Mary Ann Hinnerichs, 76, spends most days caring for Howard, 75, her husband of 56 years. Last July, Howard had triple-bypass surgery and now, taking 15 steps "is a lot for him," she says. They watch what they eat ("no meat, no dairy") and enjoy the company of their six grandchildren and four great-grandchildren. At their ages, the Hinnerichses of White Bear Lake accept that health challenges and the deaths of peers are par for the course.

What they can't wrap their hands around is that they are moving into the winter of life in a way they never imagined: without Gary.

The youngest of their three adult children, Gary Hinnerichs, died in 2006 of a massive stroke at age 51, complicated by weight-related Type II diabetes. "We always worried about him," Mary Ann says. "It's hard to see a child go."

Grief counselors say, in fact, that losing a child may be the most wrenching grief imaginable. It upsets the natural order of things and it may take parents years before they fully re-engage in life. With so many people living well into their 80s and beyond, counselors and clergy face a modern quandary: What if the parents they serve don't have years to process the loss? How can counselors help the very old mourn the loss of an adult child who has become a friend or who was expected to take care of them in their final years?

"This is terribly complicated for aging parents," says Tom Ellis, director of the Center for Grief, Loss and Transition in St. Paul.

Cathy Seehuetter, co-coordinator for the St. Paul chapter of the Compassionate Friends, has seen a reluctance on the part of older parents to attend meetings, "because they do believe that people are not going to find their grief as legitimate as if they had a young child die." Compassionate Friends offers support to parents of any age who have lost a child for any reason.

Admittedly, the number of elderly who outlive their children remains small. But that's likely to change. People 85 and older are the fastest-growing segment of the aging population, according to the 2000 U.S. Census. Their population increased by 38 percent over the past decade, compared with an increase of 23 percent among ages 75 to 84, and less than 2 percent among ages 65 to 74.

The slowing of longevity among these "younger elders" hints at what some health experts call a spreading epidemic, particularly among baby boomers. About two-thirds of Americans are overweight, according to the Centers for Disease Control and Prevention; if the trend continues, the CDC predicts, about three-fourths of the U.S. population will be overweight within the next five years and 40 percent will be obese. Currently, about 15 percent of ages 6 to 18 are obese (defined as having a body mass index of 30 percent or more).

"Obesity is a ticking bomb, nationally and in Minnesota," says Stanton Shanedling, supervisor of the Heart Disease and Stroke Prevention Unit at the Minnesota Department of Health. "If we don't start addressing obesity and lack of exercise, we could easily witness the first generation of kids whose life expectancy is lower than their parents'."

"I call this 'dream stealing,'" says Carole Carson, author of "From Fat to Fit: Turn Yourself Into a Weapon of Mass Reduction." "It's every parent's dream to grow old and die surrounded by your children," she says. This leaves some aging parents facing a complex emotion: anger. "They may think, 'I told you to stop smoking! I told you to take care of your health!'"

Others just feel numb. Every Thursday, the Hinnerichses drive to Fort Snelling cemetery, where Gary, who served in the Air Force and is the father of two, is buried. Their other two grown children "have been so good," Mary Ann says. "But mostly it's just Howard and I."

Marion Dorfman, 82, understands. At 80, life was "wonderful," says Dorfman of St. Louis Park. "I was in good health, knock wood, and everything was rosy." Her husband, a diabetic, had died many years before, but "it was the natural order of things," she says. Then her younger daughter, Frances, who took great care of her health, died from colon cancer one year ago at age 51.

"It's very hard to process. They say you have wonderful memories, but these wonderful memories are just sad for me." She keeps busy exercising, volunteering, caring for a friend recovering from a stroke and enjoying her older daughter, Gayle, 57, and two grown granddaughters.

Steve Sims, supervisor for bereavement and spiritual care at Fairview Home Care and Hospice, says that keeping busy is a smart strategy. "Some have much more time on their hands to go through their grief over and over again," he says. Grandchildren can offer comfort, carrying the best traits of their parent into the future. Others may honor their child with a garden or memorial fund. But age does carry one advantage: a wealth of life experience to draw upon.

"By 80, you've had more than a few experiences with loss," Sims says. And what you learn "is that the earthly possessions go to the grave. The good we have done lives on."

Gail Rosenblum • 612-673-7350