L'auteure a perdu son conjoint, Didier, emporté par une leucémie en 2016. Elle reste seule avec Gabin, leur fils de 3 ans, à qui elle écrit pour raconter ce père disparu à travers l'inventaire des souvenirs. Elle confie la douleur, la colère et les angoisses qui jalonnent son cheminement émotionnel vers la reconstruction. Elle évoque son rapport à la vie et souhaite redéfinir le statut des veuves.
Young widowhood is a unique experience that has received little in-depth attention in research and clinical settings. The present study examined the lived experiences of young men and women who had lost a spouse. Eleven men and women between the ages of 18 and 49 were interviewed about their experiences postloss using phenomenological methods. After coding the interviews, three themes emerged: (1) relationship prior to death, (2) coping, and (3) concerns. Clinical implications included the need for more accessible resources for young widowed individuals, such as therapeutic services, finances, and childcare.
This study is on the effects of spousal loss among older adults who continue to live independently after bereavement. Little longitudinal studies focus on this group, which is of special interest, since in many countries, care policy and system reform are aimed at increasing independent living among older adults. Using longitudinal data from a Dutch public data repository, we investigate the effects of spousal loss on psychological well-being, perceived quality of life, and (indication of) yearly health-care costs. Of the respondents who had a spouse and were living independently (N = 9,400) at baseline, the majority had not lost their spouse after 12 months (T12, n = 9,150), but 2.7% (n = 250) had lost their spouse and still lived independently. We compared both groups using multivariate regression (ordinary least squares) analyses. The results show that spousal loss significantly lowers scores on psychological well-being and perceived quality of life, but we found no effect on health-care costs.
Objectives: In 2015 we identified three profiles of adaptation following spousal bereavement: Vulnerables; Copers and Resilients (Spahni, Morselli, Perrig-Chiello, & Bennett, 2015 ). However, adaptation to spousal bereavement is a dynamic process. Thus, we examine the trajectories of the same participants longitudinally over two years. We identify the stability and change in profiles of adaptation to widowhood; probability of stability and change; factors that influence trajectories in profile membership.
Methods: Data stem from a longitudinal questionnaire study of 309 older widowed people. The questionnaire included five measures of well-being, serving as the dependent variables of this analysis, and measures of personal resources and contextual factors, including social support, marital happiness, psychological resilience, and demography. Data was analysed using latent transition analysis of the variables loneliness, hopelessness, depressive symptoms, life satisfaction, and subjective health.
Results: The analysis replicated the three Wave 1 profiles as the best theoretical fit: Vulnerables; Copers; and Resilients. Stability was most common, but some participants moved to more or less adaptive profiles, the former being more frequent. Younger age, longer time since widowhood, new life perspectives facilitated adaptation. Those transitioning to less adaptive profiles were more likely to be women and older. Discussion: The path to adaptation was not linear. Many of the explanatory variables contributed both to positive and negative adaptation. These include previous caring experience, education, psychological resilience and personal strength. This suggests these explanatory variables do not act in isolation but are likely to interact with each other, and with other, yet not measured, factors.
This study systematically reviewed the methodology and findings of 19 peer-reviewed studies on the experience of bereavement among widowed Latinos, including risk and protective factors to the health of this vulnerable population. Of these studies, 10 included quantitative data, 3 were qualitative studies, and 6 were narrative reviews. Results emphasized the relevance of cultural beliefs about death, rituals, religion, and Latino values (i.e., familismo, respeto, simpatía, personalismo) as common themes in the included studies, along with expressions of grief (e.g., Ataque de nervios, somatization) that vary by gender and acculturation. Risk factors associated with diminished well-being in this population included being a male, financial strain, cultural stressors, having an undocumented legal status, experiencing widowhood at a younger age, and having poor physical health. Effective coping strategies identified included having adequate social support primarily from family, religion and religious practices, the use of folk medicine, volunteering, and the use of emotional release strategies. Moreover, the results highlight that researches informing the health needs of widowed Latinos in the US is limited, and studies with enhanced methodological rigor are needed to better understand the complex needs of this vulnerable population.
