Introduction: Dementia family caregiving may span more than a decade and places many family care partners (CPs) at risk for poor bereavement outcomes; estimates of complicated grief in bereaved dementia family CPs range from 10% to 20%. We adapted our efficacious complicated grief group therapy intervention for bereaved dementia caregivers for soon-to-be bereaved dementia CPs at risk for complicated grief to facilitate healthy death preparedness and eventual bereavement-pre-loss group therapy (PLGT).
Methods: In this Stage IB pilot intervention study, we implemented and evaluated PLGT in three psychotherapy group cohorts with family CPs at-risk for complicated grief whose person living with dementia (PLWD) had a life expectancy of 6 months or less and resided in a nursing home.
We evaluated the relationship between grief preparedness and grief experience in 106 family caregivers anticipating or who had experienced the death of a family member with dementia. Using a phenomenological lens to discern a process of meaning-making in narratives, we found preparation that included positive construction of memories, death as the end of suffering, relationship resolution, and shared construction of meaning were associated with positive grief. Those caregivers who experienced the family member's decline as traumatic, caregiver role loss, unavailable support, and difficulties creating a new life reported inadequate death preparation, and difficulty making meaning of the illness and death.
View Article and Find Full Text PDFHealth professions trainees' performance in teams is rarely evaluated, but increasingly important as the healthcare delivery systems in which they will practice move towards team-based care. Effective management of care transitions is an important aspect of interprofessional teamwork. This mixed-methods study used a crossover design to randomise health professions trainees to work as individuals and as teams to formulate written care transition plans.
View Article and Find Full Text PDFJ Soc Work End Life Palliat Care
September 2016
Caring for a person with Alzheimer's disease is challenging and often has negative health and mental health effects that, for 7-20% of caregivers, persist into bereavement in the form of complicated grief. Complicated grief is a state of prolonged and ineffective mourning. An under-recognized phenomenon in dementia care and bereavement is "sudden-on-chronic death.
View Article and Find Full Text PDFSome older adults are more vulnerable to housing concerns due to physical and cognitive challenges, including those with a neurocognitive disorder who need extensive support. Environmental gerontology frameworks, including Wiseman's 1980 Behavioral Model of Elderly Migration, have informed scholarship on aging in place and relocation. Understanding Wiseman's model, including considerations for working with families confronting a neurocognitive disorder, can help practitioners ensure that older clients live in settings that best meet their wants and needs.
View Article and Find Full Text PDFThe experience of aging may necessitate transitions in living environments, either through adaptations to current residences or through relocations to more supportive environments. For over a half century, the study of these transitions has informed the work of researchers, health and mental health providers, policymakers, and municipal planners. In the 1970s and 80s, knowledge about these transitions advanced through Lawton and Nahemow's ecological theory of competence and environmental press, Wiseman's behavioral model of relocation decision making, and Litwak and Longino's developmental perspective on senior migrations.
View Article and Find Full Text PDFJ Gerontol Soc Work
December 2013
Social workers in diverse service systems throughout the United States encounter many opportunities for improving quality of life for people with dementia and their families. Yet practice with this population is unclearly defined and a core set of competencies for such practice does not yet exist. Instead, it is shaped by roles within aging and health systems.
View Article and Find Full Text PDFAdvancing the development of drugs for the prevention and treatment of Alzheimer's disease (AD) is dependent on the ability of investigators to identify, recruit, and retain appropriate subjects in clinical trials. Innovations in care that link primary-care providers with AD researchers can help overcome barriers to early, specific diagnosis and access to research studies. Collaborative care provides a new paradigm for the mutual benefit of patients, providers, and AD research.
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