Death Of Spouse Research Articles

Mortality and Function After Widowhood Among Older Adults With Dementia, Cancer, or Organ Failure

The widowhood effect, in which mortality increases and function decreases in the period following spousal death, may be heightened in older adults with functional impairment and serious illnesses, such as cancer, dementia, or organ failure, who are highly reliant on others, particularly spouses, for support. Yet there are limited data on widowhood among people with these conditions. To determine the association of widowhood with function and mortality among older adults with dementia, cancer, or organ failure. This longitudinal cohort study used population-based, nationally representative data from the Health and Retirement Study database linked to Medicare claims from 2008 to 2018. Participants were married or partnered community-dwelling adults aged 65 years and older with and without cancer, organ failure, or dementia and functional impairment (function score <9 of 11 points), matched on widowhood event and with follow-up until death or disenrollment. Analyses were conducted from September 2021 to May 2024. Widowhood. Function score (range 0-11 points; 1 point for independence with each activity of daily living [ADL] or instrumental activity of daily living [IADL]; higher score indicates better function) and 1-year mortality. Among 13 824 participants (mean [SD] age, 70.1 [5.5] years; 6416 [46.4%] female; mean [SD] baseline function score, 10.2 [1.6] points; 1-year mortality: 0.4%) included, 5732 experienced widowhood. There were 319 matched pairs of people with dementia, 1738 matched pairs without dementia, 95 matched pairs with cancer, 2637 matched pairs without cancer, 85 matched pairs with organ failure, and 2705 matched pairs without organ failure. Compared with participants without these illnesses, widowhood was associated with a decline in function immediately following widowhood for people with cancer (change, -1.17 [95% CI, -2.10 to -0.23] points) or dementia (change, -1.00 [95% CI, -1.52 to -0.48] points) but not organ failure (change, -0.84 [95% CI, -1.69 to 0.00] points). Widowhood was also associated with increased 1-year mortality among people with cancer (hazard ratio [HR], 1.08 [95% CI, 1.04 to 1.13]) or dementia (HR, 1.14 [95% CI, 1.02 to 1.27]) but not organ failure (HR, 1.02 [95% CI, 0.98 to 1.06]). This cohort study found that widowhood was associated with increased functional decline and increased mortality in older adults with functional impairment and dementia or cancer. These findings suggest that persons with these conditions with high caregiver burden may experience a greater widowhood effect.

Development of loneliness and social isolation after spousal loss: A systematic review of longitudinal studies on widowhood.

Spousal loss is a stressful life event that is associated with loneliness and social isolation, both of which affect mental and physical health. The primary objective of this paper was to synthesize longitudinal studies that investigated loneliness and social isolation in widowhood. A systematic search of the literature was conducted using three electronic databases. 26 longitudinal studies published through June 2024 were included for further analysis. Participant characteristics, study design, and key findings were extracted. Most studies were from the United States or Europe, included more widows than widowers, and assessed loneliness in older adults aged >60 years. Loneliness peaked directly following spousal death, but findings were inconsistent regarding the lasting effects of widowhood. Heterogeneity in the longitudinal trajectories of loneliness was noted, with studies showing linear increases, decreases, or curvilinear relationships over time. Several factors modified the relationship between widowhood and loneliness, including volunteerism, military experience, income, and age. Widowers consistently reported greater loneliness and worse social isolation when compared with widows. Few studies investigated social isolation specifically, but those that did found that social isolation may decrease in widowhood. As the world grapples with a social pandemic of loneliness and social isolation, widowed adults may be uniquely affected. Few studies investigated the longitudinal trajectory of loneliness and especially social isolation in widowhood, and those that did found heterogenous results. Future work is needed to understand why some widowed adults are uniquely affected by feelings of loneliness and social isolation while others are not, and whether potentially modifiable factors that moderate or mediate this relationship could be leveraged by psychosocial interventions.

Changes in Household Wealth Over the Process of Widowhood Across European Countries.

