"We moved her too soon": Navigating guilt among adult child and spousal caregivers of persons living with dementia following a move into residential long-term care
Open accessAbstract
Guilt is a complex and multifaceted emotion navigated by many family caregivers. Guilt is sometimes experienced following a transition into a residential long-term care facility, even when the move is necessary given high care needs related to Alzheimer's disease and related dementias. This mixed methods study identifies and compares areas of guilt most frequently experienced by spouse and adult child caregivers (N=83) of a family member with dementia following transition into residential long-term care. Nearly half of caregivers reported experiencing guilt from their care recipient, other family members, or facility staff. Quantitative analyses explored variables that predict heightened feelings of guilt, and qualitative thematic analyses provided rich insight into subjective experiences of guilt. Person-specific and situational characteristics influenced caregiver guilt, including level of involvement in care, frequency and quality of visits, and perceptions of the residential long-term care facility. We identify specific opportunities for tailored couple and family psychology interventions including communication strategies, decision-making approaches, focusing on positives, psychoeducation, self-forgiveness exercises, stress management and self-care activities, and validation. The present work informs how counseling interventions can provide practical support by highlighting specific clinical mechanisms that help to alleviate common facets of caregiver guilt following a transition into residential long-term care. Critically, we distinguish variation between spouses and adult children to design treatment plans that best support clients who are caring for a person living with dementia in residential long-term care.
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Emotional responses to transitions for both the individual with dementia and caregivers ranged from guilt and grief to relief and acceptance, depending on the level of preparation and perceived quality of care.
“Emotional responses to transitions for both the individual with dementia and caregivers ranged from guilt and grief to relief and acceptance, depending on the level of preparation and perceived quality of care (Fitzpatrick & Grace, 2019; Statz et al., 2022).”
From Mind the gap: a systematic review of barriers, facilitators, and experiences of care transitions for people living with dementia and their informal caregivers. (2026) · cites this paper as Statz et al., 2022
The Results (Qualitative Results and Facility Context; page not provided) describe caregivers’ guilt, grief and relief after a residential-care move, with guilt varying according to the care recipient’s adjustment and perceived quality of care. The paper describes some care recipients’ distress, but does not establish the claimed range of emotions for both care recipients and caregivers, or link those emotions to the level of preparation or acceptance. (LLM, conf=0.86)
Experimental — accuracy not yet measuredInconsistent or absent social support exacerbated grief, guilt, and uncertainty.
“Conversely, inconsistent or absent social support exacerbated grief, guilt, and uncertainty (Statz et al., 2022).”
From Mind the gap: a systematic review of barriers, facilitators, and experiences of care transitions for people living with dementia and their informal caregivers. (2026) · cites this paper as Statz et al., 2022
The Discussion (page unavailable) links caregivers’ guilt to family dynamics, others’ perceptions, and differences in relatives’ involvement. It does not establish that inconsistent or absent social support exacerbated grief or uncertainty, or directly identify lack of support as the cause of guilt. (LLM, conf=0.78)
Experimental — accuracy not yet measuredFeelings of guilt, shame, and perceived failure were frequently reported, especially when caregivers were influenced by negative societal judgments or the disapproval of other family members.
“Feelings of guilt, shame, and perceived failure were frequently reported, especially when caregivers were influenced by negative societal judgments or the disapproval of other family members (Johannessen et al., 2019; Statz et al., 2022).”
From Mind the gap: a systematic review of barriers, facilitators, and experiences of care transitions for people living with dementia and their informal caregivers. (2026) · cites this paper as Statz et al., 2022
The Results (Quantitative Results; page unavailable) report that 46.3% of caregivers felt guilt attributed to their care recipient, family members, or facility staff. The Discussion (Sources of Guilt; page unavailable) links spouses’ guilt to perceived peer or community judgment and describes guilt associated with other family members, particularly among adult children. The paper does not establish that shame or perceived failure were frequently reported. (LLM, conf=0.86)
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- Authors
- Statz, T. L., Peterson, C. M., Birkeland, R. W., McCarron, H. R., Finlay, J. M., Rosebush, C. E., Baker, Z. G., & Gaugler, J. E.
- Affiliations
- University of Minnesota (US)
- University of Michigan (US)
- ORCID
- Venue
- Couple and Family Psychology Research and Practice
- Published
- 2022-12
- Volume
- 11
- Issue
- 4
- Pages
- 300-314
- ISSN
- 2160-4096 (ISSN-L)
- 2160-410X
- PMC
- PMC9897423
- OpenAlex
- W3161927943
- Cited by
- 37
- References
- 22
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 2 · 2021: 1
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Couple and Family Psychology Research and Practice (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging
- National Institutes of Health (R01AG049692; F32AG064815; UL1TR002240)
- Sponsor name not included
- Topics
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Keywords
- caregiver guilt, dementia, long-term residential care, family caregivers, adult child caregivers, spousal caregivers, transition to long-term care, Alzheimer's disease, caregiver self-care, self-forgiveness, caregiver stress, family communication
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