The Fight for Survival Part 2 – Loss Aversion

There are small losses we experience almost daily and there are big losses that become a once in a lifetime, defining moment, altering who we are and who we become.We lose our keys, our our favorite sock, a pair of shorts that we loved last summer. Then there are losses that rank higher on the “imminent concern” scale such as the loss of a wallet, a credit card, and a good job opportunity. Even more catastrophic in nature are the losses such as a house that is leveled during a tornado, a car that is totaled after an accident, Although everything exists on a spectrum, these types of losses are mostly physical in nature. They are things, items that can be replaced.

Regardless, some of the items we lose have sentimental value that cannot be replaced. Recently my husband lost a water shoe after he capsized his canoe on a river trip. The shoes were old and worn down, and that particular model is no longer available. Yet, what hurts him most is the fact that these shoes are close to 30 years old with invaluable memories attached to each trip he has taken. It is the nostalgia that he lost, and that cannot be replaced.

The primitive instinct of loss aversion runs deep through all of us and does not diminish as we age, but rather, appears to grow deeper. Loss Aversion is defined as a hard wired survival technique guiding individuals to keep what they have safe. Some studies suggest that the psychological pain in losing is twice as great as the psychological joy of gaining. Thats pretty intense.

Consider the phrase, “you can take the man out of the stone ages, but you can’t take the stone age out of the man.” From an evolutionary perspective, those living in the stone ages had so little, often living below their means, that the loss of even one item could be the difference between life and death. Those that operated from a healthy anxiety regarding the importance of not losing as well as protecting their items were able to use them, hence ward off dangerous situations and pass their genetic material down the evolutionary line.

When an older adult recognizes that they have lost or are losing cognitive abilities, the internal fight is extraordinary. People will go to great lengths NOT to appear to have their awareness and orientation stripped away, including compensation, justification and avoidance. From an emotional perspective, the nostalgia of memory being lost a little more each day can be incredibly painful and frightening. Consider this perspective when working with a person living in the early stages of a form of dementia. This also holds true for the adult who loses one of their five senses that they rely so heavily upon to make sense of their surroundings; or the physical loss in aging that redefines how much (or how little) one can independently engage in their own lives, their own care.

From a progressive memory loss perspective, we often document “behaviors” such as wandering, hoarding, rummaging and attempt to “care plan them away”. When we look further and consider that these reasonable reactions are based on an instinctual need to collect and keep what we think is important for our own survival, then they no longer carry the negative

stigma of a “behavior” but rather an emotional expression to the social and physical environment. Additionally when we provide simplistic, non-meaningful redirection to those responding to their environment in these manners, we can induce shame and embarrassment. These are emotions we all work tirelessly to avoid as well, therefore leading to some intense inter and intrapersonal reactions.

Approach is key to identifying and bringing peace to the person engaging in loss aversion. First of all, recognize that you have been there too. Losing and the loss of what we hold near and dear can be devastating. Step into that place with the PLD and see if you can establish a relationship based on common ground. Listen to what your care recipient is looking for, missing or wanting to acquire. Avoid shaming comments and actions, providing meaningful redirection that may require assistance in acquiring items that brings your residents purpose, meaning and a sense of acquisition.