The Mourning Process of People with Moderate and Severe Alzheimer's Disease who Lost Their Spouse

Abstract

Purpose
The aim of this study was to reveal the mourning process of older people with moderate and severe Alzheimer's disease (people with dementia) who had lost their spouse and to consider the mourning process in Japanese Buddhist rituals for the purpose of devising a nursing intervention for them.
Methods
A 60-minute semi-structured interview was conducted with each family and two professionals. Qualitative content analysis was used to identify mourning aspects of the widows with dementia.
Results
Participants were 3 families and 2 professionals. Extracted data from the interviews were categorized according to similar meaning, then put into time period and dementia stage order for analysis. The mourning process of people with dementia includes the followings: Bereaved - funeral; people with dementia recognized the death of their spouse when their spouse passed away and at the funeral but couldn't remember it. Funeral - 1 year; people with dementia believed their spouse was alive, which resulted in asking about their spouse at home but at no other place. 1 - 2 years; people with dementia mentioned 'if he had lived longer, we would have taken a family picture together'. The family had explained to people with dementia about their spouse's death repeatedly for nearly 2 years since their spouse died.
Discussion
This study confirms that joining rituals, such as funerals, is not enough for people with dementia to remember their spouse's death. We also find that it is crucial to take personal history into account when caregivers explain the bereavement to allow people with dementia to guess reality.