Dementia caregivers’ coping with pre-death grief: effects of a CBT-based intervention

ABSTRACT

Objectives: Pre-death grief plays a significant role in dementia caregiving, and has adverse impacts on caregivers. It was the purpose of the present study to examine whether a cognitive-behavioral intervention including a grief intervention module could increase caregivers’ coping with pre-death grief and whether these effects could be maintained as of a six-month follow-up assessment.

Method: In a randomized-controlled trial examining the effectiveness of a cognitive-behavioral intervention, 273 caregivers were allocated to either an intervention or control group. Intervention group participants received 12 therapy sessions over six months; all participants completed a measure of pre-death grief. The analysis was conducted using latent change models. In the first model, study group was included as a predictor of change in pre-death grief; subsequent models also included care situation and sociodemographic variables.

Results: The burden due to pre-death grief was reduced for intervention but not control group participants at the time of the six-month follow-up assessment (Cohen's d = −0.361). When controlling for changes in the care situation and sociodemographic variables, the treatment effect was also found in the assessment completed post intervention (Cohen's d = −0.248).

Conclusion: Results indicate that a cognitive-behavioral intervention including grief-specific strategies can successfully foster caregivers’ coping with loss and reduce burden of pre-death grief.

KEYWORDS:

• Caregiving and intervention
• cognitive behavioral therapy
• dementia and cognitive disorders
• loss
• mental health caregiving

Acknowledgments

The authors wish to thank all family caregivers who participated in the study. We are also grateful to our colleagues Prof. Dr Renate Soellner, Maren Reder, MPH, and Anna Machmer, MSc at our cooperating institution, the University of Hildesheim. Research was conducted at the Friedrich Schiller University Jena, Germany and the University of Hildesheim, Germany.

Disclosure statement

The authors have reported no conflict of interest.

Additional information

Funding

This work was supported by the German Federal Ministry of Health [grant number IIA5-2512FSB555].