Marwit-Meuser Caregiver Grief Inventory Research Articles

ADRD CAREGIVERS’ ROLE PERCEPTION AND MENTAL HEALTH AFTER LTC-PLACEMENT OF FAMILY MEMBERS

Abstract The Chronic Grief Management Intervention-Video (CGMI-V) clinical trial tested the effects of an 8-week live online intervention for caregivers who placed their family members with ADRD in LTC on caregivers’ mental health outcomes (grief, depression and anxiety symptoms, positive states of mind). This cross-sectional study used baseline data (n=95) from the CGMI-V. We performed hierarchical linear regression to examine the main effects of caregiving role perceptions on caregivers’ levels of grief, depression, anxiety symptoms, and positive states of mind, controlling for potential covariates. At baseline, perceived caregiver role captivity was the most significant factor of outcome variables, followed by feelings of guilt and loss. Increased feelings of role captivity were linked to sum scores of grief as measured with the Marwit-Meuser Caregiver Grief Inventory. These findings indicate that increased feelings of role captivity were associated with increased feelings of loss and loss of interpersonal connections. Higher levels of perceived role captivity were associated with more depressive and anxiety symptoms. Caregivers with lower levels of perceived role captivity had higher levels of positive states of mind. The findings confirmed the need for interventions targeting caregivers’ feelings of role captivity, loss, and guilt related to caregiving obligations post-LTC placement of family members with ADRD to reduce caregivers’ grief, depression, and anxiety and to increase their positive states of mind. These baseline findings are preliminary. Future presentations will report the effects of the CGMI-V intervention on caregivers’ grief and mental health, including weeks 8 and 24 follow-up data.

P151: A Chronic Grief Management-Intervention-Video: A Profile of the Sample

Objectivesof this presentation are to: Describe the Chronic Grief Management Intervention-Video (CGMI-V) – an ongoing stage I clinical trialDescribe the profile of the study sample using baseline dataStudy purpose:to pilot-test the CGMI-V for establishing effect sizes in caregiver outcomes including chronic grief, symptoms of depression and anxiety, positive states of mind, satisfaction with care in the facility and conflict with staff.Methods:Participants were randomized to either a control condition or to CGMI-V, a manualized intervention delivered on-line over eight consecutive weeks to family caregivers of persons diagnosed with dementia who were placed in long-term care. Caregivers were measured with standardized demographic and situational surveys (baseline only) and with the following instruments at weeks 8 and 24: Knowledge of Alzheimer’s (FKAT)Marwit-Meuser Caregiver Grief Inventory (MM-CGI)CES-D 20Family Perception of Caregiver RoleFamily Perception of Caregiving ToolState Trait Anxiety InstrumentPositive States of MindRecruitment was conducted via direct contacts with facilities, radio and online advertising.Results:For the purposes of this presentation, we are reporting only baseline demographic and situational characteristics of the entire sample. Enrollment closed in November, 2022. The study remains open for follow-up only. The final sample size is 99 participants (Intervention=50; Control=49) recruited from across 14 states in the USA.Participant Characteristics: There were no significant differences in demographics between participants in both conditions. The sample was predominantly Caucasian and female with over two thirds being highly educated, adult children. The average caregiver age was 62.06 (SD=10.20) for those in the CGMI-V condition and 58.18 (SD=11.27) respectively, for those in the control condition. Similarly, there were no significant differences in care recipient demographics. The sample was predominantly Caucasian and female. Over one third of care recipients across both conditions were diagnosed with dementia within the past four years of interviewing. Further analyses are pending.Conclusions:Sample characteristics illuminate similarities across dementia caregivers who placed family members with dementia in long-term facilities across 14 states in the USA. These findings may inform future grief interventions.

Exploratory factor analysis of the caregiver grief inventory in a large UK sample of dementia carers

Objectives Anticipatory grief (AG) is the process of experiencing loss prior to the death of a significant person. Coping with this multifaceted experience in the context of dementia caregiving is a relatively novel, yet significant area in caregiving literature. The Marwit-Meuser Caregiver Grief Inventory (MM-CGI) and its abbreviated MM-CGI-Short-Form (MM-CGI-SF) is the most widely used scale measuring AG. However, limited research has employed robust analytical strategies to assess its dimensional structure. This study employed contemporary factor analytical techniques to assess the dimensional structure of the MM-CGI/SF. Method Caregivers of persons with dementia (n = 508) completed a survey containing MM-CGI/SF and other associated psychological measures. Exploratory factor analysis was employed to compare eight alternative factor analytical models to determine the optimal model. Internal-consistency reliability was assessed by Cronbach’s α and construct validity was assessed by Spearman’s correlation-coefficient. Results The best fitting model was the MM-CGI-SF three factor model (Personal Sacrifice and Burden, Heartfelt Sadness and Longing and Worry and Felt Isolation). The MM-CGI-SF three factor model demonstrated internal consistency reliability and factor correlations with associated psychological measures indicated construct validity. Conclusion The MM-CGI-SF three factor model demonstrated adequate fit and utility, however, the Worry and Felt Isolation subscale needs further replication and revision to assess its dimensionality. The MM-CGI-SF is the more useful tool due to its brevity and better model fit.

