WASHINGTON, D.C.---Losing a spouse is one of the most stressful events a person can experience. But most older adults are resilient and bounce back to earlier levels of physical and psychological health within 18 months of their loss, according to new research on bereavement from the University of Michigan Institute for Social Research (ISR), the world's largest academic survey and research organization.

The research also calls into question the widespread belief that the sudden death of a spouse is more difficult for the surviving member of the couple than a long-anticipated death, finding that for older men, especially, the sudden death of their wives is actually easier to handle psychologically than a lingering illness.

Moreover, the new findings debunk a longstanding doctrine of psychologists and bereavement counselors---that the more conflicted and unhappy the marital relationship, the more a guilt-ridden surviving spouse is likely to grieve. Instead, the research confirms the common sense view that the closer a marital relationship was, the more depressed the surviving spouse is likely to be.

The research, some of which is being presented here March 31 at the annual meeting of the Population Association of America, is part of an ongoing analysis of data from the ISR Changing Lives of Older Couples study, a prospective survey of a random community-based sample of 1,532 married men and women age 65 and older, started in 1987. Other findings from the study will be published later this year in the Journal of Gerontology: Social Sciences. The analysis is funded by the National Institute on Aging.

Over the years, the researchers monitored the deaths of participants, and followed up with interviews of the surviving as spouses at six months, 18 months, and four years after their losses. They also re-interviewed members of married couples in the study who had not yet lost their spouses, then matched these still-married elders with the widows and widowers on key demographic variables, including income, education, and health. In addition to detailed information on each person's physical and mental health, collected both before and after a spouse's death, the study contains information on the quality of their marital relationships.

"Collecting data before the spouse dies allows us to avoid both positive and negative recall bias," sociologist Deborah Carr explains. "Some people just can't say anything negative about a spouse who's dead. 'Oh, he didn't drink a drop.' 'He was a saint.' Other people get so depressed, their current mood colors their assessment of the quality of their marriage. They remember things being a lot worse than they really were."

Carr found that the closer the marital relationship, the more depressed both men and women were likely to be after their spouse died. She also found that surviving spouses who were better off economically, as measured by home ownership, were likely to be more depressed than peers who lived in apartments or retirement communities. "Those who own a home may do worse because they have the added strain of caring for a house," Carr speculates. "They may be more socially isolated, lonely, and even afraid of living in a home alone, compared to surviving spouses who live in apartments and have neighbors close by."

In addition, she found that widows who were highly dependent on their husbands for male-stereotyped tasks such as financial management and home repairs were at higher risk for anxiety as widows. "These findings suggest a changing picture for bereavement among older couples," Carr notes, "as more egalitarian divisions of labor make women less dependent on their husbands for home repair and financial management, and as couples are more likely to dissolve dissatisfying marriages and remain in unions with higher levels of marital satisfaction."

Carr also examined whether forewarning of a spouse's death affected the survivors' risk of heart disease and psychological adjustment at six and 18 months after the loss. Overall, she found that roughly one-third of widowed persons experienced no forewarning of their spouse's death, while another third reported more than six months forewarning. The average warning time was five to six months.

In the analysis, Carr controlled for the widow's physical and psychological health before the spouse's death, how long the survivor knew the spouse was going to die, whether the respondent was providing care to the dying spouse, and whether the dying spouse was in a nursing home. She also compared how the widows and widowers fared compared to matched controls who had not lost their spouses.

She found that prolonged forewarning (more than six months) significantly increased the likelihood that men reported having heart problems six months after their spouse's death. But by 18 months after their wives' deaths, the men's health, as measured by heart problems, had rebounded to previous levels.

Carr also found that sudden death was more emotionally distressing to women than to men. "Men cope best if their wives' deaths are quick and unexpected," she says, "while women cope best if their husband's deaths come after some period of warning. I think it's because, for this cohort anyway---the parents of the baby boomers---women are used to the role of care-givers and don't find it stressful. But men do."

Carr also notes that men and women often have very different types of personal relationships. "Women may have friends to turn to for support during the long and drawn-out process of widowhood," she says, "whereas men may withdraw from others and seek closeness only from their dying wives."

The findings, she notes, have implications for both professionals working with bereaved older men and women and for concerned family and friends. "It's important to realize that a sudden death is not necessarily more difficult for older men and women to handle than a death that comes slowly," Carr says. "But it's also important to realize that as stressful as the death of a spouse is, most older women and men can and do recover from it, emotionally and physically."

Carr's collaborators include U-M researchers James S. House, Randolph M. Nesse, Camille Wortman, and John Sonnega, all at the U-M Institute for Social Research, and Harvard University researcher Ronald C. Kessler.

---The University of Michigan

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