Anticipatory Grief and Aged Widows and Widowers

Gerber, Irwin; Rusalem, Roslyn; Hannon, Natalie; Battin, Delia; Arkin, Arthur M.

doi:10.1093/geronj/30.2.225

Cited by 106 publications

(45 citation statements)

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“…In a recent review Fasey (1990) drew atten-gave insufficient weight to measures of social tion to evidence in the literature of some adjustment (Faschingbauer et al, 1977). In a further review of the subject, Gerber et al (1975) found no evidence of any beneficial effect of anticipatory grief on the course of bereavement. This study showed that spouses did worse after chronic fatal illnesses, but outcome measures were unsophisticated and no psychological measurements were made.…”

Section: Anticipatory Griefmentioning

confidence: 88%

Is there a desolation effect after dementia? A comparative study of mortality rates in spouses of dementia patients following admission and bereavement

Ryan¹

1992

Int J Geriat Psychiatry

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SUMMARYMortality rates following patient admission and patient death were measured in the surviving spouses of a sample of dementia patients admitted to a psychogeriatric unit between 1971 and 1986. The vital status of 85% of spouses was confirmed, and the ratio of observed to expected deaths (SMR) was calculated using regional and national mortality statistics.Spouse mortality following first admission to hospital was significantly lower than expected (p < 0.006), and spouse deaths following bereavement were significantly fewer than expected (p < 0.026). When male and female spouse mortality rates were compared, no significant differences were found, but there was a trend towards lower mortality in female spouses.The results give no support to the theory that hospital admission often follows a breakdown in the health of a caring spouse. Previous studies have shown an increase in mortality following conjugal bereavement, but the spouses of dementia patients were relative survivors and outlived their married and widowed counterparts in the general population. The possible relationships between dementia, anticipatory grief, and the impact of bereavement on the health of the surviving spouse are discussed.KEY woms-Dementia, spouse, bereavement, mortality.The historical observation of high mortality rates in the widowed (Durkheim, 1951; OPCS, 1971) has stimulated research into mortality and morbidity following bereavement. MORTALITY AFTER BEREAVEMENTMortality rates in the bereaved are higher than those in the married. Evidence of a 'mortality effect' during the initial 12 months following bereavement is stronger for widowers than for widows. Young et al.( 1 963) found a 40% increase in mortality during the initial six months of bereavement in a group of 4486 widowers aged 55 years and over. Parkes (Parkes et al., 1969) was able to explain the rise in mortality by an increase in cardiovascular deaths which was confined to the six months following bereavement. Rees and Lutkins (1967) confirmed Young's observations in a Welsh rural population and presented evidence of higher mortality rates following bereavement proportional to the nearness of the blood relationship. Helsing and Szklo (1981) were not able to show an increase in the female mortality rate following bereavement, although they did find evidence of significantly greater mortality after bereavement in widowed males. Clayton (1974) did not find evidence of higher mortality rates in a controlled 12-month follow-up study of widows and widowers, but the numbers in this study were insufficient for adequate postbereavement analysis of mortality rates. MORBIDITY AFTER BEREAVEMENTMorbidity studies have tended to rely either on the uncertain relationship between consultation rates and true morbidity or on self-report questionnaires on health after bereavement. Parkes (1964) found

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Section: Anticipatory Griefmentioning

confidence: 88%

Is there a desolation effect after dementia? A comparative study of mortality rates in spouses of dementia patients following admission and bereavement

Ryan¹

1992

Int J Geriat Psychiatry

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“…We reasoned that the 6-month point minimized these confounds but was still early enough in the bereavement to capture the quality of initial coping responses (Dyregrov & Matthiesen, 1991;Gerber, Rusalem, Hannon, Battin, & Arkin, 1975;Windholz, Marmar, & Horowitz, 1985). Somatic symptoms were assessed with an 18-item self-report checklist used in the Whitehall II study, a large scale study of morbidity among civil servants in London, England (Marmot et al, 1991;Stansfeld, Smith, & Marmot, 1993).…”

Section: Phase 2: Structured Grief Symptom Interview (6 Months)mentioning

confidence: 99%

When avoiding unpleasant emotions might not be such a bad thing: Verbal-autonomic response dissociation and midlife conjugal bereavement.

Bonanno¹,

Keltner²,

Holen³

et al. 1995

Journal of Personality and Social Psychology

275

318

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It has been widely assumed that emotional avoidance during bereavement leads to either prolonged grief, delayed grief, or delayed somatic symptoms. To test this view, as well as a contrasting adaptive hypothesis, emotional avoidance was measured 6 months after a conjugal loss as negative verbal-autonomic response dissociation (low self-rated negative emotion coupled with heightened cardiovascular activity) and compared with grief measured at 6 and 14 months. The negative dissociation score evidenced reliability and validity but did not evidence the assumed link to severe grief. Rather, consistent with the adaptive hypothesis, negative dissociation at 6 months was associated with minimal grief symptoms across 14 months. Negative dissociation scores were also linked to initially high levels of somatic symptoms, which dropped to a low level by 14 months. Possible explanations for the initial cost and long-term adaptive quality of emotional avoidance during bereavement, as well as implications and limitations of the findings, are discussed.

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“…Thus, although the death of a spouse is usually a traumatic life event, the aged are more prepared for such losses by experience of peers and may have a less severe reaction than the young. Data indicate that widows over 65 fare better than anticipated (Heyman and Gianturco, 1973), depending upon financial circumstances (Atchley, 1975), although widowers may do less well (Parkes et al, 1969;Gerber et …”

Section: Age and Stressmentioning

confidence: 97%