scholarly journals The value of personalized psychosocial interventions to address behavioral and psychological symptoms in people with dementia living in care home settings: a systematic review

2014 ◽  
Vol 26 (7) ◽  
pp. 1083-1098 ◽  
Author(s):  
Ingelin Testad ◽  
Ann Corbett ◽  
Dag Aarsland ◽  
Kristin Osland Lexow ◽  
Jane Fossey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Psychological Symptoms ◽  
Care Home ◽  
Psychosocial Interventions ◽  
Good Evidence ◽  
People With Dementia ◽  
Post Test ◽  
Cluster Randomized ◽  
Meta Analyses ◽  
Behavioral And Psychological Symptoms

ABSTRACTBackground:Several important systematic reviews and meta-analyses focusing on psychosocial interventions have been undertaken in the last decade. However, they have not focused specifically on the treatment of individual behavioral and psychological symptoms of dementia (BPSD) with personalized interventions. This updated systematic review will focus on studies reporting the effect of personalized psychosocial interventions on key BPSD in care homes.Methods:Systematic review of the evidence for psychosocial interventions for BPSD, focusing on papers published between 2000 and 2012. All care home and nursing home studies including individual and cluster randomized controlled trials (RCTs) and pre-/post-test studies with control conditions were included.Results:641 studies were identified, of which 40 fulfilled inclusion and exclusion criteria. There was good evidence to support the value of personalized pleasant activities with and without social interaction for the treatment of agitation, and reminiscence therapy to improve mood. The evidence for other therapies was more limited.Conclusions:There is a growing body of evidence indicating specific effects of different personalized psychosocial interventions on individual BPSD and mood outcomes.

Psychosocial Interventions for Family Carers of People With Dementia: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 32 (9) ◽  
pp. 1198-1213 ◽  
Author(s):  
Áine Teahan ◽  
Attracta Lafferty ◽  
Eilish McAuliffe ◽  
Amanda Phelan ◽  
Liam O’Sullivan ◽  
...  
Keyword(s):  
Social Sciences ◽  
Systematic Review ◽  
Positive Impact ◽  
Meta Analysis ◽  
Psychosocial Interventions ◽  
Future Research ◽  
Family Carers ◽  
People With Dementia ◽  
Meta Analyses ◽  
Study Designs

Objective:This study aimed to review and synthesize findings of the effectiveness of psychosocial interventions aimed at improving outcomes for family carers of people with dementia. Method: A systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We systematically searched the following databases: Cochrane, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Excerpta Medica Database (EMBASE), and Applied Social Sciences Index and Abstracts (ASSIA). RevMan 5 software was used to conduct meta-analysis and subgroup analysis using a random-effects model. Results: The search yielded 22 high-quality intervention articles that were suitable for further meta-analysis. Meta-analysis revealed that psychosocial interventions have a small to moderate significant effect on carer burden (standardized mean difference [SMD] = −0.34, confidence interval [CI] = [−0.59, −0.09]), depression (SMD = −0.36, CI = [−0.60, −0.13]), and general health (SMD = 0.34, CI = [0.18, 0.51]). Discussion: Psychosocial interventions had a positive impact on carer outcomes; however, these results should be interpreted with caution, given the significant level of heterogeneity in study designs. Future research could examine contextual and implementation mechanisms underlying psychosocial interventions to develop effective support systems for family carers of people with dementia.

scholarly journals Behavioural and psychological symptoms in dementia and the challenges for family carers: Systematic review

2016 ◽  
Vol 208 (5) ◽  
pp. 429-434 ◽  
Author(s):  
Alexandra Feast ◽  
Martin Orrell ◽  
Georgina Charlesworth ◽  
Nina Melunsky ◽  
Fiona Poland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Norms ◽  
Psychological Symptoms ◽  
Psychosocial Interventions ◽  
Family Carers ◽  
High Quality ◽  
People With Dementia ◽  
Behavioural And Psychological Symptoms ◽  
Fundamental Reason ◽  
Support Programmes

