scholarly journals Psychosocial interventions for people with dementia: a synthesis of systematic reviews

2018 ◽  
Vol 23 (4) ◽  
pp. 393-403 ◽  
Author(s):  
Orii McDermott ◽  
Georgina Charlesworth ◽  
Eef Hogervorst ◽  
Charlotte Stoner ◽  
Esme Moniz-Cook ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Psychosocial Interventions ◽  
People With Dementia

scholarly journals Updated meta-review of evidence on support for carers

2018 ◽  
Vol 23 (3) ◽  
pp. 196-207 ◽  
Author(s):  
Jane Dalton ◽  
Sian Thomas ◽  
Melissa Harden ◽  
Alison Eastwood ◽  
Gillian Parker
Keyword(s):  
Mental Health ◽  
Systematic Reviews ◽  
Mental Health Problems ◽  
Psychosocial Support ◽  
Psychosocial Interventions ◽  
Negative Effects ◽  
High Quality ◽  
People With Dementia ◽  
Meta Review

Objective To update a 2010 meta-review of systematic reviews of effective interventions to support carers of ill, disabled, or older adults. In this article, we report the most promising interventions based on the best available evidence. Methods Rapid meta-review of systematic reviews published from January 2009 to 2016. Results Sixty-one systematic reviews were included (27 high quality, 25 medium quality, and nine low quality). The quality of reviews has improved since the original review, but primary studies remain limited in quality and quantity. Fourteen high quality reviews focused on carers of people with dementia, four on carers of those with cancer, four on carers of people with stroke, three on carers of those at the end of life with various conditions, and two on carers of people with mental health problems. Multicomponent interventions featured prominently, emphasizing psychosocial or psychoeducational content, education and training. Improved outcomes for carers were reported for mental health, burden and stress, and wellbeing or quality of life. Negative effects were reported in reviews of respite care. As with earlier work, we found little robust evidence on the cost-effectiveness of reviewed interventions. Conclusions There is no ‘one size fits all’ intervention to support carers. There is potential for effective support in specific groups of carers, such as shared learning, cognitive reframing, meditation, and computer-delivered psychosocial support for carers of people with dementia. For carers of people with cancer, effective support may include psychosocial interventions, art therapy, and counselling. Carers of people with stroke may also benefit from counselling. More good quality, theory-based, primary research is needed.

scholarly journals Psychosocial intervention for carers of people with dementia: What components are most effective and when? A systematic review of systematic reviews

2016 ◽  
Vol 29 (1) ◽  
pp. 31-43 ◽  
Author(s):  
Claire Dickinson ◽  
Johanne Dow ◽  
Grant Gibson ◽  
Louise Hayes ◽  
Shannon Robalino ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Psychological Health ◽  
Effective Means ◽  
Cost Effective ◽  
Psychosocial Interventions ◽  
Future Research ◽  
Group Format ◽  
People With Dementia ◽  
Informal Carers ◽  
The Cost

ABSTRACTBackground:Psychosocial interventions for carers of people with dementia are increasingly recognized as playing an important role in dementia care. We aim to systematically review the evidence from existing systematic reviews of psychosocial interventions for informal carers of people with dementia.Methods:Thirty-one systematic reviews were identified; following quality appraisal, data from 13 reviews, rated as high or moderate quality, were extracted.Results:Well-designed, clearly structured multi-component interventions can help maintain the psychological health of carers of people with dementia and delay institutionalization of the latter. To be most effective, such interventions should include both an educational and a therapeutic component; delivery through a support group format may further enhance their effectiveness.Conclusions:Successful translation of evidence into practice in this area remains a challenge. Future research should focus on determining the most cost-effective means of delivering effective multi-component interventions in real-world settings; the cost-effective potential of technology-based interventions is considerable.

