Preparedness for the Death of a Loved One and Mental Health in Bereaved Caregivers of Patients with Dementia: Findings from the REACH Study

Hebert, Randy S.; Dang, Qianyu; Schulz, Richard

doi:10.1089/jpm.2006.9.683

Cited by 204 publications

(192 citation statements)

References 36 publications

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“…All participants were prior caregivers, and therefore the results may not be generalizable to more diverse samples because of the participants' caregiving experience before death, particularly at the end of the life stage. According to a recent study, many caregivers anticipate and grieve prior to the death of their relatives 21 . It is possible that grieving before death influences the level of complicated grief after death.…”

Section: Discussionmentioning

confidence: 99%

Trajectories of complicated grief

Nam

2015

Eur. J. Psychiat.

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-Background and Objectives:In the discussion of apparent similarities between symptoms of grief and depression, research and theory have often confounded these two constructs because, as a construct, grief is distinct from depression and because these two constructs may have distinct trajectories. This study examines the trajectories of complicated grief and associated risks and the relationship between trajectories of complicated grief and depression.Design: Longitudinal. Setting: Intervention methods for enhancing family caregiving for persons with dementia. Participants: A total of 221 participants of the Resources for Enhancing Alzheimer's Caregiver Health project.Measurement: The Inventory of Complicated Grief. Results:The results based on group-based mixture modeling identify two distinct trajectories of grief (persistently high and low) and three distinct trajectories of depression (persistently high, moderate, and low). There were significant differences between the proportion of grief trajectory membership and that of depression trajectory membership, indicating distinct patterns over time.Conclusions: Noteworthy is the significant difference between the proportion of grief trajectory membership and that of depression trajectory membership, indicating differences in distinct patterns over time.

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Section: Discussionmentioning

confidence: 99%

Trajectories of complicated grief

Nam

2015

Eur. J. Psychiat.

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“…This suggests that preparing families for death is a way to improve care. This approach is further validated by a study that showed that prepared families suffered from less depression and complicated grief [132], and acknowledgment as a terminal illness may also benefit patients ( Table 1).…”

Section: Research Trends In Dementia At the End Of Lifementioning

confidence: 99%

Dying with Dementia: What We Know after More than a Decade of Research

Steen

2010

JAD

224

177

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Abstract. Death with dementia is increasingly common. Although prognostication is difficult, it is an incurable life-limiting illness for which palliative care for the patient is often appropriate. Dementia patients are otherwise at risk of overtreatment with burdensome and possibly non-beneficial interventions and undertreatment of symptoms. Although recent studies indicate encouraging trends of improved palliative care, little evidence supports effectiveness of specific treatments. As of January 2010, at least 45 studies, almost all performed after 2000, have reported on treatment, comfort, symptom burden, and families' satisfaction with care. Over half (25; 56%) of these studies were in US settings, and most were small or retrospective. Few randomized trials and prospective observational studies have been performed so far, but several promising studies have been completed recently or are underway in various countries. Guidelines for care and treatment, still mostly consensus-based, support the benefits of advance care planning, continuity of care, and family and practitioner education. Assessment tools for pain, prognosis, and family evaluations of care have been developed and some have been shown to be effective in clinical practice. With increasing numbers of well-designed, large-scale studies, research in the next decade may result in better evidence-based guidelines and practice.

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“…As palliative care is shifting from the hospital to the community and the home, there is a need for more research focused on understanding informal family caregivers' knowledge and information needs (Docherty et al, 2008). Providing cross-cultural and culturally appropriate information on hospice and end-of-life care will help health professionals enrich communication and provide anticipatory guidance and preparedness for Hawai'i's family caregivers regarding end-of-life care (Hebert, Dang, & Schulz, 2006). Providing cross-cultural strategies to support, inform, and prepare family caregivers will lead to positive consequences and outcomes.…”

Section: Discussionmentioning

confidence: 99%

Hospice utilization of Medicare beneficiaries in Hawai‘i compared to other states

Taira¹,

Kataoka‐Yahiro²,

Angela³

2017

Asian/Pacific Island Nursing Journal

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The objective is to examine hospice utilization among Medicare beneficiaries in Hawai'i compared to other states. Data were from the 2014 Medicare Hospice Utilization and Payment Public Use File, which included information on 4,025 hospice providers, more than 1.3 million hospice beneficiaries, and over $15 billion in Medicare payments. Multivariable linear regression models were estimated to compare hospice utilization in Hawai'i to that of other states. Control variables included age, gender, and type of Medicare coverage. Medicare beneficiaries using hospice in Hawai'i differed significantly from beneficiaries in other states in several ways. Hawai'i beneficiaries were more likely to be Asian (57% vs. 1%, p < .001) and "other race" (10% vs. 0.1%, p < .001), and less likely to be White (28% vs. 84%, p < .001). Hawai'i beneficiaries were also more likely to have Medicare Advantage (55% vs. 30%, p = .05). Regarding primary diagnoses, hospice users in Hawai'i were significantly more likely to have a primary diagnosis of stroke (11% vs. 8%, p = .03) and less likely to have respiratory disease (5% vs. 11%, p = .003). In addition, hospice users in Hawai'i were more likely to use services in their homes (74% vs. 52%, p = .03). Hawai'i hospice users were also less likely to die while in hospice (42% vs. 47%, p = .002). Characteristics of Medicare beneficiaries in Hawai'i differ from those in other states, regarding demographic characteristics, type of coverage, primary diagnoses, likelihood of using services in their homes, and death rates. Further research is needed to better understand factors affecting these differences and whether these differences warrant changes in policy or practice.

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Preparedness for the Death of a Loved One and Mental Health in Bereaved Caregivers of Patients with Dementia: Findings from the REACH Study

Cited by 204 publications

References 36 publications

Trajectories of complicated grief

Trajectories of complicated grief

Dying with Dementia: What We Know after More than a Decade of Research

Hospice utilization of Medicare beneficiaries in Hawai‘i compared to other states

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