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Beyond individual psychology: Social paradoxes in dementia caregivers' pre-death grief
Author(s)
Date Issued
2026
Citation
Ng, Y. H., & Wang, J. (2026 Jul 7). Beyond individual psychology: Social paradoxes in dementia caregivers' pre-death grief. 23rd IAGG world congress of gerontology and geriatrics, RAI Amsterdam, The Netherlands.
Type
Conference Paper
Abstract
Background
This study challenges the view of pre-death grief in dementia caregiving as an individual psychological response by examining how it emerges from ongoing interactions between caregivers and their social environments.
Study Setup (Methods)
A causal loop diagram was created to map interactions across 11 social domains, based on interviews with 33 dementia caregivers in Singapore, revealing feedback loops in which well-intentioned actions paradoxically intensified grief.
Results
Four paradoxical patterns emerged: efforts to preserve personhood paradoxically limited spontaneous moments of connection that alleviate grief; caregivers' advocacy efforts simultaneously strengthened relationships and created family conflicts; workplace distrust led caregivers to conceal their caregiving to protect careers, but this protective concealment paradoxically required career sacrifices that made the very professional losses it aimed to prevent; and interactions with fellow caregivers reduced grief through downward comparisons but generated discomfort that paradoxically decreased peer engagement.
Discussion
These findings reframe caregivers' pre-death grief experiences as a dynamic social process rather than solely individual psychological responses. The paradoxes reveal how social interactions and structures can inadvertently intensify grief despite caregivers’ efforts to navigate them. Building compassionate communities becomes essential – a relationship-centric and community-led public health palliative care model that mobilizes community resources and advocates for structural changes. This includes transforming workplaces to support rather than stigmatize caregiving and nurturing social networks that enable authentic relationships and sustainable support.
This study challenges the view of pre-death grief in dementia caregiving as an individual psychological response by examining how it emerges from ongoing interactions between caregivers and their social environments.
Study Setup (Methods)
A causal loop diagram was created to map interactions across 11 social domains, based on interviews with 33 dementia caregivers in Singapore, revealing feedback loops in which well-intentioned actions paradoxically intensified grief.
Results
Four paradoxical patterns emerged: efforts to preserve personhood paradoxically limited spontaneous moments of connection that alleviate grief; caregivers' advocacy efforts simultaneously strengthened relationships and created family conflicts; workplace distrust led caregivers to conceal their caregiving to protect careers, but this protective concealment paradoxically required career sacrifices that made the very professional losses it aimed to prevent; and interactions with fellow caregivers reduced grief through downward comparisons but generated discomfort that paradoxically decreased peer engagement.
Discussion
These findings reframe caregivers' pre-death grief experiences as a dynamic social process rather than solely individual psychological responses. The paradoxes reveal how social interactions and structures can inadvertently intensify grief despite caregivers’ efforts to navigate them. Building compassionate communities becomes essential – a relationship-centric and community-led public health palliative care model that mobilizes community resources and advocates for structural changes. This includes transforming workplaces to support rather than stigmatize caregiving and nurturing social networks that enable authentic relationships and sustainable support.
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