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Ng YH, Jiao K, Suen MHP, Wang J, Chow AYM. The role of the social environment on dementia caregivers' pre-death grief: A mixed- methods systematic review. DEATH STUDIES 2024:1-20. [PMID: 38497324 DOI: 10.1080/07481187.2024.2329755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
This systematic review examined the role of social environment in pre-death grief experiences of dementia caregivers. Ninety-three Chinese and English articles were included from a comprehensive search of empirical studies using nine databases. Six social environment domains were generated: the person with dementia, dyadic relationship, family members and the wider community, health and social care services, place of care, and social-cultural contexts. A complex interplay between caregivers and their social environments that aggravate and attenuate pre-death grief experiences is evident. Research has focused mainly on the effects of people with dementia and dyadic relationships and has paid modest attention to the effects of family, relatives, and health and social care services. Caregivers' experiences with their friends, fellow caregivers, the wider community, and social-cultural norms are influential but understudied. Future research could adopt a systems thinking approach with sociological perspectives to generate a comprehensive and nuanced understanding of pre-death grief experiences.
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Affiliation(s)
- Yong Hao Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Keyuan Jiao
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Margaret H P Suen
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Juan Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Lee J, Baik S, Becker T, Cheon J. Themes describing social isolation in family caregivers of people living with dementia: A scoping review. DEMENTIA 2021; 21:701-721. [PMID: 34872364 DOI: 10.1177/14713012211056288] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The number of people with dementia has been increasing. Evidence shows that over 16 million family caregivers provide unpaid care for people with dementia. However, family caregivers experience several challenges throughout their caregiving role, including that of social isolation. Although social isolation in people with dementia has been well documented, social isolation in their family caregivers has not received as much scholarly attention. This scoping review sought to address this dearth of research through the following research question: "What are themes, concepts, or constructs that describe social isolation of family caregivers for people living with dementia?". METHOD An electronic search was conducted in PubMed, PsycInfo, and Scopus, using the following Boolean search phrase: dementia AND "social isolation" AND (caregiver OR carers). Content analysis was conducted to identify relevant themes. FINDINGS The initial search yielded 301 studies. Through screening processes, 13 studies were eligible for review. Based on a synthesis of evidence, five themes emerged from the data: disease progression, psychological state, social networks, social supports, and technology. DISCUSSION This review demonstrates that caregiving is related to social isolation in family caregivers of people living with dementia. The experience of social isolation was related to the progression of dementia, psychological states, and lack of supports. In contrast, social supports, social networks, and using technology may reduce social isolation. Identifying themes provides policy and practice implications, such as using information and communication technology to create and redefine social networks.
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Affiliation(s)
- Joonyup Lee
- 115980University of Maryland School of Social Work, Baltimore, MA, USA
| | - Sol Baik
- 115980University of Maryland School of Social Work, Baltimore, MA, USA
| | - Todd Becker
- 115980University of Maryland School of Social Work, Baltimore, MA, USA
| | - Jihyang Cheon
- 115980University of Maryland School of Social Work, Baltimore, MA, USA
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Flanagan J, Post K, Hill R, DiPalazzo J. Feasibility of a Nurse Coached Walking Intervention for Informal Dementia Caregivers. West J Nurs Res 2021; 44:466-476. [PMID: 33745386 DOI: 10.1177/01939459211001395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study's purpose was to determine the feasibility of a nurse coached walking intervention for informal caregivers of persons with dementia. Participants were randomly assigned to a nurse coached intervention or a control group. Five male and 27 female caregivers (n = 32) participated. Measures included steps, walked well-being, and perceived stress. For steps walked, each group experienced a statistical difference (p = .01 control; p = .02 intervention) and large effect size (0.90). Neither group had a statistical difference in well-being (p = .38 control; p = .08 intervention) or perceived stress (p = .56 control; p = .18 intervention). The intervention group achieved a large effect size in well-being (1.38) and moderate effect size in perceived stress (0.51). A 0.94 pedometer adherence, self-reported user ease with technology and 100% retention rate support feasibility. Many participants described feelings of loneliness and grief, but reported the pedometer motivated them to walk.