Widowhood has been shown to decrease surviving spouses' economic well-being. However, previous research has focused mostly on income-related outcomes, and has been less attentive to the importance of wealth, the processual nature of spousal death, and cross-national variation. In this study, we assessed how total, housing, and nonhousing wealth changes over the process of widowhood across 11 European countries. Individual fixed-effects regressions and longitudinal data from the Survey of Health, Ageing and Retirement in Europe were used to estimate how household net total wealth, housing wealth, and nonhousing wealth changed 3 years prior and 6 or more years after spousal death relative to 4 or more years prior to widowhood in 11 European countries. In all countries, household net wealth stayed relatively constant across the widowhood process, except for Austria, the Czech Republic, and Poland, where wealth declines were observed especially in the years following death. However, we found declines in housing wealth over the widowhood process, including prior to spousal death, across most countries in our sample, particularly in Austria, France, Denmark, the Czech Republic, and Poland. Declines in housing wealth were generally not reflected by changes in nonhousing wealth but coincided with leaving homeownership and downsizing. Widowhood is associated with lower wealth, especially housing wealth, even in the years before spousal loss. Future research should focus on adjudicating the mechanisms behind country differences and exploring the implications of lost wealth following widowhood for surviving spouses' well-being and intergenerational transfers.

The Sound of Silence: The Treatment of Spousal Death in Chopin's "The Story Of An Hour" and Celal's "Melahat Hanım's Orderly Life"

Both “The Story of an Hour” (1894) and “Melahat Hanım’ın Düzenli Yaşamı” (“Melahat Hanim’s Orderly Life”) (1999) take an intimate look at widows directly following the deaths of their spouses. While Kate Chopins’s story reveals the inner turmoil of its protagonist through insinuations regarding the taxing quality of her marriage, it also focuses on figurative implications of life after this death through imagery contemplated outside a window. Peride Celal’s story, on the other hand, similarly looks back on a challenging marriage, yet this time through the inside of the house, by focusing on the late husband’s possessions. Both characters hesitatingly embrace the prospect of a new life which promises escape from the social role of a wife. Unfortunately, the characters share the same fate of not being allowed to do so as they both die at the end of the stories, and in similar circumstances. This paper wishes to explore the lingering presence of the husbands by looking at motifs and imagery inside and outside the confines of the house which restricts the promised liberty of the two women.

Spousal bereavement and four-year trajectories of medication use: A nationwide register-based study in Swedish older adults.

Medication use around widowhood has been poorly described for most medication classes. Medication use patterns can reflect health consequences of spousal loss, as previously shown for psychotropic drugs. We used data from nationwide health registers (2008-2020) to describe the patterns of use of dispensed medications in all widowed Swedes aged ≥65 years followed between 2 years before and 2 years after spousal death. All prescription drugs used by at least 5% of the cohort were considered according to their therapeutic subgroups (Anatomical Therapeutic Chemical [ATC] classification system 2nd level). We used group-based trajectory models to cluster widowed individuals into up to 4 distinct longitudinal patterns of monthly medication use. We ranked the therapeutic subgroups with similar patterns according to their plausibility to reflect potential health effects of spousal loss, compared to those of psycholeptics (mainly anxiolytics, hypnotics) and psychoanaleptics (mainly antidepressants) as the references. From 212,111 widowed adults included (68% female and 70% aged ≥75 years), we observed a significant increasing trend in medication use, especially after spousal death, for 21 out of the 39 different therapeutic subgroups that were used by at least 5% (most represented pharmacological groups: cardiovascular system, nervous system, and alimentary tract and metabolism). This increasing trend often concerned only a small proportion of individuals, with varying magnitude and speed of change in medication use across therapeutic subgroups. The patterns of use of antiepileptics, laxatives, skin emollients/protectives, analgesics, and drugs for anemia, constipation, or peptic ulcers, were the closest to those of references, displaying the largest changes in use, and were therefore ranked as the most likely to reflect health effects of spousal loss. Our results confirmed the increase in psychotropic medications' use in widowed older adults and identified several potential physical health effects of spousal loss that warrant further research.

