Why Older Adults Should Embrace Discussing End-of-Life Regrets

i-heartEarl had been diagnosed with cancer. It was late—Stage 4—and as he joked, “There is no Stage 5.” The dark humor he showed masked the sadness he felt at his own passing, because there was still so much he wanted to do. It wasn’t the future that bothered him the most in our conversation, though — it was the past. He expressed a lifetime of regrets. He avoided interesting job opportunities because of the risk involved; he didn’t want to give up the security of what he already had. Trips he had always wanted to take never happened because of his commitment to his daily routine. He said that regrets about the past bothered him, even situations from high school, and he now wished he would have taken more chances.

Regrets at the end of life are something that I’ve heard far too often. What are regrets exactly? Regrets are negative cognitive/emotional states that involve blaming ourselves for a bad outcome. Regrets trigger the surfacing of loss and/or sorrow at what might have been or wishing that we could have made other decisions in life. So many people I have talked to face the end of their lives with deep remorse and regret. I hear people say “If only I knew that life would end, I may have made other choices. I didn’t know. I guess I thought I would live forever.” That dwelling—the way we let regret overwhelm the last years of our lives—is a tragedy. It’s important to neither dwell on regret nor ignore it. Either of these paths can lead to depression, anxiety, and a diminished quality of life at the time when you should be focused on valuing the time you have.

Confronting Common End-of-Life Regrets

While every life is different, there are a few common regrets that tend to cut across cultures, class, race, age, and gender:

    • I didn’t properly show my love to the people closest to me. It’s important to make your peace with how things really are and spend the time that you have with the ones you love. Let them know how you feel. If there’s unfinished business between you and others, now is the time to communicate these concerns. Letting go of the past isn’t easy. However, you can choose to stay grounded in the present moment and connect with family and friends in the here and now.
    • I didn’t take good enough care of myself. For some people with terminal illnesses, especially if you have an illness that might be considered preventable, there’s a tendency to regret the choices you made that led to this. Even people in relatively good health might think that if they had only exercised more or eaten better, they might have more time. Instead, focus on what is important to you right now. Family, friends, spirituality, and other issues may need your full attention at this time.  
    • I didn’t do what I set out to do in life. You start out in life believing that you can achieve anything. Unplanned life events, however, can interfere with youthful goals. Being drafted in a war, an unplanned pregnancy, the need for a job, postponing college, and other situations can place your dreams on hold. So many of us feel that we were never able to do what we wanted and never truly lived our dreams. When we believe that our life is only about accomplishments, we often suffer because we failed to write the great American novel or climbed a mountain or made enough money. Our life story doesn’t have to be about achievements; it can be about the individual moments of our lives, the time we spent with our family and friends, the little everyday things that we often took for granted. The real story of who you are continues until your last breath.
    • I wish I had taken more risks. You might think that your life would have turned out differently if you had taken the “road less traveled”—that it would have made all the difference. At the end of their lives, people tend to blame their regrets on their decision to play it safe. When we are looking back, we often think only about the positive side of the “what might have been.” Life has a way of unfolding that can’t be easily controlled or explained.  It is simply our story and our life.  And the way in which our life story ends is important.   

The Mental and Physical Risks of Dwelling on Regrets

While it’s easy to dwell on the above regrets, there are serious mental health consequences to these endless ruminations:

  • Depression: Repetitive negative thinking is one of the hallmarks of depression. Many psychologists believe that focusing on regrets can trigger depression, especially in the elderly. By  focusing on the negatives of life, you may find yourself questioning your self-worth. You may regret even being born because you didn’t accomplish what you wanted during youth. Negative ruminations may lead to depression over time. Unfortunately, depression in the elderly is often seen as a stigmatizing illness. Family and/or friends may fear that an interaction with their “depressed” older loved one will result in their somehow becoming depressed as well.
  • Chronic Stress: I’ve talked to people who were still regretting decisions they made years ago. In doing so, they were literally reliving the stress and anxiety of those days that should have been behind them. Regret allows the negative experiences of your past to stay with you. When you are consumed with reimagining different outcomes or rehashing the mistakes you made in the past, you bring that stress into your present life. Chronic stress can cause digestive problems, heart disease, weight gain, and sleep disorders, in addition to being another trigger for depression.  
  • Physical health problems: Mental health issues often lead to physical problems. We know that stress can lead to ulcers, digestive issues, headaches, and more. But what can be even more damaging are the physical effects that come from people who stop caring. I’ve seen people who stopped eating altogether due to regrets or have stopped taking care of themselves in other ways. They don’t eat well or exercise or see their doctor as often as they should. It increases the physical ailments that can come with aging and, in doing so, starts a cycle of more regrets.

Regrets aren’t just about the past; they can invade your present and rob you of the future. Don’t let the life you wish you had overcome the life you have. Perhaps we should follow the advice of French singer Édith Piaf who famously said “Non, Je Ne Regrette Rien” — “I have no regrets.”

The Power of Conversation

This isn’t a call to ignore your regrets by any means. That would be just as unhealthy as dwelling on them. Not talking about our regrets increases our isolation and makes regrets linger even longer. Rather, this is a call to recognize that regrets are a part of any life, and it’s important to confront them openly and honestly.

There are a couple of options once you’re ready to talk about your feelings with someone else:

You can talk to your loved ones. If you’re sad because you didn’t spend enough time with your kids, you let your job take too much time away from your spouse, or you let a friendship fade, you can talk to the people affected. Make your peace. Even if your regrets are about choices you made or chances you didn’t take, discussing them with the people who love you — and who have been impacted by your decisions — can help you see them in a new light. Maybe their lives are better for what you did or didn’t do.

You can seek out group therapy or professional help. Of course, sometimes you need to talk to professional people who aim to understand and support you. Professional geriatric counseling services can help you figure out why you have your regrets and how to overcome them. Another option is group discussions. While you are still functioning, it may be useful to hear that other people have similar regrets and disappointments which can put yours in perspective. It’s always good to talk to people who understand what’s going on with you.

Most people’s lives aren’t exactly how they pictured them when they were young. Every life has failures as well as triumphs, but there is personal joy in a story well-told, one that’s been full as only a human life can be. Being open, being honest, and being courageous about our lives is to meet the end of life without crippling regret. Forgiving ourselves and others can relieve us of emotional burdens, enabling us to fully engage with our dying process.  

 

To learn more about navigating the challenges of end-of-life anxiety and planning, contact us at Institute on Aging.

 

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Dr. Patrick Arbore

Dr. Patrick Arbore, ED.d, is the Director and Founder of the Center for Elderly Suicide Prevention and Grief Related Services. A nationally recognized expert on suicide and a powerful advocate for mental health services for older adults, Dr. Arbore is a role model for living life with true compassion. He's an experienced presenter and has held seminars and workshops on topics relevant to older adults’ mental health.

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