Trajectories of social support and well-being across the first two years of widowhood

Factors Contributing to Well-Being in Japanese Community-Dwelling Older Adults Who Experienced Spousal Bereavement

PURPOSE

Providing support for older adults after spousal bereavement is crucial for psychological recovery through the grieving process and for promoting a healthy and happy remainder of life. The current study aimed to understand factors influencing well-being among Japanese community-dwelling older adults who experienced spousal bereavement by evaluating how their roles and activities affected their psychological well-being following the loss.

METHOD

We conducted a cross-sectional, anonymous, self-administered questionnaire survey of 332 older adults who had experienced death of a spouse in later adulthood.

RESULTS

Identified factors that affected well-being after spousal loss were sex, ability to go out without assistance from others, long duration since spousal loss, having a hobby, and adopting a life-oriented approach to cope with bereavement. Well-being following spousal loss was influenced by participants' activities and roles.

CONCLUSION

Findings of the current study provide potentially valuable suggestions for surviving spouses and their supporters when coping with grief following spousal loss. [Research in Gerontological Nursing, 17(3), 121-130.].

"Life after him was just hell": Young rural women's lived experiences of widowhood in Rajasthan, India

This phenomenological study was conducted in rural Rajasthan, India, to explore young widows' lived experiences. On receipt of written informed consent, we interviewed 14 young widows. The data were analyzed in an idiographic style using the interpretive phenomenological approach. The perspective of loss and sociocultural contexts grounded the analysis. Six themes emerged corresponding to the women's widowhood experiences: becoming a widow; entangled by customs; stigmatization; the impossible marriage; hope in widowhood; and economic deprivation. The results underline the predicaments of young widows, and these experiences are largely framed by the sociocultural and gender norms prevailing in rural communities. The study's findings imply the need for strengthening social and legislative measures for young widows.

Trajectories of Instrumental and Emotional Social Support and the Associated Risk of Mortality in Bereaved Older Adults in Taiwan

This study identified the trajectories of instrumental and emotional perceived social support (PSS) from 1996 to 2003 and investigated the associated risk of mortality in bereaved older adults in Taiwan. The study analyzed 1,188 bereaved older adults who had experienced loss of a spouse, a child, or both before 1996 from the Taiwan Longitudinal Study on Aging. More favorable trajectories of PSS are associated with lower mortality risk in bereaved older adults. Compared with the spousal or dual bereavement, the parental bereavement benefited more from consistently high instrumental PSS. The present study revealed that consistently high emotional PSS had a stronger protective effect on mortality risk for a widow or widower than did consistently high instrumental support. The findings of this study can serve as an empirical reference to inform social policies and clinical practices for bereaved older adults in culturally similar societies.

Social Isolation, Social Support, and Loneliness Profiles Before and After Spousal Death and the Buffering Role of Financial Resources

Objectives

We provide new evidence on the profiles of social isolation, social support, and loneliness before and after spousal death for older widows. We also examine the moderating effects of gender and financial resources on changes in social health before and after widowhood.

Methods

We use 19 waves of data from the Household, Income and Labour Dynamics in Australia Survey, including 749 widowed individuals and a comparison group of around 8,000 married individuals. We apply coarsened exact matching weights and control for age and time trends. Local polynomial smoothed plots show the profiles of social health from 3 years pre- to 3 years postspousal death. All analyses were stratified by gender.

Results

Spousal death was strongly associated with increased loneliness for women and men, but also an increase in interactions with friends and family not living with the bereaved. For men, financial resources (both income and asset wealth) provided some protection against loneliness. Spousal death was not associated with changes in social support or participation in community activities.

Discussion

We demonstrate that loneliness is a greater challenge of widowhood than social isolation or a lack of social support. Our findings suggest that interventions focusing only on increasing social interactions are unlikely to alleviate loneliness following spousal death. Moreover, policies that reduce the cost of formal social participation may have limited effectiveness in tackling loneliness, particularly for women. Alternative strategies, such as helping the bereaved form a new sense of identity and screening for loneliness around widowhood by health care workers, could be beneficial.