Is preparation for end of life associated with pre-death grief in caregivers of people with dementia?

Family caregivers of people with dementia can experience loss and grief before death. We hypothesized that modifiable factors indicating preparation for end of life are associated with lower pre-death grief in caregivers. Cross-sectional. Caregivers of people with dementia living at home or in a care home. In total, 150 caregivers, 77% female, mean age 63.0 (SD = 12.1). Participants cared for people with mild (25%), moderate (43%), or severe dementia (32%). Primary outcome: Marwit-Meuser Caregiver Grief Inventory Short Form (MMCGI-SF). We included five factors reflecting preparation for end of life: (1) knowledge of dementia, (2) social support, (3) feeling supported by healthcare providers, (4) formalized end of life documents, and (5) end-of-life discussions with the person with dementia. We used multiple regression to assess associations between pre-death grief and preparation for end of life while controlling for confounders. We repeated this analysis with MMCGI-SF subscales ("personal sacrifice burden"; "heartfelt sadness"; "worry and felt isolation"). Only one hypothesized factor (reduced social support) was strongly associated with higher grief intensity along with the confounders of female gender, spouse, or adult child relationship type and reduced relationship closeness. In exploratory analyses of MMCGI-SF subscales, one additional hypothesized factor was statistically significant; higher dementia knowledge was associated with lower "heartfelt sadness." We found limited support for our hypothesis. Future research may benefit from exploring strategies for enhancing caregivers' social support and networks as well as the effectiveness of educational interventions about the progression of dementia (ClinicalTrials.gov ID: NCT03332979).

Assessing Grief in Family Caregivers of Individuals With Alcohol Use Disorder or Substance Use Disorder using the Marwit-Meuser Caregiver Grief Inventory Short Form (MM-CGI-SF).

This study assessed grief in caregivers of family members with alcohol use disorder (AUD) and substance use disorder (SUD) using the Marwit-Meuser Caregiver Grief Inventory Short Form (MM-CGI-SF). We used snowball sampling to recruit participants who had family members with AUD and SUD. The sample was comprised of 100 caregivers of family members with AUD and 75 caregivers of family members with SUD. The original MM-CFI-SF was modified by changing the wording to reflect those with AUD and SUD. The 18-item instrument consisted of 3 factors: personal sacrifice burden, sadness and longing, and worry and felt isolation. The professional care of caregivers with family members with AUD and SUD should be addressed by health professionals in the same manner as dementia caregivers. AUD and SUD caregivers may also downplay the distress, require social support, or have a common reaction to the stress and grief encountered. The correlations were moderate to strong and significant between each of the factors for both AUD and SUD caregiver scale.

The three dimensions of caregiver grief in dementia caregiving: Validity and utility of the subscales of the Marwit-Meuser Caregiver Grief Inventory.

BackgroundThe experience of grief in family caregivers as they provide care for persons with dementia is often overlooked. The Marwit‐Meuser Caregiver Grief Inventory (MM‐CGI) is one among the few scales that capture such experiences. In a recent study, MM‐CGI was found to contain three subscales identifying dimensions of loss in caregivers—Personal‐Sacrifice Burden (PSB), Heartfelt Sadness, Longing, and Worry (HSLW), and Felt Isolation (FI). We aimed to evaluate the validity and utility of these dimensions in a multiethnic Asian population.MethodsFamily caregivers (n = 394) completed MM‐CGI and scales assessing caregiver burden, depression, and gains. Internal consistency reliability was examined using Cronbach α; test‐retest reliability using intraclass correlation coefficient; and construct validity using Pearson correlation coefficient. The utility of the MM‐CGI dimensions was evaluated by comparing caregivers with high subscale scores across dementia stages and caregiving relationship.ResultsThe three dimensions of MM‐CGI exhibited adequate internal consistency, test‐retest reliability, construct validity, and known‐group validity. PSB correlated most strongly with caregiver burden (r = 0.78); HSLW with caregiver depression (r = 0.75); and FI with caregiver burden and caregiver depression (r = 0.60, respectively). Caregivers with high total grief scores tended to experience most difficulty with HSLW (90.8%), followed by PSB (75.4%) and FI (46.2%). The three dimensions also increased across the dementia stages, with FI higher in mild dementia, PSB higher in moderate dementia, and HSLW higher in severe dementia. Spousal caregivers experienced most difficulty in HSLW, whereas children caregivers experienced similar levels of difficulty across the dimensions.ConclusionsThe three dimensions of MM‐CGI captured distinct aspects of caregiver grief in a multiethnic Asian population and would enable more individualized assessments and interventions for caregiver grief.

