With research outlining the typical experiences associated with bereavement that those in the later adulthood can endure, as well as features that can improve or obstruct the quality of life when entering the last life stage, what exactly are the experiences of conjugal bereavement in later adulthood?
The final stage of life can create apprehension for multifaceted reasons such as, age-related health concerns along with the dissolution of emotional and social support networks. What’s more, individuals may find themselves reflecting on life, something which Erikson (1969) described in the eighth stage of his developmental theory as, ‘Ego Integrity Versus Despair’. According to Erikson, one can find themselves reviewing their life, which, if they feel satisfaction at the end of it, there’s a state of content that arises – as such, individuals can feel better prepared to face death. Whereas those who may feel discontent can have lingering regret, thus, despair. Gabriel and Bowling, (2004) research proposes that Quality of Life (QoL) in those aged 65 and over is dependent upon social support, the ability to accept life changes, good health, and performing a role in society of some value. This presupposition is reinforced by Sarvimaki and Stenbock-Hult (2000) who explain that healthy social relationships enhance QoL in later adulthood.
However, with the certainty of growing old impending it is useful to consider the factors which may impair QoL during later adulthood in order to empower older cohorts. With the wide-ranging experiences occurring during later adulthood having either a positive or negative effect on development, what presents the greatest risk factor towards reducing QoL? The loss of family members appears to significantly condense psychological wellbeing and QoL, in particular when it is spousal loss (Boekel, 2021). In addition to this, Naef et al., (2013) purports on the disruption that occurs following bereavement on health, finances, social cohesion and independence during widowhood. However, this finding can be challenged as not all share the same experience, for example Glick (2015) suggests there is a sex difference in the recovery process as widowers are more likely to form romantic connections readily compared to widows; indicating the ability to adapt to life after bereavement.
Additionally, Stroebe et al., (2001) reports that males are considered more vulnerable to health risks compared to females. This is due to widowers being susceptible to nutritional insufficiencies, thus declining health (Sweeting et al., 2014). On the other hand, female experiences in later adulthood sees them having higher financial dependency on their spouse which following bereavement can result in poverty, leading to a higher morbidity and mortality for women (Benzeval & Judge, 2000).
It’s important to note the factors which can buffer the effects of bereavement, for example, Ong et al., (2010) finds that psychological adaptation to death is stronger when the personality characteristic of ‘trait resilience’ is present, resulting in the ability to maintain stable psychological and physical functions during loss. Furthermore, Bonanno et al., (2011) suggests resilient bereaved individuals are more likely to show positive emotions before and after bereavement. Though, this finding is only true for partnerships that experienced lower levels of conflict and a high degree of warmth (Carr, 2000). Marriages that were conflictual, the bereaved reported lower levels of depression and less issues with adapting to the loss of their spouse (Spahni et al., 2016).
On balance, there are multiple experiences that can occur before and after bereavement for those in later adulthood which we should explore further to help readily prepare this cohort for coping with loss and grief.
