Caregiver depression after bereavement: chronic stress isn't over when it's over.

Although the adverse mental health consequences of caregiving for a relative with a progressive dementia are well documented, little is known about caregivers' adaptation after bereavement. This longitudinal study examined changes in three groups: continuing caregivers, who had been caregiving across a 4-year period (n = 98), bereaved caregivers, whose impaired relative died between Years 1 and 4 (n = 49), and controls (n = 107). Although a mean of 19.8 months had elapsed since bereavement by Year 4, bereaved and continuing caregivers did not differ on syndromal depression or depressive symptoms; both groups were significantly more depressed than controls. Time since bereavement was unrelated to depression or social support. Those caregivers who ruminated more about caregiving after bereavement reported more depression, greater stress, and greater social isolation.