Effects of own and spousal disability on loneliness among older adults

OBJECTIVES: This study examines the effects of own and spousal disability on social and emotional loneliness among married adults aged 65 and older. METHOD: Data from 710 men and 379 women of a Dutch community sample were analyzed with linear regression analyses. RESULTS: For men, only their wives' disability was related to higher levels of social loneliness, whereas for women mainly their own disability was related to higher levels of social loneliness. Own disability and spousal disability were related to higher levels of emotional loneliness among both men and women. Effects of disability remained unaffected after controlling for characteristics of the social network and the marital relationship. DISCUSSION: Findings underscore the importance of considering effects of both spouses' health on measures of individual well-being. Also, the traditional division of social roles makes older married men relatively vulnerable to social loneliness when their wives suffer from disability.     

Impact of husbands' involuntary job loss on wives' mental health,among older adults

OBJECTIVES: This study estimates the consequences of older husbands' involuntary job loss for their wives' mental health. METHODS: Using longitudinal data from the 1992, 1994, and 1996 waves of the Health and Retirement Study, multivariate regression models were estimated to measure the impact of older husbands' involuntary job loss on wives' mental health. We created two longitudinal data sets of two waves each to use in our analysis. The first data set, or period, combined Waves 1 and 2 of the Health and Retirement Study and described the 1992-1994 experience of spouse pairs in our sample. It included the wives of 55 husbands who experienced involuntary job loss between these survey dates and a comparison group of wives of 730 continuously employed husbands. The second data set described the 1994-1996 experience of couples. In particular, it included the wives of an additional 38 husbands who were displaced from their jobs between Waves 2 and 3, and a comparison group of wives of 425 husbands who were continuously employed from 1994 to 1996. RESULTS: Husbands' involuntary job loss did not have a statistically significant effect on wives' mental health. We found no evidence that changes in husbands' depressive symptoms modified the effect of his job loss on wives' mental health. In the first period only, the effect of husbands' job loss on wives' mental health was more pronounced for wives who were more financially satisfied at baseline. DISCUSSION: There is limited evidence among this cohort that husbands' job loss increases wives' subsequent depressive symptoms. However, the effect of husbands' job loss on wives' mental health appears to be magnified when wives report being financially satisfied pre-job loss. This suggests that, for subgroups of older couples, mental health services specifically targeted at displaced men should also be made available to wives.     

Marital quality and psychological adjustment to widowhood among older adults: a longitudinal analysis

OBJECTIVES: This study examined whether psychological adjustment to widowhood is affected by three aspects of marital quality--warmth, conflict, and instrumental dependence-assessed prior to the loss. METHODS: The Changing Lives of Older Couples (CLOC) is a prospective study of a two-stage area probability sample of 1,532 married individuals aged 65 and older. The CLOC includes baseline data on marital quality and mental health and data on grief, anxiety, and depression collected 6, 18, and 48 months after spousal loss. RESULTS: Widowhood was associated with elevated anxiety among those who were highly dependent on their spouses and lower levels of anxiety among those who were not dependent on their spouses. Levels of yearning were lower for widowed persons whose relationships were conflicted at baseline and higher for those reporting high levels of marital closeness and dependence on their spouses. Women who relied on their husbands for instrumental support had significantly higher levels of yearning than men who depended on their wives. DISCUSSION: The findings contradict the widespread belief that grief is more severe if the marriage was conflicted and suggest a more complex relationship between bereavement and characteristics of the marriage.     

The health impact of living with a cognitively impaired elderly spouse: depressive symptoms and social functioning

The purpose of this study was to identify the social and psychological consequences of living with a cognitively impaired spouse among community-dwelling elderly individuals. The study sample consisted of 318 spouse pairs drawn from a representative sample of noninstitutionalized elderly individuals. Our principal findings were that: (a) Cognitive impairment in wives is significantly (p less than .05) associated with depressive symptomatology in husbands, whereas cognitive impairment in husbands is only weakly (p greater than .20) associated with depressive symptomatology in wives; (b) Decreased participation in social/leisure activities is selectively related to spouses' level of cognitive functioning among both men and women; (c) The relationship between wives' cognitive impairment and husbands' depressive symptoms is influenced by perceived availability of financial support from friends and relatives, but not by ADL limitations in wives, lack of emotional or instrumental support from wives, household responsibilities among husbands, or lack of participation in social/leisure activities in husbands.     

