Most senior citizens learn to adapt to the loss of a partner

(Dominic Bracco Ii For The Washington Post)
By Abigail Jones and Scott Sell
Tuesday, August 10, 2010

For months after her husband of 52 years died last spring, Laurel Frisch struggled to read a book. She couldn't make decisions; she only occasionally left her Rockville home. In those rare moments when she could summon the energy, she wandered aimlessly through stores.

"I thought that I had prepared myself for it," Frisch, 72, says of life as a widow. "Maybe I did, but I'm still feeling devastated. I'm still feeling practically immobile."

Psychological and emotional losses change older Americans' lives. How they navigate a cascade of challenges -- particularly social isolation, death of a spouse and depression -- can determine the course of their final decades.

These struggles often intertwine. Illness, for example, compromises independence and mobility. What begins as arthritis, for someone living in a walk-up apartment, can lead to social isolation, a cause of depression. Depressed people may grow withdrawn, isolating themselves further. Meanwhile, to make matters worse, many older adults lose their spouses, partners and friends, who were sources of companionship, stability and support.

Isolation is a common gateway to this cycle of loss. A 2006 University of Chicago study of people ages 50 to 68 found a mind-body link: Those measuring higher than others on loneliness scales had higher blood pressure, for example, a major risk factor for heart disease. The primary predictor of loneliness in those older than 50 is not being married, according to a 2010 study by Laurie Theeke of the West Virginia University School of Nursing.

Isolation can be particularly acute for seniors who lose their spouses or partners and live alone. Women far outnumber men in this group. Last year, 41 percent of American women older than 65 were widowed, compared with 13 percent of men, census data show.

Losing a partner can affect older adults in several ways, especially if they're already ill or frail. A couple with health limitations can live independently by relying on each other; when one dies, the other may be ill-prepared for new responsibilities and stresses.

Jackie Buttimer, for instance, had never balanced a checkbook and rarely used a computer before her husband of nearly 50 years died in April. "It's a huge learning curve, and I had never lived alone," says Buttimer, 71, who lives in Bethesda.

Among older Americans, the death or illness of a spouse increases the mortality rate for the surviving spouse, a 2006 study published in the New England Journal of Medicine found. Over the nine years of the study, a wife's death increased the husband's risk of death by 21 percent; a husband's death raised the wife's risk by 17 percent. Even a spouse's hospitalization raises the risk of death.

Yet while bereaved spouses' lives change forever, most find ways to "adapt over time and arrive at a level of functioning -- physically, psychologically, emotionally," says Michael Caserta, a University of Utah gerontologist and bereavement researcher.

The boomer effect

Isolation and widowhood can contribute to depression in certain older adults. Among those who live independently, estimates of major depression range from less than 1 percent to about 5 percent, according to a 2003 study by the Duke University Medical Center. But the Duke study also shows that depression jumps to nearly 12 percent in elderly hospital patients and to almost 14 percent in those who need home health care.

And among those older than 85, the 2006 Health and Retirement Study, sponsored by the National Institute on Aging, found 19 percent reporting depressive symptoms. "Elderly populations in this country have less social support than anyone," explains Amy Fiske, a West Virginia University psychologist.

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