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Hospice care may reduce depression in surviving spouses

Surviving spouses of hospice care users may face less depressive symptoms following their spouse’s death compared with those who did not use hospice services, according to recently published data in JAMA Internal Medicine. 

“Surviving spouses of individuals who used hospice for at least 3 days were more likely to have some reduction in depressive symptoms after their spouses died than were surviving spouses who did not use hospice. This finding applied to all spouses (ie, not just those identified as primary caregivers) and was most evident at least 1 year after death,” Katherine A. Ornstein, PhD, MPH, department of geriatrics and palliative medicine, Icahn School of Medicine at Mount Sinai, and colleagues wrote.

Researchers connected data from the Health and Retirement Study with Medicare claims to assess the correlation between hospice use and depressive symptoms among widows/widowers following the deaths of their spouses.

A total of 1,016 participants were included in the study, with 30% having used hospice care for three or more days in the year prior to death.

Depressive symptoms increased over time among 51.9% of participants, regardless of hospice care use. While not statistically significant, researchers found that scores for the Center for Epidemiological Studies Depression Scale improved among 28.2% of spouses of hospice users compared with only 21.7% of non-hospice users’ spouses.

Among participants interviewed more than 12 months after their spouses death (n = 438), 38.1% of hospice care spouses had improved depression symptoms, compared with 26.1% of non-hospice care spouses (P = .01).

“Maximizing the use of hospice for appropriate patients is a high-value intervention that can benefit both the patients and their families. Attention to the quality of caregiver support and bereavement services within hospice will be necessary to increase its benefits for families,” Ornstein and colleagues concluded.

In an accompanying editorial, Holly G. Prigerson, PhD and Kelly Trevino, PhD, of the Center for Research on End-of-Life Care at Cornell University, said that antidepressive effects of hospice care may be due to the services’ ability to create a less depressive environment for spousal caregivers. However, they said it is not surprising that the reduction in depressive symptoms was only moderate, since grief is often deep-rooted. They suggest that the benefits of hospice care could be improved further by focusing more on the psychological needs of spouse caregivers and widowed survivors.

“[Hospice care] may lighten the heavy load of caring for a terminally ill spouse and may ease the trauma of watching and worrying while a loved one dies as well as the transition to widowhood,” Prigerson and Trevino wrote. – by Casey Hower

Disclosure: The researchers report no relevant financial disclosures.