Saying hello again rather than a long goodbye: a novel way of addressing pre-death grief and facilitating continuing bonds for dementia caregivers

The ‘Hello Again’ letter-writing intervention is sometimes used in grief counselling to facilitate continuing bonds with the deceased. Family member caregivers of those with dementia often experience a ‘long goodbye’, as the relationship with their loved one gradually changes through serial losses before they have physically died, making the relationship markedly different than the one before the dementia. There are limited interventions to support caregivers with this pre-death grief. This study aimed to address this lack by offering the ‘Hello Again’ intervention to dementia family caregivers, exploring the perceived helpfulness of the task, and attempting to understand the meanings of the ongoing relationship as expressed through letter writing. Two dementia caregivers were recruited to the study. Each participant met with the researcher on several occasions, completed two interviews, which were audio-recorded, and two take-home letter-writing tasks. The audio recordings were transcribed, and both interview data and letters were analysed using Dialogical Narrative Analysis. The analysis revealed positive perceptions of the task, and participants described individual journeys of rediscovery and forgiveness. It was concluded that this study provides initial evidence for a promising innovative intervention to address pre-death grief experiences. Further development and testing of the intervention with a wider range of dementia caregivers is recommended.