Martha Toner, 81, met her husband Charles in high school in the 1950s. They married when they were 19, and the relationship would last nearly 62 years. Their marriage ended shortly before that landmark anniversary when Charles, then 81, died unexpectedly after a fall in June.

Sarah Fiebig, 74, had a different experience. She knew her husband Edward, 82, was dying because he had been diagnosed with dementia, and he was ill for several years before he died last January. Sarah had been widowed before she met Edward, about 16 years after her first husband died.

Losing a partner is never easy, whether the death is anticipated or unexpected.

“When someone close to you dies, your world changes. You are in mourning—feeling grief and sorrow at the loss,” according to a recent National Institute on Aging (NIA) white paper. “You may feel numb, shocked, and fearful. You may feel guilty for being the one who is still alive. You may even feel angry at your loved one for leaving you. All of these feelings are normal. There are no rules about how you should feel.”

Therapy and counseling are often recommended to help someone get through the pain, according to Peter Willig, a Miami-based marriage and family therapist with a specialty in thanatology—which is the study and practice of death, dying, and bereavement.

“Ultimately, the real goal of therapy is to help them adjust,” Willig said. “There is no getting over grief. We don’t close the door and forget the person. We try to adjust in a way that allows their connection to us to continue but allows us to function as individuals going forward.”

Death doulas can also be part of the picture. Shanti Vani defines herself as a transforming grief specialist who helps people and their loved ones through the dying process. Hospice and palliative care provide physical end-of-life care, but a doula can offer an additional layer of support.

“There is a certain reality, and that is that death is certain,” Vani said. “Acceptance of death eases the pain and burden. A lot is for them to feel that there is someone who is really with them, who is listening and caring. Our job as doulas is to meet the person where they are. “

For the surviving spouse, the goal is to make healthy adjustments when a long-term spouse passes on. Toner and Fiebig are on that path, carrying on with help from friends and family, one day at a time.

“I have to keep telling myself this is what he would want me to do,” Toner said. “Whatever life I have left in me, I want to have the best I can have. It won’t be perfect without him here, but I’m trying my best.”

After living her entire adult life with her husband, being without him is a surreal experience.

“It’s very bizarre and not believable,” Toner said. “Like, where is he? I’m suddenly 81 years old and on my own for the first time in my life, and it’s very scary.”

On the day of her husband’s fall, Martha said she had returned from an exercise class, and Charles told her he was going to go outside to rake leaves. A few minutes later, a neighbor was pounding on the door of their home to tell Martha her husband was lying on the ground outside in a pool of blood.

“He was in the hospital for 15 days,” Toner said. “I thought they could save him, but they could not. He had a traumatic brain injury. That was it. Otherwise, I think he might still be here, if he hadn’t fallen in the street.”

Fiebig had a fair warning. Her husband, a veteran, received assistance from the Malcom Randall Department of Veterans Affairs Medical Center with home health care, which allowed Fiebig to get out and about to run errands. His death was anticipated.

“Some people don’t have the warning that I did,” she said. “But having lost both husbands, I learned that staying busy and being with other people helps. I can’t be sad or down when I am with other people.

Sometimes, that means getting out and doing things even when she doesn’t want to.

“I take advantage of everything that is offered that I can do,” she said. “So I am not a lonely person at all.”

The two women are doing precisely what counselors suggest a bereaved person do after the loss of a long-time spouse: Get out, stay busy, get around, and have a purpose.

Licensed clinical social worker Susan Lake sees her role as a counselor as helping people process their loss “so they don’t wear out their friends or family members as much.” Over the years, Lake has noticed that many more of her clients are women.

“It is women who are in the club that no one wants to be in,” Lake said. “Women are more resilient. Women are better able to adjust. Men tend to remarry quicker, and women carry on alone.”

Lake offers some practical suggestions.

“If you lost your spouse of 50 years and the house is empty, before you leave, turn on some lights, turn on some music,” Lake said. “If you are in the same house, rearrange the bedroom. Think about getting a pet. And if the depression is going on for weeks, maybe it’s time to seek counseling.”

Mental health experts are learning that there are all kinds of grief—what some call prolonged grief disorder or PGD, when a survivor can’t cope with death, even years later. Psychiatrists debated for years whether grief could be considered a mental illness. However, PGD was added to psychiatry’s Diagnostic and Statistical Manual of Mental Disorders in 2022, according to the NIA.

Only some people in the field agree with this approach.

“Grief is universal,” Willig said. “Not to minimize it, but it’s such a common experience during our lives, but we don’t address it until it is front and center.”

Lake says prolonged grief is very real, but she disagrees with the label that comes with a diagnosis.

“I don’t like any label, but with our health care system, we are forced to do it,” she said. “We are forced to label so that people can get care coverage. It can help get paid support for the services one needs.”

Some try to plan but sidestep confronting the issue. Esther Lynn Mauffrey, 70, and her 79-year-old husband of 23 years, Bill, 79, are that couple. Both are now retired.

“My husband and I are very good friends,” she said. “We spend a lot of time together. And if something happened to one of us, it would be very difficult for the other person.”

But they have made one joint decision to look toward the future.

“We decided when one of us starts to fail, we have to downsize so that if something happens to one of us, the other won’t be left alone,” Mauffrey said. “We want the okay person to be able to carry on, so we will move somewhere surrounded by other people.”

Editor’s note: This is the latest story in Mainstreet’s ongoing Aging Matters series. It was independently reported by Ronnie Lovler and underwritten by Elder Options.