Prolonged grief symptoms related to loss of physical functioning: examining unique associations with medical service utilization

Disabil Rehabil. 2016;38(3):205-10. doi: 10.3109/09638288.2015.1031830. Epub 2015 Apr 14.

Abstract

Purpose: Prolonged grief, a severe and chronic form of grieving most commonly studied in the context of bereavement, may have relevance to losses associated with chronic illness (e.g. grief related to loss of functioning or loss of a planned future). The purpose of the present study is to examine the unique associations between prolonged grief symptoms and service utilization patterns.

Methods: An online self-report assessment battery was administered among a sample of 275 older adults with at least one chronic illness that caused significant physical impairment.

Results: Even after statistically controlling for relevant physical health (e.g. severity of physical limitations, somatic symptoms, number of chronic illnesses) and psychosocial variables (e.g. social support, depression/anxiety), more severe prolonged grief symptoms were associated with a greater number of emergency room visits, overnight stays in the hospital and total nights in the hospital.

Conclusions: These findings highlight the importance of screening for prolonged grief symptomatology with older individuals with a debilitating chronic illness.

Implications for rehabilitation: Recent evidence suggests that prolonged grief may have relevance for losses associated with physical illness. The present study shows that prolonged grief reactions related to physical illness (e.g. grieving the loss of functioning) are uniquely associated with increased hospital-based service utilization. Given the relevance of prolonged grief reactions in this population, practitioners may wish to assess for these symptoms. Future clinical research should focus on developing interventions to target prolonged grief symptoms associated with these losses.

Keywords: Chronic illness; gerontology; grief; older adults; physical health.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / diagnosis*
  • Chronic Disease / economics
  • Chronic Disease / psychology*
  • Depression / diagnosis*
  • Disabled Persons / psychology*
  • Disabled Persons / rehabilitation
  • Female
  • Grief*
  • Health Expenditures
  • Health Services for the Aged / statistics & numerical data*
  • Humans
  • Life Change Events
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Regression Analysis
  • Self Report
  • Socioeconomic Factors
  • United States