Ambiguous Loss 101

“With ambiguous loss, there is no closure; the challenge is to learn how to live with ambiguity.”  --Pauline Boss, Ph.D.

Ambiguous Loss: Dementia and Alzheimer's

Pauline Boss created the theory of Ambiguous Loss, a loss that occurs when a person is physically present but mentally absent, as is the case in Alzheimer’s Disease and dementia related illnesses.  With the diagnosis of Alzheimer’s, this cruel disease slowly strips a loved one of their mental faculties long before the body declines.

Ambiguous Loss Prevents Closure

This type of loss is complicated and painful and flies in the face of the oft repeated goal of seeking ‘closure’ for the family member. The family member often grieves the identity of the former loved one while recognizing that their physical presence remains.  Family members are forced to live with a state of ambiguity, not quiet having their loved one mentally present and somehow left with the task of caregiving and maintaining a relationship.  It is this new, changed relationship that must be recognized and acknowledged in order to start moving forward. Living with and coming to accept this gray area is difficult, and often brings up strong feelings of anger and sadness.  These emotions are normal and should be expressed with trusted loved ones, possibly in a support group or with a skilled therapist.  New approaches to the relationship should be explored, along with managing family and caregiver stress.  Seeking support from friends and family, counseling with an experienced therapist, avoiding isolation and maintaining rituals are all antidotes to the ambiguous loss experienced by families and caregivers of Alzheimer’s patients.

Recommended Books by Pauline Boss:

Ambiguous Loss: Learning to Live with Unresolved Grief. By Pauline Boss. October 2000.

Loss, Trauma and Resilience: Therapeutic Work with Ambiguous Loss.  By Pauline Boss. January 2006.

Loving Someone Who Has Dementia: How to Find Hope While Coping with Stress and Grief.  By Pauline Boss. August 2011.