An extended review of couple-centred interventions in dementia: Exploring the what and why — Part B

Dementia ◽  
2017 ◽  
Vol 18 (7-8) ◽  
pp. 2450-2473 ◽  
Author(s):  
Therése Bielsten ◽  
Ingrid Hellström
Keyword(s):  
Relationship Quality ◽  
Caregiver Burden ◽  
Web Of Science ◽  
Adult Child ◽  
Psychosocial Interventions ◽  
People With Dementia ◽  
Scoping Reviews ◽  
As Relationship ◽  
Academic Search ◽  
Extended Review

This scoping review is an extended version of a narrative review of couple-centred interventions in dementia shared in part A and the previous publication in this edition. The rationale for expanding study A emerged through the fact that most dyadic interventions have samples consisting of a majority of couples. The exclusion of interventions with samples of mixed relationships in part A therefore contributed to a narrow picture of joint dyadic interventions for couples in which one partner has a dementia. The aim of this second review is to explore the ‘what’ (types of interventions) and the ‘why’ (objectives and outcome measures) of dyadic interventions in which sample consists of a majority of couples/spouses and in which people with dementia and caregivers jointly participate. Method A five-step framework for scoping reviews guided the procedure. Searches were performed in Academic Search Premier, CINAHL, PsycINFO, PubMed, Scopus, and Web of Science. Results Twenty-one studies with various types of psychosocial interventions were included. The main outcome measure for people with dementia was related to cognitive function, respectively caregiver burden and depression for caregivers. Conclusions The findings of this extended review of joint dyadic interventions in dementia are in line with the findings of part A regarding the negative approach of outcomes, lack of a genuine dyadic approach, lack of tailored support, neglect of interpersonal issues and the overlook of the views of people with dementia. This review also recognises that measures of caregiver burden, as well as relationship quality should be considered in samples of mixed relationships due to the different significance of burden and relationship quality for a spouse as opposed to an adult child or friend.

scholarly journals How to Achieve the Desired Outcomes of a Complex Intervention in Nursing Homes: A Theory of Change

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 383-383
Author(s):  
Martin Dichter ◽  
Jonas Hylla ◽  
Almuth Berg ◽  
Daniela Eggers ◽  
Ralph Möhler ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Psychosocial Intervention ◽  
Sleep Disturbances ◽  
Intervention Development ◽  
Psychosocial Interventions ◽  
Causal Chain ◽  
Theory Of Change ◽  
Expert Survey ◽  
People With Dementia ◽  
Individual Knowledge

Abstract Background Recent systematic reviews suggest the effectiveness of complex psychosocial interventions to reduce sleep disturbances in people with dementia (PwD) living in nursing homes. However, it is unclear how and under which circumstances these interventions work and which components and processes are crucial determinants for effectiveness. Objectives To develop a Theory of Change (ToC) that describes a causal chain for the reduction of sleep disturbances. Design and Methods The ToC approach is a participatory method in intervention development to generate knowledge about how, why, and under which circumstances interventions are effective. We conducted two expert workshops, a subsequent expert survey (n=12), a systematic literature review, and expert interviews (day and night nurses). Results Necessary preconditions for the reduction of sleep disturbances were identified on staff, management and cultural levels of nursing homes. Intermediate goals like “individual knowledge on PwD is available”, “a specific institutional concept to promote sleep is implemented”, “person-centred care is implemented” and “sleep preferences of PwD are fulfilled” were defined. The intermediate goals, interventions, promoting and inhibiting factors as well as rationales were sorted into a causal chain. All intermediate goals were rated as relevant or highly relevant based on the expert survey. Conclusions The ToC model displays how a complex psychosocial intervention is likely to be effective in reducing sleep disturbances and meeting sleep preferences of PwD in nursing homes. The model is the basis for the development and evaluation of a planned complex psychosocial intervention to prevent and reduce sleep disturbances in PwD.

Effectiveness of psychosocial interventions in reducing grief experienced by family carers of people with dementia

2017 ◽  
Vol 15 (3) ◽  
pp. 809-839 ◽  
Author(s):  
Sally Wilson ◽  
Christine Toye ◽  
Samar Aoun ◽  
Susan Slatyer ◽  
Wendy Moyle ◽  
...  
Keyword(s):  
Psychosocial Interventions ◽  
Family Carers ◽  
People With Dementia

Non-pharmacological interventions in care homes, with particular emphasis on the treatment of people with dementia

2020 ◽  
pp. 265-280
Author(s):  
Ian A. James ◽  
Alan Howarth
Keyword(s):  
Psychosocial Interventions ◽  
Care Homes ◽  
Future Research ◽  
Pharmacological Interventions ◽  
Cognitive Health ◽  
Care Plans ◽  
People With Dementia ◽  
The Individual ◽  
The Uk ◽  
Preventative Interventions