Household Labor Supply and the Value of Social Security Survivors Benefits

We combine quasi-experimental variation in spousal death and age eligibility for survivors benefits using US tax records to study the effects on American households’ labor supply and the design of social security’s survivors insurance. Benefit eligibility at the exact age of 60 induces sharp reductions in the labor supply of newly widowed households, highlighting the value of survivors benefits and the liquidity they provide following the shock. Among eligible widows, the spousal death event induces no increases in labor supply, suggesting little residual need to self-insure. Using theory, we underscore the program’s protective insurance role and its high valuation among survivors. (JEL D12, D91, G22, G51, H55, J16, J22)

Military Widows’ Experiences of Social Isolation, Loneliness and Unmet Social Needs

Military widow/ers can experience spousal death suddenly and in traumatic circumstances. Evidence shows that this experience often has a long-term effect on surviving family members, highlighting the unique experiences of loneliness and social isolation in the armed forces community. This study aimed to explore military widow/ers’ lived experiences of social isolation and loneliness and unmet needs relating to social participation. This paper presents the qualitative findings of a sequential study in which Phase One utilized an online survey (N = 165) and Phase Two employed semi-structured interviews (N = 26). Almost all participants across both Phases discussed feeling lonely, socially isolated, or both. Findings highlight the complexity in transition from military spouse to military widow/er through the loss of a military community and geographical location. This was further compounded by language barriers and perceived hierarchy (through service life or circumstances of death) which created obstacles to help seeking. However, individuals who did join military widow/ers’ associations valued peer support through shared connection and understanding. Peer support was particularly valued as, for many, existing relationships with friends or family members were often negatively impacted following bereavement. These changed relationships led to feelings of both vulnerability and loss. Consideration needs to be given to how access to appropriate support is gained and what provision needs to be in place. This study recommends the use of more inclusive language for the military bereaved to promote inclusive practices and broaden the availability of support, including that which would increase social participation, across the sector.

Prevalence and correlates of ICD-11 prolonged grief disorder among adults living in Ukraine during the war with Russia.

Although high rates of bereavement are evident in war-affected populations, no study has investigated the prevalence and correlates of probable ICD-11 prolonged grief disorder (PGD) under these circumstances. Participants were 2050 adults who participated in a nationwide survey exploring the effects of the Ukraine-Russia war on the daily lives and mental health of Ukrainian people. Of the total sample, 87.7% (n = 1797) of people indicated a lifetime bereavement. In the full sample, 11.4% met the diagnostic requirements for probable ICD-11 PGD, and amongst those with a lifetime bereavement, the conditional rate of probable ICD-11 PGD was 13.0%. Significant risk factors of ICD-11 PGD included the recent loss of a loved one (6 months to a year ago), being most affected by a partner or spouse's death, loved one dying in the war, no recent contact with the deceased prior to their death, and meeting depression and anxiety diagnostic requirements. The study reveals that a significant percentage of Ukrainian bereaved individuals have probable ICD-11 PGD, and identifying risk factors, particularly war-related losses, will aid in the development of intervention and prevention programs for bereaved adults.

Cognitive Decline After Divorce and Widowhood: Is Marital Loss Always a Loss?

We used longitudinal data to determine whether the type of marital loss is associated with the rate of cognitive change before and after divorce or widowhood. Previous research found that relationship status was associated with older adults' cognitive performance: married persons performed better on memory assessments and had lower dementia risk than unmarried-cohabitating, never-married, divorced, and widowed persons. However, the end of a marriage may cause distress or reduce distress because a stressor disappears. Questions thus remain about the mechanisms by which marital change affects cognitive outcomes and, specifically, whether termination of marriage can improve cognitive performance for some. Using data from the 1998-2016 waves of the Health and Retirement Study (N = 23,393), we conducted two analyses. First, we used trajectory analysis to create clusters of participants with similar cognitive trajectories and tested the association between participants' cluster membership and marital loss type. Second, we used multilevel modeling to analyze the relationship between participants' cognitive scores while married and following divorce or widowhood and linked these to marital features. Participants who divorced showed no difference in trajectory distribution; widowed participants were more likely to be in the lower-performing and more quickly declining groups. Participants had lower rates of decline following divorce (β = .136, p < .001), while widowed participants had accelerated decline following spousal death (β = -0.183, p < .001) and an immediate decline following spousal death (β = -0.113, p = .028). We found that the type of marital loss was important, and predicted improvements in cognition for some and decrements for others, with individuals who were divorced performing best while those who were widowed or separated but not divorced performing worse.

