Articles

Hospice May Reduce Bereaved Spouses’ Death Risk
By Jane Koppelman

In the first large-scale study of its kind, researchers have found that spouses whose partners died while receiving hospice services were more likely to be alive 18 months after their loss than those who spouses died without hospice.

One and–a-half years after the deaths of their husbands, 5.4 percent of wives whose husbands did not use hospice died, compared with 4.9 percent of wives whose husbands used hospice. The death rate was 13.7 percent for bereaved husbands whose wives died without hospice, compared with 13.2 percent for husbands whose wives died using hospice. Researchers Nicholas Christakis and Theodore Iwashyna drew their results from the experiences of over 61,000 elderly couples; half of them used hospice and half did not. Their findings were published in the August issue of Social Science and Medicine.

According to the study, the correlation between wives’ survival rates and hospice use is nearly as strong as the relationship between timely beta-blocker use and heart attack survival rates; and similar to the life-prolonging effect that diet and exercise has had with widows.

Researchers say the death of a spouse is a stressful event that is compounded by the survivor’s loss of a major source of social support. This trauma is believed to cause a “widow-er effect,” which is the increased likelihood that a surviving spouse will die shortly after the death of his or her partner. The widow-er effect is far more common among surviving husbands than among wives.

“Our hypothesis was prompted in part by the clinical observation that patients who die “good deaths” often impose less stress on their families,” say Christakis and Iwashyna. Hospice care provides pain relief, symptom management, family and bereavement support and it strives to allow the patient to die at home. Hospice is particularly effective if patients and their families are receiving its services for longer rather than shorter periods of time. The researchers suggest that hospice care both reduces the trauma of the death and “partially replaces the support lost due to the death of the spouse.”

Researchers say their findings have both clinical and policy implication. Physicians concerned with the impact of patients’ deaths on their spouses “have another tool at their disposal beyond bereavement counseling or medication;
namely, they can attend to the specific manner of death of the sick partner before it occurs.” In addition, they say that greater spousal survival should be considered in assessing the cost effectiveness of hospice. Finally, they state, the type of health care given to a patient can have positive health effects on members of their social network.

“The health impact of health care on families: a matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses,” written by Nicholas Christakis and Theodore Iwashyna, appeared in the August issue of Social Science and Medicine. The article can be purchased at www.sciencedirect.com.

Source: Last Acts, Fall 2003

Hospice of Southeastern Connecticut is a resource to your patients and the community. Our hospice families receive bereavement follow-up for 13 months after the death of a loved one.

We also offer bereavement support groups throughout New London County and one-on-one counseling for those who so choose. Groups are open to all bereaved individuals not just hospice bereaved. Our bereavement counselors are always available to provide information and education about grief and loss.

For information call Cyndia Shook, LCSW, or Dee Keaney at 848-5699.