A Brief, 6-Item Scale for Caregiver Grief in Dementia Caregiving

Caregivers of persons with dementia (PWD) can experience loss and grief long before the death of the person. Although such experience of caregiver grief is measurable, available scales (such as the Marwit-Meuser Caregiver Grief Inventory, MM-CGI) are lengthy and have overlaps with other caregiving constructs. We developed a briefer scale that captures the essence of caregiver grief-with comparable psychometric properties and total score to MM-CGI, as well as less overlap with other caregiving constructs. Family caregivers of community-dwelling PWD (N = 394) completed questionnaires containing MM-CGI and other caregiving scales. Initially, we split the study samples into two -the derivation sample (n = 179) was used to develop a brief scale that best predicts MM-CGI (using the best-subset approach with tenfold cross-validation), whereas the validation sample (n = 215) verified its actual performance in predicting MM-CGI. Thereafter, we evaluated the derived scale in its reliability and validity, and mapped its scores to MM-CGI using the equipercentile equating method. We derived a 6-item scale, which explained 84.1% of the variability in MM-CGI and had area under the receiver operating characteristic curve of .96 in discriminating high caregiver grief (95% CI: .94-.99). It had single dimension in confirmatory factor analysis (comparative fit index = .98; Tucker-Lewis index = .97) and maintained good psychometric properties similar to those of MM-CGI, while showing lower correlation with caregiver burden and depression. It also had scores that could be mapped to MM-CGI with reasonable precision. We developed the first brief scale with less than 10 items that can conveniently and accurately measure caregiver grief, which opens the way for grief-related interventions in clinical care. Notably, this 6-item scale was developed using rigorous methods and demonstrated consistent evidence of capturing the essence of caregiver grief.

Detecting pre-death grief in family caregivers of persons with dementia: measurement equivalence of the Mandarin-Chinese version of Marwit-Meuser caregiver grief inventory

BackgroundPre-death grief (PDG) is a key challenge faced by caregivers of persons with dementia (PWD). Marwit-Meuser Caregiver Grief Inventory (MM-CGI) and its abbreviated MM-CGI-Short-Form (MM-CGI-SF) are among the few empirically-developed scales that detect PDG. However, they have not had a Mandarin-Chinese version even though Chinese-speaking populations have among the largest number of PWD. We produced a Mandarin-Chinese version of MM-CGI and evaluated whether it had equivalent scores and similar psychometric properties to the English version.MethodsWe produced the Chinese MM-CGI through the methods of forward-backward translation and cognitive debriefing. Then, we recruited family caregivers of PWD (n = 394) to complete either the Chinese (n = 103) or English (n = 291) version. The two versions were compared in their score-difference (adjusting for potential confounders using multiple linear regression), internal-consistency reliability (using Cronbach’s α) and test-retest reliability (using intraclass correlation-coefficient), known-group validity (based on the relationship with the PWD and stage of dementia) and construct validity (using Spearman’s correlation-coefficient).ResultsThe two versions showed similar mean scores, with the adjusted score-difference of 1.2 (90% CI -5.6 to 7.9) for MM-CGI and − 0.4 (90% CI -2.9 to 2.1) for MM-CGI-SF. The 90% CI for adjusted score-difference fell within predefined equivalence-margin (±8 for MM-CGI and ± 3 for MM-CGI-SF) and indicated equivalence of the scores. The two versions also demonstrated similar characteristics in reliability and validity.ConclusionsThe Chinese MM-CGI opens the way for PDG assessment and intervention among Chinese-speaking caregivers. Establishing its measurement equivalence with the English version paves the way for cross-cultural research on PDG in dementia caregiving.

Psychological morbidity in family caregivers of people living with terminal cancer: Prevalence and predictors.

