Do anticipatory grief and preparedness affect distress in bereaved caregivers?

1. Do anticipatory grief and preparedness affect distress in bereaved caregivers? Increased risk of depression and complicated grief during bereavement was significantly associated with pre-loss measurements of low preparedness and presence of anticipatory grief in family caregivers of terminally ill patients. Highest prevalence of depression was found in older female spouses and highest prevalence of complicated grief was found in older spouses. These findings are consistent with previous studies, although we hypothesized a higher prevalence of complicated grief in female caregivers. Health professional shouldbeaware of pre-losslevels of preparedness and anticipatorygriefamongfamilycaregivers as theseconstitute potential risk factors for depression and complicatedgrief post-loss, especially in spouses. Nielsen M.K.1,2,, Guldin M.-B.1,3, Neergaard M.A.3, Jensen A.B.2, Bro F.1 1Research Unit for General Practice, Aarhus University, 2Department of Oncology, Aarhus University Hospital, 3The Palliative Team, Department of Oncology, Aarhus University Hospital Familycaregivers: Previous studies have foundincreasedrisk of depression and complicatedgriefduringbereavementamongcaregivers. Low preparedness for impendingdeath and anticipatorygriefseem to berisk factors for depression and complicatedgrief. Large-scale studies of familycaregiversarescarce. Aim: To study the association of two possible risk factors, pre-loss preparedness and anticipatory grief, with depression and complicated grief Background Response rates were 38% for Q1 and 87% for Q2. Prevalence of depression was 19% and highest in older female spouses. Prevalence of complicated grief was 6% and highest in older spouses. (Table 1) Association with depression post-loss: Risk of depression post-loss increased if caregiver had a low preparedness score (RR=1.6) or experienced anticipatory grief pre-loss (RR=3.2). (Table 1) Association with complicated grief: Risk of complicated grief increased if caregiver had a low preparedness score (RR=2.3) or experienced anticipatory grief pre-loss (RR=6.0). (Table 1) Results Terminally ill patients eligible for drug reimbursement* in 2012 received a request to pass on a questionnaire to closest caregiver (Q1). Responding caregivers of patients who died within six months received a follow-up questionnaire six months post-loss (Q2). Inclusion and exclusion criteria are displayed in Figure 1. Presented results are based on data ready for analysis from 1,093 caregivers who completed both Q1 and Q2. Method Table 1: Measurements, prevalence and results *Reported by doctor to the Danish Health and Medicines Authority Figure 1: Flow chart of respondees and non-respondees *p-value<0.05 usingWilcoxon-Mann-Whitneyranksum-test #p-value<0.05 using Chi-2 test For furtherinformation, pleasecontact: Mette.nielsen@alm.au.dk Conclusion