Not Your Average Grief: Addressing the Many Layers of Dementia-Related Loss

Abstract

Grief is a common and significant human emotional experience. It has known physical, emotional, and social ramifications in patients and their families. In particular, grief is central to the dementia experience for all involved – the people living with dementia (PLWD) themselves, and for all of their caregivers: family members, staff members of assisted living facility (ALF) settings, and clinicians. Grief can ultimately take a large toll on all of these different players in the dementia experience, including medically, interpersonally, and socially, and end up at times causing significant harm if not recognized and addressed.This presentation will describe the medical, psychological, and psychosocial manifestations of grief in general, and then specifically in the context of dementia. We will discuss ways in which grief can present through defense mechanisms in interactions between various caregivers of the PLWD, as well as in the PLWD themselves. We then will discuss a model of grief for caregivers of PLWD, and a newer extension of this model to apply to PLWD themselves, as well as approaches to management. Finally we will turn to a discussion of prolonged grief disorder, how this manifests in the dementia experience and beyond for the greater population, as well as appropriate treatment. Clinical case examples from the outpatient as well as ALF setting will be incorporated throughout the presentation.