Late-life Spousal Bereavement Research Articles

Are Sensory Experiences of One's Deceased Spouse Associated with Bereavement-Related Distress?

Following late-life spousal bereavement, sensory and quasi-sensory experiences of the deceased (SED) are commonly reported. This longitudinal study examined SED among 310 older widowed adults 6-10 (T1) and 18-20 (T2) months post loss. Reports of SED in the first 6-10months after loss were associated with higher symptom levels of prolonged grief, post-traumatic stress, and loneliness at T1. Experiencers of SED were more likely to experience symptoms of prolonged grief and post-traumatic stress above cut-off scores at T1. Importantly, only a minority of the experiencers of SED displayed these elevated levels of bereavement-related distress. In addition, employing multi-level-modeling, a similar trajectory of decreasing bereavement-related distress over time was found for both experiencers and non-experiencers of SED. We argue that SED may be one of several potential reactions to bereavement, which should not be seen as an indicator of grief complications per se.

“Take good care of yourself” An integrative review of older widows’ self-care for health and well-being

ABSTRACT Take good care of yourself is a regard often said to older bereaved women. However, what does it mean? Though self-care is a well-known phenomenon within health, it is not well understood in the context of late life spousal bereavement and widowhood. We undertook an integrative review to synthesize knowledge of older women’s self-care challenges, resources and activities when bereaved and in a healthy transition to widowhood. Good care refers to health-promoting self-care and can be explained as the older widows’ ability to access and mobilize resources and activities that are significant for a healthy transition to widowhood.

A systematic review of late-life spousal bereavement and widowhood, with an emphasis on immigrants in western countries, and older Chinese adults

ABSTRACTSpousal bereavement becomes increasingly common among older-aged individuals, posing considerable challenges to adults in late life. Immigrants, and older Chinese immigrants to Western countries, specifically may experience heightened negative outcomes as a consequence of spousal bereavement, due to migratory stress and marginalisation. This systematic review aims to summarise the research literature on spousal bereavement and/or widowhood in late life, with an emphasis on immigrants to Western countries in general and older Chinese adults. The paucity of spousal bereavement adjustment studies on older immigrants, and specifically on older Chinese immigrants, highlights the need for further research on this topic in order to inform the development of culturally sensitive interventions for social work services for this population.

Can a Function-Based Therapy for Spousally Bereaved Seniors Accrue Benefits in Both Functional and Emotional Domains?

Late-life spousal bereavement has detrimental effects in daily functioning and emotional distress. This study tested the hypothesis that a therapy based exclusively upon functioning issues (sleep and daily lifestyle regularity) would accrue benefits in both functional and emotional domains. A comparison was made with a control therapy that concentrated on emotional issues, and specifically avoided discussing sleep or lifestyle regularity. Thirty-eight spousally bereaved seniors were randomly assigned to either functional or control therapy. Assessments were made before, during, and after a 6-month, 10-session individual therapy. The functional therapy assisted in both functional and emotional domains and the hypothesis was confirmed.

Changes in routine health behaviors following late-life bereavement: a systematic review.

This systematic review examines the relationship between late-life spousal bereavement and changes in routine health behaviors. We review six behavioral domains/modifiable risk factors that are important for maintaining health among elderly populations: physical activity, nutrition, sleep quality, alcohol consumption, tobacco use, and body weight status. Thirty-four articles were identified, derived from 32 studies. We found strong evidence for a relationship between bereavement and nutritional risk and involuntary weight loss, and moderate evidence for impaired sleep quality and increased alcohol consumption. There was mixed evidence for a relationship between bereavement and physical activity. We identify several methodological shortcomings, and describe the clinical implications of this review for the development of preventive intervention strategies.

Measuring Meaning: Searching for and Making Sense of Spousal Loss in Late-Life

Despite much recent theorizing, evidence regarding the temporal relationship of sense-making to adjustment following bereavement remains relatively sparse. This study examined the role of searching for and making sense of loss in late-life spousal bereavement, using prospective, longitudinal data from the Changing Lives of Older Couples (CLOC) project (N = 250). Searching at 6 and 18 months post-loss predicted both contemporaneous and subsequent grief. Sense-making was not related to grief for this sample. In contrast, sense-making at 6 months and 18 months predicted positive affect at 48 months, although searching had no prospective effect on this outcome. Searching at 6 months predicted depression at 18 months. Results are interpreted in terms of meaning-oriented theories of bereavement and processes promoting both adaptive and maladaptive outcomes.

Sleep Disturbance in Bereavement.

