Family caregiving for a relative with Alzheimer's dementia: coping with negative choices.

The constant comparative method was used to generate a grounded theory explicating the process of family caregiving for a relative with Alzheimer's dementia. Findings from 20 in-depth, face-to-face interviews conducted with a purposive sample of family caregivers in their homes revealed that much of the caregiving experience consists of coping with negative choices wherein all possible alternatives are undesirable. The three stages of Surviving on the Brink, (1) Taking it on, (2) Going through it, and (3) Turning it over, capture the variation in behavior. Continued validation of this process of coping and decision making offers promise for substantive theory development on which nursing intervention programs for easing caregiver burdens might be based.