Effects of Satisfaction with Social Support on Complicated Grief in Bereaved Dementia Caregivers

IlSung Nam; Dhawoon Hyun

doi:10.15384/kjhp.2014.14.2.43

Korean J Health Promot > Volume 14(2); 2014 > Article

Nam and Hyun: Effects of Satisfaction with Social Support on Complicated Grief in Bereaved Dementia Caregivers

Original Article

Korean Journal of Health Promotion 2014;14(2):43-49.

Published online: January 20, 2014

DOI: https://doi.org/10.15384/kjhp.2014.14.2.43

Effects of Satisfaction with Social Support on Complicated Grief in Bereaved Dementia Caregivers

¹Hallym University Institute of Aging, Chuncheon, Korea

²Department of Social Welfare, Graduate School of Hallym University, Chuncheon, Korea

IlSung Nam¹, Dhawoon Hyun^2,

￭ Corresponding author：Dhawoon Hyun, MSW Department of Social Welfare, Graduate School of Hallym University, 1 Hallymdaehak-gil, Chuncheon 200-702, Korea
Tel: +82-10-5797-1957, Fax: +82-33-248-3095 E-mail: tree333h@hanmail.net

Received December 02, 2013 Accepted June 10, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

While complicated grief can lead to adverse health outcomes, social support has been shown to be an important protective factor of its negative effects. The present study investigated the relationship between social support including satisfaction with support, received support, and negative interactions and complicated grief in the transitional context from caregiving to bereavement.

Methods

Bereaved caregivers (n=221) who participated in a multi-site study of dementia caregiving were assessed for complicated grief. Social support measured before and after death were used to examine the longitudinal associations among social support and complicated grief.

Results

We found that caregivers reporting greater increase in satisfaction with social support were likely to experience lower levels of complicated grief, while the amount of received social support did not significantly impact complicated grief. Negative social interaction was significantly associated with the level of complicated grief after the death of the care recipient.

Conclusions

The relationship between social support and complicated grief suggests that satisfaction with social support may be associated with lower levels of complicated grief. Study findings point to the importance of the type of social support for reducing the level of complicated grief.

Keywords: Complicated grief, Social support, Bereavement

Table 1.

Demographic characteristics, social support, and caregiving characteristics

	Mean	SD
Outcome and main predictors
Complicated grief	18.51	12.81
Satisfaction with social support
Before death	5.40	2.30
After death	6.58	2.22
Change	1.18	2.19
Received social support
Before death	13.00	6.55
After death	9.95	8.04
Change	–3.05	8.29
Negative social interaction
Before death	2.69	2.64
After death	2.27	2.15
Change	–0.42	2.17
Continuous covariates
Care recipient age, y	80.91	7.64
Caregiver age, y	64.76	13.47
Time since loss, d	107.87	70.25
Years of caregiving for care recipient	4.38	4.43
Hours per day spent caregiving	13.12	6.69
	N	%
Categorical covariates
Caregiver gender
Female	186	84.16
Male	35	15.84
Care-recipient gender
Female	103	46.61
Male	118	53.39
Caregiver race/ethnicity
Caucasian	146	66.06
African American	45	20.36
Hispanic/Latino	30	13.58
Caregiver education
Did not complete high school	52	23.53
High school graduate	80	36.20
College graduate	89	40.27
Relationship with care-recipient
Non spouse	112	50.68
Spouse	109	49.32
Intervention assignment
Control group	80	36.20
Intervention group	141	63.80
Antidepressant use
No	176	79.64
Yes	45	20.36

Table 2.

Correlations for complicated grief and social support constructs^a

	Correlation coefficient	P^a
Satisfaction with social support
Before death	‐0.10	0.071
After death	‐0.26	<0.001
Change	‐0.16	0.031
Received social support
Before death	0.02	0.142
After death	0.12	0.065
Change	0.10	0.072
Negative social interaction
Before death	0.12	0.065
After death	0.21	0.003
Change	0.06	0.105

^a Assessed by zero-order correlation analysis.

Table 3.