The issues surrounding a patient's terminal phase of cancer and the imminent death of the individual represent a major family crisis affecting all its members. The goal of this study was to assess the prevalence of psychological morbidity in family caregivers of persons with terminal cancer in terms of psychological distress, depression, anxiety, somatization, and complicated anticipatory grief, and to determine which factors may influence these responses. One hundred and twelve family caregivers of individuals with terminal cancer completed an assessment protocol comprising the Brief Symptom Inventory (depression, anxiety, somatization, and a computed score for global distress), the Marwit-Meuser Caregiver Grief Inventory - Short Form (anticipatory grief), the Family Inventory of Needs (importance and satisfaction of needs), and the Systemic Clinical Outcome Routine Evaluation -15 (family functioning). Prevalence of psychological morbidity was determined through descriptive and frequency statistics. Predictors of psychological morbidity were ascertained through structural equation modelling methods.ResultRegarding the prevalence of psychological morbidity in family caregivers, 66.1% reported high levels of distress, 68.8% showed high risk of depression, 72.3% showed high risk of anxiety, 50.9% reported high levels of somatization, and 25.9% showed high risk of complicated anticipatory grief. It was found that the predictors of age, gender, relationship to the family member with terminal cancer, the caregiving role played (i.e., primary vs. nonprimary), the satisfaction of needs by healthcare professionals, and family functioning play an important role in terms of one's risk of developing psychological morbidity.Significance of resultsThis study revealed an alarming prevalence of psychological morbidity in family caregivers of individuals living with terminal cancer, making it crucial to move forward from a patient-centered approach to a family-centrad approach to reduce the risk of family maladjustment when facing the imminent death of a family member and to prevent postdeath unadjusted responses.

Detecting Predeath Grief in Family Caregivers of Persons With Dementia: Validity and Utility of the Marwit-Meuser Caregiver Grief Inventory in a Multiethnic Asian Population.

Background and ObjectivesCoping with predeath grief (PDG) is an unmet need in caregivers of persons with dementia (PWD). The Marwit-Meuser Caregiver Grief Inventory (MM-CGI) and its abbreviated MM-CGI-Short-Form (MM-CGI-SF) are among the few empirically developed scales that detect PDG, yet they have not been substantially validated outside United States. We evaluated the reliability and validity of the PDG scales in a multiethnic Asian population distinct from that of United States.Research Design and MethodsFamily caregivers of community-dwelling PWD (n = 300) completed self-administered questionnaires containing MM-CGI and other scales of related construct. Sixty percent of the participants repeated the questionnaires 1 week later for test-retest reliability. Internal-consistency reliability was assessed by Cronbach’s α, test-retest reliability by intraclass-correlation-coefficient, construct validity by Spearman’s correlation-coefficient, and factorial validity by confirmatory factor analysis (CFA). Cohen’s κ was used to compare the agreement between MM-CGI and a commonly-used caregiver burden scale (Zarit Burden Interview).ResultsMM-CGI and MM-CGI-SF demonstrated internal-consistency reliability, test-retest reliability, construct validity, and known-group validity. In CFA, MM-CGI showed modest model-fit (comparative-fit-index, CFI = .80; Tucker-Lewis-index, TLI = .79), whereas MM-CGI-SF showed better model-fit (CFI = .91; TLI = .90). Eighty-six percent of the caregivers reported average or high levels of PDG, with 18% reporting high PDG. High scores in the caregiver burden scale only showed modest agreement with high scores in MM-CGI (κ = .47).Discussion and ImplicationsMM-CGI and MM-CGI-SF demonstrated adequate psychometric properties and utility, beyond that of a caregiver burden scale, in detecting high PDG in a multiethnic Asian population. They open the way for PDG intervention in clinical care, as well as further exploration in caregiver research.

Validation of a Spanish Version of the Marwit–Meuser Caregiver Grief Inventory Short Form in a Puerto Rican Sample

Purpose: This study was intended to adapt into Spanish and validate the short form of the Marwit–Meuser Caregiver Grief Inventory (MMCGI), an instrument for the assessment of levels of grief in caregivers of patients with dementia. Method: The adaptation was based on the cross-cultural equivalence model that included forward and backward translations, use of a bilingual committee, and a comprehension test. The validation study was carried out with 100 Puerto Rican caregivers. Results: Semantic and content equivalence were attained as judged by the bilingual committee. Conceptual equivalence was only partially supported as factor analysis failed to replicate the three-factor structure proposed for the original English version. A one-factor structure was the best suitable for the Spanish version. On the other hand, correlations of the total scores of this version of the instrument with measures of constructs expected to be related to grief supported conceptual equivalence. Discussion: The Spanish version of the MMCGI was found equivalent to the English counterpart except for its dimensionality.

