Elders are more likely to confront the death of a sibling than any oth
er kinship bereavement. Yet we know almost nothing about the impact of
sibling deaths on older adults. We used attachment theory to generate
hypotheses about the impact of this life event on physical health, mo
od, social support, and economic outcomes in late life. At the Duke Un
iversity site of a large multi-center epidemiologic study (EPESE), 317
3 elderly community-dwellers provided data on bereavements experienced
in the past year as well as on demographic, health-related, and socio
economic characteristics. Bereaved siblings were more functionally and
cognitively impaired than bereaved friends and rated their overall he
alth as worse than bereaved spouses or bereaved friends who were simil
arly impaired. Brothers and sisters bereaved of a brother reported exc
ess financial hardship and mood impairment, respectively. Terminal car
e programs should screen for excess risk among surviving siblings and
plan for assisting these survivors in adaptation to this loss.