BackgroundTailored psychosocial interventions can help families to manage behavioural and psychological symptoms in dementia (BPSD), but carer responses to their relative's behaviours contribute to the success of support programmes.AimsTo understand why some family carers have difficulty in dealing with BPSD, in order to improve the quality of personalised care that is offered.MethodA systematic review and meta-ethnographic synthesis was conducted of high-quality quantitative and qualitative studies between 1980 and 2012.ResultsWe identified 25 high-quality studies and two main reasons for behaviours being reported as challenging by family carers: changes in communication and relationships, resulting in ‘feeling bereft’; and perceptions of transgressions against social norms associated with ‘misunderstandings about behaviour’ in the relative with dementia. The underlying belief that their relative had lost, or would inevitably lose, their identity to dementia was a fundamental reason why family carers experienced behaviour as challenging.ConclusionsFamily carers' perceptions of BPSD as challenging are associated with a sense of a declining relationship, transgressions against social norms and underlying beliefs that people with dementia inevitably lose their ‘personhood’. Interventions for the management of challenging behaviour in family settings should acknowledge unmet psychological need in family carers.

Exercise training for managing behavioral and psychological symptoms in people with dementia: A systematic review and meta-analysis

2015 ◽  
Vol 24 ◽  
pp. 274-285 ◽  
Author(s):  
Philipe de Souto Barreto ◽  
Laurent Demougeot ◽  
Fabien Pillard ◽  
Maryse Lapeyre-Mestre ◽  
Yves Rolland
Keyword(s):  
Systematic Review ◽  
Exercise Training ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
People With Dementia ◽  
Behavioral And Psychological Symptoms

Implementation of evidence-based, non-pharmacological interventions addressing behavior and psychological symptoms of dementia: a systematic review focused on implementation strategies

2020 ◽  
pp. 1-29
Author(s):  
Sally Bennett ◽  
Kate Laver ◽  
Margaret MacAndrew ◽  
Elizabeth Beattie ◽  
Lindy Clemson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quantitative Methods ◽  
Psychological Symptoms ◽  
Implementation Strategies ◽  
Practice Change ◽  
Evidence Based ◽  
Pharmacological Interventions ◽  
People With Dementia ◽  
Implementation Studies ◽  
Behavioral And Psychological Symptoms

ABSTRACT Objective This study aimed to identify the nature and effects of implementation strategies to increase the use of evidence-based, non-pharmacological interventions designed to reduce the frequency and/or severity of behavioral and psychological symptoms associated with dementia, for people living in the community. Design This was a systematic review of implementation studies. We searched six databases (in January 2019) and hand-searched reference lists of reports. Studies were included if they used quantitative methods evaluating the use of implementation strategies to increase the use of non-pharmacological interventions. These interventions had to have been tested in a randomized controlled trial (RCT) and found to reduce behavioral and psychological symptoms of dementia, for those living in the community. Studies needed to report the effect of the implementation on clinical practice, for example, a change in practice or the adoption of the intervention in community settings. Results Twelve studies were included: 11 one-group pre-post design studies and 1 cluster RCT. All studies reported practice change – the majority implementing a new intervention, with six different types of interventions implemented. All studies reported including using partnerships, new funding, educational strategies, and ongoing support and consultation. Seven implementation studies reported positive outcomes for clients on some aspect of behavior or depression for the person with dementia. Conclusions Implementation studies using multiple implementation strategies to increase the use of non-pharmacological interventions have demonstrated improvements in behavioral and psychological symptoms common in people with dementia, when provided by clinicians as part of their everyday work routines.

TOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6a. QUALITY OF LIFE FOR PEOPLE WITH DEMENTIA LIVING IN RESIDENTIAL AND NURSING HOME CARE: THE IMPACT OF PERFORMANCE ON ACTIVITIES OF DAILY LIVING, BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS, LANGUAGE SKILLS, AND PSYCHOTROPIC DRUGS

2009 ◽  
Vol 21 (6) ◽  
pp. 1026-1030 ◽  
Author(s):  
C. Ballard ◽  
M. Margallo-Lana ◽  
J. T. O'Brien ◽  
I. James ◽  
R. Howard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Psychological Symptoms ◽  
Social Withdrawal ◽  
Care Home ◽  
Well Being ◽  
Nursing Home Care ◽  
People With Dementia ◽  
The Impact ◽  
Behavioral And Psychological Symptoms

The majority of people with dementia develop behavioral and psychological symptoms of dementia (BPSD) at some point during their illness (Jeste et al., 2008). These symptoms, which are especially common among care home residents, are frequently distressing for the patients who experience them (Gilley et al., 2006; Jeste et al., 2008) and problematic for their professional and/or family caregivers. The starting point for our paper “Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs” (Ballard et al., 2001) was to try and understand the impact of BPSD, function and language skills on quality of life in care home residents with dementia. Although there were frequent statements in previous work referring to the capacity of psychiatric and behavioral symptoms to reduce quality of life, we had been unable to identify any empirical evidence to support this clinical impression in a thorough literature review. The parallel validation of Dementia Care Mapping (DCM), predominantly a practice development tool, as an observational measure of well-being/quality of life (Kitwood and Bredin, 1997; Fossey et al., 2002) provided an excellent opportunity to examine this issue in a care home setting. The study focused on 209 people with dementia living in residential and nursing home care in north-east England in the U.K., who received a detailed assessment of BPSD, function and cognition. A DCM evaluation was completed for 112 of these individuals, providing a detailed observational measure of well-being, activities and social withdrawal as indices of quality of life over a six-hour daytime period. To our surprise, there was actually no association between well-being, social withdrawal or activities and BPSD. In contrast, there was a significant association between antipsychotic medication and reduced well-being, social withdrawal and activities respectively, even after controlling for the severity of behavioral disturbance. Using an arbitrary definition of “ill-being”, defined as a well-being score of less than zero, 5% of people not taking antipsychotics, 10% of people taking atypical antipsychotics and 22% of people taking typical antipsychotics were defined as having ill-being. Lower levels of functional ability were also associated with significantly lower well-being, less activities and more social withdrawal. At first this latter finding appears to be contrary to one of the central principles of DCM – namely, that the assessment should be independent of dementia severity. Although high levels of well-being and engagement are possible for people with severe dementia, this probably requires higher staff numbers and a workforce with more specialized skills in order to achieve this.

scholarly journals A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia

2016 ◽  
Vol 29 (8) ◽  
pp. 1308-1349 ◽  
Author(s):  
Kate Laver ◽  
Rachel Milte ◽  
Suzanne Dyer ◽  
Maria Crotty
Keyword(s):  
Systematic Review ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Randomized Controlled ◽  
People With Dementia ◽  
Significant Difference ◽  
Person With Dementia ◽  
Multicomponent Interventions ◽  
Behavioral And Psychological Symptoms

Objective: The aim of this study was to compare the efficacy of two approaches: multicomponent interventions that focus on working with the carer and dyadic interventions that work with both the carer and the person with dementia. Method: A systematic review involving a search of Medline, EMBASE, and PsycINFO in October 2015 was performed. Randomized controlled trials involving carers of people with dementia and comparing multicomponent interventions with usual care were included. Results: Pooling of all studies demonstrated that multicomponent interventions can reduce depressive symptoms, improve quality of life, reduce carer impact, and reduce behavioral and psychological symptoms of dementia as well as caregiver upset with these symptoms. We were unable to find a significant difference in the effects of dyadic interventions in comparison with carer focused interventions for these outcomes. Discussion: Although effect sizes associated with intervention are small, multicomponent interventions are relatively inexpensive to deliver, acceptable, and widely applicable.

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