The Self-Forgiveness Process of Caregivers after the Death of Carereceivers Diagnosed with Alzheimer's Disease

The self-forgiveness process of caregivers after the death of carereceivers diagnosed with Alzheimer's disease

Background and Purpose: Caregivers of deceased carereceivers who were diagnosed with Alzheimer's disease often experience a long period of caregiving. The caregiver may experience significant difficulty adjusting to the death of the carereceiver. The research literature has not included an exploration of caregivers working through self-forgiveness as part of the grief process. The objective of this study was to explore the relationship of self-forgiveness with adaptive coping, religious/spiritual practices, social support, decreased grief, and mental well-being. The study focused on individuals that used the services of hospice organizations, participated in support groups, and resided in retirement communities.

Methods: The study employed an exploratory cross-sectional design using a homogeneous sample of participants. Participants in the study had been caregivers of loved ones who had died of Alzheimer's disease within the two year period prior to the study. Participants were recruited by contacting area organizations that provided hospice care, retirement communities, and community centers and social organizations that work with retired individuals. The agencies and organizations agreed to mail the survey with a cover letter to their list of prospective subjects. The participants in this study ranged in age from 41 to 91 years and they were mostly European American females who were either children or spouses of carereceivers. A total of 426 surveys were received by participants, and 133, or 31%, of the surveys were returned. The measures for the study consisted of an Adaptive Coping Scale which was taken from Zuckerman and Gagne (2003) R-COPE; two religious/spiritual practice questions developed for the study; a 10-item self-forgiveness scale developed for the study; a 12-item social support scale developed for the study; three items from Marwitt and Meuser's (2002) Caregiver Grief Inventory; and a five item version of the General Health Questionnaire (Shamasunder, Sriram, Murali Raj, and Shanmughan, 1986). Data analysis consisted of descriptive statistics, the Pearson Correlational Coefficient, and stepwise-regression.

Results: As hypothesized, the bivariate analysis revealed a significant relationship between self-forgiveness and the five variables: adaptive coping, religious/spiritual practice, social support, decreased grief, and mental well-being. Furthermore, stepwise regression models were computed for the study variables. In the revised self-forgiveness framework decreased grief, adaptive coping and social support were significant in explaining the variation in self-forgiveness. Mental well-being and religious/spiritual practices were not significant explainers of self-forgiveness.

Conclusions and Implications: This is first study to examine the relationship between self-forgiveness and caregiver grief after the death of a carereceiver diagnosed with Alzheimer's disease. Since the concept of self-forgiveness as part of the grieving process had not been address in past research, this study offers new insights. Additional research using more reliable measures of self-forgiveness, religious/spiritual practices, and social support, is needed to further explore the relationship of the variables in this study with a more diverse population.