The chances of older adults being institutionalized, for instance in a nursing home, go up significantly immediately after the death of a spouse, according to new research from Finland.

The study was conducted by Elina Nihtila and Pekka Martikainen, sociology researchers at the University of Helsinki in Finland and was published online in the American Journal of Public Health yesterday, May 29th.

The researchers investigated the risk of an older adult entering long-term institutional care after the death of their spouse, compared with how long they lived after their loss. They also looked at whether level of education or household income had an effect.

Nihtila and Martikainen looked at data on 140,902 Finnish adults aged 65 and over, who were living with a spouse at the start of the study period and who were followed from January 1998 to December 2002.

They found that:

  • The excess risk of institutionalization (compared with still living with a spouse) was highest during the first month after the death of a spouse.

  • The risk during this first month, which was more than three times higher compared with still living with a spouse, was slightly higher for women than for men (adjusted hazard ratios were 3.31 and 3.62 respectively).

  • The risk decreased over time for both men and women, stabilizing at approximately 20 to 50 per cent higher over 1 to 5 years.

  • Level of education and household income did not have a significant effect on risk of institutionalization compared to duration of life without a spouse.

The authors concluded that:

“Risk of institutionalization is particularly high immediately after the death of a spouse, demonstrating the importance of loss of social and instrumental support.”

Speculating on their findings, Nihtila told Reuters Health that:

“It may be related to the loss of social and instrumental support, in the form of care and help with daily activities such as help in cooking, cleaning, and shopping formerly shared with the deceased spouse.”

Another reason might be that grief and loss of the spouse triggers symptoms like depression, anxiety, loss of appetite, disturbed sleep, fatigue, and other things that increase the need for long term institutional care, she said.

Plus, grief can affect the immune system and make a person more susceptible to physical diseases.

The researchers recommended that home support services be targeted to help the bereaved immediately following a spouse’s death in order to reduce the need for long term institutional care.

“Institutionalization of Older Adults After the Death of a Spouse.”
Elina Nihtilä and Pekka Martikainen.
Am J Public Health, published online ahead of print May 29, 2008.
DOI:10.2105/AJPH.2007.119271

Click here for Abstract.

Source: Journal Abstract, Reuters.

Written by: Catharine Paddock, PhD