Anticipatory grief in the context of dementia caregiving.

Abstract

The current study investigated the nature of anticipatory grief in a sample of dementia caregivers, and examined the relationship between anticipatory grief and caregiver burden. Anticipatory grief can be described as one's reaction to the impending death of a loved one, in addition to responses to other previously endured, ongoing, and anticipated losses. Interest in anticipatory grief has been inconsistent, and has typically focused on terminal diseases such as cancer. However, the issues involved in anticipatory grief are unique in the context of dementia due to the progressive deterioration of both cognitive and physical abilities. A total of 80 informal caregivers of individuals with dementia completed interviews and questionnaires assessing his or her experience of grief, physical and mental health, aspects of the caregiving situation, and the severity of patient impairment. Results reveal that anticipatory grief is strongly related to burden and its correlates, including depression, well-being, social support, and behavior problems in the care recipient. Anticipatory grief is shown to be a significant and independent predictor of caregiver burden in this sample, beyond the effects of known predictors such as background characteristics, primary stressors, and depressive symptoms. The current results suggest that grief may be an important yet understudied aspect of the caregiving experience. The nature of anticipatory grief in dementia caregivers is described, and recommendations for future research directions, including longitudinal examination of anticipatory grief, are provided.