Dementia caregivers' coping with pre-death grief: effects of a CBT-based intervention.

Objectives
Pre-death grief plays a significant role in dementia caregiving, and has adverse impacts on caregivers. It was the purpose of the present study to examine whether a cognitive-behavioral intervention including a grief intervention module could increase caregivers' coping with pre-death grief and whether these effects could be maintained as of a six-month follow-up assessment.

Method
In a randomized-controlled trial examining the effectiveness of a cognitive-behavioral intervention, 273 caregivers were allocated to either an intervention or control group. Intervention group participants received 12 therapy sessions over six months; all participants completed a measure of pre-death grief. The analysis was conducted using latent change models. In the first model, study group was included as a predictor of change in pre-death grief; subsequent models also included care situation and sociodemographic variables.

Results
The burden due to pre-death grief was reduced for intervention but not control group participants at the time of the six-month follow-up assessment (Cohen's d = -0.361). When controlling for changes in the care situation and sociodemographic variables, the treatment effect was also found in the assessment completed post intervention (Cohen's d = 0.248).

Conclusion
Results indicate that a cognitive-behavioral intervention including grief-specific strategies can successfully foster caregivers' coping with loss and reduce burden of pre-death grief.