Labour supply and survivor insurance in the Netherlands

This paper investigates the effects of survivor benefits (SB) on the labour supply of widows. Using rich administrative data on the Dutch population and a reform that considerably restricted eligibility to SB, we identify the causal effect of SB on labour supply. Using a regression discontinuity design strategy based on the cohort-based implementation of the reform, we show that labour income after spousal death increased significantly following the reform (+110 euros, +23%). The effects are driven by changes in labour force participation and hours worked by widows. We also find evidence of program substitution, with widows relying more on disability, unemployment and welfare benefits as a result of the reform. This increase in alternative benefits further limits the reduction in total income caused by the reform by an average of 60 euros. Regarding the heterogeneity of the labour supply response, we find that widows with a relatively higher need for self-insurance increase their labour supply relatively more.

Journey Towards a Meaningful Life: Adaptation and Resilience in the Lives of Young Hindu Widows.

Spousal death is a life-altering and traumatic life event in married life, compelling the surviving partner to transition and make substantial adjustments to their new life situation. Losing a spouse can affect individuals differently based on gender, impacting their psychological, social, and economic well-being. This article describes adaptation to a new life condition as widows strive to reconcile their roles, status, and identity while binding their resilience to direct their lives. This study explored the lives of 17 young Hindu widows in rural and semi-urban areas of Haryana, India. Using personal face-to-face interviews and purposive sampling, it captured their unique life stories. After losing their spouses, participants showed impressive resilience, reshaping their lives and identities. They navigated challenges firmly, emphasising personal commitment over social support for effective adaptation. It highlights a need for better support systems for widows, offering potential pathways to enhance their post-loss well-being.

The joint effects of genetic liability and the death of close relatives on risk for major depression and alcohol use disorder in a Swedish national sample.

To determine whether genetic risk factors for major depression (MD) and alcohol use disorder (AUD) interact with a potent stressor - death of spouse, parent, and sibling - in predicting episodes of, respectively, MD and AUD. MD and AUD registrations were assessed from national Swedish registries. In individuals born in Sweden 1960-1970, we identified 7586, 388 459, and 34 370 with the loss of, respectively, a spouse, parent, and sibling. We started following subjects at age 18 or the year 2002 with end of follow-up in 2018. We examined time to event - a registration for MD within 6 months or AUD within a year - on an additive scale, using the Nelson-Aalen estimator. Genetic risk was assessed by the Family Genetic Risk Score (FGRS). In separate models controlling for the main effects of death of spouse, parent, and sibling, FGRS, and sex, significant interactions were seen in all analyses between genetic risk for MD and death of relative in prediction of subsequent MD registration. A similar pattern of results, albeit with weaker interaction effects, was seen for genetic risk for AUD and risk for AUD registration. Genetic risk for bipolar disorder (BD) and anxiety disorders (AD) also interacted with event exposure in predicting MD. Genetic risk for both MD and AUD act in part by increasing the sensitivity of individuals to the pathogenic effects of environmental stressors. For prediction of MD, similar effects are also seen for genetic risk for AD and BD.

Князь перед кончиной: «Даю ряд сыном своим и своеи княгини…»

&lt;p&gt;The article considers annalistic texts and wills of princes, revealing their care about their families' and clans' future. The important role of princesses in solving family disputes, caring for the preservation of sons' fiefdoms after a spouse's death is shown.&lt;/p&gt;

The Impacts of Spirituality and Religious Participation on the Emotional Well-Being of Widowed Older Adults in Southeast Nigeria.

