Psychological adjustment to sudden and anticipated spousal loss among older widowed persons

Objectives. This study examined if older adults' psychological adjustment t o widowhood varies based on whether the death was sudden or anticipated and if these effects are mediated by death context characteristics (e.g., pred eath care-giving, nursing home use. spouse's age at death, and couple's com munication about the death). Methods. The effects of forewarning on multiple indicators of mental health and grief were examined in a sample 210 widowed persons who participated i n the Changing Lives of Older Couples (CLOC) study. The CLOG is a probabili ty sample of 1,532 married individuals aged 65 and older for whom baseline information was collected in 1987-881 with widowed persons reinterviewed 6, 18, and 48 months after spousal loss. Results. Forewarning did not affect depression. anger, shock, or overall gr ief 6 or 18 months after the loss. Prolonged forewarning was associated wit h elevated anxiety both 6 and 18 months after the death. Sudden spousal dea th elevated survivors intrusive thoughts at the 6-month follow-up only. Sud den death was associated with slightly higher levels of yearning among wome n but significantly lower yearning among men both 6 and 18 months after the loss. Discussion. The findings call into question the widespread belief that grie f is moi e severe if death is sudden and suggest a more complex relationshi p between bereavement and circumstances of spousal death.