A Biopsychosocial-Ecological Framework for Family-Framed Dementia Care

Abstract

The biopsychosocial model has been applied through collaborative care dementia models to the diagnosis, symptom management, and treatment of dementia with a focus specifically on the person with dementia. Because individuals with dementia are increasingly dependent upon others particularly as the illness advances, dementia care requires the involvement and commitment of others, usually family, along with support from community-based resources. Hence, the quality and effectiveness of a person's dementia care are shaped in large part by the foundation of family relationships and the social and community networks in which they are embedded. While most current dementia care models incorporate biopsychosocial principles and recognize the essential role that family members play as caregivers, they fail to consider a patient's family system and relationships as potential risk factors or social determinants for care outcomes. This paper introduces a biopsychosocial-ecological framework to dementia care that is person-centered and “family-framed” in that it targets factors that influence care considerations at both the individual and relational levels of the social ecological networks that the patient and their family members occupy. We use this model to illustrate how current dementia care practices tend to focus exclusively on the individual patient and caregiver levels but fail to identify and address important relational considerations that cut across levels. We call for the need to add assessment of family relational histories of persons with dementia and family members who care for them in order to better meet the needs of the patient and the caregiver and to prevent harm. This model accentuates the need for interprofessional education on family assessments and caregiver-centered care, as well as interdisciplinary, collaborative models of dementia care that assume more accountability for meeting the needs of family caregivers in addition to those of persons with dementia.

Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study

“…As found in this research, dyads benefit from personalised facilitation to meet their complex and changing needs. This aligns with the broadly accepted recommendations for the personalised use of music for people with dementia ( 52 , 53 ) and the need to consider family dynamics within family-centred approaches to dementia care ( 54 , 55 ). Due to the heterogeneity of dyads’ contexts, music therapists need to build an understanding of dyads’ musical worlds ( 15 ) to provide the best individualised care.…”

Informal carers’ information needs in managing behavioural and psychological symptoms of people with dementia and related mHealth applications: a systematic integrative review to inform the design of an mHealth application

“…Moreover, the present review demonstrated that carers needed to know their roles as carers. Similarly, previous reviews reported various roles of carers throughout the trajectory of care provision, for example, care provider, communicator and interpreter 35 86. Therefore, informal carers should be provided with information related to their caring roles,87 and it is essential to develop affordable educational resources for carers, especially in developing countries.…”

Systemic family therapists and dementia: A constructivist grounded theory study

“…Podgorski et al. (2021) has more specifically developed a biopsychosocial–ecological framework to more broadly guide family‐framed dementia care from a service perspective. This framework informs a path to increasing adoption of systemic congruent ideas in dementia services, rather than specifically focusing on therapy guidance.…”