PSYCHOMETRIC EVALUATION OF A PRE-DEATH GRIEF (PDG) SCALE FOR DEMENTIA FAMILY CAREGIVERS

Caregiver support in dementia care traditionally focuses on the emotion of stress, with emphasis on improving coping skills and reducing burden. However, the emotional experience of family caregivers can be more complex, and may be better understood with the concept of pre-death grief(PDG). PDG includes a range of emotional responses as caregivers mourn for the psychologically absent patient and anticipate impending losses. It is prevalent among dementia caregivers and is associated with negative consequences. The 50-item Marwit-Meuser Caregiver Grief Inventory(MM-CGI) is a useful measure of PDG. It has three subscales representing different losses, with the Heartfelt Sadness and Longing(HSL) subscale specifically measuring the core of PDG (that is, one’s intrapersonal reactions to lost relationship). Because MM-CGI was never validated outside of USA, we aimed to evaluate its psychometric properties in a multi-ethnic Asian population. Alternatively, we also examined whether the 15-item HSL subscale alone is sufficient as a reliable, valid and unidimensional measurement. Spouses or children of non-nursing home dementia patients were recruited from the clinics of two tertiary hospitals. They completed questionnaires containing the following scales: MM-CGI, Zarit-Burden-Interview(ZBI) and Centre-for-Epidemiologic-Studies-Depression(CES-D). 60% of participants repeated the questionnaires one week later for test-retest reliability. Internal consistency was assessed by Cronbach’s alpha; test-retest reliability by intra-class correlation(ICC); construct validity by correlation with ZBI and CES-D; and confirmatory factor analysis(CFA) by Chi-Square, Standardized-Root-Mean-Square-Residual(SRMR<0.08), Comparative-Fit-Index(CFI>0.90) and Tucker-Lewis-Index(TLI>0.90). Table 1 showed the demographic information. Cronbach’s alpha was 0.97 for MM-CGI and 0.93 for HSL. ICC was 0.94 for MM-CGI and 0.93 for HSL. MM-CGI showed convergent validity with ZBI(Pearson’s r=0.77) and CES-D(r=0.77); and divergent validity with Finance subscale of ZBI(r=0.47) and positive affect subscale of CES-D(r=0.40). HSL showed convergent validity with ZBI(r=0.64) and CES-D(r=0.69); and divergent validity with Finances subscale of ZBI(r=0.37) and Positive Affect subscale of CES-D(r=0.36). In CFA, MM-CGI showed Chi-Square p<0.001, SRMR 0.059, CFI 0.81 and TLI 0.80. HSL had better model-fit, with Chi-Square p<0.001, SRMR 0.046, CFI 0.90 and TLI 0.89. Both MM-CGI and HSL demonstrated reliability and construct validity. However, MM-CGI may require re-exploration of its factor structure. The briefer HSL subscale offers a viable alternative to measuring PDG.

Applicability of the pre-death grief concept to dementia family caregivers in Asia.

ObjectivePre‐death grief is prevalent among dementia family caregivers. When unaddressed, it produces adverse outcomes. With its research primarily conducted in Caucasians, its applicability to non‐Caucasians is uncertain. We explore the existence and the characteristics of pre‐death grief in a multi‐ethnic Asian population using an established pre‐death grief scale—Marwit–Meuser Caregiver Grief Inventory (MM‐CGI).MethodsSeventy‐two dementia family caregivers were recruited from a tertiary hospital. Existence of pre‐death grief was shown by its measurability on MM‐CGI, together with good internal consistency reliability and construct validity. Characteristics of pre‐death grief were explored through multivariate linear regression of MM‐CGI and by comparing MM‐CGI scores with those from the original US study using one‐sample T‐test.ResultsIn the Asian context, pre‐death grief was measurable in a reliable and valid manner. Risk factors of pre‐death grief included caring for patients with severe dementia, spousal relationship and secondary or below education. Influence of culture was palpable—Asians had more worries and felt isolation, and certain ethnicity showed more pre‐death grief.ConclusionsPre‐death grief is applicable even to the non‐Caucasian population. It bears much similarity to that in Caucasians. Yet, its expression is modified by culture. Clinicians working with non‐Caucasian populations need to be sensitive to its presence and to the influence of culture on its expression. © 2015 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