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Affiliation(s)
- Jane Flanagan
- Boston College, Chestnut Hill, MA, USA.,Massachusetts General Hospital (MGH), Boston, MA, USA
| | - Kathryn Post
- Massachusetts General Hospital (MGH), Boston, MA, USA
| | - Rebecca Hill
- Boston College, Chestnut Hill, MA, USA.,MGH Institute of Health Professions, Boston, MA, USA
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Oh S, Yu M, Ryu YM, Kim H, Lee H. Changes in Family Dynamics in Caregiving for People With Dementia in South Korea: A Qualitative Meta-Synthesis Study. QUALITATIVE HEALTH RESEARCH 2020; 30:60-72. [PMID: 31502915 DOI: 10.1177/1049732319871254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Living with a person with dementia considerably affects the lives of both the primary caregiver and the entire family. This study aimed to synthesize the findings of qualitative studies that explored dementia caregivers' experiences, to further understand the impact of dementia caregiving on family dynamics. Thirty-seven qualitative studies were analyzed and synthesized according to the meta-synthesis methods suggested by Sandelowski and Barroso. Four themes were identified to describe the impact of dementia caregiving on the family: cracked foundation of the family caused by dementia, voluntary or involuntary setup of a marked boundary of care, family as supportive foreground versus reluctant or interfering background, and re-established relationships within and outside the family. The findings illuminate that dementia caregiving has a destructive impact on the entire family, and therefore, it is imperative to develop interventions and infrastructures for both the caregiver and the entire family of individuals with dementia.
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Affiliation(s)
- Seieun Oh
- Dankook University, Cheonan, South Korea
| | - Mi Yu
- Gyeongsang National University, Jinju, South Korea
| | | | - Haejin Kim
- Suwon Women's University, Suwon, South Korea
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Egilstrod B, Ravn MB, Petersen KS. Living with a partner with dementia: a systematic review and thematic synthesis of spouses' lived experiences of changes in their everyday lives. Aging Ment Health 2019; 23:541-550. [PMID: 29405735 DOI: 10.1080/13607863.2018.1433634] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Dementia causes dramatic changes in everyday-living for spouses. Occured changes in marital relationship, force spouses to perform more both mentally and physically. Leading to a spousal perceived burden. To improve understanding of spouses' needs, spouses lived experiences is needed. The aim was to identify and synthesise qualitative studies on spouses' lived experiences of living with a partner with dementia. METHODS A systematic search was undertaken in January 2017. Six databases (CINAHL, Cochrane Library, Embase, PubMed, PsycINFO and Sociological Abstracts) were searched, using search terms in accordance with PICo. A descriptive synthesis and a thematic synthesis were undertaken. FINDINGS Fifteen studies met the inclusion criteria. Three themes derived from the analysis 1) Noticing changes in everyday life 2) Transformation to a new marital relation in everyday life, with corresponding sub-themes; changes in marital relationship, management of the transitioned marital relation in everyday life 3) Planning the future. CONCLUSION Findings provide an overview of how spouses notice changes and transform their marital relationships in everyday-life. Findings offer a deeper understanding of changes that occurs over time while the partner is living at home. Findings contribute with knowledge on spouses' experiences of changes in early-stages of dementia. Interventions supporting spouses are needed.