The population of older individuals in Africa is increasing, and at a rapid rate. Although the numbers of these individuals increase, many African countries, including Nigeria, are devoid of state-sponsored welfare systems that address their well-being. This situation has placed the bulk of support on the family members including spouses. Studies have shown that spouses are considered to be veritable sources of support in later life. However, spousal death tends to reduce the perceived support including emotional support, which usually occasions lower well-being, life dissatisfaction, and higher mortality rates. This study ascertains the impact of spirituality/religious participation on the emotional well-being of widowed older adults. The study was conducted in Enugu State, southeast Nigeria. The study implemented a qualitative approach to collect data from 71 widowed older adults, aged 60 and older. The thematic analytical method was used to analyze the generated data. Participating in spiritual/religious activities like prayers, church programs/activities reading, studying, and meditating on the word of God have enabled the widowed older adults to buffer some of the emotional challenges. Older adults should be encouraged to participate in spiritual and religious activities. Religious leaders should also make every effort to organize activities that will address the emotional needs of these individuals.

Examining the Role of Leisure in Navigating Spousal Death: A Phenomenological Multi-Case Study of Widowhood

The current study will explore the post-pandemic bereavement window of widowed caregivers who experienced higher degrees of social isolation and the ways in which leisure was used to cope. A phenomenological multi-case study technique was used to explore the “multiple realities” among female caregivers whose social convoys suffered pre-pandemic because of spousal caregiving and were further impacted by COVID-19 mitigation strategies during the pandemic. Initial analyses utilized the two-cycle approach, as defined by Saldana. In the initial cycle, the researchers independently immersed themselves in the raw data gathered during participant interviews and engaged in open coding to discern concepts, patterns, themes, and categories associated with the multiple realities among the widows whose leisure participation was affected due to the strain of spousal caregiving and exacerbated by COVID-19 mitigation strategies. After completing the first cycle, the researchers then moved to the second phase, thematic analysis, which sought to develop a more structured framework by which to understand the data by identifying, analyzing, and reporting patterns (e.g., themes) within it. A qualitative comparison technique was then employed to deepen our understanding of individuals’ lived experiences. Thematic findings revealed three areas of similarities: Social isolation from caregiving, using leisure to self-focus and explore future possibilities, and core groups.

Risk for Complicated Grief After the COVID-19 Death of a Marital Partner in Late Life

To identify 1) complicated grief symptom clusters among acutely-bereaved older adults who have lost a spouse to COVID-19 and 2) if spousal death due to COVID-19 increased risk of developing probable PGD METHODS: Eighty adults participating in a randomized controlled trial for depression prevention (mean age [± SD] = 70.4 [6.6]) completed the Inventory of Complicated Grief, every 3 months over a maximum of 15 months. Twenty-four percent (n = 19) of participants lost a spouse to COVID-19; 76% (n = 61) lost a spouse to other causes of death. Adjusted linear regression examined the associations between COVID-19 bereavement and six symptom clusters: yearning and preoccupation, anger and bitterness, shock and disbelief, estrangement from others, hallucinations, and behavior change. Compared to the non-COVID-19 group, the COVID-19 bereaved group reported greater shock and disbelief, hallucinations of the deceased, and estrangement from others. COVID-19 death was also associated with higher risk for probable prolonged grief disorder (PGD) at 12 months (odds ratio = 4.38, p = 0.027). Older adults who have lost a spouse to COVID-19 present with specific symptoms of distress and may eventually require clinical care for PGD.

B - 32 Grief in Neuropsychological Assessment among Culturally Diverse Middle-Old Older Adults.

