Predictors of well-being in bereaved former hospice caregivers: the role of caregiving stressors, appraisals, and social resources.
OBJECTIVE
The current literature on caregiving and bereavement indicates that the relationship between these two common life events is complex and needs to be further studied in order to gain a more comprehensive understanding of their interaction.


METHODS
In the current project, 50 spouses of hospice patients with end-stage lung cancer or dementia were assessed while caregiving and at an average of 4 months after the death on a variety of measures, including caregiving stressors, appraisals, social resources, and well-being. A stress process model was utilized in order to examine which preloss factors were associated with postloss depression, life satisfaction, and grief.


RESULTS
Our results indicated that patient diagnosis (cancer or dementia) and caregiver appraisals (stressfulness of functional impairment and positive aspects of caregiving) were not predictors on any of our well-being outcomes. However, fewer months caregiving was a significant predictor of both higher depression and grief postloss. Additionally, lower levels of social activities, smaller social networks, and lower satisfaction with social support were significantly associated with higher postloss depression.


CONCLUSIONS
Results support both the resource depletion and anticipatory grief hypotheses and suggest that short-term bereavement outcomes are different than factors that predict well-being while caregiving. Future studies should address whether long-term bereavement outcomes differ by baseline caregiving characteristics to guide intervention research.
Burton
Allison M
AM
Center for Health Services Research in Primary Care, Durham VAMC/Duke University Medical Center, Durham, North Carolina 27705, USA. allison.burton@duke.edu
Haley
William E
WE
Small
Brent J
BJ
Finley
Margaret R
MR
Dillinger-Vasille
Marie
M
Schonwetter
Ronald
R
D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D003704:Dementia / Q000523:psychology; D003863:Depression / Q000175:diagnosis; D005260:Female; D017051:Hospice Care / Q000523:psychology*; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012944:Social Support; D018454:Spouses / Q000523:psychology*