Respite Utilization and Responses to Loss Among Family Caregivers: Relationship Matters

Family caregivers of physically and cognitively impaired older adults face multiple challenges when providing care, including responses to tangible and anticipated losses. However, little is known about the grief experiences of family caregivers and how these might differentially influence the care-related behaviors of spouses and adult children. The present study examined the longitudinal relationship between grief reactions in current spousal and adult-children caregivers (N = 72) and in-home respite utilization over 3 months. The Heartfelt Sadness and Longing subscale of the Marwit–Meuser Caregiver Grief Inventory Short Form (S. J. Marwit & T. M. Meuser, 2005) was used to assess the grief experiences of participants, and demonstrated good internal reliability among spousal and adult-child caregivers of older adults with a variety of cognitive and physical conditions. Although there was not an association between spouses’ grief subscale scores and later respite use, adult children were more likely to use respite after reporting higher levels of grief reactions. This study contributes to our ongoing understanding of differences between spousal and adult-children caregivers of impaired older adults and also lends further support for the reliability and construct validity of the Heartfelt Sadness and Longing subscale of the Marwit–Meuser Caregiver Grief Inventory.

Evidence for grief as the major barrier faced by Alzheimer caregivers: a qualitative analysis.

Feelings of loss and grief are frequent companions for current Alzheimer's family caregivers. Increased acknowledgment and understanding of caregiver grief among researchers has led to more comprehensive explorations of the multifaceted nature of caregiver grief and loss. Absent from the literature, however, is an exploration of anticipatory grief as an actual barrier to the task of caregiving. Through an analysis of 353 open-ended survey responses, the present article explores links between anticipatory grief, ambiguous loss, and principal barriers that family members face as dementia caregivers across the state of Indiana. By drawing parallels between caregiver responses and the Marwit-Meuser Caregiver Grief Inventory subscales, this article illustrates that the fundamental barrier experienced by current Alzheimer's caregivers appears to be a combination of anticipatory grief and ambiguous loss rather than hands-on care issues. The implications of this finding for future caregiver research and interventions are discussed.

Assessing pre‐death grief in cancer caregivers using the Marwit–Meuser Caregiver Grief Inventory (MM‐CGI)

The Marwit-Meuser Caregiver Grief Inventory (MM-CGI) was developed and initially validated with caregivers of persons with Alzheimer's disease, and subsequently evaluated with caregivers of persons with brain injury. The present study examined MM-CGI psychometric and validity properties in 75 caregivers of persons with cancer. As with previous studies, high internal consistency reliability of MM-CGI Total Grief and subscale scores (Personal Sacrifice and Burden, Heartfelt Sadness and Longing, and Worry and Felt Isolation) was demonstrated. Construct validity of the subscale scores was supported by differential associations with other caregiver measures of depression, strain, well-being, and family support. Based on these preliminary results, the MM-CGI appears useful for assessing pre-death grief in caregivers of persons with cancer.

Measuring grief in caregivers of persons with acquired brain injury

Primary objective: To investigate the psychometric and validity properties and applicability of a modified version of the Marwit-Meuser Caregiver Grief Inventory (MM-CGI) for use with caregivers of patients with acquired brain injury (ABI).Research design: Replicate Marwit and Meuser's original psychometric study assessing grief in caregivers of dementia patients.Methods and procedures: The MM-CGI was administered to 28 ABI caregivers along with standardized measures of caregiver strain, depression, well-being and family support.Main outcomes and results: Results for ABI caregivers were similar to those for dementia caregivers with the instrument demonstrating excellent internal consistency reliability for total and sub-scale grief scores and strong divergent validity. Results also parallel those of a recent study of cancer caregivers.Conclusions: The MM-CGI is as useful for diagnosing and treating grief in ABI caregivers as it is for those caring for persons with other serious illnesses.

DEVELOPMENT OF A SHORT FORM INVENTORY TO ASSESS GRIEF IN CAREGIVERS OF DEMENTIA PATIENTS

ABSTRACT This article describes the derivation of a short-form of the Marwit-Meuser Caregiver Grief Inventory (MM-CGI), an inventory designed to measure grief in caregivers of persons with progressive dementia. It presents initial reliability and validity data and describes ways to use the inventory both clinically and scientifically. The resulting MM-CGI Short Form, presented here in its entirety, is comprised of 18 items and, like its full-form relative, is self-scoring and yields a Total Grief score and sub-scale scores measuring factors representing Personal Sacrifice Burden, Heartfelt Sadness and Longing, and Worry and Felt Isolation.