Chronic Grief Management for Dementia Caregivers in Transition: Intervention Development and Implementation

Abstract

Research reveals that Alzheimer’s disease (AD) caregivers (CGs) do not relinquish their role after placing a family member in long-term care. Caregivers report increased emotional upset around the time of placement, with sustained losses over time leading to chronic grief. Chronic grief increases caregivers’ risk for depression and suicide. There are no documented interventions designed to decrease CGs chronic grief post placement. The Chronic Grief Management Intervention (CGMI) builds on existing evidence to target caregiver chronic grief in the transition of a family member into long-term care. The intervention is structured into three major components: 1) knowledge, 2) skill in communication and conflict resolution, and 3) chronic grief mangement skill. The 12-week intervention was pilot tested with thirty four caregivers for feasibility and preliminary effects on caregiver skill, knowledge, chronic grief, and depression. This article presents a general study description while focusing on the development and implementation of the CGMI.

Pre‐death grief in the context of dementia caregiving: a concept analysis

“…, Ott et al . , Paun & Farran ). This analysis paves the path for future researchers, clinicians and families by defining and exploring the important concept of pre‐death grief in dementia caregiving.…”

A Chronic Grief Intervention for Dementia Family Caregivers in Long-Term Care

“…Sessions 4 through 6 addressed caregiver skills in communication, conflict resolution, and hands-on care in the context of long-term care (Maas et al, 2004;McCallion et al,1999;Pillemer et al, 2003;Robinson et al, 2007), and Sessions 7 through 12 addressed caregiver grief management skills such as (a) recognizing losses, (b) processing reactions to separation, (c) re-experiencing the relationship with the care receiver, (d) relinquishing old attachments, (e) readjusting, and (f) investing in new attachments; processing group closure (Adams & Sanders, 2004;Boss, 1999;Kuhn, 2001;Rando, 2000;Worden, 2002). A complete description of the intervention development was published elsewhere (Paun & Farran, 2011). The intervention consisted of 12, 60 to 90 minute-long, weekly group meetings, that were conducted by the PI (principal investigator) and two comoderators.…”

Family members’ experiences of caring for a person with dementia at end-of-life

“…This is in keeping with findings of other studies that suggest that placement does not end the caregiving role, rather it signals a change for the caregiver where renegotiation and understanding of their new role is required (Davis & Buckwalter, 2001;Sanders et al, 2008). Furthermore it is recognised that, while placing a loved one in a formal care facility often produces feelings of relief, it is also associated with guilt, grief, increased stress and sadness Paun & Farran, 2011;Victor, 1997). Conflict is often associated with admission to a formal care facility (Dellasega & Mastrian, 1995;Maas et al, 2004).…”