This information comes from a groundbreaking study by the Harvard Medical School, which examined the medical records of more than 500 couples age 65 or older for a period of nine years. During that time, more than two-thirds of the individuals were hospitalized and more than one-third died.
- The study authors examined the effect of illness in one spouse on the risk of illness in a partner -- commonly called the "caregiver burden."
- At the same time, researchers looked at the effect of the death of one spouse on the mortality of the other, known as the "widower effect."
By considering these effects together for the first time, study authors were able to assess how specific illnesses or diseases affect the caregiver partner.
Study Confirms the Widower Effect
Details of the study, reported in the February 16, 2006 issue of the New England Journal of Medicine, show that a wife’s risk of death is 61 percent greater during the first 30 days following the death of her husband.
If a wife dies, the husband’s risk of death during the first 30 days increases by 53 percent.
Time tends to help people heal. After one year, surviving husbands in the study had a 21 percent increase in the risk of death, and surviving wives had a 17 percent increase.
The Burden on Caregivers
Study authors pointed out that one of the most significant finding of this study is the serious effect that a spouse’s hospitalization can have on the caregiver spouse. In some cases, the effect of sudden, serious illness is almost has devastating to the caregiver spouse as a death would be.
"When a spouse is hospitalized, the partner's risk of death increases significantly and remains elevated for up to two years," said Nicholas Christakis, MD, PhD, and professor in the Department of Health Care Policy at Harvard Medical School. Christakis was quoted in a news release from Harvard Medical School.
“The period of greatest risk is over the short run, within 30 days of a spouse's hospitalization or death. Over this time frame, hospitalization in a spouse can confer to a partner almost as much risk of dying as the actual death of a spouse.”
According to the study authors, a spouse who suddenly needs to provide more caregiving may become cut off from emotional, social, economic or other practical support. "When a spouse falls ill or dies, partners may increase harmful behavior, such as drinking,” said Christakis.
“Stress and lack of social support may also adversely affect immunologic measures, so spousal hospitalization may have physiological effects on partners."
Degree of Caregiver Burden Depends on the Spouse’s Illness
The study revealed that the more disabling a medical condition is to physical and mental ability, the greater the effect it will have on the caregiver spouse. For example, people with dementia often need more constant care than people who have cancer, so having a spouse with dementia increases the caregiver’s risk of illness or death.
Age, race, and the level of poverty affected the mortality risk of a having a sick spouse in this study.
- For women, the effect of a husband's hospitalization increased with age and the level of poverty.
- For men, the effect of a wife's hospitalization increased only with age.
The study also found that specific illnesses impacted the caregiver spouse differently.
- Among men with hospitalized wives, if the wife was hospitalized for colon cancer, there was almost no effect on her husband's mortality.
- But if a wife was hospitalized with heart disease, her husband's risk of death was 12 percent higher than it would be if the wife was not sick at all.
- Dementia, which requires a high level of caregiver attention, appeared to have a strong effect on the mortality of both men and women. If a wife was hospitalized with dementia, her husband's risk was 22 percent higher and a similar effect was seen in women whose husbands were hospitalized with dementia.
What Can We Learn from This Study?
"Our study shows that people are connected in such a fashion that the health of one person is related to the health of another," Christakis said. He suggests that interventions could be especially useful during riskiest times for caregivers, such as when a spouse is hospitalized for stroke or dementia.
The study also underscores the need for medical practitioners, family, and friends to consider the needs of the caregiver spouse as well as the person with the illness.
"It seems clear that a person's illness or death can have health consequences for others in his or her social network," Christakis said.
"The training and assistance of caregivers can lower costs and also improve the health of patients and caregivers alike."
February 16, 2006