Professional Support After Partner Loss: Likelihood and Correlates of Help-Seeking Behavior

Intimate partner loss in later life can be one of the most stressful events in adulthood. Individuals who struggle to adapt to the new life conditions may need support from a mental health professional. However, less is known about the likelihood to seek professional help after separation, divorce, or bereavement in later life and associated factors. This study investigated professional help-seeking (PHS) for partner loss after a long-term marriage in separated, divorced, and bereaved individuals and examined the extent to which specific person and event-related variables, as well as depressive symptoms, increase its likelihood. The data were derived from the LIVES "Intimate Partner Loss Study." The self-administered questionnaires were completed by 388 adults. PHS was higher after separation (57%) and divorce (49%), compared to widowhood (18%). Higher likelihood of PHS was associated with separation and divorce, female gender, having someone to count on, loss unexpectedness, needing more time to overcome the loss, and more depressive symptoms. Informing individuals unlikely to seek help (e.g., males, bereaved, and individuals with no confidant) about PHS benefits may facilitate adaptation to partner loss.

Social Support Experiences of Spousally Bereaved Individuals in a South African Township Community: The Botho/Ubuntu Perspective

Bereavement is a deeply personal experience that is also shaped by one’s socio-cultural context. This qualitative study explored the social support experiences and needs of spousally bereaved individuals in a South African township. The botho/ubuntu philosophical framework was used to interpret participants’ experiences in this regard. Six ethnically diverse, bereaved spouses aged 55–67years, residing in a predominantly Setswana-speaking township in the North West Province of South Africa, were interviewed. Thematic analysis was used to analyze the data. An indigenous knowledge consultant was interviewed to situate participant experiences pertaining to mourning rites and traditions within the indigenous socio-historical and contemporary cultural context. The following themes were identified: (i) Sources of social support during bereavement; (ii) Inadequate social support after spousal death; (iii) The need for grief counseling; and (iv) Social restrictions and systematic isolation during the traditional mourning period: “It is as if you smell.” Broadly, bereaved spouses drew on their support networks at various stages of their bereavement, which included family members, in-laws, friends, burial societies, their surrounding communities, and religious communities and figures. However, some experienced ostracization and stigmatization during the mourning period, which was invariably longer for the widows in this study, in line with conventions across Black South African cultures. Some participants reported withdrawal of support by their in-laws and harmful attitudes and assumptions rooted in patriarchal ideology by family members and in-laws. As pertaining to botho/ubuntu, the study also showed that communality or relationality entailed both positive and negative aspects, including support, co-operation, care, lack of support, stigmatization, and ostracization. Unlike conventional conceptualizations of botho/ubuntu, the study findings illustrate the human experience as comprising varying dimensions of relationality, ranging from harmony to disharmony. Findings regarding the negative aspects of communality are compatible with those relating to relational interdependence in African and East Asian settings. The findings also expand our understanding of the nature of disharmony alongside harmony in interdependent socio-cultural contexts.

Social participation in widowhood: Evidence from a 12-year panel

OBJECTIVES

Social participation is important to the quality of life of older adults, especially widows. This is the first study to test whether older widows' formal and informal social participation rises or declines using multiple panel observations pre- and post-bereavement. The paper also tests the moderating effects of economic and marital satisfaction, depression, and husband's illness before death on these trends.

METHODS

Seven waves of the Korean Longitudinal Study of Ageing are used to track changes in four measures of social participation - meeting and contacting a child, meeting friends, and attending a formal group. A comparison group of married individuals, weighted with coarsened exact matching, controls for age and time trends. Mixed model regressions estimate the effects of widowhood over time.

RESULTS

Social participation shows little change before bereavement and rises significantly after bereavement for all measures. However, frequencies of meeting and contacting a child peak and decline early post-bereavement, while meeting friends and attending a group show delayed but long-lasting effects. Moderators economic and marital satisfaction are positively associated with overall social participation levels, but negatively associated with social participation post-bereavement.

DISCUSSION

Increased social participation after bereavement underscores the resilience of widows and the social support they receive. However, differences in timing suggest that contact with children is gradually substituted with extra-familial relationships in the long run. The negative moderating roles of economic and marital satisfaction point to a paradox where seemingly well-off individuals may be more vulnerable to widowhood.

Predicting change in perceived social support in late life: The role of personality and gender

OBJECTIVES

Perceived social support (PSS) has a uniquely beneficial effect on physical and mental health in older adults, yet relatively little is known about patterns of change in PSS during late life. The purpose of this study was to identify risk factors related to individual-level change in PSS, with a focus on personality (specifically Neuroticism and Extraversion) and gender as primary variables of interest.

