Background: Although it has been suggested that family and friends who are prepared for the
death of a loved one have less distress, the relationship between preparedness and bereavement
mental health is inconclusive.
Objectives: To determine the relationship between preparedness for the death and mental
health in bereaved caregivers of dementia patients and explore predictors of preparedness.
Design: A prospective study of family caregivers of persons with dementia. Standardized
assessment instruments and structured questions were used to collect data at study entry and
at 6, 12, and 18 months. Multiple caregiving-related variables were collected. Bereaved caregivers
reported whether they were "not at all" prepared or prepared for the death of their
loved one.
Subjects: Two hundred twenty-two bereaved caregivers
Results: Twenty-three percent of caregivers were not prepared for the death. These caregivers
had more depression, anxiety, and complicated grief symptoms. Black caregivers, caregivers
with less education, those with less income, and those with more depressive symptoms
prior to the death were more likely to perceive themselves as "not at all" prepared. In contrast,
the amount of pain the care recipient was in prior to death was positively associated
with preparedness.
Conclusions: Despite providing high-intensity care, often for years, many bereaved caregivers
perceived themselves as unprepared for the death. These caregivers had more depression,
anxiety, and complicated grief symptoms. Future work should be directed to confirming
these findings and determining how best to intervene with high-risk caregivers.
