Spouses of dying patients who received hospice care for three or more days were more likely to report fewer depressive symptoms, compared to surviving spouses of patients who did not receive hospice, according to a new study led by researchers at the Icahn School of Medicine at Mount Sinai.
The study is the first to look at depressive symptoms in spouses of patients with all types of serious illnesses that used hospice care. Hospice was designed to improve quality of life in dying patients as opposed to curing disease.
Hospice services were delivered by an interdisciplinary team of professionals for patients with a prognosis of six months or less to live and who agreed to forego curative treatments.
“We know hospice provides high quality care to patients, but now we’re also seeing a benefit for spouses,” said Katherine Ornstein, Ph.D., MPH, Assistant Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai and lead author of the study.
“If we want to understand the impact of hospice care, we should consider the potential benefit not just to the patient, but to the caregiver, and perhaps, the entire family and social network. We need to remember that care near the end of life affects not only patients, but also their loved ones.”
Until now, research showing the benefits of hospice use on caregivers has been mostly limited to cancer patients and their families, but hospice use has increased among patients with other fatal illnesses. Currently, forty-five percent of terminally ill patients in the U.S. die while receiving hospice care — an increase of more than 20 percent over the past decade.
For the study, researchers analyzed data from 1,016 deceased patients and their surviving spouses from the Health and Retirement Study (HRS), a national sample of adults over age 50 linked to Medicare claims.
Surviving spouses were observed up to two years after their loved one’s death. Hospice services included medical services, symptom management, spiritual counseling, social services, and bereavement counseling.
The findings showed that improvement in depressive symptoms was more common among those who had used hospice, a benefit that was even more pronounced a year after a spouse’s death. It is unknown which specific aspects of hospice care are tied to improved symptoms for spouses.
“Although our research suggests that hospice may help alleviate depression symptoms among some spouses, we also found that the majority of bereaved spouses have increased symptoms of depression overall compared to earlier time points,” said Amy Kelley, M.D., Assistant Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine, and senior author of the study.
“Additional support is needed for families and caregivers throughout the often long course of serious illness. We need to promote the high quality caregiver support and bereavement services offered in hospice and expand access to palliative care for people who are not hospice eligible.”
The findings are published online in JAMA Internal Medicine.
Source: Mount Sinai Medical Center