WUNRN
Caring for an elderly, ailing spouse is an unimaginably difficult task, especially when the caregivers are elderly themselves. But wives fare worse, physically and emotionally, than husbands, researchers at the University of California, San Francisco, have found.
Women
tend to marry men older than themselves, and men generally have more health
problems and shorter lives. “So it’s typically the woman taking care of the
man,” said the lead author, John Cagle, a research fellow in geriatrics at
U.C.S.F. “We don’t have a clear understanding of what happens when men take
care of their wives.” Now that he’s been able to follow 745 spousal pairs in
which one cared for the other until he or she died, we have a fuller picture —
and it’s not happy news for women.
These couples weren’t very old: The women who were caregivers (as usual, a great majority of the group) were a touch past 70, on average, caring for husbands about the same age at death. The caregiving husbands were a little older – they averaged 73 and the wives they cared for, 75. Cancer was the leading cause of death.
Looking at results from 1998 to 2008 in the national Health and Retirement Study, conducted every other year, Dr. Cagle found few gender differences in the hands-on tasks that spouses undertook — the so-called activities of daily living. Both husbands and wives were likely to help with dressing and bathing during the final three months of life.
Surprisingly, the husbands were significantly more likely than wives to say they “helped” with meals and grocery shopping during those months. “I suspect these are partly due to gender expectations,” Dr. Cagle said. “If traditionally a wife prepares meals and the husband doesn’t, she may not recognize this as ‘help.’ It’s just their routine.”
Their experiences were quite different, regardless. Wives were significantly more depressed before their husbands’ death and at a year afterward. Though depressive symptoms eventually ebbed for both genders, wives still reported greater depression even after three years. Three years after a spouse’s death, a growing proportion of both men and women reported that they needed help themselves with one of the activities of daily living — but widows were more likely to need such help than widowers.
The proportion who rated their own health good or excellent rose a bit a year after a spouse’s death. “Even if there’s emotional devastation,” said Dr. Cagle, a former hospice social worker, “there’s some respite from the day-to-day physical burdens.” But after three years, the surviving spouses were less likely than before to call their own health good or excellent — and again, women reported poorer health at every stage.
Are these differences attributable to the burdens of caregiving? Maybe, but the data do not tell us that. Because women showed higher rates of depression, poorer health and higher need for help at the start of the study, perhaps they were in worse shape even before intensive caregiving began. (Women are more likely to report depression across the life span, too.) Or perhaps these wives had already been shouldering caregiving responsibilities for years; that could explain the differences.
Or, Dr. Cagle pointed out, “It might have to do with men not saying things are as bad as they are.”
So we can’t conclude that caring for a dying spouse takes a greater toll on wives, but we can say that they don’t do as well before or after death parts them from their husbands. “They’re more at risk,” Dr. Cagle said. “This suggests that women are in greater need of support.”