In sickness and health: Caring for ailing spouse may prolong your life

ANN ARBOR, Mich., 27nov 2008---Older people who spent at least 14 hours a week taking care of a disabled spouse lived longer than others. That is the unexpected finding of a University of Michigan study forthcoming in Psychological Science, a journal of the Association for Psychological Science.
The study supports earlier research showing that in terms of health and longevity, it really is better to give than to receive.
"These findings suggest that caregivers may actually benefit from providing care under some circumstances," said U-M researcher Stephanie Brown, lead author of the study report. "Previous studies have documented negative health effects of caregiving. But the current results show that it is time to disentangle the presumed stress of providing help from the stress of witnessing a loved one suffer."
Brown is an assistant professor of internal medicine at the U-M Medical School and a faculty associate at the U-M Institute for Social Research (ISR). She is also affiliated with the Ann Arbor Veterans Affairs Hospital.
For the study, Brown and colleagues reviewed seven years of data from the U-M Health and Retirement Study, a nationally representative sample of Americans age 70 and older. The analysis focused on 1,688 couples, all of whom lived on their own.
At the start of the study in 1993, both members of each couple reported how much help they received from their spouse with a long list of everyday activities. These included eating, dressing and bathing, preparing meals, managing money and taking medications.
The vast majority---approximately 81 percent---said they received no help at all from their spouse. Another nine percent reported getting less than 14 hours of help a week, and the remaining ten percent reported getting 14 hours of help or more each week.
Over the course of the study, 909 people died---about 27 percent of the study population. After controlling for health, age, race, gender, education, employment status and net worth, Brown and colleagues found that the individuals who provided at least 14 hours of care a week to their spouses were significantly less likely to have died during the study period than those who provided no spousal care.
The results of this study add to a growing literature on the positive, beneficial health effects of caregiving, helping and altruism, according to Brown. Her own earlier work has shown that providing social support to friends, relatives and neighbors has a beneficial impact on mortality and on coping with spousal loss.
Brown has a theory about why this is the case. Rather than assuming that humans are selfish and necessarily act only on the basis of rational self-interest, she believes that strong evolutionary forces favor altruistic motivation when individuals are interdependent.
"There is growing recognition that economic decisions may be influenced by complex motivations, not limited to self-interest," she said. "We don't know yet exactly how caregiving motivation and behavior might influence health, but it could be that helping another person---especially someone you love---relieves some of the harmful stress effects of seeing that person suffer."
With support from the National Science Foundation, Brown will examine how altruistic, helpful behavior, including caregiving, enhances well-being. Starting in 2009, this research will focus on the neuro-affective mechanisms of helping behavior.
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The ISR Health and Retirement Study is funded by the National Institute on Aging.