2017-09-29 17:33:02
 The New Old Age: A Child’s Death Brings ‘Trauma That Doesn’t Go Away’

Anne McBrearty Giotta doesn’t remember much of what happened on that August morning in 2013.

One moment she was cursing her older son, Michael, who was supposed to have picked her up for a long-planned beach weekend, but was late and not answering his phone.

The next moment, the police were at her door in River Vale, N.J., saying that Michael, 51, had been found dead in his home of an apparent heart infection.

“Don’t tell me lies like that,” she told the officers in a barely softened brogue.

Ms. Giotta immigrated from Ireland 60 years ago, worked as a bookkeeper, raised five children and then divorced. In her long life — she’s 87 — “that was the worst time.”

To have a child die before you, at any age, upsets what we all consider to be life’s natural order. “You lose a part of yourself,” Ms. Giotta said.

Children are supposed to outlive us. When they don’t, grieving parents can suffer depression, poorer physical health and higher rates of ruptured marriages even decades later, researchers have found.

“This is a trauma that doesn’t go away,” said Marsha Mailick, a social scientist at the University of Wisconsin-Madison who has studied bereavement.

But to be an old person when an adult child dies brings particular trials, both emotional and pragmatic. “The loss means something different at that stage of life,” Dr. Mailick said. “It can have a profound effect.”

It happens more frequently than we might think. Researchers at the University of Texas at Austin, reviewing data from the federal Health and Retirement Study from 1992 to 2014, report that 11.5 percent of people over age 50 have lost a child. The figure is far higher among blacks (16.7 percent) than whites (10.2).

But those percentages don’t tell us when the child died. Looking specifically at child deaths after parents have turned 50, the figure grows from 2.8 percent by age 70 to 3.4 percent by age 80.

Of the roughly 2.5 million Americans who are 90 and older, 7 percent — about 175,000 mourning parents — have lost a child since turning 50. Because the so-called “old-old” group (over 85) is growing fast, the number of seniors who will confront such late-life losses will also rise.

Deaths of people in middle age are what sociologists call “off-time events,” things that happen earlier or later than normal in the life course. “It often puts you out of sync with your peers,” said Deborah Carr, a sociologist at Boston University.

I received a heartbreaking email from a Wisconsin couple whose son died in an auto accident at 36, leaving them without grandchildren, such a source of joy for their friends. “Our lives are so empty,” his mother wrote.

In other cases, losses later in parents’ lives reflect not the premature deaths of children, but the parents’ very advanced years.

“We’d see a centenarian whose 80-year-old daughter had died,” said Kathrin Boerner, a gerontologist at the University of Massachusetts Boston who studies the oldest of the old. “With increased longevity, the likelihood that a child dies before you increases.”

We know rather little about the impact of these late-life losses, far less than we do about the effects of a young child’s death. Research takes a while to catch up with demographic changes.

But in a country that relies so heavily on family caregiving, an adult child’s loss clearly threatens to undermine the support a parent may need.

“He was the one the rest of us relied on,” said Kathleen Giotta Delano of her brother. “If Mommy’s not answering the phone, who do we call? Michael, who lived five minutes away.”

All the children live hours away or have no car. Anne Giotta still drives to mass on Saturdays and has lots of friends in her condo building, but Michael was the one who spontaneously took her out to dinner, asked if she needed anything at the supermarket, and brought her to his house, where he had a generator, when Hurricane Sandy hit.

At least the Giottas are a large family, not that she mourns her son any the less. But most families are smaller now, and the loss of a child can upend everyone’s expectations.

In fact, Dr. Boerner said, an older person whose child dies may feel more vulnerable than someone who never had a child (another growing cohort) and therefore formed the extended social networks that childless people often depend on.

The cause of death matters, too. Rising rates of drug-related mortality and suicides in midlife are making early deaths more common among whites (blacks have long experienced premature deaths). Researchers say that sudden or violent deaths, and those from stigmatized causes, prove more difficult to handle.

In such cases, “parents wonder what they could have done differently,” said Dr. Carr. “There’s a lot of self-blame.”

Michael Giotta, who owned a landscape firm, had developed a dependence on prescription pain medications. “We fought, we argued,” his mother said. “I carry a lot of guilt.”

After he was arrested for leaving the scene of an accident while drinking and went to rehab, he emerged a different person, she said. “I wish it had happened years before.”

Neighbors and friends don’t always step up with casseroles and condolence calls when someone dies from censured behavior.

“People might not be getting the social support they need, because others just don’t know how to broach these tragic topics,” Dr. Carr said.

Moreover, some of the factors proven to help younger parents regain their footing after a child’s death become less available with the years, pointed out Jan Greenberg, social scientist at the University of Wisconsin-Madison who has published studies with Dr. Mailick.

Older people cannot have more children, and if they’ve lost a spouse, they cannot take comfort in a close marriage, another demonstrated source of support.

But they can still find, or retain, a sense of purpose in life, which can help foster resilience in the face of great grief.

In 2010, Nancy Koontz and her husband, Grant, experienced the shock and horror of finding their son Jeremy dead in his bedroom in Raleigh, N.C. After years of struggling with bipolar disorder, anxiety and addiction to prescription drugs, including multiple hospitalizations, he died of an overdose at 34.

Earlier, when Mr. Koontz was a minister at a conservative congregation, “we tried to present the picture of the perfect preacher’s family,” said Ms. Koontz, who’s 74.

Now more open about their family’s troubles, the Koontzes work with the National Alliance for Mental Illness and annually join Raleigh’s Walk for Hope to raise money for research on mental illness.

“I’m not ashamed anymore,” Ms. Koontz said.

Anne Giotta finds strength in her religious faith; each morning, after breakfast, she says the rosary for Michael. The ritual helps her keep going, yet “I fight with God an awful lot,” she confessed.

“I ask him, ‘How could you do that? How could you take Michael?’”