Characteristics of the bereavement experience of older persons after spousal loss: An integrative review

International Journal of Nursing Studies

Volumn 50, Issue 8, 2013, Pages 1108-1121

  Naef, Rahel ^a,b   Ward, Richard ^c   Mahrer Imhof, Romy ^a   Grande, Gunn ^b  

^a ZURICH UNIVERSITY OF APPLIED SCIENCES   (Switzerland)

^b UNIVERSITY OF MANCHESTER   (United Kingdom)

^c UNIVERSITY OF STIRLING   (United Kingdom)

Author keywords

Bereavement; Coping; Grief; Literature review; Nursing; Old age; Spousal loss; Widows and widowers

Indexed keywords

BEREAVEMENT; FEMALE; HUMAN; MALE; MIDDLE AGED; REVIEW; SPOUSE;

BEREAVEMENT; FEMALE; HUMANS; MALE; MIDDLE AGED; SPOUSES;

EID: 84879603533     PISSN: 00207489     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.ijnurstu.2012.11.026     Document Type: Review

References (119)

1. Administration on Aging A Profile of Older Americans: 2011 2011, Retrieved from:. http://www.aoa.gov/AoARoot/Aging_Statistics/Profile/index.aspx.on.
2. Anderson K.L., Dimond M.F. The experience of bereavement in older adults. Journal of Advanced Nursing 1995, 22(2):308-315.
3. Attig T. The importance of conceiving of grief as an active process. Death Studies 1991, 15(4):385-393.
4. Attig T. How We Grieve: Relearning the World 1996, Oxford University Press, New York, NY.
5. Attig T. The Heart of Grief: Death and the Search for Lasting Love 2000, Oxford University Press, New York, NY.
6. Attig T. Relearning the world: making and finding meaning. Meaning Reconstruction and the Experience of Loss 2001, 33-53. American Psychological Association, Washington, DC. R.A. Neimeyer (Ed.).
7. Attig T. Meanings of death seen through the lens of grieving. Death Studies 2004, 28(4):341-360.
8. Balaswamy S., Richardson V., Price C.A. Investigating patterns of social support use by widowers during bereavement. The Journal of Men's Studies 2004, 13:67-84.
9. Benner P., Wurbel J. The Primacy of Caring: Stress and Coping in Health and Illness 1989, Addison-Wesley, Menlo Park.
10. Bennett K.M. A longitudinal study of wellbeing in widowed women. International Journal of Geriatric Psychiatry 1997, 12(1):61-66.
11. Bennett K.M. Widowhood in elderly women: the medium- and long-term effects on mental and physical health. Mortality 1997, 2(2):137-148.
12. Bennett K.M. Longitudinal changes in mental and physical health among elderly, recently widowed men. Mortality 1998, 3(3):265-273.
13. Bennett K.M., Stenhoff A., Pattinson J., Woods F. "Well if he could see me now": the facilitators and barriers to the promotion of instrumental independence following spousal bereavement. Journal of Gerontological Social Work 2010, 53(3):215-234.
14. Bent K.N., Magilvy J.K. When a partner dies: Lesbian widows. Issues in Mental Health Nursing 2006, 27(5):447-459.
15. Boerner K., Schulz R. Caregiving, bereavement and complicated grief. Bereavement Care 2009, 28(3):10-13.
16. Brabant S., Forsyth C.J., Melancon C. Grieving men: thoughts, feelings, and behaviors following deaths of wives. Hospice Journal 1992, 8(4):33-47.
17. Byrne G.J.A., Raphael B. A longitudinal study of bereavement phenomena in recently widowed elderly men. Journal of Research in Psychiatry and the Allied Sciences 1994, 24:411-421.
18. Byrne G.J.A., Raphael B. The psychological symptoms of conjugal bereavement in elderly men over the first 13 months. International Journal of Geriatric Psychiatry 1997, 12:241-251.
19. Byrne G.J.A., Raphael B. Depressive symptoms and depressive episodes in recently widowed older men. Psychogeriatrics 1999, 11(1):67-74.
20. Carlsson M.E., Nilsson I.M. Bereaved spouses' adjustment after the patients' death in palliative care. Palliative & Supportive Care 2007, 5(4):397-404.
21. Carnelley K.B., Wortman C.B., Bolger N., Burke C.T. The time course of grief reactions to spousal loss: evidence from a national probability sample. Journal of Personality and Social Psychology 2006, 91(3):476-492.