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Affiliation(s)
- Barbara Egilstrod
- a Department of Health Science and Technology, Faculty of Medicine , Aalborg University , Denmark
| | - Maiken Bay Ravn
- a Department of Health Science and Technology, Faculty of Medicine , Aalborg University , Denmark
| | - Kirsten Schultz Petersen
- a Department of Health Science and Technology, Faculty of Medicine , Aalborg University , Denmark
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Theurer C, Burgsmüller L, Wilz G. [Care of parents with dementia: comparison of caregiving sons and daughters]. Z Gerontol Geriatr 2018; 52:648-653. [PMID: 30519768 DOI: 10.1007/s00391-018-01483-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/22/2018] [Accepted: 11/16/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In view of the demographic changes and the associated increasing need for care, the role of caregiving sons will also become more important; however, little is known about the caregiving experiences of sons. OBJECTIVE Potential differences between caregiving sons and daughters were investigated with respect to the style of caregiving, the feeling of stress and burden and the utilization of support offers. MATERIAL AND METHODS Baseline survey data from the interventional study Tele.TAnDem conducted from September 2012 to January 2014 were analyzed. From the total sample of 322 caregiving relatives of people suffering from dementia the participating sons (n = 17) were selected. For comparison 17 participants from the subsample of daughters (n = 111) were selected by propensity score matching. The analyses were conducted using t‑tests, Mann-Whitney tests and χ2-tests. RESULTS The analyses regarding the style of caregiving, the feeling of stress and burden and the utilization of professional and informal assistance did not reach statistical significance. Daughters scored on average higher than sons only with respect to the acceptance of the caregiving situation (p < 0.05). CONCLUSION Overall caregiving daughters and sons did not differ with respect to caregiving experiences as strongly as previously assumed. Perhaps earlier studies found more gender differences because caregiving sons compared to daughters already have different initial situations, which however remained uncontrolled.
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Affiliation(s)
- Christina Theurer
- Abteilung Klinisch-Psychologische Intervention, Institut der Psychologie, Friedrich-Schiller-Universität Jena, Semmelweißstraße 12, 07743, Jena, Deutschland.
| | - Lena Burgsmüller
- Abteilung Klinisch-Psychologische Intervention, Institut der Psychologie, Friedrich-Schiller-Universität Jena, Semmelweißstraße 12, 07743, Jena, Deutschland
| | - Gabriele Wilz
- Abteilung Klinisch-Psychologische Intervention, Institut der Psychologie, Friedrich-Schiller-Universität Jena, Semmelweißstraße 12, 07743, Jena, Deutschland
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Burgstaller M, Mayer H, Schiess C, Saxer S. Experiences and needs of relatives of people with dementia in acute hospitals—A meta‐synthesis of qualitative studies. J Clin Nurs 2018. [DOI: 10.1111/jocn.13934] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Melanie Burgstaller
- Department of Nursing Science University of Vienna Vienna Austria
- Institute for Applied Nursing Sciences IPW‐FHS University of Applied Sciences FHS St.Gallen St. Gallen Switzerland
| | - Hanna Mayer
- Department of Nursing Science University of Vienna Vienna Austria
| | - Cornel Schiess
- Institute for Applied Nursing Sciences IPW‐FHS University of Applied Sciences FHS St.Gallen St. Gallen Switzerland
| | - Susi Saxer
- Institute for Applied Nursing Sciences IPW‐FHS University of Applied Sciences FHS St.Gallen St. Gallen Switzerland
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Abstract
Previous literature reveals a high prevalence of grief in dementia caregivers before physical death of the person with dementia that is associated with stress, burden, and depression. To date, theoretical models and therapeutic interventions with grief in caregivers have not adequately considered the grief process, but instead have focused on grief as a symptom that manifests within the process of caregiving. The Dementia Grief Model explicates the unique process of pre-death grief in dementia caregivers. In this paper we introduce the Dementia Grief Model, describe the unique characteristics of dementia grief, and present the psychological states associated with the process of dementia grief. The model explicates an iterative grief process involving three states- separation, liminality, and re-emergence-each with a dynamic mechanism that facilitates or hinders movement through the dementia grief process. Finally, we offer potential applied research questions informed by the model.