Research on marital status-gender differences in later-life trajectories of cognitive functioning is scarce. Drawing on seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, this research uses growth curve models to examine later-life dynamics of cognitive functioning among married and widowed older men and women of Mexican descent (aged 65+; N = 3329). The findings demonstrate that the widowed, regardless of gender, had lower initial levels of cognition but a less steep cognitive decline across waves, compared to married men. Age and socioeconomic resources accounted for these marital status differences in levels and rates of change in cognitive functioning completely among widowed men and partially among widowed women. Moreover, net of all the factors, married women had a slower cognitive decline than married men. This study also shows that health and social integration might shape cognitive functioning among older adults of Mexican descent.
Caregiving in the last years of life is associated with increased depression and negative health outcomes for surviving spouses, many of whom are themselves in poor health. Yet it is unclear how often spouses are caregiving alone, how they differ from supported spouses, and whether lack of support affects postbereavement outcomes. We hypothesized that spouses who were solo caregivers-that is, the only caregivers (paid or unpaid) who provided assistance with a spouse's self-care or household activities-would experience more depression after bereavement than supported spouses would. Using information from the Health and Retirement Study, we found that 55 percent of the spouses of community-dwelling married people with disability were solo caregivers. Solo caregiving was even common among people who cared for spouses with dementia and those with adult children living close by. Bereavement outcomes did not differ between solo and supported caregiving spouses. Caregiving spouses are often isolated and may benefit from greater support, particularly during the final years before bereavement. While some state and federal policy proposals aim to systematically recognize and assess caregivers, further innovations in care delivery and reimbursement are needed to adequately support seriously ill older adults and their caregivers. Ultimately, the focus of serious illness care must be expanded from the patient to the family unit.
This study investigated (a) whether significant health changes occur before imminent widowhood and (b) the effects of widowhood on the physical and psychological health of men and women = 50 years old. Generalized estimating equations were used to examine a matched-pair sample of the Taiwanese Elderly. We found that for men, the major effect of widowhood was on psychological health, but that for women, the major effect was on physical health. Psychological health was significantly worse for widowed than for non-widowed women, but not for men. The difference in psychological health between widowed and non-widowed women, however, changed before widowhood.
Relatively little is known about the experiences of Chinese widows, especially those living outside China. This qualitative study examines the experiences of eight Chinese or Hong Kong-born widows living in the UK. Using a semistructured approach to interviewing, participants were asked about their lives before, during, and after their spousal bereavement. Five major themes emerged: (1) complexity of marital lives; (2) experiences around the time of the death including fate; (3) loneliness and isolation; (4) the challenges of practical tasks; and finally, (5) current life. The implications of the findings for social policy and practice are briefly discussed.
Aim: To examine factors that influence the health of older widows and widowers. The review question was: What is the evidence of the relationship between widowhood and health in older adults?
Design: Systematic review.
Data sources: Academic Search Elite, CINAHL, Medline (Ovid) and PubMed were searched for articles published between January 2013-December 2017.
Review methods: A systematic review of quantitative research with a qualitative thematic analysis.
Results: The selection process resulted in 12 studies. One of the themes that emerged was: emotional challenges related to experiences of bereavement, depression and anxiety, which was based on the sub-theme social support as the main strategy for coping with emotional pain and suffering. The second theme was: struggling with poor physical health. The findings indicate that healthcare professionals need knowledge and skills to deal with the health consequences of widowhood in old age. Building community teams can prevent emotional and physical health problems, as well as reduce mortality.
PURPOSE: To conduct a systematic review and meta-analysis examining the association of the prevalence of depression and time since spousal loss in widowed people.
METHODS: The databases MEDLINE, Embase and PsycInfo were searched (May 2017) for papers reporting on time since spousal loss in widowed people and the prevalence of common mental disorders. A systematic review was conducted according to MOOSE guidelines. Random effects meta-analyses of the prevalence of depression were conducted by intervals of time since spousal loss.
