The grief experienced by spousal caregivers of dementia patients: the role of place of care of patient and gender of caregiver.

A comparison of the grief responses of spousal caregivers who cared for their demented partners at home with those who provided ongoing nursing home care, together with an examination of gender differences, is reported here. Four psychological states of grief were examined: anxiety, sadness, anger, and guilt. Sixty spousal caregivers participated in the study: thirty husbands and thirty wives, with equal numbers of home and nursing home caregivers. Content analysis scales were scored to assess the four psychological states. A self-rating, adjective mood scale was also used as a secondary measure of those states. A personal construct model of spousal caregivers' bereavement for their demented partners was developed and provided the two hypotheses about differences in grieving. As predicted, nursing home caregivers expressed significantly higher levels of sadness and guilt than home caregivers. Against prediction, home caregivers expressed significantly more anger than nursing home caregivers. Home caregiving wives were found to be the most angry cohort. Also, as predicted, caregiving wives expressed significantly higher levels of anxiety, sadness, and anger than caregiving husbands. The results of the content analysis scales were confirmed by the secondary measure, but the former measure proved more powerful for detecting statistically significant differences. The inclusion of severity of the patients' dementia, and the spiritually and age of the spousal caregivers as covariates in the statistical analyses showed place of care and gender of caregiver to remain the most powerful predictors of the four psychological states of grief.