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Invited Commentary
July 2015

The Antidepressant Effect of Hospice: Need for a More Potent Prescription

Author Affiliations
  • 1Center for Research on End-of-Life Care, Cornell University, New York, New York
  • 2Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medical College, New York, New York
JAMA Intern Med. 2015;175(7):1146-1147. doi:10.1001/jamainternmed.2015.1726

Although caring for a terminally ill spouse can be gratifying, it can also be depressing. Research1,2 has shown that caregiving poses risks to a spouse’s mental health both before and after the ill spouse dies. Depending on the circumstances of the death, psychological distress may increase or decrease as the surviving spouse transitions from caregiver to widow or widower. Important environmental factors external to the caregiver may contribute to a widowed person’s bereavement adjustment. One such environmental factor is the end-of-life care that the patient receives. For example, research3 has shown that the rate of major depressive disorder increases significantly among bereaved caregivers following deaths that involve aggressive life-prolonging care compared with deaths that do not involve such care. Given caregivers’ heightened vulnerability to psychological distress and their expanding role in the provision of care for terminally ill patients, there is a human, clinical, and public health interest in determining ways in which end-of-life care might improve the mental health of spousal caregivers.

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