METHOD

The study sample consisted of 409 community-dwelling, healthy older adults (56.5% female) who were followed annually for up to five years. Personality traits were analyzed independently and as combined Neuroticism-Extraversion quadrants. Linear mixed effect models (LMEM) and Cox proportional hazards regression were used to examine continuous change and incidence of decline in PSS, respectively. Analyses were conducted for the entire sample and in stratified models in order to explore the potential moderating effect of gender.

RESULTS

Personality was identified as a significant predictor of PSS change, including personality quadrants and High Neuroticism alone. Stratified models revealed significant gender differences, with High Neuroticism-Low Extraversion and High Neuroticism alone consistently linked to PSS decline in males, while Low Neuroticism-Low Extraversion was linked to PSS decline in females.

CONCLUSION

Patterns in LMEM and Cox model results suggest that PSS decline in males is likely associated with High Neuroticism, while PSS decline in females may be associated instead with Low Extraversion. Future clinical implications include earlier identification of individuals who are at risk for decreased social support, and its related impact on health.

The effect of social assistance on kin relationships: evidence from Roma communities

This paper discusses the effects of social assistance on kinship relationships in Roma, a disadvantaged European minority population, and how variation in kin support affects self-reported health and reproductive success. Data were collected in 2016-7 in several rural Roma settlements in central Serbia. The sample consisted of 143 men and 221 women. Demographic information (e.g., age, gender, educational level, marital and reproductive history, level of socioeconomic status and residence pattern), social assistance history, health status, height, and weight were collected, in addition to kinship relationship dynamics. Receiving social assistance was consistently negatively associated with all measures of kin support, more so for Roma males than females while decreased kin support was found to result in poorer self-rated health and decline in reproductive success.

Stability of clinically relevant depression symptoms in old-age across 11 cohorts: a multi-state study

AIMS

To study the temporal dynamics of depression symptom episodes in old-age and the related influence of risk factors.

METHODS

Data from 41 362 old adults (54.61% women; mean age = 75.30, SD = 6.20) from the Ageing Trajectories of Health - Longitudinal Opportunities and Synergies (ATHLOS) project were used. Depressive symptoms were followed over an 18-year period. A multi-state model, comprising three statuses (no depression, new clinically relevant episode of symptoms and episode persistence), was fitted. Multinomial regression was used to study the role of risk factors in status transition.

RESULTS

Almost 85% of participants showed no depression, but prevalence became lower over time (B = -0.25, P < 0.001). New episode point prevalence was over 5.30% with a significant probability of moving to persistence status (transition probability = 0.27). Episode persistence became evident in 9.86% of episode status transitions, with increasing rate over time (B = 0.54, P < 0.01). Loneliness was proven to be the strongest predictor of episode emergence (OR = 17.76) and persistence (OR = 5.93).

CONCLUSIONS

The course of depression tends to become chronic and unremitting in old-age. This study may help to plan interventions to tackle symptom escalation and risk factor influence.

"They brought my smile back": A phenomenological description of widows' experiences of psychosocial support

The consequences of widowhood can be overwhelming. Widows sometimes experience difficulties to obtain psychosocial support to overcome the challenges they face. In this phenomenological study, purposively selected widows were asked about their experiences of widowhood in terms of different sources of support. The analysis illuminated the meaning widows attach to different sources of psychosocial support. Participants experienced both positive and negative encounters with their sources of support. During negative encounters, widows experienced feelings of disappointment; and when their psychosocial support needs were met, they experienced a sense of happiness and a positive level of satisfaction.

The Development of the Widowhood Resilience Scale

Widowhood researchers have been increasingly interested in the construct of resilience and identifying factors which contribute to adaptive responses to conjugal loss. Available measures of general resilience were validated on nonwidowed samples and broadly lack face validity for use with widowed people. This article reports the development and validation of a resilience scale specific to widowhood, the Widowhood Resilience Scale. Initially, qualitative responses from 744 widowed people were analyzed and cross-referenced with existing literature on resilience to develop 49 items. The 49 items were tested on a sample of 1,188 widowed people, resulting in a 6-factor, 25-item scale.

Factors that influence the health of older widows and widowers-A systematic review of quantitative research

AIM

To examine factors that influence the health of older widows and widowers. The review question was: What is the evidence of the relationship between widowhood and health in older adults?

DESIGN

Systematic review.

DATA SOURCES

Academic Search Elite, CINAHL, Medline (Ovid) and PubMed were searched for articles published between January 2013-December 2017.