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Affiliation(s)
- Kesstan Blandin
- The Dartmouth Centers for Health and Aging, Lebanon, NH, USA
| | - Renee Pepin
- The Dartmouth Centers for Health and Aging, Lebanon, NH, USA; Geisel School of Medicine, The Dartmouth Institute, Lebanon, NH, USA
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Hynninen N, Saarnio R, Elo S. Care practices of older people with dementia in the surgical ward: A questionnaire survey. SAGE Open Med 2016; 4:2050312116676033. [PMID: 27895915 PMCID: PMC5117247 DOI: 10.1177/2050312116676033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 09/27/2016] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The objective of this study was to describe the care practices of nursing staff caring older people with dementia in a surgical ward. METHODS The data were collected from nursing staff (n = 191) working in surgical wards in one district area in Finland during October to November 2015. Data were collected using a structured questionnaire and analyzed statistically. The instrument consists of a total number of 141 items and four dimensions. The dimensions were as follows: background information (12 of items), specific characteristics of older people with dementia in a surgical ward (24 of items), specific characteristics of their care in a surgical ward (66 of items) and use of physical restraints and alternative models for use of restraints for people with dementia (39 of items). RESULTS The questions which measure the nursing staff's own assessment of care practices when caring for people with dementia in surgical wards were selected: counseling people with dementia, reaction when a surgical patient with dementia displays challenging behavior and use of alternative approach instead of physical restraints. Most commonly the nursing staff pay attention to patient's state of alertness before counseling older people with dementia. Instead of using restraints, nursing staff gave painkillers for the patient and tried to draw patients' attention elsewhere. The nursing staff with longer work experience estimate that they can handle the patients' challenging behavior. They react by doing nothing more often than others. They pretend not to hear, see or notice anything. CONCLUSION The findings of this study can be applied in nursing practice and in future studies focusing on the care practices among older people with dementia in acute care environment. The results can be used while developing patient treatments process in surgical ward to meet future needs.
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Affiliation(s)
- Nina Hynninen
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Reetta Saarnio
- Metropolia University of Applied Sciences, Espoo, Finland
| | - Satu Elo
- Metropolia University of Applied Sciences, Espoo, Finland
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Van Bruggen S, Gussekloo J, Bode C, Touwen DP, Engberts DP, Blom JW. Problems experienced by informal caregivers with older care recipients with and without cognitive impairment. Home Health Care Serv Q 2016; 35:11-24. [PMID: 27018745 PMCID: PMC4917916 DOI: 10.1080/01621424.2016.1145166] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The care of older persons can have negative impact on the caregiver. The objective of this population-based observational study is to identify problems experienced by informal caregivers, and the extent of related difficulties, in their care of older care-dependent recipients with and without cognitive impairment. Caregivers (n = 2,704) caring for a home-dwelling person aged ≥ 75 years responded to a questionnaire with 23 questions on problems and related difficulties by mail. Prevalence of self-reported problems and related difficulties was calculated. The impact of the problem was estimated by weighing the percentage of problems reported as being difficult against the prevalence of problems. The median number of problems was 12 (range 0–23), with 5 (range 0–23) reported as difficult. Informal caregivers experience a variety of problems, with the impossibility to engage in joint social activities having the highest impact. The impact of problems increased when the care recipient had a cognitive problem.
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Affiliation(s)
- Sytske Van Bruggen
- a Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands
| | - Jacobijn Gussekloo
- a Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands
| | - Christina Bode
- b Department of Psychology, Health, and Technology , University of Twente , Enschede , The Netherlands
| | - Dorothea P Touwen
- c Department of Health Ethics and Health Law , Leiden University Medical Center , Leiden , The Netherlands
| | - Dick P Engberts
- c Department of Health Ethics and Health Law , Leiden University Medical Center , Leiden , The Netherlands
| | - Jeanet W Blom
- a Department of Public Health and Primary Care , Leiden University Medical Center , Leiden , The Netherlands
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Meyer J, Mc Cullough J, Berggren I. A phenomenological study of living with a partner affected with dementia. Br J Community Nurs 2016; 21:24-30. [PMID: 26692133 DOI: 10.12968/bjcn.2016.21.1.24] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Caring for people affected by dementia is a collective effort that involves public health, primary care, and informal care. The third mainly comprises the efforts of spouses. AIM This study aimed to describe spouses' experiences of living with a partner affected with dementia. METHOD The study has a descriptive phenomenological approach based on a reflective life-world perspective. Seven in-depth interviews were conducted with spouses of persons affected with dementia. The interviews were audiotaped and analysed using the procedures described by Giorgi (2009) . FINDINGS The essence of living with a partner affected by dementia formed a comprehensive theme: from togetherness to loneliness, which along with three descriptive categories-changes in their partner's behaviour, changes in everyday life, and a changed future-describes the phenomenon. CONCLUSION The theme 'From togetherness to loneliness' reflects the spouses' descriptions of their life-world. Daily life changed gradually in line with their partners' personality, and their role became that of a care provider rather than a spouse. Information and knowledge about dementia should be provided at an early stage. Health care has a major responsibility to meet their needs, thus ensuring that all parties are satisfied.
