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June 28, 2001

Caregiving helps spouse cope with partner's death, study shows

New Pitt research suggests that people who care for their sick spouses cope better when their partner dies than those who take no role in caregiving, and they have a lesser chance of depression, weight loss and poor health.

The study by Richard Schulz, professor of psychiatry, epidemiology and sociology, and his colleagues is the first to clearly show that the way married couples cope with the death of a spouse varies depending on how active they were with caring for their dying partner. The research was published in the June 26 Journal of the American Medical Association (JAMA).

"While caregivers can become depressed after the death of their spouse, in many ways the death can actually bring relief from some of the more demanding tasks of caregiving," Schulz said. "Death also brings an end to their partner's suffering and allows them to get back into a more normal routine."

Partners who have a limited role or no participation in caregiving may take the death harder because it is less expected, said Schulz. If the deceased spouse had not been ill, the survivor also suffers the loss of an active life partner.

Schulz's study shows that non-caregivers have a higher risk for negative health consequences such as weight loss, increased depression and increased medication use.

According to Schulz, the study takes on a greater meaning considering that most deaths in the United States today are preceded by an extended period of illness and disability. As the population ages, family members will be called upon to provide support and care to relatives before they die. It also suggests that clinicians and family members need to understand the role of caregiving and how it affects bereavement to help them better meet the survivor's needs.

Schulz said, "During the next 15 to 20 years there will be more people hitting their 70s and 80s than ever before, increasing the burden of care on relatives."

Researchers followed 819 married men and women ages 66 to 99 for four years. During that time, 129 individuals were widowed. Survivors were classified as non-caregivers, caregivers who reported no strain, or strained caregivers.

Individuals classified as strained caregivers before the death of their spouse tended to cope much better with the death than those who had a less active role. Researchers outlined several reasons: Death is more predictable so individuals can better prepare for it; death brings an end to patient suffering as well as an end to demanding caregiving tasks; death is a relief to both patient and caregiver; and, because caregiving demands disrupt normal routines, death enables the former caregiver to return to normal activities.

Shock and disruption surrounding a spouse's death were the two most likely reasons for increased depression and poorer health in general for those with limited or no caregiving roles.

Other authors of the study were: Scott Beach and Bozena Zdaniuk of Pitt's University Center for Social and Urban Research (UCSUR); Lynn Martire of the Pitt medical school and UCSUR; Bonnie Lind of the University of Washington, Seattle; Calvin Hirsch of the University of California's Davis Medical Center; Sharon Jackson of Wake Forest, and Lynda Burton of Johns Hopkins.

Research was partly supported by grants from the National Institute of Mental Health, the National Institute on Aging and the National Heart, Lung and Blood Institute.

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