Bereavement Increases Social Isolation
Upon reading the literature, it is evident that both widows and widowers experiences surrounding bereavement induced social isolation, this experience is true before and after. Social isolation is the loss of social relationships, infrequent social contact with others and something which can be objectively measured (National Academies of Sciences & Medicine, 2020). The causes of social isolation before and after bereavement are multifactorial, and can lead to the subjective emotion of ‘loneliness’ – for some during widowhood they choose to be alone, as such, whilst they may seem to be experiencing ‘social isolation’ they do not imbue the emotion of ‘loneliness’. Furthermore, social isolation has sub-themes attached i.e., not wanting to be a burden to others. Limited mobility and health decline are some of the contributing factors towards social isolation which can begin prior to, and after bereavement,
“I have had several heart attacks after the death of my spouse. I have also had problems with my knees and shoulders, but I really want to manage myself and do not want to bother anybody with my health problems” (Holm et al., 2019)
“After my wife died I got a heart attack. Both of these two separate experiences have influenced my health condition. I have had two heart operations. In addition, I had lung cancer and had surgery for that too” (Holm et al., 2019)
Additionally, the literature finds that for some in widowhood dealing with tasks unfamiliar to them such as financial management can be isolating. Van Baarsen et al., (1999) purports on the difficulties of establishing personal contacts during widowhood, thus, due to reduced social contacts for widows there’s limited support in the management of finances which can lead to social isolation,
“Like most women of my vintage, I didn’t have anything to do with the money. I left it all to my husband… Of course, when he died, I had to handle everything… I have found it very difficult. If you want to know the worst part of the year in having to cope without my husband, it has been the money…it’s not knowing anything about it, understanding how it works, because he had shares, managed funds, all those sort of things…If I could have had more financial help, that would have been good. But I ended up having to go to a financial advisor and he charged an arm and a leg. He charged $6,000 for the plan and he is implementing it as well because I don’t understand any of it at all” (DiGiacomo et al., 2015)
What’s more, there are occasions where widows do seem to have close friendship support but chose to reject the help, as a result causing social isolation. Some widows preferred to share their experience of bereavement with people they do not hold dear or those that have endured similar events.
The theme of social isolation as an experience both before and after the death of a spouse is a major challenge observed for those in later adulthood. A key postulate of Cumming and Henry’s disengagement theory (1961) suggests that people lose social ties around them as they near death with their ability to engage with others decreasing overtime, criticisms of the theory suggest that much of the reasons for social disengagement tends be due to involuntary choices such as disconnection as a result of widowhood and poor health (Marshall & Clarke, 2007).The events leading up to the death alongside the level of caring responsibility for the deceased spouse can contribute towards increased social isolation. Burton et al., (2005) discusses that extremely stressed caregivers may be at an increased risk for social isolation due to the anticipatory bereavement which can continue after the decedent. Furthermore, high-stress caregiving may lead to problems with social isolation which is something we see in the final transcript from Bennett and Hall, (2000).
Adapting to Life following Bereavement
The theme of adapting to life following bereavement sees various sub-themes emerge, one in which the bereaved demonstrate resilience, a mindset of ‘getting on with life’ and the pursuit of finding new roles in society. On the other hand, widowhood can be a time where individuals struggle to adapt to bereavement, they can present an unwillingness to take on new routines or connect with others; deducing that ‘grief lasts forever’. Those who are better able to adapt psychologically to bereavement find a new position in society and form an identity different to that lived prior to bereavement. However, those who struggle to adapt to life after bereavement can find it hard to discover their ‘place in the world’, have lingering feelings of regret and guilt (Stroebe & Schut, 1999) possibly as a result of not doing enough to support their spouse prior to the death or where death was unexpected leaving them unable to say their final goodbye.
The literature highlights the ways women adapted to life following bereavement. Some widows’ experiences were that of demonstrating resilience,
“I just tried to get on with things as best I could” (Bennett & Hall, 2000).
Some widows believe it is possible to adapt as long as there’s a willingness to search for meaning in your daily life and maintain a positive outlook which supports the Dual Process Model of restorative-orientation (Stroebe & Schut, 1999),
“You have to find the light yourself, find moments that light up your everyday life and do something you find positive” (Holm et al., 2019)
“It goes back really to my first disappointments when I couldn’t go to [Naval College] and I had TB (Tuberculosis)… I was lying in bed in hospital… I mean I’ve seen people who came into hospital who gave up, who didn’t get better because their mind set was wrong… but if you have a positive attitude you will deal with it” (Collins, 2017)
Occasionally, widows used humour as a method of adapting to bereavement before and after. Wilson et al., (2022) states that humour can be a way for most to cope with their grief,
“Well, sort of, we had to laugh, you know, we couldn’t but he was really poorly. I mean we didn’t know how poorly he was then” (Bennett & Hall, 2000).
