Forewarning of Spouse's Death and Psychological Adjustment to Widowhood among Older Adults

Forewarning of Spouse’s Death and Psychological Adjustment to Widowhood Among Older Adults This study examined: (1) whether psychological adjustment to widowhood is affected by the amount of forewarning prior to spouse’s death; (2) whether the effect of forewarning differs for men and women; and (3) the extent to which the effect of forewarning is mediated or suppressed by death context characteristics (i.e., pre-death care giving, nursing home usage, spouse age at death and couple communication about the impending death). Analyses are based on data from The Changing Lives of Older Couples (CLOC) study, a probability sample of 1,532 married individuals age 65 and older for whom baseline information was collected in 1987-88, with widows reinterviewed 6, 18, and 48 months after spousal loss. Overall, the effects of death forewarning (and sudden death) were quite limited; forewarning did not significantly affect depression, anger, shock, or overall grief six or 18 months after the loss. Prolonged forewarning (i.e., more than six months warning) was associated with elevated levels of anxiety both six and 18 months after the death. Sudden death was a positive and significant predictor of intrusive thoughts at the six-month follow up only. Warning time had significantly different effects on men’s and women’s yearning. At both six and 18 months after the loss, sudden death was associated with slightly higher levels of yearning among women, but with significantly lower yearning among men. The findings call into question the widespread belief that grief is more severe if the death was sudden. Understanding how death forewarning affects diverse aspects of older widowed persons’ well-being is critically important today, as chronic diseases account for the majority of older adults’ deaths. Dataset used: Changing Lives of Older Couples (CLOC) Study: United States, 1987-1994 Widowhood is characterized as among the most stressful of life events (Holmes & Rahe, 1967). The psychological consequences of widowhood vary widely, however, based on characteristics of the survivor (Matthews, 1991; Stroebe & Stroebe, 1983; Umberson, Wortman & Kessler, 1992), the deceased (Parkes, 1985; Reed, 1998), and the marital relationship (Carr et al., 2000). The context of the death including whether the death was sudden or the endpoint of a long and lingering illness is also an important influence on patterns of grief (Ball, 1977; Carey, 1979-80; Lundin, 1984; O’Bryant, 1990-1991; Rando 1986; Smith, 1978; Vachon et al., 1982). Numerous studies explore whether sudden or anticipated deaths are more distressing for bereaved spouses, but this research is inconclusive and does not specifically address the unique circumstances of the elderly bereaved. Understanding the linkage between death forewarning and older widowed persons’ wellbeing is critically important today as chronic diseases, or ongoing conditions for which there is no cure, account for the majority of older adults’ deaths (McLeroy & Crump, 1994; Olshansky & Ault, 1986). Furthermore, advances in medical technology which delay old-age mortality mean that interval between diagnosis and death is lengthening. It is thus critically important that scholars and practitioners understand how the “living-dying interval” affects survivors’ adjustment (Pattison, 1977, 1978).