ABSTRACT
INTRODUCTION Physicians across almost all specialties are faced with the clinical dilemma of distinguishing between normal grief due to the loss of a loved one and syndromes that warrant clinical treatment such as major depressive disorder. When presented with a bereaved patient, the clinician faces a number of questions: Is the patient experiencing normal grief or a pathologic depression? Should these symptoms be treated, or left to resolve on their own in what many believe to be a restorative process? And, if intervention is appropriate, which therapeutic domain maximizes the probability of a successful outcome? These issues, perplexing in any clinical encounter, pose an additional set of challenges when the patient is elderly as the loss may be accompanied by a host of factors associated with aging, such as poor health, impaired cognitive abilities, declining income, decreasing independence, and the loss of social and occupational roles to name a few.
