Community-Dwelling and Recently Widowed Older Adults: Effects of Spousal Loss on Psychological Well-Being, Perceived Quality of Life, and Health-Care Costs.

This study is on the effects of spousal loss among older adults who continue to live independently after bereavement. Little longitudinal studies focus on this group, which is of special interest, since in many countries, care policy and system reform are aimed at increasing independent living among older adults. Using longitudinal data from a Dutch public data repository, we investigate the effects of spousal loss on psychological well-being, perceived quality of life, and (indication of) yearly health-care costs. Of the respondents who had a spouse and were living independently (N = 9,400) at baseline, the majority had not lost their spouse after 12 months (T12, n = 9,150), but 2.7% (n = 250) had lost their spouse and still lived independently. We compared both groups using multivariate regression (ordinary least squares) analyses. The results show that spousal loss significantly lowers scores on psychological well-being and perceived quality of life, but we found no effect on health-care costs.

Losing a partner: the varying financial and practical impacts of bereavement in different sociodemographic groups.

OBJECTIVES: The purpose of this study was to describe the financial and practical impacts of the death of a life partner, up to 5 years after bereavement. The study compared the impact felt by different sociodemographic groups and evaluated the role of financial and caring organisations in improving these impacts. METHODS: An evidence review of the subject area was conducted and a qualitative assessment of the target population (individuals whose partner had died in the past 3 years) was carried out using a semistructured interview (n=6). Subsequently, a multiple choice survey was constructed to collect data from a wider target population (individuals whose partner had died in the past 5 years) and covered topics including finances, interaction with organisations and management of daily tasks (n=500). RESULTS: The results of the multiple choice survey have been interpreted here using basic descriptive statistical analysis. 69% of people who lost a partner were unprepared, either financially or practically, for bereavement. Women and those under the age of 50 experienced the most significant financial impact and practical changes continued beyond 3 years postbereavement. To manage this disruption, 61% of participants reported that they felt they needed more help from financial and caring organisations postbereavement. CONCLUSIONS: The results of this survey demonstrate some of the key struggles each demographic group faces immediately after bereavement and into the future. It is clear that preparation and bereavement support have a profound effect on mitigating the negative impacts seen here.

Risk and Resiliency in the Relationship Between Widowhood and Depressive Symptoms Among Older Mexican Americans.

This study examined the association between widowhood and depressive symptoms and the extent to which the association is contingent upon risk and resiliency, including immigration status, functional limitations, financial strains, and intergenerational support, among older Mexican Americans. The sample included 344 parent-child pairs reported by 83 respondents. Clustered regression analysis showed that widowhood elevated risks for depressive symptoms. We found that having some functional limitations, having more children and living in the same city with children exacerbated the adverse effects of widowhood on depressive symptoms. We also found that living in the same city with children increased the detrimental effects of widowhood on the depressive symptoms in men, whereas we did not find this pattern in women. The findings highlight the heterogeneity within the widowed Mexican American older adults. Implications for future research and practice are discussed.

The Distributional Impact of Social Security Policy Options.

Using microsimulation, we estimate the effects of three policy proposals that would alter Social Security's eligibility rules or benefit structure to reflect changes in women's labor force activity, marital patterns, and differential mortality among the aged. First, we estimate a set of options related to the duration of marriage required to receive divorced spouse and survivor benefits. Second, we estimate the effects of an earnings sharing proposal with survivor benefits, in which benefits are based entirely on earned benefits with spouses sharing their earnings during years of marriage. Third, we estimate the effects of adjusting benefits to reflect the increasing differential life expectancy by lifetime earnings. The results advance our understanding of the distributional effects of these alternative policy options on projected benefits and retirement income, including poverty and supplemental poverty status, of divorced and widowed women aged 60 or older in 2030.

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.

Widowhood and Access to Health Care: A Population Based Study in Uganda.

BACKGROUND: Little is known about the health care that widows receive in sub-Saharan Africa. This study examined whether widows were at greater risk of facing challenges in accessing health care compared with other women in Uganda. METHODS: The study analyzed Demographic and Health Survey data from 8,674 women in Uganda collected in 2011. RESULTS: About 81% of widows and 64% of non-widowed women report at least one barrier to accessing health care. Multivariable logistic regressions showed that widows were more likely than non-widowed women to be afraid of seeking medical care alone and to identify financial costs as a barrier to accessing health care. Pregnant, older and landless widows were more vulnerable than other women. CONCLUSIONS: Findings suggest that widows are at risk of not accessing health care due to financial and social barriers. Interventions are needed to eliminate these barriers and address the different sources of vulnerability.

The business of death: a qualitative study of financial concerns of widowed older women.

BACKGROUND: The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women's experiences in the period soon after their husbands' death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life. METHODS: This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis. RESULTS: Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband's death. CONCLUSIONS: Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models.

An integrative and socio-cultural perspective of health, wealth, and adjustment in widowhood.