RESULTS: The literature search identified 12,982 studies of which 22 were eligible for inclusion in the systematic review. Of these, 14 were furthermore eligible for inclusion in the meta-analysis. The summary estimates found in the meta-analysis for the prevalence of depression in the intervals of time since spousal loss were: = 1 month: 38.2% (21.9–55.8%); > 1 month to 3 months: 25.0% (17.3–33.5%); > 3 months to 6 months: 23.1% (18.0–28.7%); > 6 months to 12 months: 19.4% (15.2–24.0%); > 12 months to 18 months: 11.1% (5.3–18.7%); > 18 months to 24 months: 15.2% (12.3–18.2%); > 24 months to 60 months: 10.5% (4.3–18.5%).
CONCLUSION: Widowhood is associated with a high prevalence of depression and the study identifies a population group needing special attention in daily clinical practice. The prevalence is highest in the first month of widowhood, however, continues to be high at least 5 years into widowhood.
BACKGROUND: As the U.S. population ages, dramatic shifts are occurring in the proportion of older adults who are divorced and widowed. Health status and behaviors are known to differ across marital status groups, yet research on end-of-life (EOL) care planning has only compared married and unmarried persons, overlooking differences between divorced and widowed individuals, by gender.
OBJECTIVE: This study aimed to examine marital status differences in EOL care planning by comparing the likelihood of discussions about EOL care, designation of medical durable power of attorney (MDPOA) for health care decisions, and completion of a living will for married, divorced, and widowed older adults, by gender.
METHODS: Analyses used data from the U.S. Health and Retirement Study for 2243 adults (50 years of age and older), who died during the course of the study. Post-death, proxy respondents reported on the decedents' EOL care discussions, living will completion, and establishment of an MDPOA. Multivariate regressions were estimated to test differences in care planning across marital status groups, for men and women.
RESULTS: Divorced men were less likely than married men to have had care discussions and to have engaged in any of the three planning behaviors. Widowers were more likely to have established an MDPOA. Both divorced and widowed women were more likely to have performed any of these EOL planning activities than married women.
CONCLUSIONS: Divorced men and married women are at risk for lacking EOL care planning. Practitioners are encouraged to discuss the importance of such planning as they encounter these at-risk groups.
PURPOSE: The present study explores transition experiences during courses of incurable cancer from the perspective of bereaved spouses.
METHOD: Ten bereaved spouses participated in individual semi-structured interviews conducted in participants' private homes. The study takes a phenomenological-hermeneutic approach and data was analysed inspired by the French philosopher Paul Ricoeur's theory of interpretation.
FINDINGS: Two main themes were identified. The first one: "Being present when the life of their loved one is ending" consisted of three subthemes: "Challenged by suffering", "Transitions during the final days" and "Moving on in life". The second main theme: "Meaningful transitions in palliative care" consisted of two subthemes: "Changing direction towards palliative care" and "Transitions in palliative care".
CONCLUSION: Bereaved spouses experienced meaningful transitions when the life of their loved one was ending and related to receiving palliative care. Spouses were challenged by witnessing their loved one's suffering and experienced a deviation in the quality of professional palliative care offered in the system of healthcare.
I examine: whether specific emotion-focused coping and help-seeking strategies adopted by older widow(er)s 6 months postloss affect depressive, anger, and yearning symptoms 1 year later; whether these effects are accounted for by psychosocial factors which guide the selection of coping strategies; and the extent to which patterns differ by gender. I estimate nested multivariate OLS regression models using data from the Changing Lives of Older Couples, a prospective multiwave survey of spousal bereavement (N = 164). Widows are more likely to use positive reframing, active distraction, help-seeking, and turning to God for strength, whereas widowers tend to use avoidant strategies, and are more likely to seek connection with their late spouse. Avoidant strategies like trying to forget and dulling the pain with alcohol increase depressive and anger symptoms; substance use is particularly consequential for men’s anger symptoms. Positive reframing increases depressive symptoms yet mitigates against anger. Seeking comfort from God also protects against anger. Seeking help from a doctor increases anger and depressive symptoms in baseline models, although effects are accounted for by selection. Maladaptive coping strategies are linked with anger, whereas depression and yearning are relatively immune to coping strategies, reflecting the relatively short-lived time course of these two symptoms. The results carry implications for bereavement theories and mental health interventions targeting older widow(er)s. Older widowers who cope by turning to unhealthy behaviors are especially prone to anger, which has documented physical health effects and may alienate potential sources of social support.