“At the General. Erm, I think we both thought it was a stomach ulcer or something like that, nobody ever thought it was serious (laughs), I don’t think.” (Bennett & Hall, 2000)
For some the experience of bereavement presented a clear indication of pain, and loneliness which demonstrates the difficulties with being able to adapt to the life event as the feelings of guilt take over,
“It was like being inside a bubble where everything outside was foggy. It was a tough time. I ask myself why he died before me. Why him and not me?” (Holm et al., 2019)
The theme of adapting to life after bereavement has twofold conclusions along with multiple sub-themes. The Dual Process Model (DPM) (Stroebe & Schut, 1999) proposes that following bereavement two types of stressors arise; loss-orientation (LO) and restoration-orientation (RO).
Loss-orientation involves the coping process directly focused on the stress associated with the loss. During LO grief-related feelings ensue, such as sadness, guilt, regret and worry – the feelings can dissipate along the bereavement healing process but can return sporadically. Moreover, restoration-orientation relates to the processes the bereaved use to cope with stressors such as adopting new roles, identities, mastery of new tasks, making important decisions and meeting role expectations. The latter can see those in widowhood achieving a sense of self-efficacy, personal growth and feeling confident in being able to manage one’s own world.
Discussion and implications for future research
The aim of this analysis was to gain an understanding of the experiences for those in later adulthood facing conjugal bereavement. The analysis presented many themes; some of which appear to add, sustain and reduce the quality of life (QoL) for those in their later years.
Before and after the bereavement, social isolation can increase which has a direct effect on the quality of life. Cohen and Wills (1985) in their stress-buffering theory purport that in maintaining social support this can reduce loneliness and improve well-being for those experiencing bereavement. The concept of experiencing social isolation and loneliness following bereavement as discussed previously are often used synonymously which can create a misperception of what this means for widowhood, it is clear that although some may choose to discard help from friends or family not all in widowhood seem to be lonely; some appear to be content with the new world constructed (Saha & Ashikuzzaman, 2021).
The theme of social isolation increasing following bereavement has links to the idea that as we age, social disengagement occurs (Cummings & Henry, 1961). This concept can make it hard to distinguish whether social isolation increasing following bereavement is as a result of death itself or the ageing process. Nevertheless, the literature makes it clear that social isolation can increase for many before and after bereavement as we can evidence through loss of friendships as death was anticipated due to health decline.
In addition to the experience of social isolation increasing following bereavement, the theme of adapting to life after loss of a spouse produces evidence in support of the Dual Process Model (DPM) whereby the stress associated with grief creates loss-orientation (LO) and restorative-orientation (RO) behaviours.
The oscillation of memory recall and rehearsal of events for widows is evident in the narratives they tell both of the lead up to their husbands’ death and following. This process of confronting the bereavement sees some recurring patterns of regret and guilt for widows. Where situations such as this occurred, the literature demonstrates that women found it harder to adapt to life after bereavement and so, loss-orientated behaviours befell i.e., thinking about how much you miss your husband or wife and recalling particular memories; powerful emotions can be brought up during LO such as anger and regret (Stroebe & Schut, 1999).
On the other hand, those in widowhood who were cognizant of their partner being unwell and so, death was expected appeared to have time to cognitively process the experience, as was the case for one of the women who had taken over the finances when her partner retired, this supported the ability to adapt to life after bereavement as some of the tasks she inevitably would have assumed had begun ahead of the loss.
Wortman (2004) suggests that compared to widowers, widows are most likely to experience personal growth following bereavement along with reports of becoming ‘stronger’ compared to men who can find it challenging managing bereavement (Wortman et al., 1993)
This finding can lead us to question whether future research should focus on the support available for men to social networks and women to be better financially educated; which both could psychologically prepare them for adaption to bereavement whilst strengthening social inclusion.
References
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Benzeval, M., & Judge, K. (2001). Income and health: the time dimension. Social Science & Medicine, 52(9), 1371–1390. https://doi.org/10.1016/s0277-9536(00)00244-6
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Cheng, B. B. Y., & Ma, J. L. C. (2000). Stress, Social Support and Quality of Life of Bereaved Spouses in Hong Kong. Asia Pacific Journal of Social Work and Development, 10(1), 37–58. https://doi.org/10.1080/21650993.2000.9755821
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