 A new study published in The New England Journal of Medicine finds that seniors who care for seriously ill spouses significantly raise their own risk of death.
There has never been any dispute that the death of a spouse can hasten the death of the surviving husband or wife. Whether by study or simple observation of individual cases, the “broken heart†factor is often identified as a distinct precipitating factor in the death of a spouse who has been left behind.
After studying extensive data on over 500,000 couples over the age of 65, a research team led by Dr. Nicholas Christakis, a professor of health care policy at Harvard Medical School, found that this same risk extends to those caring for a seriously ill spouse.
In fact, when the illness invovolved is especially debilitating, as in the case of dementia, the toll exacted on the caregiver is even greater than in situations where the spouse dies.
At a press conference, Dr. Christakis stated: “We showed you can die of a broken heart not just when your partner dies, but when your partner falls ill. We showed it is not just death that can give you a broken heart, but illness — even when the spouses don’t die.”
Statistically, the couples analyzed ranged in age from 65 to 98 with the average man being 75 and the average woman being 73.
According to the study, a spouse’s death increased a man’s risk of death by 21% and a woman’s risk of death by 17%. When all situations were considered, illness was only one-fifth as “deadly†to caretakers as when a spouse died. In some situations, however, the risk in the case of spousal illness was at least as great as when thespouse died.
Thus, the psychiatric illness of a spouse was found to increase the risk of death by 19% for men and by 32% for women. A spouse’s dementia raised the risk of death by 28% for women and by 22% for men. Heart failure, hip fracture or other serious fracture, and chronic lung disease also take a heavy toll on caretakers. Oddly, cancer of a spouse did not increase the risk of caretaker’s death.
Christakis observed that it is the “disablement and not the lethality of a spouse’s illness that can be harmful to you and contribute to your risk of dying.”
Poverty also exacerbates the pain of a sick or dying partner. “If you are living at the margin, economically or in terms of age or being sicker, you are more vulnerable to your spouse being sick. If I am richer or younger, it is not as big a shock.”
Seniors living in poverty have limited access to health care and often suffer from more of the things that have a negative impact on health, such as obesity-related problems like high blood pressure, diabetes, and small strokes.
According to Christakis, there are two danger periods during a spouse’s illness that combine to increase the risk of a caregiver’s death. At first, elevated stress levels can lead increases in harmful behaviors (drinking or unhealthy diet for example) as well as an increased risk from heart attack, suicide, and accidents. There is an increase in infections.”
When the initial impact of added stress diminishes, a new set of health risks can occur as support from family and peers begins to wane. Once that happens loneliness sets in.
The researchers hope their findings will prompt health care providers and insurers to pay more attention to caregivers. Such an approach would also save money in the long run by heading off problems before they take their toll on the health of the caretakers.
Christakis also pointed out that the teams work “shed light on particular vulnerabilities to elderly people, and shows there are time windows to target interventions. Seeing people as interconnected might change the way we see the costs of health care. Taking care of both spouses while one is dying increases the health benefits for the surviving partner.”
In a broader context, Christakis observed that: “Because people are interconnected, we think this phenomenon we studied in elderly married couples applies more generally. We are looking at broader connections — between parent and child, brother and sister, neighbors, and friends.” (Sources: New England Journal of Medicine, 2/16/06; WebMD Medical News 2/15/06)
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