29.

Jacobs, R. J., Ownby, R. L., Acevedo, A., & Waldrop-Valverde, D. (2017). A qualitative study examining health literacy and chronic illness self-management in Hispanic and non-Hispanic older adults. Journal of Multidisciplinary Healthcare, 10, 167–177. https://doi.org/10.2147/JMDH.S135370

Jalaluddin. (2005). Psikologi Agama (9 th). Jakarta: Rajagrafindo Persada.

Joshi, S., Mooney, S. J., Rundle, A. G., Quinn, J. W., Beard, J. R., & Cerdá, M. (2017). Health & Place Pathways from neighborhood poverty to depression among older adults. Health & Place, 43(February 2016), 138–143. https://doi.org/10.1016/j.healthplace.2016.12.003

Keegan, L. (2011). End of life : nursing solutions for death with dignity. New York: Springer Publishing Company.

Kementerian Kesehatan RI. (2015). Peraturan menteri kesehatan republik Indonesia nomor 67 tahun 2015 tentang penyelenggaraan pelayanan kesehatan lanjut usia di pusat kesehatan masyarakat.

Kholifah, S. N. (2016). Modul bahan ajar cetak keperawatan : keperawatan gerontik (1st ed.). Jakarta: Kementerian Kesehatan Republik Indonesia.

Kim, S. H. (2016). Suicidal ideation and suicide attempts in older adults: Influences of chronic illness, functional limitations, and pain. Geriatric Nursing, 37(1), 9–12. https://doi.org/10.1016/j.gerinurse.2015.07.006

Kurpas, D., Mroczek, B., Knap-czechowska, H., Bielska, D., Nitsch-osuch, A., Kassolik, K., & Andrzejewski, W. (2013). Respiratory Physiology & Neurobiology Quality of life and acceptance of illness among patients with chronic respiratory diseases ଝ. Respiratory Physiology & Neurobiology, 187(1), 114–117. https://doi.org/10.1016/j.resp.2013.02.009

Lubkin, I. M., & Larsen, P. D. (2006). Chronic Illness: Impact and Intervention (sixth edit). London: Jones and Bartlett Publishers.

Medicinenet. (2016). Medical Definition of Chronic disease. Retrieved from https://www.medicinenet.com/script/main/art.asp?articlekey=33490

Nations, U. (2015). World Population Ageing.

Noma, H., Ph, D., Sasaki, Y., Ph, D., Kondo, K., & Ph, D. (2016). Childhood Socioeconomic Status and Onset of Depression among Japanese Older Adults : The JAGES Prospective Cohort Study. The American Journal of Geriatric Psychiatry, 24(9), 717–726. https://doi.org/10.1016/j.jagp.2016.06.001

Park, J.-I., Park, T. W., Yang, J.-C., & Chung, S.-K. (2016). Factors associated with depression among elderly Koreans: the role of chronic illness, subjective health status, and cognitive impairment. Psychogeriatrics : The Official Journal of the Japanese Psychogeriatric Society, 16(1), 62–69. https://doi.org/10.1111/psyg.12160

Restorick Roberts, A., Betts Adams, K., & Beckette Warner, C. (2017). Effects of chronic illness on daily life and barriers to self-care for older women: A mixed-methods exploration. Journal of Women and Aging, 29(2), 126–136. https://doi.org/10.1080/08952841.2015.1080539

Ristriyani, R., Rachmawati, I. N., & Afiyanti, Y. (2018). Status disclosure and the acceptance of women living with HIV. Enfermería Clínica, 28, 195–198. https://doi.org/10.1016/S1130-8621(18)30066-4

Ross, E. K. (2009). On death and dying : what the dying have to teach doctors, nurses, clergy and their own families. Oxon: Routledge.

Son, Y.-J., & Won, M. H. (2017). Depression and medication adherence among older Korean patients with hypertension : Mediating role of self ‐ efficacy. Internationa Journal of Nursing Practice, 23(December 2016), 1–8. https://doi.org/10.1111/ijn.12525

Stuart, G. W. (2013). Principles and practice of psychiatric nursing (10th ed.). Elsevier Inc.

Touhy, Theris A & Jett, F. K. (2014). Ebersole dan Hess gerontological nursing and healthy aging. Philadelphia: Elsevier.

van Baal, P. H. M., Hoogendoorn, M., & Fischer, A. (2016). Preventing dementia by promoting physical activity and the long-term impact on health and social care expenditures. Preventive Medicine, 85, 78–83. https://doi.org/10.1016/j.ypmed.2016.01.013

Videbeck, S. L. (2008). Psychiatric-mental health nursing (4th ed.). Philadelphia: Lippincott Williams & Wilkins.

Warner, C. B., Roberts, A. R., Jeanblanc, A. B., & Adams, K. B. (2017). Coping Resources, Loneliness, and Depressive Symptoms of Older Women With Chronic Illness. Journal of Applied Gerontology, 073346481668721. https://doi.org/10.1177/0733464816687218

Westerbotn, M., Fahlstrom, E., Fastbom, J., Aguero-Torres, H., & Hilleras, P. (2008). How do older people experience their management of medicines ? Older Peoples’ Management of Medicines. https://doi.org/10.1111/j.1365-2702.2007.02151.x

WHO. (2017a). Elderly population. Retrieved from http://www.searo.who.int/entity/health_situation_trends/data/chi/elderlypopulation/en/

WHO. (2017b). Noncommunicable diseases. Retrieved from http://www.who.int/topics/noncommunicable_diseases/en/

Wilkins, S. (2009). Women with Osteoporosis : Strategies for Managing Agig and Chronic Illness Women with Os teo po ro sis : Strat egies for Man aging Aging and Chronic Ill ness. Journal of Women & Aging, 13(3), 59–77. https://doi.org/10.1300/J074v13n03

Wilson, J. S., Elborn, J. S., & Fitzsimons, D. (2010). ‘ It ’ s not worth stopping now ’: why do smokers with chronic obstructive pulmonary disease continue to smoke ? A qualitative study. Journal of Clinical Nursing, 20, 819–827. https://doi.org/10.1111/j.1365-2702.2010.03319.x

Young, C. (2011). Spirituality, Health and Healing : An Integrative Approach. Ontario: Jones and Bartlett Publishers.

Zerwekh, J. V. (2006). Nursing care at the end of life : palliative care for patients and families. Philadelphia: F. A. Davis Company.

Zhang, H., Shan, W., & Jiang, A. (2014). The meaning of life and health experience for the Chinese elderly with chronic illness: A qualitative study from positive health philosophy. International Journal of Nursing Practice, 20(5), 530–539. https://doi.org/10.1111/ijn.12198

Zhong, B. L., Chen, S. L., Tu, X., & Conwell, Y. (2017). Loneliness and cognitive function in older adults: Findings from the chinese longitudinal healthy longevity survey. Journals of Gerontology - Series B Psychological Sciences and Social Sciences, 72(1), 120–128. https://doi.org/10.1093/geronb/gbw037