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AJPH First Look, published online ahead of print May 29, 2008
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AJPH.2007.119271v1
98/7/1228    most recent
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July 2008, Vol 98, No. 7 | American Journal of Public Health 1228-1234
© 2008 American Public Health Association
DOI: 10.2105/AJPH.2007.119271

RESEARCH AND PRACTICE

Institutionalization of Older Adults After the Death of a Spouse

Elina Nihtilä, MSocSc and Pekka Martikainen, PhD

The authors are with the Population Research Unit, Department of Sociology, University of Helsinki, Helsinki, Finland.

Correspondence: Requests for reprints should be sent to Elina Nihtilä, Population Research Unit, Department of Sociology, PO Box 18, FIN-00014 University of Helsinki, Helsinki, Finland (e-mail: elina.k.nihtila{at}helsinki.fi).

Objectives. We investigated the risk of entering long-term institutional care after the death of a spouse in relation to the duration of widowhood among older Finnish men and women. We also examined whether high levels of education or household income buffered the effects of bereavement on institutionalization.

Methods. We used linked register-based data on Finnish adults 65 years or older who were living with a spouse at the beginning of the study period (n=140902) and were followed from January 1998 to December 2002.

Results. The excess risk of institutionalization was highest during the first month following a spouse’s death compared with still living with a spouse (adjusted hazard ratio=3.31 for men, 3.62 for women). This risk decreased over time among both men and women. The relative effect of the duration of widowhood on institutionalization did not significantly vary according to the level of education or income.

Conclusions. Risk of institutionalization is particularly high immediately after the death of a spouse, demonstrating the importance of loss of social and instrumental support.






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