Bereavement, exacerbated by losses stemming from the COVID-19 pandemic, contributes to high rates of grief and associated mood disturbances among older adults, potentially impacting neurocognition. Middle-old cohorts (ages 75-84) are particularly vulnerable, due to elevated levels of baseline depression, complicated grief, and perceived lower quality of life. The contributory role of grief and culturally-relevant manifestations of bereavement should be carefully considered as potential confounds or performance contributors. Four cases seen for neuropsychological assessment in the Department of Neurological Surgery: A 75-year-old bilingual (Russian, English) patient with a meningioma who noticed cognitive changes following spouse's death from COVID-19; A 77-year-old monolingual (English) patient with Parkinson's disease undergoing a pre-surgical work-up prior to Deep Brain Stimulator insertion. Mood reportedly worsened sharply since spouse's recent death; An 81-year-old monolingual (Cantonese) patient undergoing a pre-surgical work-up prior to DBS insertion. Shared grieving the recent death of younger sibling from COVID-19; An 84-year-old, monolingual (English) patient who was evaluated due to longstanding cognitive challenges in the context of cerebrovascular disease (monitored by Neurological Surgery). Cognitive deficits reportedly precipitously worsened following spouse's death. While levels of neurocognitive and adaptive dysfunction varied, mood disturbance and affective distress likely reduced engagement in the testing process. Reluctance to disclose depressive and anxious symptomatology on questionnaires as a function of culture was noted. Thorough, culturally-sensitive, clinical interviewing and metrics are needed to elicit nuanced information. Grief and associated mood disturbances are to be prioritized and carefully considered in the evaluation and treatment plan with middle-old older adults.

Narrating Final Memories From Spousal Loss: The Role of Place and Quality of Death.

Objective: Personal memories of the death of a spouse can guide bereavement adjustment. Place of death and quality of death are end-of-life factors that are likely to influence death experiences and formation of subsequent personal memories. The current study employs narrative content-analysis to examine how place and quality of death relate to affective sequences present in older adults' final memories from the death of their spouse. Method: Based on power analyses, 53 older adults were recruited and completed a Final Memory Interview. They also reported place of spouse's death (ie, in hospital, out of hospital) and quality of death across four subscales. Final memory narratives were reliably content-analyzed (interrater agreements >.70), revealing positive and negative affective sequences, including: redemption, contamination, positive stability, and negative stability. Findings: Experiencing the death of a spouse in hospital was related to narrating final memories with contamination. In terms of quality of death, reporting a less comforting social environment at time of death was related to the presence of redemption in final memories. Reporting that one's spouse received appropriate medical care related to narrating memories that showed positive stability. Conclusions: Final memories are carried with the bereaved long after their loss. Positive final memories appear to stem from witnessing a comfortable, medically appropriate death outside of a hospital setting. End-of-life 'that is' between care and aligned with patients' values for place and treatment may be critical for spouses' formation of constructive final memories and bereavement adjustment.

PSYCHO-SOCIAL CHALLENGES FACED BY WORKING WIDOWS IN PAKISTAN

Widowhood is a significant life event that brings about various emotional, social, and economic changes for the woman, who navigates the challenges of grief, loss, and the adjustments required in her roles and responsibilities. The objective of this study was to explore socio psychological and emotional challenges faced by a working widows in Pakistan. For this purpose, a qualitative study was conducted to see how working widows faced different challenges and to analyze the social and cultural factors influence on their mental health. The sample of the study consisted of 12 working widows with age range of 35 to 59 years, who have been facing psycho-social challenges since spouse death. The data was collected through in-depth interviews based on semi-structured questions. Before collection of data a pilot study was conducted in order to polish the questionnaire. Privacy and confidentiality were maintained throughout the process. Thematic analysis was conducted to analyze the results. Participants frequently mentioned the absence of moral and emotional support in their lives. They expressed feelings of loneliness, difficulty in decision-making, and a lack of emotional outlets. Moreover, the nature of moral and emotional support they lack is primarily related to matters of children's upbringing, domestic affairs, and financial responsibilities. The research also uncovers the impact on children's mental health after losing their fathers. &#x0D;

The Widowhood Effect in Serious Illness: The Impact of Spousal Death on Mortality in Dementia, Organ Failure, and Cancer (FR223C)

The Widowhood Effect in Serious Illness: The Impact of Spousal Death on Mortality in Dementia, Organ Failure, and Cancer (FR223C)