The purpose of this descriptive study was to identify whether meaning reconstruction was associated with indicators of bereavement adaptation in 66 spouses and adult child caregivers of person's with Alzheimer's disease. A cross-sectional mixed-methods design was used. Hierarchical regression models were used to examine whether meaning making predicted grief, depression, and positive and states of mind in the sample. Qualitative interviews were conducted to gain further knowledge about ways in which Alzheimer's disease caregivers construct meaning during bereavement. The majority of participants reported experiencing positive aspects of meaning reconstruction. Benefit-finding and identity change contributed to reductions in grief, and benefit-finding contributed to positive states of mind. Being a spouse and female gender contributed to increased grief and depression. Bereaved caregivers who are at risk for high levels of grief should be targeted for grief therapy interventions that foster meaning making.
This study investigated whether the 30 prompted categories of Gillies, Neimeyer, and Milman’s (2014) Meaning of Loss Codebook (MLC) emerged in the unprompted and naturalistic blogs of four grieving widows. Furthermore, the study aimed to examine how such meanings emerged through each participant’s processes of narrativization. Results showed that 26 of 30 MLC meanings emerged over 582 posts. Furthermore, in blogs demonstrating continued bonds with the deceased, MLC meanings formed networks integrated within narrative pathways. Conversely, in cases where severing ties were formulated as a condition of “moving on,” meanings appeared in isolation of narrative and complications in narrativization were evident.
We investigate how daughters' feelings of loneliness are impacted when widowed parents develop health limitations, and when daughters take on personal care tasks in response. Using longitudinal data from daughters of widowed parents drawn from the French Family and Intergenerational Relationships Study (ERFI, 1485 observations nested in 557 daughters), we assess (a) whether health limitations of widowed parents are associated with daughters' feelings of loneliness regardless of whether or not daughters provide personal care and (b) whether there is an effect of care provision on loneliness that cannot be explained by parental health limitations. Fixed effect regression analyses show that widowed parents' health limitations were associated with raised feelings of loneliness among their daughters. No significant additional effect of providing personal care to a widowed parent was found. Prior research on the impact of health limitations of older parents on the lives of their adult-children has focused mostly on issues related to informal caregiving. Our findings suggest that more attention to the psychosocial impact of parental health limitations-net of actual caregiving-on adult children's lives is warranted.
Veuve depuis plusieurs années, Fang Xiuying, 68 ans, est née à Huzhou, dans la région du Fujian où elle travaillait comme ouvrière agricole. Elle a souffert les dernières années de sa vie de la maladie d’Alzheimer. Après avoir été hospitalisée en 2015, elle a été renvoyée chez elle pour y mourir, entourée de sa famille. Mais la mort est longue à venir…
Objectives: The study investigates whether the disadvantaged position of men in the adverse consequences of widowhood for health and mortality also exists for changes in cognitive health.
Methods: We used data of up to 1,269 men and women aged 65 years
and older who participated in the Long itudinal Aging Study Amsterdam
in three -yearly assessments between 1992 and 2012 (5,123 person-
observations). All were married and without cognitive impairment (MMSE =
24) at baseline and up to 419 lost their spouse. In fixed effects regression
models, the effect of spousal loss on change in four domains of cognitive functioning was estimated independently of age - related cognitive change.
Results: For women, a robust temporary decrease was found in the second year after spousal loss in the reasoning domain, but not in global cognitive functioning, processing speed, or memory. No robust effects were found for men.
Discussion: Considering that only one cognitive domain was affected and effects were temporary, cognitive functioning seems rather robust to the experience of spousal loss. Despite men having often been reported to be in a disadvantaged position in other health domains, our analyses indicate no such pattern for cognitive functioning.