Regression results on relationships between satisfaction with social support and complicated grief^a

	B	SE	P^a
Change in satisfaction with social support	–0.783	0.391	0.041
Caregiver's age	–0.052	0.071	0.471
Care-recipient's age	–0.264	0.112	0.033
Female	–3.591	2.361	0.132
Race (ref group: White)
Black	1.791	2.193	0.412
Hispanic	0.262	2.794	0.934
Caregiver education (ref group: <high school)
High school graduate	–2.564	2.264	0.261
College graduate	–4.734	2.271	0.042
Time since loss	0.023	0.013	0.123
REACH intervention assignment	–1.872	1.774	0.292
Antidepressant use	5.611	2.092	0.011
Years of caregiving for care-recipient	–0.017	0.201	0.934
Hours per day spent caregiving	–0.041	0.131	0.774

^a Assessed by multiple regression analysis.

References

1. Schulz R, Boerner K, Shear K, Zhang S, Gitlin LN. Predictors of complicated grief among dementia caregivers: a prospective study of bereavement. Am J Geriatr Psychiatry 2006;14(8):650-8.

2. Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, Goodkin K, et al. Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med 2009;6(8):): e1000121..

3. Simon NM, Pollack MH, Fischmann D, Perlman CA, Muriel AC, Moore CW, et al. Complicated grief and its correlates in patients with bipolar disorder. J Clin Psychiatry 2005;66(9):1105-10.

4. Prigerson HG, Bierhals AJ, Kasl SV, Reynolds CF 3rd, Shear MK, Day N, et al. Traumatic grief as a risk factor for mental and physical morbidity. Am J Psychiatry 1997;154(5):616-23.

5. Germain A, Caroff K, Buysse DJ, Shear MK. Sleep quality in complicated grief. J Trauma Stress 2005;18(4):343-6.

6. Maytal G, Zalta AK, Thompson E, Chow CW, Perlman C, Ostacher MJ, et al. Complicated grief and impaired sleep in patients with bipolar disorder. Bipolar Disord 2007;9(8):913-7.

7. Burke LA, Neimeyer RA, McDevitt-Murphy ME. African American homicide bereavement: aspects of social support that predict complicated grief, PTSD, and depression. Omega (Westport) 2010;61(1):1-24.

8. Macias C, Jones D, Harvey J, Barreira P, Harding C, Rodican C. Bereavement in the context of serious mental illness. Psychiatr Serv 2004;55(4):421-6.

9. Ogrodniczuk JS, Joyce AS, Piper WE. Changes in perceived social support after group therapy for complicated grief. J Nerv Ment Dis 2003;191(8):524-30.

10. Vanderwerker LC, Prigerson HG. Social support and technological connectedness as protective factors in bereavement. J Loss Trauma 2004;9(1):45-57.

11. Hogan DP, Eggebeen DJ. Sources of emergency help and routine assistance in old age. Soc Forces 1995;73(3):917-36.

12. Gallagher SK, Gerstel N. Kinkeeping and friend keeping among older women: the effect of marriage. Gerontologist 1993;33(5):675-81.

13. Wilsey SA, Shear K. Descriptions of social support in treatment narratives of complicated grievers. Death Stud 2007;31(9):801-19.

14. White DL, Walker AJ, Richards LN. Intergenerational family support following infant death. Int J Aging Hum Dev 2008;67(3):187-208.

15. Bedard M, Raney D, Molloy DW, Lever J, Pedlar D, Dubois S. The experience of primary and secondary caregivers caring for the same adult with Alzheimer's disease. J Ment Health Aging 2001;7(2):287-96.

16. Litwin H, Landau R. Social network type and social support among the old-old. J Aging Stud 2000;14(2):213-28.

17. Mitrani VB, Czaja SJ. Family-based therapy for dementia caregivers: clinical observations. Aging Ment Health 2000;4(3):200-9.

18. Krause N, Markides K. Measuring social support among older adults. In J Aging Hum Dev 1990;30(1):37-53.

19. Somhlaba NZ, Wait JW. Psychological adjustment to conjugal bereavement: do social networks aid coping following spousal death? Omega (Westport) 2008;57(4):341-66.

20. Hebert RS, Dang Q, Schulz R. Preparedness for the death of a loved one and mental health in bereaved caregivers of patents with dementia: findings from the REACH study. J Palliat Med 2006;9(3):683-93.