22. Carr D., House J.S., Wortman C., Nesse R., Kessler R.C. Psychological adjustment to sudden and anticipated spousal loss among older widowed persons. Journals of Gerontology Series B: Psychological Sciences & Social Sciences 2001, 56B(4):S237-S248.
23. Carter P.A. Bereaved caregivers' descriptions of sleep: impact on daily life and the bereavement process. Oncology Nursing Forum 2005, 32(4):741.
24. Caserta M.S., Lund D.A. Bereavement stress and coping among older adults: expectations versus the actual experience. Omega: Journal of Death & Dying 1992, 25(1):33-45.
25. Chan W.C.H., Chan C.L.W. Acceptance of spousal death: the factor of time in bereaved older adults' search for meaning. Death Studies 2011, 35(2):147-162.
26. Chovan M.J., Chovan W. Profiles of change in self-constructions among early- and later-bereaved widows. Psychological Reports 2006, 98:563-568.
27. Costello J. Grief and loneliness in older people: case study accounts of conjugal bereavement. Quality in Ageing 2002, 3(4):3-11.
28. Costello J., Kendrick K. Grief and older people: the making or breaking of emotional bonds following partner loss in later life. Journal of Advanced Nursing 2000, 32(6):1374-1382.
29. Cowles K.V. Cultural perspectives of grief: an expanded concept analysis. Journal of Advanced Nursing 1996, 23(2):287-294.
30. Cowles K.V., Rodgers B.L. The concept of grief: a foundation for nursing research and practice. Research in Nursing & Health 1991, 14(2):119-127.
31. Easley C., Schaller J. The experience of being old-old: life after 85. Geriatric Nursing 2003, 24(5):273-277.
32. Elwert F., Christakis N.A. The effect of widowhood on mortality by the causes of death of both spouses. American Journal of Public Health 2008, 98(11):2092-2098.
33. Federal Interagency Forum on Aging-Related Statistics Older Americans 2012: Key Indicators of Well-Being 2012, Retrieved from:, (accessed 31.10.12). http://www.agingstats.gov/agingstatsdotnet/main_site/default.aspx.
34. Feetham S.L. Conceptual and methodological issues in research of families. Family Theory Development in Nursing: State of the Science and Art 1991, 55-68. F.A. Davies, Philadelphia. A.L. Whall, J. Fawcett (Eds.).
35. Field N.P., Filanosky C. Continuing bonds, risk factors for complicated grief, and adjustment to bereavement. Death Studies 2010, 34(1):1-29.
36. Field N.P., Friedrichs M. Continuing bonds in coping with the death of a husband. Death Studies 2004, 28(7):597-620.
37. Field N.P., Gal-Oz E., Bonanno G. Continuing bonds and adjustment at 5 years after the death of a spouse. Journal of Consulting and Clinical Psychology 2003, 71(1):110-117.
38. Florczak K.L. The persistent yet everchanging nature of grieving a loss. Nursing Science Quarterly 2008, 21:7-11.
39. Fry P.S. The unique contribution of key existential factors to the prediction of psychological well-being of older adults following spousal loss. Gerontologist 2001, 41(1):69-81.
40. Ganong L.H. Return of the "intimate outsider": current trends and issues in family nursing research revisits. Journal of Family Nursing 2011, 17(4):416-440.
41. Gass K.A. The health of conjugally bereaved older widows: the role of appraisal, coping and resources. Research in Nursing & Health 1987, 10(1):39-47.
42. Gass K.A. Aged widows and widowers: similarities and differences in appraisal, coping, resources, type of death, and health dysfunction. Archives of Psychiatric Nursing 1988, 2(4):200-210.
43. Gilliss C.L. The family as the unit of analysis: strategies for the nurse researcher. Advances in Nursing Science 1983, 5(3):50-59.
44. Gilliss C.L., Davis L.L. Family nursing research: precepts from paragons and peccadilloes. Journal of Advanced Nursing 1992, 17(1):28-33.
45. Ha J. Changes in support from confidants, children, and friends following widowhood. Journal of Marriage and Family 2008, 70(2):306-318.
46. Ha J. The effects of positive and negative support from children on widowed older adults' psychological adjustment: a longitudinal analysis. Gerontologist 2010, 50(4):471-481.
