Predictors of Complicated Grief Among Dementia Caregivers: A Prospective Study of Bereavement

Schulz, Richard; Boerner, Kathrin; Shear, Katherine; Zhang, Song; Gitlin, Laura N.

doi:10.1097/01.jgp.0000203178.44894.db

Cited by 226 publications

(269 citation statements)

References 33 publications

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“…Younger and less educated grievers were more likely to belong to the high-grief trajectory group. These results are consistent with the findings of Schulz et al 15 . In addition, the effects of social activities and negative interactions were associated with trajectory group membership.…”

Section: Discussionsupporting

confidence: 83%

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Trajectories of complicated grief

Nam

2015

Eur. J. Psychiat.

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-Background and Objectives:In the discussion of apparent similarities between symptoms of grief and depression, research and theory have often confounded these two constructs because, as a construct, grief is distinct from depression and because these two constructs may have distinct trajectories. This study examines the trajectories of complicated grief and associated risks and the relationship between trajectories of complicated grief and depression.Design: Longitudinal. Setting: Intervention methods for enhancing family caregiving for persons with dementia. Participants: A total of 221 participants of the Resources for Enhancing Alzheimer's Caregiver Health project.Measurement: The Inventory of Complicated Grief. Results:The results based on group-based mixture modeling identify two distinct trajectories of grief (persistently high and low) and three distinct trajectories of depression (persistently high, moderate, and low). There were significant differences between the proportion of grief trajectory membership and that of depression trajectory membership, indicating distinct patterns over time.Conclusions: Noteworthy is the significant difference between the proportion of grief trajectory membership and that of depression trajectory membership, indicating differences in distinct patterns over time.

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Section: Discussionsupporting

confidence: 83%

“…Previous studies have observed that not all caregivers feel relieved from the burden of caring or the psychological burden of watching a loved one suffer from severe pain after death 7,19,20 . Indeed, a majority of bereaved individuals may not exhibit some relief by the death of a loved one.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of complicated grief

Nam

2015

Eur. J. Psychiat.

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“…In addition, dementia bereavement will be a heterogeneous experience for different individuals and some will be at risk of severe grief reactions which may be partly predicted by circumstances before death (Schulz et al, 2006). …”

Section: Discussionmentioning

confidence: 99%

The mental health and mortality impact of death of a partner with dementia

Shah

Carey

DeWilde

et al. 2016

Int J Geriat Psychiatry

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Objective Caring for a partner with dementia and partner bereavement are independently associated with poor health. An understanding of the health effects of living with a partner dying with dementia can help optimise support. We describe health in the year before and after loss of a partner with dementia compared with other bereavements. Methods In a UK primary care database, 2624 older individuals whose partner died with dementia during 2005–2012 were matched with 7512 individuals experiencing bereavement where the deceased partner had no dementia recorded. Results Prior to bereavement, partners of the deceased with dementia were more likely to be diagnosed with depression (OR 2.31, 1.69–3.14) and receive psychotropic medication (OR 1.34, 1.21–1.49) than partners from bereavements without dementia. In contrast, psychotropic medication initiation two months after dementia bereavement was lower (HR 0.69, 0.56–0.85). Compared with other bereaved individuals, mortality after bereavement was lower in men experiencing a dementia bereavement (HR 0.68, 0.49–0.94) but similar in women (HR 1.02, 0.75–1.38). Prior to bereavement, those who died with dementia were less likely to receive palliative care (OR 0.47, 0.41–0.54). Conclusion In the year before bereavement, partners of individuals dying with dementia experience poorer mental health than those facing bereavement from other causes, and their partner is less likely to receive palliative care. In the year after, individuals whose partner died with dementia experience some attenuation of the adverse health effects of bereavement. Services need to address the needs of carers for individuals dying with dementia and improve access to palliative care. Copyright © 2016 John Wiley & Sons, Ltd.

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“…7 These findings were echoed in the study by Schulz et al who found caregiver burden to be correlated with negative health outcomes such as depression, illness and reduced quality of life. 16 It has emerged that caregivers of people with dementia engage in more caregiving tasks than other long-term illnesses, and, as already been reported, have decreased quality of life, and higher anxiety and depression than caregivers of people with physical illnesses. 17 The amount of time spent in performing caregiving tasks is expected to increase as the dementia progresses.…”

Section: Introductionmentioning

confidence: 97%

Caregiving for people with dementia in a rural context in South Africa

Gurayah

2015

South African Family Practice

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Background: This research is an exploratory pilot study into the phenomenon of caregiving for people with dementia in a rural context in South Africa. Method: This study used a qualitative method of inquiry for conducting individual interviews with five caregivers to collect the data. The interviews were conducted in the local language of isiZulu. All interviews were audiotaped, and then transcribed into English. Transcriptions were analysed using thematic analysis. Findings: There were three main emergent themes, namely views and responsibilities of the caregiver, impact of caregiving, and skills and services to assist the caregiver. There were numerous subsidiary themes such as acceptance of the ageing process, a sense of duty and kinship in African culture, and dealing with problem behaviours. Caregiving was also viewed as a character-building experience, and has major implications such as promoting social isolation, restricting activities of daily living, reducing employment and increasing financial burden. Services that would alleviate caregiver burden are education, caregiver training, a financial grant and respite care. Conclusions: Although these findings are not generalisable, it would appear that caregivers of people with dementia suffer significant psychosocial distress, and would benefit from emotional and financial support. It remains to be seen who will provide this support, but policy-makers as well as governmental and non-governmental organisations will have to factor this into their forward planning to render an effective service for people with dementia and their families. Advocacy groups should also disseminate information on dementia and caregiving responsibility, whilst healthcare professionals should screen for caregiver stress or caregiver burden in individuals caring for people with dementia.

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Predictors of Complicated Grief Among Dementia Caregivers: A Prospective Study of Bereavement

Cited by 226 publications

References 33 publications

Trajectories of complicated grief

Trajectories of complicated grief

The mental health and mortality impact of death of a partner with dementia

Caregiving for people with dementia in a rural context in South Africa

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