Pre-death grief in the context of dementia caregiving: a concept analysis

J Adv Nurs. 2014 Oct;70(10):2196-207. doi: 10.1111/jan.12411. Epub 2014 Apr 7.


Aim: The aim of this study was to report on an analysis of the concept of pre-death grief in the context of dementia family caregiving.

Background: Research indicates that witnessing changes and losses in a family member with dementia can lead to pre-death grief. Pre-death grief is associated with depression, burden and maladaptive caregiver coping. However, the concept lacks a refined definition and blurs with similar constructs.

Design: Concept analysis using a hybrid of Penrod and Hupcey's principle-based concept analysis and Chin and Kramer's conceptualization of meaning.

Data sources: 49 peer-reviewed papers (2000-2013) that addressed pre-death grief in dementia family caregivers were used for the principle-based analysis; two examples from the popular media were used for the analysis of conceptual meaning.

Methods: The scientific papers were examined for epistemological, linguistic, pragmatic and logical clarity. The two examples from the popular media were explored for conceptual meaning.

Results: Pre-death grief in the context of dementia caregiving is a meaningful concept found in the popular media. From a scholarly point of view, it is an emerging concept. A definition is offered to advance conceptual clarity. Discussion focuses on advancing the concept into a situation-specific middle-range theory of pre-death grief in family caregiving.

Conclusions: The concept of pre-death grief has salience for researchers and caregivers. This analysis lays the foundation for use of the concept in nursing research and practice across cultural, environmental and illness domains.

Keywords: caregiving; concept analysis; dementia; family care; grief; loss; nursing; pre-death grief; sorrow.

MeSH terms

  • Caregivers / psychology*
  • Death
  • Dementia / nursing*
  • Family / psychology*
  • Grief*
  • Humans