47. Ha J., Carr D., Utz R.L., Nesse R. Older adults' perceptions of intergenerational support after widowhood: how do men and women differ?. Journal of Family Issues 2006, 27(1):3-30.
48. Harrison T., Kahn D.L., Hsu M. A hermeneutic phenomenological study of widowhood for African-American women. Omega: Journal of Death & Dying 2004, 50(2):131-149.
49. Hedtke L., Winslade J. Re-membering Lives: Conversations with the Dying and the Bereaved 2004, Baywood Publishing Company, Amityville, NY.
50. Heeb J.L., Ambroz F., Bopp M., Egli K., Hoepflinger F., Martin M., et al. Gesundheit im Alter. Ein Bericht aus dem Kanton Zürich 2008, University of Zurich, Institute of Social and Preventive Medicine, Zurich, Switzerland.
51. Hegge M. A qualitative retrospective study of coping strategies of newly widowed elderly: effects of anticipatory grieving on the caregiver. American Journal of Hospice & Palliative Care 1991, 8(4):28-34.
52. Hegge M., Fischer C. The elderly woman at risk. American Journal of Nursing 2000, 100(6):54.
53. Heidegger M. Sein und Zeit 1926/2001, Max Niemeyer, Tübingen.
54. Herth K. Relationship of hope, coping styles, concurrent losses, and setting to grief resolution in the elderly widow(er). Research in Nursing & Health 1990, 13(2):109-117.
55. Hinck S. The lived experience of oldest-old rural adults. Qualitative Health Research 2004, 14(6):779-791.
56. Hockey J., Penhale B., Sibley D. Landscapes of loss: spaces of memory, times of bereavement. Ageing & Society 2001, 21(1):739-757.
57. Holtslander L., Bally J.M.G., Steeves M.L. Walking a fine line: an exploration of the experience of finding balance for older persons bereaved after caregiving for a spouse with advanced cancer. European Journal of Oncology Nursing 2011, 15(3):254-259.
58. Holtslander L., Duggleby W. The psychosocial context of bereavement for older women who were caregivers for a spouse with advanced cancer. Journal of Women & Aging 2010, 22(2):109-124.
59. Jacob S.R. An analysis of the concept of grief. Journal of Advanced Nursing 1996, 18:1787-1794.
60. Jacob S.R. The grief experience of older women whose husbands had hospice care. Journal of Advanced Nursing 1996, 24(2):280-286.
61. Janke M., Nimrod G., Kleiber D.A. Leisure patterns and health among recently widowed adults. Activities, Adaptation & Aging 2008, 32(1):19-39.
62. Jeffreys J.S. Older adult grief. Helping Grieving People: When Tears are not Enough 2011, 183-204. Brunner-Routledge, New York, NY. J.S. Jeffreys (Ed.).
63. Jordan J.R., Neimeyer R.A. Does grief counselling work?. Death Studies 2003, 27(9):765-786.
64. Kim S.H., Kjervik D., Belyea M., Choi E.S. Personal strength and finding meaning in conjugally bereaved older adults: a four-year prospective analysis. Death Studies 2011, 35(3):197-218.
65. Klass D., Silverman P., Nickman S. Continuing Bonds: New Understandings of Grief 1996, Taylor & Francis, Washington.
66. Kowalski S.D., Bondmass M.D. Physiological and psychological symptoms of grief in widows. Research in Nursing & Health 2008, 31(1):23-30.
67. Lalitha K., Jamuna D. Adaptation to bereavement in older men and women. Psychological Studies 2004, 49(1):73-77.
68. Lalive d'Epinay C., Cavalli S., Guillet L.A. Bereavement in very old age: impact on health and relationships of the loss of a spouse, a child, a sibling, or a close friend. Omega: Journal of Death and Dying 2009, 60(4):301-325.
69. Law M., Stewart D., Pollock N., Letts L., Bosch J., Westmorland M. Guidelines for Critical Review of Quantitative Studies 1998/2007, Retrieved from:, (accessed 07.07.11). http://www.srs-mcmaster.ca/Portals/20/pdf/ebp/quanguidelines.pdf.
70. Letts L., Wilkins S., Law M., Stewart D., Bosch J., Westmorland M. Guidelines for Critical Review of Qualitative Studies 2007, Retrieved from:, (accessed 07.07.11). http://www.srs-mcmaster.ca/Portals/20/pdf/ebp/qualguidelines_version2.0.pdf.
71. Lund D., Caserta M.S., van Pelt J., Gass K.A. Stability of social support networks after later-life spousal bereavement. Death Studies 1990, 14(1):53-73.
