The Relationship between Caregiving and Bereavement: A Series of Three Studies

Spousal bereavement has been consistently demonstrated in the literature to be one of the most highly stressful experiences in an individual’s lifetime. In addition many deaths in the United States are preceded by a period of caregiving, which is also believed to be highly stressful and have a profound impact on bereavement. However the literature has been inconsistent as to the exact nature of the relationship between caregiving and bereavement and there has been some debate as to whether or not positive and negative affect variables are mutually exclusive. This dissertation sought to further address the issue of the relationship between caregiving and the bereavement experience through a series of three studies which utilized information from two datasets. The first was the Changing Lives of Older Couples (CLOC) study, a project that included both pre- and post-loss data. The second was a subset of a dataset that recruited elderly spousal caregivers of terminally ill patients from a large, local non-profit hospice. This dataset included both pre- and post-loss data and included a variety of widely used and validated measures that allowed for the examination of caregiving stressors, appraisals, and social support and their effect on both positive and negative mental health outcomes during bereavement. The first study examined the impact of caregiving on well-being during bereavement, specifically within the domains of psychological, social, and physical health, utilizing both positive and negative affect measures. The second addressed how varying levels of caregiving experience were related to previously established bereavement trajectories (Boerner, Wortman, & Bonanno, 2005; Bonanno, Wortman, Lehman, Tweed, Haring, et al., 2002), and the last one examined the mechanisms by which caregiving had an effect on bereavement outcomes, specifically focusing on stressors, appraisals, and social support. This dissertation consists of five chapters. Chapter 1 is an introduction to the caregiving and bereavement literature, Chapters 2-4 describe the series of three studies conducted, and Chapter 5 discusses the overall conclusions as well as future directions for research