Women comprise a larger proportion of the ageing population than men, often outlive their spouses, and face a variety of challenges upon widowhood. Discrete aspects of the health impact of widowhood have been described in the literature; however, the expanse of sociocontextual issues that impact on older women's adjustment is less prominent. We undertook a literature review to synthesize recent research and interventions and identify current trends and gaps in knowledge and services. Although many health, social, cultural, and economic factors impact on recently widowed older women throughout the world, we found that few interventions targeting this population incorporate these factors.

Total length of stay, costs and outcomes at final discharge for admitted patients with hip fracture: linked episode data for Australian veterans and war widows.

BACKGROUND AND AIM: To identify the total duration of hospital stay, total hospital costs and outcomes at final discharge for a series of Australian patients with hip fracture. METHODS: The study type was retrospective cohort study using episode linkage within and between administrative databases. Study population is 2552 Australian veterans and war widows with primary diagnosis of hip fracture (International Classification of Diseases 10th revision, S 72.0-S 72.2) and hospital separation dates between 1 July 2008 and 30 June 2009. The unique identifying number within Department of Veterans' Affairs health service databases was used to link records for relevant hospital episodes as defined. Additional linkages were made with data for residential care admissions and date of death. RESULTS: Mean length of stay (LOS) for unlinked acute episodes was 11.1 days, and cost of hospitalisation was A$ 13,095. Fifty-one per cent of these episodes ended with transfer to ongoing hospital care, 9.5% were discharged to residential aged care (RAC), in-hospital mortality was 6.5%, and 23% were discharged to 'usual residence'. When data for all continuous episodes following hip fracture were combined, mean LOS was 30.8 days, costs were A$ 26,023 and in-hospital mortality was 11.1%. Additional linkage with RAC records identified 38% of final discharges to RAC facilities with 44% of patients returning to independent living. CONCLUSION: For complex conditions such as hip fracture, a process of patient-specific episode linkage is required to identify accurately hospital LOS, costs and patient outcomes.

Adverse effects of widowhood in Europe.

I investigate the relationship between widowhood and the financial situation among women aged 50 and above in Europe. The results of the paper are based on the Survey of Health, Ageing and Retirement in Europe, and its retrospective third wave (SHARELIFE). Using retrospective data makes it possible to analyze the dynamics of the adverse effects of widowhood. I estimate both the short run and long run effects of widowhood on financial circumstances, health, and labor force status. I argue that not only the lack of the deceased husband's income, but also the worse health condition and earlier retirement of widows contribute to the unfavorable financial conditions, although these indirect effects are small. I also analyze the role survivors' pensions have in mitigating the adverse effects of widowhood, and provide evidence for varying compensating effects of survivors' pensions in the European countries analyzed.

The implications of marital history change on women's eligibility for Social Security wife and widow benefits, 1990-2009.

Social Security retirement benefits in the United States (US) reflect marital histories and lifetime earnings of current and former married couples. Focusing on the link between marital history and benefit eligibility, this article examines women's marital patterns over the past two decades. Using the 1990 and 2009 Marital History Modules to the Census Bureau's Survey of Income and Program Participation, descriptive/regression analysis reveals substantial changes in women's marital patterns among baby boomers and generation Xers. Those changes have prompted a decline in qualifying marital histories for Social Security spouse and widow benefits. The findings also reveal substantial variation by race/ethnicity. Black women are significantly more likely to be potentially ineligible for a marriage-based benefit than white women, particularly in more recent cohorts. Hispanic women's marriage-based eligibility is between that of black and white women. US-born Hispanic women had higher shares without a qualifying marital history compared with the foreign born.

Wearing the garment of widowhood: variations in time since spousal loss among community-dwelling older adults.

We examine how the passage of time since spousal loss varies by social and demographic characteristics, using data from the University of Alabama at Birmingham Study of Aging. In multivariate analyses, African American race, female sex, lower income, and higher risk of social isolation had significant and independent associations with variation in time since spousal loss. African American women were at highest risk for long-term widowhood. Accurate characterizations of widowhood among community-dwelling older adults must consider variation in the length of time individuals are living as widowed persons and socioeconomic concomitants of long-term widowhood.

Guilds and middle-class welfare, 1550­1800: provisions for burial, sickness, old age, and widowhood.

Guilds provided for masters' and journeymen's burial, sickness, old age, and widowhood. Guild welfare was of importance to artisans, to the functioning of guilds, to the myriad of urban social relations, and to the political economy. However, it is an understated and neglected aspect of guild activities. This article looks at welfare provision by guilds, with the aim of addressing four questions. Firstly, for which risks did guild welfare arrangements exist in the Netherlands between 1550 and 1800, and what were the coverage, contributions, benefit levels, and conditions? Secondly, can guild welfare arrangements be regarded as insurance? Thirdly, to what extent and how did guilds overcome classic insurance problems such as adverse selection, moral hazards, and correlated risks? Finally, what was the position of guild provision in the Dutch political economy and vis-à-vis poor relief?

Widows' land security in the era of HIV/AIDS: panel survey evidence from Zambia.