REVIEW METHODS

A systematic review of quantitative research with a qualitative thematic analysis.

RESULTS

The selection process resulted in 12 studies. One of the themes that emerged was: emotional challenges related to experiences of bereavement, depression and anxiety, which was based on the sub-theme social support as the main strategy for coping with emotional pain and suffering. The second theme was: struggling with poor physical health. The findings indicate that healthcare professionals need knowledge and skills to deal with the health consequences of widowhood in old age. Building community teams can prevent emotional and physical health problems, as well as reduce mortality.

Resilience Among Nepali Widows After the Death of a Spouse: "That Was My Past and Now I Have to See My Present"

Responses to the death of a spouse vary; although some are at increased risk of poorer physical and mental health outcomes, others have more resilient responses. In light of the limited scope of research on widows' experiences in Nepal, a setting where widows are often marginalized, we explore themes of resilience in Nepali widows' lives. Drawing from a larger qualitative study of grief and widowhood, a thematic narrative analysis was performed on narratives from four widows that reflected resilient outcomes. Individual assets and social resources contributed to these widows' resilient outcomes. Forgetting, acceptance, and moving forward were complemented by confidence and strength. Social support and social participation were key to widows' resilient outcomes. These four narratives reflect the sociocultural context that shape widows' resilient outcomes in Nepal. Future studies on the emergent themes from this exploratory study will help identify how best to encourage resilient outcomes among widows.

Marital Status and Trajectories of Depressive Symptoms Among Older Adults of Mexican Descent

Little is known about the implications of marital status for the age patterning of depressive symptoms in later life. Drawing on seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly, this research uses growth curve models to examine age trajectories of depressive symptoms among continuously married and recently and continuously widowed older adults of Mexican descent (aged 65 years and older; N = 1,452). The findings demonstrate that despite having a higher mean level of depressive symptoms, the recently widowed experienced a similar rate of increase in distress with age to that of their married counterparts. Compared with the married, the continuously widowed had a steeper rise in depressive symptoms with age, although they had fewer symptoms at younger ages in later life. Physical health, financial strain, social support, and church attendance might account to a certain extent for marital status differences in depressive symptoms across later life.

Changes in depressive symptoms during widowhood among older Mexican Americans: the role of financial strain, social support, and church attendance

OBJECTIVES

This study examines how depressive symptoms change during the widowhood process among older adults of Mexican descent. This research also investigates whether financial strain, social support, and church attendance moderate changes in depressive symptoms in the context of widowhood.

METHOD

This study uses seven waves of data from the Hispanic Established Population for the Epidemiologic Study of the Elderly collected at approximately two-year intervals. This research applies multiphase growth models to examine changes in depressive symptomatology before, during, and after the transition to widowhood (the measurement wave at which spousal bereavement was first reported) among 385 older adults of Mexican descent who experienced the death of a spouse during the survey.

RESULTS

This study demonstrates that older adults of Mexican descent experienced a significant increase in depressive symptoms pre-widowhood and in particular, during the transition to widowhood. The levels and rates of changes in depressive symptoms post-widowhood did not differ from the pre-widowhood ones. Greater social support was related to more depressive symptoms during the transition to widowhood. More frequent church attendance was a protective factor against increases in depressive symptoms pre-widowhood.

CONCLUSION

This study highlights the multiphase pattern in the effects of the widowhood process on depressive symptomatology among older adults of Mexican descent. The findings also suggest that social support and church attendance can have implications for the interplay between widowhood and depressive symptoms.

Depressive Symptoms Among Older Mexicans: The Role of Widowhood, Gender, and Social Integration

Widowhood is often associated with decreased mental health. In developing countries with low institutional support, such as Mexico, social integration can be particularly consequential for widowed older adults' psychological well-being. This study investigates the interplay among depressive symptoms, widowhood, gender, and social integration in a nationally representative sample of older Mexicans. Drawing on Waves 1 (2001) and 2 (2003) of the Mexican Health and Aging Study, we estimated the ordinary least squares regressions to examine the implications of widowhood, gender, social support, social network, and social engagement for changes in depressive symptoms between the waves among Mexicans aged 50 and older (N = 8,708). The findings indicate that social integration can mitigate as well as exacerbate depressive symptomatology among older Mexicans. Certain aspects of social integration can moderate marital status-gender differences in depressive symptoms among older Mexicans.