Transitioning From Caregiving to Widowhood

Abstract

ContextOlder women commonly assume a caregiving role for their husbands at end-of-life and are more vulnerable to poorer health, wellbeing, and social and economic challenges. ObjectivesThe aim of this study was to ascertain older women's experiences of spousal caregiving at endof-life and the ways in which this experience impacts on the transition to widowhood. Methods:Longitudinal in-depth semi-structured interviews were conducted with older women three times over a one year period following the death of their husbands. This report focuses on the initial interviews that examined the transition from caregiving to widowhood. Transcripts were analysed using Interpretive Phenomenological Analysis methods. Participants were community-dwelling women over the age of 65 who had recently been caregivers for their husbands who died within the past two years.Results: Older women caregivers described their caregiver role as taxing, particularly in light of their own chronic conditions, which they failed to prioritise and address. They did not ask for help in managing their roles and health problems, but quietly endured. Hence, they did not communicate their needs or strains explicitly. The degree of perceived adequacy of communication and interaction with health professionals were important factors impacting on their bereavement. Conclusion:It is imperative for health professionals to appreciate that older women caregivers may need more supportive interaction and information during end-of-life caregiving, they may have expectations of communication, and they may deny or fail to focus on their own health issues. A patient/family/carer-centred approach could negate this oversight and improve outcomes for these women as they transition into widowhood.3

Understanding the barriers to identifying carers of people with advanced illness in primary care: triangulating three data sources

“…For example, carers may prioritise the needs of the cared-for person [45], experience feelings of guilt, and question the legitimacy of their needs [46]. Carers may feel that their home will become medicalised and no longer feel like their own if they have equipment or external carers to help them.…”

Caregiver characteristics and bereavement needs: Findings from a population study

“…1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 A u t h o r ' s c o p y 12 The results included bereaved spousal caregivers' desire for more information about what to expect from services and the disease course. Research has previously noted the need for improved communication between health professionals, health services staff, and caregiving spouses regarding illness trajectory, expectations at end-of-life, and services and supports available [27]. Health professionals should not assume duration of caregiving equates to caregiver knowledge of care recipients' condition.…”

“…Health professionals should not assume duration of caregiving equates to caregiver knowledge of care recipients' condition. Outcomes of perceived inadequate information provision may include more protracted and complicated bereavement periods [27].…”

The personal communities of men experiencing later life widowhood

“…Later life transitions such as widowhood can have a negative effect on well‐being (Collins, ; ILC‐UK, ). Many older widows and widowers are often in poor health themselves (Hirst & Corden, ), particularly if they have been caregivers (DiGiacomo, Lewis, Nolan, Phillips, & Davidson, ), necessitating the use of health and social care services (Beaumont, ). A recent policy report identified life events, such as widowhood, to be associated with increased loneliness and isolation, particularly for older men (ILC‐UK, ) who tend to have smaller support networks and less contact with family and friends than older women (Martin‐Matthews, ).…”