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Affiliation(s)
- Jennie Meyer
- Registered Nurse, Department for Home Care, The Community of Tanum, Tanumshede
| | - Joanne Mc Cullough
- Registered Nurse, Department for Home Care, The Community of Lysekil, Lysekil
| | - Ingela Berggren
- Associate Professor, Department of Nursing, Health and Culture, University West, Trollhättan, Sweden
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Hynninen N, Saarnio R, Isola A. Treatment of older people with dementia in surgical wards from the viewpoints of the patients and close relatives. J Clin Nurs 2015; 24:3691-9. [DOI: 10.1111/jocn.13004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Nina Hynninen
- Department of Nursing Science and Health Administration; Faculty of Medicine; Oulu University Hospital; University of Oulu; Oulu Finland
| | - Reetta Saarnio
- Helsinki Metropolia University of Applied Sciences; Helsinki Finland
| | - Arja Isola
- Department of Nursing Science and Health Administration; Faculty of Medicine; University of Oulu; Kuopio Finland
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Reliability and Validity of the Dutch Translation of the Filial Maturity Measure in Informal Caregivers. JOURNAL OF ADULT DEVELOPMENT 2015; 22:138-147. [PMID: 26294893 PMCID: PMC4537506 DOI: 10.1007/s10804-015-9207-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study explored the reliability and validity of a Dutch translation of the 10-item Filial Maturity Measure (FMM) in a sample of Dutch informal caregivers. The FMM was translated with a forward-backward method and completed by 93 informal caregivers (62 % response rate) with a need dependent parent. Dimensionality of the Dutch FMM was examined by principal component and internal consistency analyses. Criterion validity was examined by assessing correlations with filial love, filial autonomy and level of closeness between parent and child. Construct validity was tested by examining associations with the traits openness and agreeableness. In addition, the relationship with state and trait affectivity was explored. After removal of the item "I worry about turning out like my parent", the original dimensional structure, internal consistency, criterion and construct validity were confirmed. Additional exploration of the relation between the FMM subscales and trait and state affectivity scales demonstrated that filial maturity is at most weakly associated with trait affectivity. Both FMM scales showed a positive partial correlation with negative state affectivity. The Dutch FMM appears to be a reliable and valid instrument for measuring filial maturity of informal caregivers who provide care to their need dependent parent. The (non-)functioning of one item pointed to the necessity to validate the FMM, but also questionnaires in general in different populations.
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Lindauer A, Harvath TA. The Meanings Caregivers Ascribe to Dementia-Related Changes in Care Recipients: A Meta-Ethnography. Res Gerontol Nurs 2015; 8:39-48. [DOI: 10.3928/19404921-20141121-01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 09/11/2014] [Indexed: 11/20/2022]
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Lindauer A, Harvath TA. Pre-death grief in the context of dementia caregiving: a concept analysis. J Adv Nurs 2014; 70:2196-207. [DOI: 10.1111/jan.12411] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Allison Lindauer
- Oregon Health & Science University; School of Nursing; Portland Oregon USA
| | - Theresa A. Harvath
- Oregon Health & Science University; School of Nursing; Portland Oregon USA
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