Gender roles, marital intimacy, and nomination of spouse as primary caregiver

Using data from a sample of married men and women undergoing treatment for cancer, we tested two potential hypotheses for the unequal representation of husbands and wives as spousal caregivers, including societal gender role norms and emotional closeness in the marital relationship. Multivariate analyses support both hypotheses; wives are only one third as likely as husbands to select their spouses as caregivers, and spouses who name their mates as confidants are three times more likely than those who do not to also name them as caregivers. We conclude that although gender role norms are key to caregiver selection, the intimacy inherent in the caregiving role renders an emotionally close marriage an important criterion to the selection of spouse as caregiver.     

Multiple role occupancy and social participation among midlife wives and husbands in the United Kingdom

We investigated the relationship between intensive multiple role occupancy and one key dimension of well-being, social participation (i.e., frequency of participation in social and leisure activities and meeting friends or relatives). Moreover, we examined gender differences in the association between individual, spousal and couple intensive multiple role commitments and individual social participation. Our research is based on a sample of mid-life wives (45-59) and their husbands from the 2000 British Household Panel Study (BHPS). Our findings show that, among wives whose husbands were providing care to a dependent for 20 or more hours a week, there was a negative association with social and leisure activity participation, whereas husbands' level of participation in social and leisure activities was higher if their wives were in full-time paid work. We also found lower odds of meeting friends or relatives among wives and husbands in full-time employment, and higher odds of meeting friends and relatives among wives providing care for 20 or more hours a week. Our results will aid policy thinking in addressing how people can be best supported to balance work and family commitments in order to optimize different dimensions of well-being in later life and help alleviate the pressures associated with multiple-role occupancy in mid-life.     

Impact of spouse vision impairment on partner health and well-being: a longitudinal analysis of couples

OBJECTIVES: The purpose of this study was to assess the impact of older spouses' vision impairment on the health and well-being of their partners and to test for gender differences. METHODS: Participants were 418 older couples from the Alameda County Study. Vision impairment was assessed in 1994 with a 9-point scale assessing difficulty seeing in everyday situations; outcomes were assessed in 1999. Longitudinal analyses included multivariate statistical models adjusting for paired data and partners' own vision impairment, age, gender, chronic conditions, and financial problems. We include results on outcomes for partners' own vision impairment for comparative purposes. We assessed gender differences with interaction tests. RESULTS: Spouse vision impairment negatively impacted partner depression, physical functioning, well-being, social involvement, and marital quality; these effects were not greatly different in magnitude from those associated with partners' own vision impairment. Three of four outcomes with significant gender differences evidenced stronger impacts of husbands' vision impairment on wives' well-being and marital quality than the reverse. DISCUSSION: Spouses do not live in isolation; characteristics of one impact the other. Both treatment and rehabilitation programs should include spouses and other family members of visually impaired patients. Why wives appear more sensitive to their husbands' vision impairment is unclear and warrants further study.     

The effect of spousal mental and physical health on husbands' and wives' depressive symptoms, among older adults: longitudinal evidence from the Health and Retirement Survey

OBJECTIVE: To estimate the effect of spousal depressive symptoms and physical health on respondents' depressive symptoms in a national sample of older married couples. METHOD: We used data on 5,035 respondent husbands and wives from the 1992 and 1994 waves of the Health and Retirement Survey. Multivariate regression models were estimated to examine the impact of spousal depressive symptoms and physical health on respondents' depressive symptoms. RESULTS: Adjusting for respondent mental and physical health and sociodemographic traits, having a spouse with more depressive symptoms was associated with significantly higher follow-up depressive symptoms in the respondent (p < .001). Controlling for spousal depressive symptoms, a decline in the spouses' physical health was associated with a significant reduction in respondent depressive symptoms (p < .05). DISCUSSION: Our findings suggest that health care providers treating older adults should be sensitive to the possibility that spouses may be affected when clients suffer poor mental or physical health.     

