I was my mother’s caregiver for nine years, my twin grandchildren’s guardian/caregiver for seven years, and am my disabled husband’s caregiver now. I’ve had this role for two years and there are more years to come. As time passed, I became aware of the losses associated with caregiving. These are ambiguous losses—painful losses lacking clarity, closure, or the acknowledgement of others.

Lack of privacy is an example of ambiguous loss. If your loved lives with you, the loss of privacy was immediate. I understand this loss. My mother had stroke-induced dementia and lived with us for a month before she moved to assisted living. She followed me everywhere, so close I could feel her breath on my neck, and asked “What are you doing” constantly. Her closeness and question drove me nuts.

Pauline Boss, PhD, a University of Minnesota emeritus professor and psychotherapist in private practice, pioneered in research on ambiguous loss. She thinks there are two types of ambiguous loss, physical absence with psychological presence (as with a missing child), and physical presence with psychological absence, (as with Alzheimer’s disease).

As she explains in her book, Loss, Trauma, and Resilience, ambiguous losses lack clarity and generate conflicting emotions. “Ambiguity feeds ambivalence; ambivalence feeds the uncertainty about which action to follow, which decision to make, which role to play, or which task to perform,” she explains. (p. 144) What a mess.

You have many caregiving tasks and coping with ambiguous losses adds to your work load. What are some of your losses?

Loss of friends. Caregiving leaves you little time to be with your friends. Staying in touch with friends gets harder and harder, and this contributes to loneliness.

Loss of a social life. Before caregiving, you used to go to the movies, concerts, plays, and luncheons. Now you feel lucky to get to the grocery store.

Loss of flexibility. The never-ending demands of caregiving can squelch flexibility. Doing things on the spur of the moment is rare, if not impossible.

Loss of dreams. “I always wanted to go to Paris,” a long-term caregiver shared, “but my husband is in the third stage of Alzheimer’s and I can’t leave him.”

Loss of hope. Hope fades when dreams are cast aside. It’s hard to be enthusiastic about caregiving without hope. You may struggle to keep hope alive as your loved one’s health deteriorates.   

Loss of self. Ambiguous losses can make you feel like you’re caught in a vise, Pauline Boss notes in Loving Someone Who Has Dementia (p. 40) We can learn to view ambiguous losses positively, according to Boss, and she cites some positives of them. Ambiguous losses:   

  • allow us to continue to hope
  • offer new opportunities for adventure
  • keep us observant and alert
  • foster emotional and spiritual growth
  • spark creativeness
  • give us time to say good-bye
  • enable us to learn more about ourselves.

When ambiguous losses get me down, I remember something I wrote for my book of affirmations for caregivers: Caregiving is love in action. Every day, every moment, every second we spend with a loved one is a blessing. We are sharing the miracle of life.

Written by Harriet Hodgson
Rochester resident Harriet Hodgson has been a freelance writer for writing for 38 years, is the author of thousands of articles, and 36 books. She is a member of the Association of Health Care Journalists and the Minnesota Coalition for Death Education and Support. She is also a contributing writer for The Caregiver Space website, Open to Hope Foundation website, and The Grief Toolbox website. Harriet has appeared on more than 185 radio talk shows, including CBS Radio, and dozens of television stations, including CNN. A popular speaker, Harriet has given presentations at public health, Alzheimer’s, caregiving, and bereavement conferences. Her work is cited in Who’s Who of American Women, World Who’s Who of Women, Contemporary Authors, and other directories. All of Harriet’s work comes from her life. She is now in her 19th year of caregiving and cares for her disabled husband, John. For more information about this busy author, grandmother, wife, and caregiver please visit www.harriethodgson.com

Related Articles

The State of Paid Family Leave

The State of Paid Family Leave

"The United States is one of the wealthiest countries in the world BECAUSE it doesn’t have paid family leave. In other words, our position as one of...

Old lesbian love

Old lesbian love

The week we move in together, Pam breaks her leg. They call it a fragile fracture, and I argue about the word fragile. “Why fragile? This woman...

Popular categories

After Caregiving
Finding Meaning
Finding Support

Don't see what you're looking for? Search the library

Share your thoughts


  1. Loss of friends and loss of self. So true.

  2. Very, very true and it’s what others don’t and can’t ‘get’.


Share your thoughts and experiences

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Join our communities

Whenever you want to talk, there’s always someone up in one of our Facebook communities.

These private Facebook groups are a space for support and encouragement — or getting it off your chest.

Join our newsletter

Thoughts on care work from Cori, our director, that hit your inbox each Monday morning (more-or-less).

There are no grand solutions, but there are countless little ways to make our lives better.

Share your insights

Caregivers have wisdom and experience to share. Researchers, product developers, and members of the media are eager to understand the nature of care work and make a difference.

We have a group specifically to connect you so we can bring about change.