Caregiving is dangerous.

As early as the 1960s, the British psychiatrist Colin Murray Parkes reported that after nine years of bereavement among 4,486 widowers, 55 years of age and older, 213 died during the first six months of bereavement. This death rate was 40 percent above the expected rate for married men of the same age. Often referred to as the “widowhood effect”—where the surviving spouse dies soon after—it is an example of how intimate relationships define what is important in life. Death following spousal death among older adults is estimated at between 30 percent and 90  percent in the short term, and around 15 percent in the long term.

The months and sometimes years leading to death are stressful to both partners. In 1999 Richard Schulz and Scott Beach compared 392 caregivers aged 66 to 96 years who were experiencing stress looking after their spouse reported that they were twice as likely to die within the four years of the study then 427 similar older adults who were not providing care. And there seems to be worse outcomes when their spouse dies.

In one of the largest studies, Nicholas Christakis and Paul Allison in 2006 looked at 518,240 Medicare married recipients. During the nine years of the study, 49 percent husbands and 30 percent wives died. The consequence on their surviving partner was dramatic. Overall male survivors were more likely to die than females. What is surprising from this study—for both male and female--was that the risk of death was the highest when the spouse died of dementia compared to other causes (20 and 16 percent higher mortality for males and female respectively).

One argument, that attempts to understand this proximity of death, is the shared environment. For example, people who die of heart disease are more likely to have a lifestyle that promotes such diseases and—the argument goes—this is likely shared with their spouse (e.g. smoking, high fat diet, no exercise.) In addition, older people are more likely to have diminished resilience. This argument loses its strength in light of the work of Mairi Harper and her colleagues from the University of York, England.

These researchers looked at 738 bereaved Scottish parents who had stillbirth or death of their child in its first year of life. They found that the bereaved parents are more than twice as likely to die in the first 15 years after their child's death than non-bereaved parents. Unlike older adults, females tend to suffer worse consequences. Bereaved mothers were more than four times as likely to die in the first 15 years. Although this rate decreases with time, the effect was still seen 35 years after the bereavement.

A consistent observation of increased longevity is that these unique older adults are accepting of changes that happen to them. They interpret negative events as part of their world. It seems however that sometimes the death of a loved one destroys that part of the world that is important, especially when your children die before you.

© USA Copyrighted 2014 Mario D. Garrett

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