Dementia Care Research and Psychosocial Factors.

Background: Current research around caregiving for person's with dementia (PWD) has historically emphasized caregiver burden. This leaves a gap of knowledge around other contributors to caregiving's long-term effects, including grief. The current analysis explores the relationship between caregiver grief and quality-of-life.

Method: The Tele-STELLA study is a multi-component, telehealth-based intervention that teaches caregivers strategies to manage upsetting behaviors related to dementia in 8 weekly, 1-hour sessions with professionals. The caregivers in this analysis (n = 138) cared for a family member with moderate to late-stage dementia. A multilinear analysis was used to explore the relationship between grief and quality-of-life for 138 caregivers of PWD. Caregivers were women (73.2%) and white (87.0%), with 82.6% reporting financial security. On average, caregivers were engaged in their roles for 4.64 years (SD 3.69); 87.0% of the PWDs were in the moderate stage of dementia. Pre and post questionnaires queried caregivers about frequency of problematic behaviors and their reactions to the behaviors, grief, and household quality-of-life.

Result: Of the 138 caregivers who started the 8-week intervention, 98 (71%) completed both pre/post self-reported data. Scatterplot visualization demonstrated a linear negative relationship between grief/quality-of-life at both pre and post intervention timepoints. Controlling for sex and care recipient dementia severity, a multilinear regression was performed and showed, at alpha 0.05, a significant negative relationship between quality-of-life and grief (p-value: 0.00, B1: -0.17) at the pre-intervention timepoint. Post-intervention analysis of the same model showed the magnitude of the B1 coefficient of grief changed to -0.22 and an increased significance (p-value: 0.00).

Conclusion: This analysis found that grief in dementia caregiving had a strong negative relationship with quality-of-life and that this relationship became stronger after intervention. This may be due to caregivers' increased awareness of grief, or to the progressive nature of dementia over the 8-week intervention period, but still highlights grief's impact on caregiver quality-of-life. Future longitudinal studies will be necessary to evaluate if grief can serve as a predictor of quality-of-life and long-term health outcomes for caregivers, and how best to leverage that knowledge for interventions in this population.