A review of couple-centred interventions in dementia: Exploring the what and why – Part A

Abstract

Introduction Symptoms of dementia bring about challenges to couples' relationships. Relationship-focused support has been highlighted to be of significant importance for sustained relationship quality and to reduce the negative impact of dementia on the dyadic relationship. This review aimed to explore the 'what' and 'why' of interventions aimed at couples where one partner has a diagnosis of dementia and in which the couple jointly participate. Method Searches were performed in Academic Search Premier, CINAHL, PsycINFO, PubMed, Scopus and Web of Science from January 2000 to August 2017. Results Six studies were included. Objectives for the person with dementia was related to cognitive function and for the care partner the objectives were related to well-being. The majority of the outcomes were mirrored by the objectives and focused on cognitive function for people with dementia and depression and relationship quality for care partners. Our findings indicate that people with dementia should be included in the assessment of the relationship in order to gain an overall picture of relationship dynamics and to increase tailored support in couple-centred interventions. Conclusions The findings of this review indicate that joint interventions for people with dementia and care partners are lacking a genuine dyadic approach where both partners' views of their relationship are valued. In order to identify targets for support and to use the appropriate outcome measures, the quality of the relationship should be recognised and taken into account. Moreover, there is a lack of a salutogenic approach in couple-centred interventions in which couples' strengths and resources can be identified and supported.

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia

“…As a first step of the "Living Life and Doing Things Together" study, the research team undertook a narrative review (Bielsten & Hellström, 2017a) and a scoping review (Bielsten & Hellström, 2017b) of the literature with the aim to map interventions for couples where one partner has a diagnosis of dementia. The reviews provided an overall view of types and objectives of couple-based interventions and to what extent they addressed the couple´s relationship.…”

“…Despite all the evidence of relationship quality as a crucial factor for well-being, and for the prevention of negative consequences, support aimed at couples’ relationships is scarce. Accessible support for couples, including dyadic support, are often based on the individual which leads to barriers in acknowledging needs for relationship-based support (Bielsten & Hellström, 2017a).…”

“…In recent years, several authors have highlighted the urgent need for interventions that support couples’ relationships and interaction (see, for example, Ablitt et al, 2009; Balfour, 2014; Bielsten & Hellström, 2017a, 2017b; McGovern, 2011). Support aimed at couples where one partner has a diagnosis of dementia would be advised to target the couples’ interaction, communication, and closeness in the context of everyday life, as communication and interaction often become problematic areas for couples living with dementia and have a significant impact on relationship quality (Boots, de Vugt, Withagen, Kempen, & Verhey, 2016; Reilly, Relkin, & Zbrozek, 2006; Wherton & Monk, 2008).…”

“…Couple’s relationship in dementia is often assumed to be burdensome, which reflects the predominant problem-based and symptom-oriented support accessible for couples with dementia. The targets of the support are most commonly focused on the caregiver-care-receiver roles, cognitive function of the person with dementia, and the partners’ strain and burden (Bielsten & Hellström, 2017a, 2017b; Martire, Schulz, Helgeson, Small, & Saghafi, 2010; Purkis & Ceci, 2015). This position is the complete opposite to the approach within most other chronic diseases where the goal is to learn how to live as well as possible with the disease (Robinson, 2017), learn self-management skills, promote coping strategies, and gain self-efficacy (Martin et al, 2015; Barlow, Wright, Sheasby, Turner, & Hainsworth, 2002).…”

Technology-Driven Solutions to Prompt Conversation, Aid Communication and Support Interaction for People With Dementia and Their Caregivers: A Systematic Literature Review

“…There are currently more than 46 million people worldwide living with dementia, a number that is predicted to triple by 2050 [1]. Dementia is a brain condition that affects cognitive functions, with symptoms including challenges in communication skills and impaired memory function [2].…”