72. Martikainen P., Valkonen T. Mortality after the death of a spouse: rates and causes of death in a large Finnish cohort. American Journal of Public Health 1996, 86(8):1087-1093.
73. McIntyre G., Howie L. Adapting to widowhood through meaningful occupations: a case study. Scandinavian Journal of Occupational Therapy 2002, 9(2):54-62.
74. Mendes de Leon C.F., Kasl S.V., Jacobs S. A prospective study of widowhood and changes in symptoms of depression in a community sample of the elderly. Psychological Medicine 1994, 24(3):613-624.
75. Monk T.H., Begley A.E., Billy B.D., Fletcher M.E., Germain A., Mazumdar S., et al. Sleep and circadian rhythms in spousally bereaved seniors. Chronobiology International 2008, 25(1):83-98.
76. Montbriand M.J. Seniors' life histories and perceptions of illness. Western Journal of Nursing Research 2004, 26(2):242-260.
77. Moss M.S., Moss S.Z., Hansson R.O. Bereavement and old age. Handbook of Bereavement Research: Consequences, Coping, and Care 2001, 241-260. American Psychological Association, Washington, DC. M.S. Stroebe, R.O. Hansson, W. Stroebe, H. Schut (Eds.).
78. Moules N.J. Legitimizing grief: challenging beliefs that constrain. Journal of Family Nursing 1998, 4(2):142-166.
79. Moules N.J., Simonson K., Fleiszer A.R., Prins M., Glasgow B. The soul of sorrow work: grief and therapeutic interventions with families. Journal of Family Nursing 2007, 13(1):117-141.
80. Moules N.J., Simonson K., Prins M., Angus P., Bell J.M. Making room for grief: walking backwards and living forward. Nursing Inquiry 2004, 11(2):99-107.
81. Neimeyer R.A. Grief, loss, and the quest for meaning - narrative contributions to bereavement care. Bereavement Care 2005, 24(2):27-30.
82. Neimeyer R.A. Widowhood, grief and the quest for meaning: a narrative perspective on resilience. Spousal Bereavement in Late Life 2006, 227-252. Springer, New York. D. Carr, R.M. Nesse, C.B. Wortman (Eds.).
83. Meaning Reconstruction and the Experience of Loss 2001, American Psychological Association, Washington, DC. R.A. Neimeyer (Ed.).
84. Nihitilä E., Martikainen P. Institutionalization of older adults after the death of a spouse. American Journal of Public Health 2008, 98(7):1228-1234.
85. Onrust S.A., Cuijpers P. Mood and anxiety disorders in widowhood: a systematic review. Aging & Mental Health 2006, 10(4):327-334.
86. Ott C.H., Lueger R.J. Patterns of change in mental health status during the first two years of spousal bereavement. Death Studies 2002, 26:387-411.
87. Ott C.H., Lueger R.J., Kelber S.T., Prigerson H.G. Spousal bereavement in older adults: common, resilient, and chronic grief with defining characteristics. Journal of Nervous & Mental Disease 2007, 195(4):332-341.
88. Patterson I. Participation in leisure activities by older adults after a stressful life event: the loss of a spouse. International Journal of Aging & Human Development 1996, 42(2):123-142.
89. Pilkington F.B. Grieving a loss: the lived experience for elders residing in an institution. Nursing Science Quarterly 2005, 18(3):233-242.
90. Pilkington F.B. Developing nursing knowledge on grieving: a human becoming perspective. Nursing Science Quarterly 2006, 19(4):299-303.
91. Richardson S.J., Lund D., Caserta M., Dudley W.M., Obray S.J. Sleep patterns in older bereaved spouses. Omega: Journal of Death & Dying 2003, 47(4):361-383.
92. Richardson V.E. A dual process model of grief counseling: findings from the changing lives of older couples (CLOC) study. Journal of Gerontological Social Work 2007, 48(3-4):311-329.
93. Richardson V.E. The dual process model of coping with bereavement: a decade later. Omega: Journal of Death & Dying 2010, 61(4):269-271.
94. Richardson V.E., Balaswamy S. Coping with bereavement among elderly widowers. Omega: Journal of Death and Dying 2001, 43:129-144.
95. Robinson J.H. Grief responses, coping processes, and social support of widows: research with Roy's model. Nursing Science Quarterly 1995, 8(4):158-164.