In the UK there are over 22,000 care homes, largely run by the private and charitable sectors, caring for 416,000 people. The residents in care homes present with a range of needs linked to physical health, cognitive health, and mental health. A large proportion of residents in care homes have dementia and many of them exhibit Behaviours that Challenge (BtC). This chapter focuses on the non-pharmacological interventions available in care homes to help treat BtC that occur in the context of dementia. It discusses preventative interventions designed to promote the wellbeing of people with dementia, and reviews the evidence. Formulation-led interventions identify the needs of the individual and lead to the development of person-centred care plans and the evidence strongly supports that these are needed to deliver effective psychosocial interventions in care homes. Finally, the chapter discusses the implications for future research.

scholarly journals Which moral barriers and facilitators do physicians encounter in advance care planning conversations about the end of life of persons with dementia? A meta-review of systematic reviews and primary studies

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038528
Author(s):  
Angela JJM Keijzer-van Laarhoven ◽  
Dorothea P Touwen ◽  
Bram Tilburgs ◽  
Madelon van Tilborg-den Boeft ◽  
Claudia Pees ◽  
...  
Keyword(s):  
End Of Life ◽  
Family Caregivers ◽  
Advance Care Planning ◽  
Systematic Reviews ◽  
Moral Dilemmas ◽  
Barriers And Facilitators ◽  
Care Planning ◽  
People With Dementia ◽  
Meta Review ◽  
Advance Care

Importance and objectiveConducting advance care planning (ACP) conversations with people with dementia and their relatives contributes to providing care according to their preferences. In this review, we identify moral considerations which may hinder or facilitate physicians in conducting ACP in dementia.DesignFor this meta-review of systematic reviews and primary studies, we searched the PubMed, Web of Science and PsycINFO databases between 2005 and 30 August 2019. We included empirical studies concerning physicians’ moral barriers and facilitators of conversations about end-of-life preferences in dementia care. The protocol was registered at Prospero (CRD42019123308).Setting and participantsPhysicians and nurse practitioners providing medical care to people with dementia in long-term and primary care settings. We also include observations from patients or family caregivers witnessing physicians’ moral considerations.Main outcomesPhysicians’ moral considerations involving ethical dilemmas for ACP. We define moral considerations as the weighing by the professional caregiver of values and norms aimed at providing good care that promotes the fundamental interests of the people involved and which possibly ensues dilemmas.ResultsOf 1347 studies, we assessed 22 systematic reviews and 51 primary studies as full texts. We included 11 systematic reviews and 13 primary studies. Themes included: (1) beneficence and non-maleficence; (2) respecting dignity; (3) responsibility and ownership; (4) relationship and (5) courage. Moral dilemmas related to the physician as a professional and as a person. For most themes, there were considerations that either facilitated or hindered ACP, depending on physician’s interpretation or the context.ConclusionsPhysicians feel a responsibility to provide high-quality end-of-life care to patients with dementia. However, the moral dilemmas this may involve, can lead to avoidant behaviour concerning ACP. If these dilemmas are not recognised, discussed and taken into account, implementation of ACP as a process between physicians, persons with dementia and their family caregivers may fail.

scholarly journals A systematic meta-review of self-management support for people with dementia

Dementia ◽  
2018 ◽  
Vol 19 (2) ◽  
pp. 253-269
Author(s):  
Judith G Huis in het Veld ◽  
Renate Verkaik ◽  
Berno van Meijel ◽  
Anneke L Francke
Keyword(s):  
Systematic Reviews ◽  
Well Being ◽  
Self Management ◽  
Cochrane Library ◽  
Future Research ◽  
Management Support ◽  
People With Dementia ◽  
Literature Searches ◽  
Meta Review ◽  
The Cochrane Library

Self-management support for people with dementia is important to help them and their family caregivers to cope with challenges in daily live. Insight into the effects of self-management support interventions on people with dementia is however lacking, despite existing relevant systematic reviews. We therefore conducted a meta-review of relevant systematic reviews, following the PRISMA statement. Systematic literature searches were conducted in PubMed, CINAHL, the Cochrane Library, Embase and PsycINFO. The searches were done in December 2015, and all relevant references until then were taken into consideration. No conclusions about the effects of self-management support interventions on people with dementia could be drawn. Recommendations for future research and practice include that self-management support interventions and effect measurements should be wider in scope than psychological well-being.

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