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Spousal Caregivers Are Caregiving Alone In The Last Years Of Life.
Health Aff (Millwood) 2019; 38(6):964-972HA

Abstract

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.

Authors+Show Affiliations

Katherine A. Ornstein (katherine.ornstein@mssm.edu) is an assistant professor in the Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, in New York City.Jennifer L. Wolff is a professor of public health at Johns Hopkins University, in Baltimore, Maryland.Evan Bollens-Lund is an analyst in the Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.Omari-Khalid Rahman is an analyst in the Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.Amy S. Kelley is an associate professor in the Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31158025

Citation

Ornstein, Katherine A., et al. "Spousal Caregivers Are Caregiving Alone in the Last Years of Life." Health Affairs (Project Hope), vol. 38, no. 6, 2019, pp. 964-972.
Ornstein KA, Wolff JL, Bollens-Lund E, et al. Spousal Caregivers Are Caregiving Alone In The Last Years Of Life. Health Aff (Millwood). 2019;38(6):964-972.
Ornstein, K. A., Wolff, J. L., Bollens-Lund, E., Rahman, O. K., & Kelley, A. S. (2019). Spousal Caregivers Are Caregiving Alone In The Last Years Of Life. Health Affairs (Project Hope), 38(6), pp. 964-972. doi:10.1377/hlthaff.2019.00087.
Ornstein KA, et al. Spousal Caregivers Are Caregiving Alone in the Last Years of Life. Health Aff (Millwood). 2019;38(6):964-972. PubMed PMID: 31158025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spousal Caregivers Are Caregiving Alone In The Last Years Of Life. AU - Ornstein,Katherine A, AU - Wolff,Jennifer L, AU - Bollens-Lund,Evan, AU - Rahman,Omari-Khalid, AU - Kelley,Amy S, PY - 2019/6/4/entrez PY - 2019/6/4/pubmed PY - 2019/6/4/medline KW - bereavement KW - caregiving KW - end-of-life KW - families KW - palliative care SP - 964 EP - 972 JF - Health affairs (Project Hope) JO - Health Aff (Millwood) VL - 38 IS - 6 N2 - 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. SN - 1544-5208 UR - https://www.unboundmedicine.com/medline/citation/31158025/Spousal_Caregivers_Are_Caregiving_Alone_In_The_Last_Years_Of_Life L2 - http://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00087?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -