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Abstract
Dying for the older adult assumes a reality unlike the reality of death as perceived by younger adults. When facing this reality, some older adults may employ regression as a defense mechanism to cope with their foreshortened futures. Employment of this form of regression varies considerably from the regression associated with a return to former levels of adaptation. Because it is different, this regression may be misinterpreted by professional caregivers. Nurses, who are heavily involved in the care of dying older adults and their families, need to be aware of this defense mechanism in order to deliver intelligent, holistic care.
Dying for the older adult assumes a reality unlike the reality of death as perceived by young or middle aged adults. The future is now expresses a changed time perspective that assists the older adult developmentally adapting to aging. A person who is terminally ill also faces foreshortened time and a future undeniably limited in opportunities. When old age and fatal illness coincide, the individual must integrate the demands and challenges of two complex life experiences. The individual faces the challenge of integrating a complex of losses, changes and adaptations required by the dying process into a concept of self that likewise must accomodate to the losses, changes and adaptations of later adulthood.
This complex of losses, changes, and adaptations that stimulates overwhelming anxiety also triggers defense mechanisms needed to protect the individual and enable that person to cope. Defense mechanisms for the older adult include those unconscious and automatic mechanisms used throughout a lifetime, as well as those frequently used by this age group (e.g., denial, projection, displacement, selective memory and regression).1
We hope to differentiate between the definition of regression and that posed by A.D. Weisman; to utilize Weisman's definition to assess those behaviors of the dying older adult that may indicate regression; and to suggest nursing interventions for the dying older adult and the primary caregiver.
The coping mechanism of regression generally is associated with extremely stressful situations and a return to a former level of adaptation. Regression in childhood and adolescence, precipitated by such stressful events as hospitalizations, divorce of parents, and chronic illness of siblings, is manifested in behaviors seen in earlier developmental stages. In adults, acute lifethreatening...