title: Living With an Older Person Dying From Cancer, Lung Disease, or Dementia: Health Outcomes From a General Practice Cohort Study.
abstract: Increasing numbers of people will die from chronic disease. Families contribute significantly to end-of-life care, but their role may not be recognized.
  
  
  
  To 1) establish the proportion of older cohabitees identified in primary care as "carers"; 2) describe demographic and lifestyle characteristics of cohabitees of people terminally ill with cancer, dementia, and chronic obstructive pulmonary disease (COPD); 3) describe their health a year before and after bereavement; and 4) compare health outcomes between cohabitees of people dying with cancer, COPD, or dementia.
  
  
  
  Retrospective cohort study using a U.K. primary care database (The Health Improvement Network) of 13,693 bereaved cohabitees (a proxy marker for being a carer), aged 60 years or older of people dying from cancer, COPD, or dementia. Characteristics were described one year before and after bereavement. We compared cancer, COPD, and dementia cohabitee outcomes using incidence rate ratios one year before and after bereavement and calculated mortality risk after bereavement.
  
  
  
  A total of 6.9% of cohabitees were recorded as carers. Health outcomes differed little between the three groups of cohabitees in the year before or after bereavement. The proportion of cohabitees with six or more consultations increased the year after bereavement (cancer cohabitees 16.0% to 18.8%, COPD cohabitees 17.8% to 20.4%, and dementia cohabitees 15.5% to 17.5%). At postbereavement (follow-up median 3 years, interquartile range 1.3-5.4), we found no mortality differences between the three groups.
  
  
  
  Recording of carers of terminally ill people was suboptimal. Cause of bereavement produced few differential effects on health outcomes or mortality.
authors.affiliation: Marie Curie Palliative Care Research Department, Division of Psychiatry University College London, London, United Kingdom. Electronic address: e.sampson@ucl.ac.uk.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Sampson
authors.affiliation: Marie Curie Palliative Care Research Department, Division of Psychiatry University College London, London, United Kingdom; Research Department of Primary Care and Population Health, University College London, London, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lodwick
authors.affiliation: Research Department of Primary Care and Population Health, University College London, London, United Kingdom.
authors.forename: Greta
authors.initials: G
authors.lastname: Rait
authors.affiliation: Marie Curie Palliative Care Research Department, Division of Psychiatry University College London, London, United Kingdom.
authors.forename: Bridget
authors.initials: B
authors.lastname: Candy
authors.affiliation: Marie Curie Palliative Care Research Department, Division of Psychiatry University College London, London, United Kingdom.
authors.forename: Joe
authors.initials: J
authors.lastname: Low
authors.affiliation: Division of Psychiatry, University College London, London, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.affiliation: Research Department of Primary Care and Population Health, University College London, London, United Kingdom; Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003704:Dementia / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice; D006304:Health Status; D006801:Humans; D008297:Male; D009026:Mortality; D015999:Multivariate Analysis; D009369:Neoplasms / Q000628:therapy*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012044:Regression Analysis; D012189:Retrospective Studies; D013727:Terminal Care; D006113:United Kingdom
keywords: Caregivers; bereavement; epidemiology; palliative care; primary health care