In areas of Africa hard hit by HIV/AIDS, there are growing concerns that many women lose access to land after the death of their husbands. However, there remains a dearth of quantitative evidence on the proportion of widows who lose access to their deceased husband's land, whether they lose all or part of that land, and whether there are factors specific to the widow, her family, or the broader community that influence her ability to maintain rights to land. This study examines these issues using average treatment effects models with propensity score matching applied to a nationally representative panel data of 5,342 rural households surveyed in 2001 and 2004. Results are highly variable, with roughly a third of households incurring the death of a male household head controlling less than 50% of the land they had prior to their husband's death, while over a quarter actually controlled as much or even more land than while their husbands were alive. Widows who were in relatively wealthy households prior to their husband's death lose proportionately more land than widows in households that were relatively poor. Older widows and widows related to the local headman enjoy greater land security. Women in matrilineal inheritance areas were no less likely to lose land than women in patrilineal areas.

Intimacy and the life cycle in the marital relationships of the Scottish elite during the long eighteenth century.

Traditionally marriage has been treated as one step in the life cycle, between youth and old age, singleness and widowhood. Yet an approach to the life cycle that treats marriage as a single step in a person's life is overly simplistic. During the eighteenth century many marriages were of considerable longevity during which time couples aged together and power dynamics within the home were frequently renegotiated to reflect changing circumstances. This study explores how intimacy developed and changed over the life cycle of marriage and what this meant for power, through a study of the correspondence of two elite Scottish couples.

A life-course approach to studying transitions among Canadian seniors in couple-only households.

This study tracked the occurrence of death, widowhood, institutionalization, and coresidence with others between 1994 and 2002 for a nationally representative sample of 1,580 Canadian respondents who, at initial interview, were aged 55 and older and living in a couple-only household. Although the majority of seniors remained in a couple-only household throughout the duration of the survey, nearly one in four who experienced a first transition underwent one or more subsequent transitions. Age, economic resources, and health were significant predictors of a specific first transition and multiple transitions. More work is needed to understand the dynamics of the aging process.

Marriage and the family in a Maltese parish: St. Mary's (Qrendi) in the eighteenth century.

This article addresses the Maltese traditional family, taking St. Mary's (Qrendi) as a test case. It results that couples married in their early twenties, while a high proportion of men and women never married at all. Marriage was not popular so that one-fifth of all marriages were remarriages. Very few widows remarried and it was only for some economic reason that they sought another man. There is no evidence though that a high rate of celibacy resulted in flagrant promiscuity even if there is evidence that the Qrendin were not so particular about their sex life. No birth control was practiced within marriage and children followed one another regularly. This brings into relief the parents' unconcern for their offspring's future as well as the inferior status of women because husbands made their wives several offspring. Relations between the spouses were poor so that dissatisfied couples went their own ways.

Generational jeopardy? Parents' marital transitions and the provision of financial transfers to adult children.

OBJECTIVES: Transitions into and out of marriage are becoming more commonplace among persons in middle and later life. We assess the extent to which parental marital transitions influence inter vivos financial transfers to adult children at the family level. METHODS: Panel data from 6,017 households with adult children in the 1992-1998 waves of the Health and Retirement Study are analyzed in this study. RESULTS: Net of familial characteristics, those families experiencing a parental marriage were less likely than stably married households to make a financial transfer to an adult child. The effects of divorce or widowhood were modest. Divorce was associated with a slight increase in the probability of providing a transfer. Widowhood was associated with a slight increase in the total amount transferred to children. DISCUSSION: The study adds weight to the growing argument that marital transitions may alter intergenerational exchanges. The results prompt us to further question how broader demographic and marriage patterns will influence relationships between parents and children in aging societies.

Suttee Sainthood through selflessness: pain of repression or power of devotion?

The immolation of Hindu widows has generated much horror while remaining tenaciously mixed with clandestine admiration. Reported in many eyewitness accounts and literary works, the topic has given rise to highly contested sociocultural, legal and ideological debates, strongly linked to women's rights. But the root question has not gone away: is suttee/sati just painful female victimisation or can it also reflect powerful female agency and the power of devotion? This article examines two literary works, Maud Diver's Lilamani, in which an Englishwoman unreservedly idolises a suttee, and Krupabai Satthianadhan's Kamala, where an Indian woman expresses deep pride in sutteehood. Engaging in a search for deeper meanings, this article asks what makes these two women writers revere a suttee so totally. Can one really be a suttee-saint through selflessness, or are there some deeper meanings yet to be uncovered? A wider political interpretation is suggested to re/present the root meaning of suttee.

Perfil psicosocial del viudo y huérfano afectados por la muerte materna familiar / Psychosocial profile of the widower and orphans affected by maternal death family

Objetivo: Describir el perfil psicosocial del viudo y huérfanos afectados por la muerte materna familiar en el departamento de Alta Verapaz durante el año 2009. Metodología: Estudio descriptivo en el cual se entrevistó a miembros, viudos y huérfanos, de 64 de 72 (89%) familias afectadas por muerte materna que ocurrieron en 2009. Resultados: Las familias estudiadas estaban conformadas por 62 viudos (en dos casos la fallecida no tenía pareja) y 286 huérfanos...