Enhancing Meaning when Facing Later Life Losses

Objective: This article presents several client cases to illustrate psychotherapeutic interventions for helping older adults facing later life losses enhance their sense of meaning.Methods: Cases are derived from the client population of a community mental health clinic which provides psychotherapy for low income, seriously mentally ill, culturally diverse older adults, many of whom experience serious medical illnesses. Over the course of 24 years in this setting, the primary author has observed various interventions which offer possibilities to provide hope and meaning for clients with severe problems. Results: Interventions discussed with individual cases include utilizing life review and reminiscence therapies, helping in grappling with the ending of life, facilitating enhanced relationships, encouraging creative endeavors, enabling spiritual and religious practices, honoring wisdom and legacy leaving, and engaging in mindfulness practices. Each approach is reviewed with reference to empirical support, clinical utility, and treatment considerations. Conclusions: Helping older adults to find hope and meaning in their lives can be challenging. Specific interventions which target meaning-making may be adapted to fit each client's needs.Clinical Implications: Clinicians may focus on enhancing meaning as a core or adjunct aspect of treatment with older adult clients. Considerations for implementing interventions may depend on contextual factors relevant to each case.