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Posted: June 10, 2008

Spouse's Death Increases Elderly's Odds of Needing Nursing Home Care

The death of a spouse increases one’s likelihood of entering a long-term care facility, including permanent nursing home care, and the risk is particularly high immediately after the spouse’s death, according to new international research.

Any number of factors may be responsible for this connection, said Elina Nihtila, of the department of sociology at the University of Helsinki in Finland, who led the research.

"It may be related to the loss of social and instrumental support, in the form of care and help with daily activities such as help in cooking, cleaning, and shopping formerly shared with the deceased spouse," Nihtila said.

"Second, grief and spousal loss may cause various symptoms, such as depression and anxiety, loss of appetite, sleep disturbances, fatigue and loss of concentration that could increase the need for institutional care." She added. "Furthermore, grief may cause increased susceptibility to physical diseases."

The research findings were published in the American Journal of Public Health.

Nihtila and colleagues analyzed how the death of a spouse affected the likelihood of entering institutionalized care among nearly 141,000 Finnish adults age 65 and older. All of the study subjects were living with a spouse at the beginning of the research, and they were tracked for five years.

"The data were unique in that they covered a large number of persons bereaved during the follow-up and gave the dates of bereavement and of first admission into institutional care," Nihtila wrote in the medical journal.

Their analysis showed that the risk of entering long-term institutional care was higher among older adults who had lost their spouse than among those living with their spouse. "The excess risk of institutionalization was highest during the first month after the spouse's death -- more than three times higher among both men and women -- and decreased with time from bereavement, stabilizing at approximately 20% to 50% higher over one to five years," Nihtila noted.

The researchers said it may be possible to lessen the likelihood of institutionalization if the surviving spouse receives intensive in-home caregiving by professionals and family immediately after a spouse’s death.

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