title: Caring for a dying spouse at the end of life: 'It's one of the things you volunteer for when you get married': a qualitative study of the oldest carers' experiences.
abstract: older people aged 80 and over are increasingly providing end-of-life care to spouses at home and often do so for long periods of time, while also trying to manage their own illnesses and disabilities. Little of the research on older spousal carers has focussed on the oldest carers; hence, the needs of this particular population are not fully known.
  
  
  
  to explore the experiences of the 'oldest carers' in caring for a dying spouse at home.
  
  
  
  secondary analysis was undertaken on a subset of data from a larger qualitative interview study; this dataset comprised 17 interviews from participants aged 80 or over. Framework analysis methods were used, with items derived from the thematic analysis of the main study.
  
  
  
  the oldest carers in this subset demonstrated high levels of resilience and the ability to adapt to their caring role. Caring until death was accepted as an integral part of the commitment made to their partner as part of the 'wedding contract'. Carers felt they benefitted from the support provided by family, friends and care services; however, their own care needs were not always recognised by health and social care services.
  
  
  
  these findings underscore the complexity of the oldest carers' experiences and challenges in times of illness and end of life. Healthcare professionals should be alerted to the myriad ways caregiving is enacted in serious illness and seek opportunities for developing supportive interventions specifically for older carers.
authors.affiliation: Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College Lancaster University, Lancaster LA1 4YG, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Turner
authors.affiliation: Health and Care Directorate, Cumbria County Council, Carlisle, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: King
authors.affiliation: Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College Lancaster University, Lancaster LA1 4YG, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Milligan
authors.affiliation: Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College Lancaster University, Lancaster LA1 4YG, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Thomas
authors.affiliation: Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College Lancaster University, Lancaster LA1 4YG, UK.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Brearley
authors.affiliation: Honiton Research Practice, Exeter, UK.
authors.forename: David
authors.initials: D
authors.lastname: Seamark
authors.affiliation: School of Social, Psychological and Communication Sciences, Leeds Metropolitan University, Leeds, UK.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Honiton Research Practice, Exeter, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Blake
authors.affiliation: Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College Lancaster University, Lancaster LA1 4YG, UK.
authors.forename: Sheila
authors.initials: S
authors.lastname: Payne
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D020380:Needs Assessment; D036301:Qualitative Research; D011788:Quality of Life; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological; D013727:Terminal Care / Q000379:methods / Q000523:psychology*; D006113:United Kingdom
keywords: carers; end-of-life care; older people; qualitative research; spouses