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Viewing some people living with dementia through a lens of complicated grief
Author(s) -
Ione Adrienne
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.042012
Subject(s) - flourishing , grief , dementia , psychology , disenfranchised grief , agency (philosophy) , psychotherapist , exploratory research , medicine , sociology , disease , social science , pathology
Background The concept of human flourishing holds tremendous global value for policy makers and individuals alike, and in no just society should people living with dementia be excluded. Rather than promoting what is commonly discussed as the most disturbing sequala of neurological disorders and related dementias, a few researchers have flipped BPSD (e.g., agitation, ruminating, pacing, etc.) on its head, arguing that these are expressions of agency (Boyle, 2014; Orulv, 2012; Finkle, 2000 and Kales et al., 2015). Regulation of BPSD needs to be relegated to the background, reframed as a form of agency, and therapeutic techniques aimed at increasing flourishing brought into the foreground (Ryan et al., 2013). One challenge with developing a coherent and systematic therapeutic approach for people living with dementia is determining individual needs (Smith et al., 2013). A view of BPSD, expanding on the notion of exercising one’s agency, is the human need for an attachment figure (Walsh et al., 2019). It has long been established that complicated grief leads to negative overall health and life quality consequences (Prigerson et al., 2008). Grounded in attachment theory, Complicated Grief Treatment (CGT) (Shear et al., 2014), one of the only evidence‐based techniques that has been applied to older adults, holds promise for bridging attachment gaps (Meichsner, 2020). Method Active Capabilities Therapy (ACT), an exploratory, non‐judgmental, integrative, person‐centered approach used to increase flourishing among people living with dementia, incorporates CGT principles. Result The 5‐item brief grief questionnaire (BGQ) is used to assess prolonged grief and is included in the intake assessment of people receiving ACT (Shear and Essock, 2002). The BGQ was used as an interview instrument throughout therapy sessions to measure change in grief. To maintain consistency in the evaluation cycle of CGT component of ACT, data were collected through an unbiased random selection of 6 time points, over 3 years of data collection, from a single case study. Conclusion The efficacy of CGT in people living with dementia, was evidenced by a continued point improvement on the Inventory of Complicated Grief (Prigerson et al., 1995) as well as decreased severity of items listed on NPI‐Q (Cummings, 1994).