<p>Bereavement is a ubiquitous part of the human condition. Almost no person makes it through his or her life without having to cope with the loss of a loved one several different times. The loss of a parent, child, or grandparent can be very distressing. For many, the most devastating loss is that of their spouse or partner, which usually occurs during later life. More than 800,000 older Americans are widowed every year. Apart from the severe emotional strain of the loss of a loved one, there are profound changes in lifestyle and status, often accompanied by reductions in financial security, perceived personal safety, and freedom of action. Thus, late-life spousal bereavement (LLSB) comprises one of the major impacts of bereavement on society. </p> <h4>ABOUT THE AUTHORS</h4> <p>Timothy H. Monk, PhD, DSc, is Professor of Psychiatry, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Anne Germain, PhD, is Assistant Professor of Psychiatry, University of Pittsburgh School of Medicine. Charles F. Reynolds III, MD, is the Professor of Geriatric Psychiatry and Professor of Neurology and Neuroscience, University of Pittsburgh Medical Center.</p> <p>Address correspondence to Timothy H. Monk, DSc, Western Psychiatric Institute and Clinic, Room E1123, 3811 O’Hara Street, Pittsburgh PA 15213; fax 412-246-5300; or e-mail <a href="mailto:monkth@upmc.edu">monkth@upmc.edu</a>.</p> <p>Dr. Monk, Dr. Germain, and Dr. Reynolds have disclosed no relevant financial relationships.</p> <h4>EDUCATIONAL OBJECTIVES</h4> <ol><li>Recognize the importance of sleep disruption in bereavement. </li> <li>Explain the possible role of insomnia treatment for bereaved individuals. </li> <li>Discuss the etiology of sleep disorders in bereavement. </li> </ol>

Social rhythm stability following late-life spousal bereavement: associations with depression and sleep impairment

The aim of this study was to investigate changes in social rhythm stability and sleep in spousally bereaved subjects ( n = 94) and in nonbereaved elderly control subjects ( n = 45). Social rhythm stability and activity level were measured with a diary-like instrument, the Social Rhythm Metric (SRM). We observed that spousal bereavement, per se, was not associated with a lower social rhythm stability or activity level except in the presence of a major depressive episode. We also observed an inverse correlation between severity of depression and social rhythm stability, and a positive correlation between depression and both subjective and objective measures of sleep impairment. Higher social rhythm stability was correlated with better sleep in subjects with high activity levels, but not in subjects with low activity levels. Longitudinal data, including pre-bereavement assessment of social rhythm stability, are necessary to ascertain directional effects, i.e., whether loss of spouse occasions disruption of social rhythms or whether such disruption precedes sleep impairment and depression.

Anxiety among widowed elders: is it distinct from depression and grief?

The purpose of this study was to test the validity and utility of distinguishing symptoms of anxiety from those of depression and grief in recently spousally bereaved elders. We also examined pathways from baseline (six months or less post-spousal death) to follow-up (12 and 18 months post-death) levels of anxiety, depression and grief-related symptoms. Baseline and follow-up data were available from 56 recently widowed elderly subjects recruited for an investigation of physiological changes in bereavement. Confirmatory factor analyses indicated that a model in which anxiety was specified as a third factor, apart from depression and grief factors, fit the data well and significantly better than either the one or two factor models. Path analyses revealed that both baseline severity of grief and anxiety had significant lagged effects and predicted follow-up severity of depression. Symptoms of anxiety appeared distinct from those of depression and grief, and the anxiety, depression and grief factors differentially predicted subsequent symptomatology. These findings suggest a need for more specific identification and treatment of anxiety, depression and grief symptoms within the context of late-life spousal bereavement.

The effects of late-life spousal bereavement over a 30-month interval.

Self-report measures of grief, depression, and general psychopathology were studied in widows and widowers over a 2.5-year period following death of their partner. A comparison sample of men and women was also followed for the same period. Differences in severity of depression and psychopathology previously reported at 2 months postloss (Gallagher, Breckenridge, Thompson, & Peterson, 1983) diminished to nonsignificant levels at 12 and 30 months. However, significant differences between bereaved and comparison subjects on measures of grief were still apparent 30 months after spousal loss. A main effect of gender for depression and psychopathology (but not for grief) was found at 2 and 12 months: Women reported more distress than men regardless of bereavement status. Results indicate that the experience of grief persists for at least 30 months in both older men and women who have lost their spouse.

The effects of late-life spousal bereavement over a 30-month interval.

The effects of late-life spousal bereavement over a 30-month interval.