Marital interactions and the duration of alcoholic husbands' sobriety

Recent studies of the family interactions of alcoholics have suggested that the alcoholic's general drinking adjustment may influence marital interactions. The present investigation examined the marital interactions of 30 male alcoholics who had maintained continuous sobriety for various lengths of time ranging from a few days to over 7 years. It was predicted that longer periods of sobriety would be associated with less conflict and fewer struggles for control between husbands and wives. The findings supported the hypothesis, in that the duration of the husbands' sobriety was significantly negatively correlated with the number of statements of disagreement emitted by husbands and wives. Also, there were trends for duration of sobriety to be negatively associated with the frequencies of question-asking and aggressive behaviors by husbands, and positively associated with the amount of talk time by husbands. Contrasts of 11 high sobriety couples (duration of sobriety: 2 years or longer) and 11 low sobriety couples (duration of sobriety: less than 4 months) revealed that high sobriety husbands asked fewer questions, stated fewer disagreements, and emitted fewer aggressive behaviors than husbands in the low sobriety group. In addition, high sobriety husbands displayed a trend toward more active talk time, and their wives showed a trend toward asking fewer questions than their low sobriety counterparts. The results suggest that marital functioning is superior in couples with longer periods of sobriety. The need for examining possible causal links in this relationship is emphasized.     

Who expects to continue working after age 62? The retirement plans of couples

OBJECTIVES: This study examines the individual, spousal, and household characteristics associated with the retirement expectations of husbands and wives. METHODS: Using data from the 1992 Health and Retirement Study, subjective probabilities of working full-time after reaching age 62 and age 65 are used to measure retirement expectations. The retirement expectations of husbands and wives are modeled simultaneously using a joint-generalized least-squares approach. RESULTS: Within a marriage, retirement expectations are shaped by individual, spousal, and household characteristics. We observe some gender differences in cross-spousal influence with wives' retirement expectations being more influenced by husbands' resources and constraints than vice versa. Nonetheless, individual and household factors associated with retirement expectations are widely shared by husbands and wives. DISCUSSION: Husbands and wives both respond to individual and joint constraints and opportunities when planning for retirement. Findings support that there is considerable overlap in retirement planning of husbands and wives during early parts of the retirement decision-making process. However, inequity in cross-spousal influences is a defining characteristic of retirement decision making. Implications for both policy makers and practitioners are briefly discussed.     

Adjustment to violent and natural deaths in later and earlier life for black and white widows

OBJECTIVES: This study explored the role of mode and unexpectedness of death, age, race, and marital status on psychological symptoms for widows approximately 6 months after their husbands' deaths. METHODS: Midwestern samples were drawn from death/divorce records for 276 Black and White women aged 19-74 whose husbands had died from homicide, suicide, or accidental death; 276 matched natural death widows; 188 separated/divorced women. RESULTS: Mode of death was not related to psychological symptoms. Contrary to expectation, widows of the men who had died from long-term natural illnesses exhibited more distress than widows of men who had died from violent and sudden, natural deaths combined. Indicative of their heightened overall symptoms, widows were more distressed than divorced women. Middle-aged and younger widows were more distressed than older ones. White widows reported more symptoms than Blacks in violent but not natural deaths. Black widows whose spouses had died from suicide had higher psychological distress on some indicators, supporting the greater stigma of suicide among Black persons. DISCUSSION: Results of smaller studies on the minimal role of mode of death in bereavement are supported, but more research on age, race, and "off-time" deaths in short- and long-term adjustment is needed.     

Impact of self-assessed hearing loss on a spouse: a longitudinal analysis of couples

OBJECTIVES: Hearing loss is increasingly common among older persons and is negatively associated with health and well-being. Its impact on spouses, however, is poorly researched. This study analyzed the relationship between a spouse's self-assessed hearing loss and his or her partner's physical, psychological, and social well-being 5 years later. METHODS: Subjects were 418 older married couples from the Alameda County Study. Hearing loss and adjustment variables were assessed in 1994 and outcomes in 1999. Longitudinal analyses included multivariate statistical models using generalized estimating equations to adjust for paired data and partners' hearing loss, age, gender, chronic conditions, and financial problems. RESULTS: Spouse hearing loss increased the likelihood of subsequent poorer physical, psychological, and social well-being in partners. The negative impact of husbands' hearing loss on wives' well-being appears stronger than the reverse. DISCUSSION: Findings suggest that early diagnosis and treatment of hearing loss constitute important clinical strategies to enhance the well-being of both hearing-impaired individuals and their spouses and support policy change to cover hearing devices by insurance. Further research incorporating theoretical perspectives from communication theory and qualitative methodology would enhance understanding of how hearing loss impacts older couples and support refinement of interventions to promote quality of life.     