96. Rodgers L.S. Meaning of bereavement among older African American widows. Geriatric Nursing 2004, 25(1):10-16.
97. Sable P. Attachment, loss of spouse, and grief in elderly adults. Omega: Journal of Death and Dying 1991, 23:129-142.
98. Sanger M. When clients sense the presence of loved ones who have died. Omega: Journal of Death & Dying 2009, 59(1):69-89.
99. Schut H., Stroebe M.S., van den Bout J., Terheggen M. The efficacy of bereavement interventions: determining who benefits. Handbook of Bereavement Research: Consequences, Coping, and Care 2001, 705-738. American Psychological Association, Washington, DC. M.S. Stroebe, R.O. Hansson, W. Stroebe, H. Schut (Eds.).
100. Shih S., Turale S., Shih F., Tsai J. Religiosity influences on bereavement adjustments of older widows in Taiwan. Journal of Clinical Nursing 2010, 19(5-6):856-866.
101. Steeves R.H. The rhythms of bereavement. Family & Community Health 2002, 25(1):1-10.
102. Steeves R.H., Kahn D.L. Experiences of bereavement in rural elders. Journal of Hospice & Palliative Nursing 2005, 7(4):197-205.
103. Stelle C.D., Uchida M. The stability and change in the social support networks of widowers following spousal bereavement. The Journal of Men's Studies 2004, 13:85-105.
104. Stewart M., Craig D., MacPherson K., Alexander S. Promoting positive affect and diminishing loneliness of widowed seniors through a support intervention. Public Health Nursing 2001, 18(1):54-63.
105. Stroebe M.S., Schut H. The dual process model of coping with bereavement: rationale and description. Death Studies 1999, 23:197-224.
106. Stroebe M.S., Schut H. The dual process model of coping with bereavement: a decade on. Omega: Journal of Death & Dying 2010, 61(4):273-289.
107. Stroebe W. Does social support help with marital bereavement?. Bereavement Care 2008, 27(1):3-6.
108. Swiss Statistics Demographic Portrait of Switzerland: 2009 Edition 2009, Swiss Federal Statistical Office, Neuchatel.
109. Thompson L.W., Gallagher-Thompson D., Futterman A., Gilewski M.J., Peterson J. The effects of late-life spousal bereavement over a 30-month interval. Psychology and Aging 1991, 6(3):434-441.
110. Turvey C.L., Carney C., Arndt S., Wallace R.B., Herzog R. Conjugal loss and syndromal depression in a sample of elders aged 70 years or older. American Journal of Psychiatry 1999, 156(10):1596-1601.
111. Utz R.L., Reidy E.B., Carr D., Nesse R., Wortman C. The daily consequences of widowhood. Journal of Family Issues 2004, 25(5):683-712.
112. Vale-Taylor P. "We will remember them": a mixed-method study to explore which post-funeral remembrance activities are most significant and important to bereaved people living with loss, and why those particular activities are chosen. Palliative Medicine 2009, 23:537-544.
113. van Grootheest D.S., Beekman A.T., Broese van Groenou M.I., Deeg D.J. Sex differences in depression after widowhood. Do men suffer more?. Social Psychiatry and Psychiatric Epidemiology 1999, 34(7):391-398.
114. White P., Ferszt G. Exploration of nurse practitioner practice with clients who are grieving. Journal of the American Academy of Nurse Practitioners 2009, 21(4):231-240.
115. Whittemore R. Rigour in integrative reviews. Reviewing Research Evidence for Nursing Practice: Systematic Reviews 2008, 149-156. Blackwell, Oxford, UK. C. Webb, B. Roe (Eds.).
116. Whittemore R., Knafl K. The integrative review: updated methodology. Journal of Advanced Nursing 2005, 52(5):546-553.
117. Williams B.R., Baker P.S., Allman R.M., Roseman J.M. The feminization of bereavement among community-dwelling older adults. Journal of Women & Aging 2006, 18(3):3-18.
118. Wilson S.C., Supiano K.P. Experiences of veterans' widows following conjugal bereavement: a qualitative analysis. Journal of Women & Aging 2011, 23(1):77-93.
119. Wondolowski C., Davis D.K. The lived experience of health in the oldest old: a phenomenological study. Nursing Science Quarterly 1991, 4(3):113-118.