Death and Taxes: A Grounded Theory of Financial Stress, Coping, and Decision-Making Among Diverse Female-Identified Dementia Care Partners

As the population longevity increases, so does the demand for caregivers. The cost for providing unpaid care also continues to increase significantly. Given the weight of this financial burden, it is imperative scientific and clinical communities strive to understand objective income and financial stress, and how these impact decision-making and planning for end-of-life care. Moreover, a nuanced understanding of the component parts of financial stress and subsequent behavior is necessary in order to develop and implement effective interventions. This study employed a constructivist grounded theory approach to investigate the lived experience of financial stress, coping, and decision-making among 18 female identified spousal dementia caregivers. Although end-of-life financial planning was identified as one of the greatest stressors, results revealed caregivers consistently employed avoidant coping and disengagement from end-of-life financial decision-making. Moreover, findings suggest financial stress is a complex and nuanced construct that manifests at each stage of the stress and coping process. Three categories and 13 themes were identified. Implications for scientific advancement and intervention development are discussed.