Caregiving as a life course transition among older husbands: a prospective study

Guided primarily by transitions theory, this study examined changes over two points in time (approximately 5 years apart) in multiple life domains (i.e., household tasks, social life, marital relationship, and well-being) between two groups of husbands aged 60 and older, who indicated that their wives were not in need of care or assistance due to an illness or disability at the initial interview. The two groups included husbands who identified themselves as a provider of care at Time 2 (T2; i.e., they had transitioned into the caregiver role; n = 26), and those married to healthy wives at T2 (i.e., noncaregivers; n = 262). Data came from a national probability sample of U.S. adults who were primary respondents to the National Survey of Families and Households in 1987-88, and who were followed up longitudinally in 1992-93. Findings suggested that husbands who entered the caregiving role demonstrated significant changes in household responsibilities, social integration, marital relationship, and well-being. Implications for practice and future research on the older husband caregiver are highlighted.     

Taking 'women's work' 'like a man': husbands' experiences of care work

PURPOSE: We adopted a feminist, structural approach to husbands' experiences of caring for wives with Alzheimer's disease. This framework posited that men and women draw upon gender repertoires-situational ideals of behavior based upon their respective structural locations-that create gendered experiences of stress and coping strategies. DESIGN AND METHODS: We used a qualitative, constructivist approach to analyze in-depth interviews with 22 spousal caregivers and observations within support groups. Our analysis focused on the nine husbands, the strategies these men reported using to deal with problems that arose in their care work, and the extent to which these are congruent with the masculinities of White men in the United States. RESULTS: We found that these husbands' approaches to caregiving and their strategies for dealing with the work and feelings involved were rooted in their sense of selves as men. We outline their overall approaches to caregiving, identify six strategies husbands used to deal with problems stemming from care work-exerting force, focusing on tasks, blocking emotions, minimizing disruption, distracting attention, and self-medicating-and tie these to their structural positions as working-, middle-, and professional-class men. IMPLICATIONS: Theories of gender differences in the performance or quality of care work should tie these to structural arrangements. Unless the gendered bases upon which different styles or experiences are removed (i.e., structural inequality), designers of interventions cannot and should not expect to use the experience of one group to inform appropriate strategies for the other.     

The unique contribution of key existential factors to the prediction of psychological well-being of older adults following spousal loss

PURPOSE: This study examined the unique contribution of key existential factors to the prediction of psychological well-being of older adults following spousal loss. DESIGN AND METHOD: A number of measures to assess psychological well-being, sociodemographic standing, social resources, and religious and spiritual resources were administered to a volunteer sample of widows and widowers to test the hypothesis that existential factors such as personal meaning, religiosity, and spirituality are more potent predictors of psychological well-being than are previously hypothesized variables of sociodemographic, social support, and physical factors. RESULTS: A hierarchical regression analysis of the data supported the hypothesis that existential factors are major contributors to psychological well-being of older adults following spousal loss. Findings showed that widowers, compared to widows, scored lower on the measure of psychological well-being. IMPLICATIONS: Implications of the findings are discussed for practitioners working with bereaved spouses; suggestions for further research concerning bereavement and psychological well-being are made.     

Sexual activity among older Thais: The influence of age, gender and health

This study examines sexual activity among thepopulation aged 50 and over in Thailand inrelation to age, gender and health status. Itis the first study of older persons based on alarge nationally representative survey in anynon-Western or developing country. The resultsindicate substantial proportions of oldermarried Thais remain sexually active, but atlower levels than found in Western countries. Sexual activity and desire decline steadilywith age for both married men and women but atany given age both are lower for women. Overall, the sexual desire of husbands is a farmore important determinant of marital sexualactivity than that of wives. Poor healthdepresses activity and desire but does notaccount for the decline of either with age. Forthe majority of older married Thai men andwomen behavior and desires are concordant. Discordance levels for married women exceedthose for men, however, and arise primarilyfrom being active but lacking desire. Possiblereasons for lower sexual activity relative toWestern countries are considered. Implicationsfor the quality of life of older persons andthe AIDS epidemic are discussed together withmethodological lessons for research on olderage sexual behavior.     

