“They are still with us”: Adaptive grief through continuing bonds in bereaved dementia caregivers in an online peer support forum, a netnographic approach

Bereaved dementia caregivers face significant emotional challenges following the death of a person who had lived with dementia. One way some caregivers navigate these challenges may be through ongoing connections with the deceased. Grounded in the Continuing Bonds framework, this qualitative netnographic study analyzed narratives (n = 1,771 threads; approximately 2 million words) from the Alzheimer’s Association’s ALZConnected online peer support forum using reflexive thematic analysis. Findings revealed six themes illustrating how caregivers expressed continuing bonds in ways that appeared to support adaptive grief through meaning-making, relational continuity, identity reconstruction, and enduring emotional connection after death. Continuing bonds were expressed through diverse forms of remembrance, symbolic connection, and legacy-oriented practices. These findings extend prior research by emphasizing adaptive processes alongside vulnerability and highlighting the role of online peer support spaces in sustaining connection with the deceased. Implications include the need for dementia-informed bereavement supports that recognize ongoing bonds as meaningful components of post-bereavement adaptation.