How Effective Are Support Groups for the Elderly Dealing with Death and Dying

Voluntary groups have been traditionally viewed as supplemental to the kin-based family group which provided the most reliable basis for continued social support. With higher mobility rates and less permanent marriage patterns than in previous generations, special forms of social groups have arisen in the United States. These newer forms have self-consciously considered the provision of social support to be among their aims. The differences among them and the diversity of needs and expectations subsumed under the task of social support present a source of difficulty in their study. Yet their importance to the health and well-being of their participants may be great. Several major reviews of the research literature on health breakdown show that individuals lacking supportive ties are vulnerable to a wide variety of physical and behavioral disturbances. The range has included hypertension, heart attack, clinical depression, respiratory disorders, tuberculosis, schizophrenia, and disturbances of pregnancy. It is just these deficiencies in supportive ties that the new groups address. Although relatively few voluntary groups consider their purpose to be health maintenance, their potential value in disease prevention adds to their more obvious potential for combatting loneliness and increasing the sense of belonging among their participants.

By social support we refer to a range of interpersonal exchanges that provide an individual with information, emotional reassurance, physical or material assistance, and a sense of the self as an object of concern. The study attempts to categorize the variety of social support groupings that have arisen over recent years and to relate their essential differences in structure to the needs they are meeting for their participants. The first task is to define a subset of dimensions. Two general sources from the literature are network analysis and small group theory.

Throughout life, people struggle to understand death. At the least, a basic understanding of death involves five principal concepts (Armstrong, 1987): universality (i.e., all people die); irreversibility (i.e., once truly dead, the physical body can never be brought back to life); nonfunctionality (i.e., the living body ceases to engage in activities associated with life); causality (i.e., what truly brings about death); and noncorporeal continuation (i.e., existing in some form after the death of the physical body). These concepts are linked to cognitive development, so it is no surprise that the formal operational thinking of adolescents affords them the opportunity to consider death anew on abstract and hypothetical levels (Hunsaker, 1991). However, it would be wrong to assume that their "mature" concept of death is the same as adults. People view death through the lens of wisdom accrued through the myriad of life experiences associated with expanded interactions with different people, work settings, and family relationships. Although privy to much knowledge about death through instant communication and increasingly exposed to death, adolescents do not have the social or emotional maturity to fully incorporate and process these experiences into a coherent world view (Bloch and Parry, 2002). The purpose of illuminating the tensions that hinder adolescents from dealing with death is not to have adults treat them as children, but to offer a window into the potential ambiguities that are faced in making the transition from childhood thinking toward maturity. Again, we organize these tensions according to the physical, cognitive, social, and emotional clusters. Adult acceptance of the struggles adolescents have in dealing with death may afford some insights into their forays with risky behaviors....

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