Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;34(2):258-264.
doi: 10.1002/gps.5014. Epub 2018 Nov 19.

Contrasting the risk factors of grief and burden in caregivers of persons with dementia: Multivariate analysis

Tau Ming Liew  1   2   3 , Bee Choo Tai  3 , Philip Yap  4   5 , Gerald Choon-Huat Koh  3
Affiliations

Contrasting the risk factors of grief and burden in caregivers of persons with dementia: Multivariate analysis

Tau Ming Liew et al. Int J Geriatr Psychiatry. 2019 Feb.

Abstract

Background: Caregivers of persons with dementia (PWD) can experience loss and grief long before the death of the person. While such phenomenon of pre-death grief (PDG) has been increasingly described, we are uncertain how it can be distinct from the well-studied construct of caregiver burden.

Objective: To determine whether there are differences in the risk factors of PDG and caregiver burden to aid in our understanding of the relationship between the two constructs.

Methods: Spouses or children of community-dwelling PWD were consecutively sampled from two tertiary hospitals. They completed questionnaires containing a PDG scale, a caregiver burden scale, and information related to the caregiver and PWD. Risk factors of PDG and caregiver burden were identified using multivariate regression, within which PDG and caregiver burden scores were jointly included as two separate dependent variables.

Results: We recruited 394 caregivers with a mean age of 53.0 years (SD 10.7), majority were Chinese (86.6%), children caregivers (86.3%), and primary caregivers (70.8%). In the regression analyses, we identified three risk factors which were shared by both PDG and caregiver burden (later stage of dementia, behavioral problems in PWD, and primary caregiving role) and three other risk factors which were unique to PDG alone (younger age of PWD, lower educational attainment of caregivers, and spousal caregiver).

Conclusions: The different risk factor profiles evidence a distinction between PDG and caregiver burden. They may possibly be distilled into a framework to direct our approach to PDG interventions, which may include using caregiver burden as an opportunity to initiate conversations on grief, exploring the various aspects of losses and encouraging adaptive coping.

Keywords: burden; caregiver; dementia; pre-death grief; risk factor.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
A postulated framework to conceptualize the relationship among the risk factors of pre‐death grief and caregiver burden, which will require further validation in future studies. The risk factors identified from this study are shown in italics on the top row of the figure
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Mannion E. Alzheimer's disease: The psychological and physical effects of the caregiver's role. Part 1. Nurs Older People. 2008;20(4):27‐32. - PubMed
    1. Gilhooly KJ, Gilhooly MLM, Sullivan MP, et al. A meta‐review of stress, coping and interventions in dementia and dementia caregiving. BMC Geriatr. 2016;16(1):106. - PMC - PubMed
    1. Vitaliano PP, Zhang J, Scanlan JM. Is caregiving hazardous to one's physical health? A meta‐analysis. Psychol Bull. 2003;129(6):946‐972. - PubMed
    1. Toot S, Swinson T, Devine M, Challis D, Orrell M. Causes of nursing home placement for older people with dementia: a systematic review and meta‐analysis. Int Psychogeriatr. 2016;29(2):195‐208. - PubMed
    1. Lwi SJ, Ford BQ, Casey JJ, Miller BL, Levenson RW. Poor caregiver mental health predicts mortality of patients with neurodegenerative disease. Proc Natl Acad Sci U S A. 2017;114(28):7319‐7324. - PMC - PubMed

Publication types