Pre-death grief among family caregivers of individuals living with cognitive impairment and dementia: a comprehensive review of theory, research, clinical assessment, and psychotherapy

Family caregivers of individuals living with cognitive impairment and dementia often experience pre-death grief reactions, which constitute a significant risk factor for both pre- and post-bereavement distress, as well as functional difficulties that may require professional intervention. While this issue has historically received less attention compared to the focus on family members' experiences of burden, stress, and depression, recent years have seen a marked increase in scientific interest and recognition of pre-death grief reactions. Therefore, the purpose of this article is to provide a comprehensive review of the current body of scientific knowledge on pre-death grief among individuals caring for family members living with cognitive impairment and dementia, with an emphasis on several key areas of inquiry. The article begins with an overview of the phenomenon at the centre of the discussion. It then introduces relevant theoretical concepts and key models in the field. Subsequently, clinical assessment methods are outlined, followed by a review of evidence-based treatment options for family caregivers, with particular attention to psychotherapy targeting pre-death grief within the context of dementia. The final section presents conclusions, and outlines future directions for research.