Differences between alcoholic couples accepting and rejecting an offer of outpatient marital therapy

Following an extensive initial evaluation, 35 couples with alcoholic husbands decided to participate in couples therapy (acceptors) and 28 couples did not (rejectors). A significant discriminant function indicated that acceptors were characterized by husbands with more education, better marital adjustment, full-time employment, and larger number of alcohol-related arrests. Acceptors also had sought more outpatient help in the past year. Rejectors were characterized by wives with better marital adjustment, greater living distance from clinic, and husbands with more alcohol-related hospitalizations. Rejector husbands also tended to be older. Practical implications for recruiting alcoholics and spouses into marital therapy are discussed.     

Anticipatory Socialization for Retirement: A Multilevel Dyadic Model

Role theory, widely used to examine human behavior, has often been used to describe the transition from work to retirement. Anticipatory socialization, a role theory concept, describes the process that occurs prior to role transitions and assists in that transition by helping individuals learn the norms for the new role. However, not all workers engage in retirement planning. Lack of retirement planning is of concern because those individuals who do not plan for major life transitions tend to be less successful in adjusting to role changes. Data from the Health and Retirement Study were used; selection criteria required participants to be age 45 or older, working full- or part-time, and have complete data for the study variables. Multilevel modeling results of dyadic data from the Health and Retirement Study (N?=?1,028 dual-earner couples) indicate that older age, being White, higher income, greater retirement wealth, and looking forward to retirement predicted greater anticipatory socialization (i.e., thinking about and discussing retirement) by both husbands and wives. For wives only, having a health problem limiting work, higher spouse occupational status, and having a spouse who was looking forward to retirement predicted more anticipatory socialization. For husbands only, higher education, higher depressive symptomatology, and lower occupational status predicted more anticipatory socialization. This study found evidence of spousal congruence, with husbands, on average, engaging in more anticipatory socialization than wives. These findings identify couples that could most benefit from targeted efforts to increase anticipatory socialization, which predicts better retirement adjustment and satisfaction.     

Marital aggression. Impact, injury, and health correlates for husbands and wives.

The overall aim of the current study was to comprehensively evaluate the prevalence, impact, and health correlates of marital aggression in a clinical sample of maritally discordant couples seeking psychological treatment. Participants were 93 consecutively presenting clinic couples and 16 maritally satisfied matched control couples from the community. Overall, 71% of clinic couples reported at least one act of marital aggression during the past year. Although 86% of the aggression reported was reciprocal between husbands and wives, impact and injuries sustained as a function of this aggression differed between husbands and wives. Specifically, wives were more likely than husbands to be negatively affected and to sustain severe injuries (eg, broken bones, broken teeth, or injury to sensory organs). Additionally, wives who experienced marital aggression reported clinical levels of depressive symptomatology. Recommendations are offered and risk markers are identified to improve detection by physicians of patients who may be involved in violent marriages.     

Well-being in older Mexican American spouses

PURPOSE: There is a strong connection between marriage and well-being, with evidence suggesting that the well-being of one spouse is closely correlated with that of the other. However, among older Mexican Americans, there is little information about this phenomenon. To address this, we explore two research questions: Does one spouse's well-being predict the other spouse's well-being? Are there gender differences in these effects? DESIGN AND METHODS: We assess information from 553 couples who participated in Wave 1 (1993-1994) of the Hispanic Established Populations for the Epidemiologic Studies of the Elderly. Using structural equation models, we examined three aspects of well-being among older Mexican American couples: depressive symptoms, life satisfaction, and self-rated health. RESULTS: The findings revealed evidence of an association between the well-being of one spouse and that of the other. Specifically, the self-rated health of husbands and wives predicts that of their partners. However, there is evidence that husbands' depressive symptoms and life satisfaction influence wives' well-being, but not the reverse. IMPLICATIONS: The findings from this study are important because they add to the literature on the connection of well-being among spouses, point to important gender differences, focus on an understudied minority group with unique cultural characteristics, and have implications for the examination of well-being within a marriage framework.