Killed by a broken heart: Why more elderly couples are dying within hours of each other
Hospitals are seeing increased numbers of elderly couples dying within a few hours of each other.
A box of ashes, topped with ribboned teddy bears, sits amongst dozens of framed photographs. A bottle of Heineken is propped on the right, a can of New Zealand Lager on the left. Two names, rather than one, are carved into the glossed wooden box.
Although she was dying of cancer, no-one expected Yvonne Stickland to die so soon. Yvonne's husband of 54 years, Robert Stickland, missed her final moments.
Sick with cancer himself, he managed to kiss her on the forehead once she was gone, like he used to do every night before bed. Eight hours later, he died too.
"It was a shock, a complete shock," says their daughter Kathleen. "Because we hadn't really even comprehended that mum had passed away."
The Auckland couple's four children said there was no doubt Robert died of a broken heart. He was rushed to hospital shortly after Yvonne's death with suspected pneumonia. He slipped away quietly tucked up in a hospital bed after finishing a bowl of dessert.
"Initially it was like, oh my God, I can't believe that I've lost both my parents. It was complete devastation," Kathleen says. "But then we thought, well, its better that way because they're together and dad is not suffering on his own. Because he would have just been lost without her. He would have been in so much pain."
'SHE WAS JUST HEARTBROKEN'
In August, Kevin and Madeleine Feeney, married for 63 years, also died on the same day.
Like the Sticklands, the couple were farewelled in side-by-side coffins.
"In the end, you couldn't have scripted it better," their son Paul Feeney says. "They adored each other and were a great team so for us it was just meant to be."
Despite sounding like something out of the classical romances, death by heartbreak is very real.
Dr Rod MacLeod, medical director of Hibiscus Hospice, says: "It's not uncommon for partners to die relatively quickly after one of the partners has died."
MacLeod's career in palliative medicine began 30 years ago with the story of an elderly, married couple called Roy and Millie.
Millie looked after Roy at home for months while he battled lung cancer.
"Essentially what would happen is I would go visit and watched Millie caring for Roy very well," MacLeod says. "One weekend when I was away from my practice Roy had to be admitted into hospital and died very shortly after that.
"In the following weeks I had to see Millie because she developed heart disease and died. So she literally died of a broken heart.
"She was just heartbroken. That's where the term comes from. The idea of being heartbroken and dying from a broken heart really does exist.
"The deaths the press report are the ones that die within a couple of days. That's quite rare. But it's not uncommon for people to die within a few months."
It's testament to a strong link between the mind and body that the medical world doesn't completely understand, MacLeod says.
A Harvard study found people have a 30 per cent increased risk of death in the first three months after their spouse dies.
Studies link the deaths to heart disease – known as the Widowhood Effect.
"Profound grief, acute grief is a big issue that we're not necessarily that good at dealing with," MacLeod says. "I think preparation for grief is important and support afterwards is important."
"I was so interested in why that happens and the way that it happens and the fact that I thought that we should have been able to do it better and provide better support for Milly. That's what set me off on my quest for understanding about palliative medicine."
BROKEN HEART SYNDROME
In some cases it is caused by Takotsubos Cardiomyopathy, also called Broken Heart Syndrome.
Takotsubos, first described in Japan, 1990, is a sudden, muscular heart failure, often triggered by severe stress with symptoms almost indistinguishable from a heart attack. It can be triggered by the death of a child, a pet, a court case, financial stress.
It is named after an octopus trap that takes on the shape of a heart when it balloons under stress. There is no diagnostic code for the relatively new syndrome, making it hard for doctors to diagnose.
Auckland DHB cardiologist Harvey White says they have seen an increase of cases of couples dying within a few hours of each other, with about one case every two weeks at the Auckland Hospital.
There's also been an increase in Takotsubos. "We never saw it 20 years ago," White says. "It's very unlikely that we missed it because we used to take pictures of the pumping chamber and we never saw it."
Cases of Takotsubos presented to the Auckland DHB – sometimes called Stress Cardiomyopathy or Apical ballooning Syndrome – shot from 19 in 2015 to 39 cases in 2016.
By the end of July this year, 27 cases were already documented.
White thinks it could be related to an increase in stress and anxiety.
"I think it's intense stress as a result of a very close relationship, the sadness of that and the thought of being alone and not knowing what the future holds," he explains. "It's very stressful for the heart and adrenaline can pour out. There can be a massive damage to the heart. People can die."
People usually recover over a couple of weeks but it can cause death or long-lasting damage for the heart.
For unknown reasons, cases of Takotsubos are most common in post-menopausal women. This could suggest a hormonal link – but no one knows for sure.
Yvonne and Robert Stickland's elderly cat Tiger died four weeks after his owners died.
Ken and Kathleen remembered Tiger crying and roaming around their room in the weeks after their death.
Animals can be broken-hearted too, animal behaviourist Mark Vette says.
"In the early days, say 10 or 15 years ago, we didn't attribute grief to animals," he explains. "We see what appears to be depression. You'll get appetite suppression you'll get decreased activity, you'll get howling and whining and crying.
"There have been cases where animals have died, they've pined away effectively, or that's what we think."
The most common reaction is animals searching for the owner or animal friend, usually seen in social or domestic animals like cats and dogs.
"But even in other animals. It has been described in rabbits and birds and horses. It's definitely a very real phenomena."
'MUM BURST INTO TEARS'
Yvonne and Robert first met in her home country of Niue. Robert used to see a beautiful woman riding past on a motorbike.
"He starting asking around the island then he found one of my mum's cousins, close cousins and he asked if he could be introduced," their daughter Kathleen says. "Because she wasn't really used to Europeans, my mum burst into tears when my dad asked her out on a date."
Yvonne had lots of bachelors from overseas asking to date her – but she chose Robert. They dated for about a year before getting married. She was just 17 years old.
Their relationship was less dramatic than their first meeting. They were simply best friends, Kathleen says.
Even at the height of her sickness Yvonne would hobble out of bed to the kitchen to try prepare her husband's dinner.
Son Ken says it is a comfort to think of them together – still inseparable.
"To me it has worked out better that way. I know that they're OK."
- Sunday Star Times