Effectiveness of day care in supporting family caregivers of people with dementia: A systematic review

Abstract

Day care (DC) provides a break in daily care as a support strategy for family caregivers (FC) of people with dementia (PwD). Objective: to analyze the support strategies used by the DC for FC, their methodological and theoretical models, as well as the respective benefits for FC burden, coping strategies and quality of life. Methods: a systematic review following the Prisma methodology was performed on PubMed, PsycInfo, Scopus and SciELO electronic databases in August, 2018. The search keywords were “day care”, “dementia” or Alzheimer disease, “caregiver”, “quality of life” and “psychological adaptation”. Results: twenty-one studies were included. No randomized controlled trials were found. The provision of education, counseling and support, access to information, the professionals' expertise and the quality of their relationship with DC users were highlighted by caregivers. Compared to standard programs centering on PwD, the integrated program focused on PwD and FC activities showed increased feelings of competence and self-confidence of FC to postpone institutionalization. Heterogeneity in the structure and organization of the DC programs, intervention strategies and theoretical basis was observed. Conclusion: Integrated programs are a promising approach that addresses the needs and demands of PwD and their FC in a multidimensional manner.

Relato de experiência sobre uma intervenção psicológica com familiares de praticantes de equoterapia

“…Alguns estudos 1,6,9 indicam que é comum que os cuidadores familiares remodelem sua rotina de vida em benefício das pessoas de quem cuidam, assumindo compromissos e horários rígidos. Essa situação se agrava quando a função de cuidadores foi assumida há menos tempo, por não existir treinamento ou cursos de preparação prévia, o que pode levar os cuidadores a abrir mão primeiro de atividades de cunho individual, que seriam essenciais para manutenção de sua saúde física e mental 8 .…”

“…A vivência de sobrecarga é um achado frequente nos trabalhos com cuidadores 5,8,9 e pode se relacionar com o surgimento de outros quadros emocionais negativos, como estresse e depressão 11 . Esses aspectos negativos somam-se às pressões sociais e tornam a vivência como cuidador um fator de risco para a qualidade de vida dessa população e para a qualidade dos cuidados que prestam a outro(s) 9 .…”

“…Especificamente na equoterapia, não há intervenções pensadas para os cuidadores e as orientações dadas aos familiares são focadas nos praticantes. O apoio efetivo aos cuidadores familiares pode auxiliá-los a manter sua qualidade de vida 3,6 , minimizar a sobrecarga e outras questões emocionais que podem surgir como decorrência do papel de cuidadores, além de auxiliá-los a manter bons sentimentos sobre poder cuidar de um ente querido 8,9 .…”

Dropout from farm-based day care for people with dementia in Norway: a follow-up study

“…These elements are known to affect a person’s level of energy and the ability to perform activities [ 43 ]. Furthermore, there is a close relationship between people with dementia’s experience of social support and whether the next of kin experience social support in their lives [ 44 , 45 ]. This is a consequence of people with dementia becoming more dependent on their next of kin during the course of dementia [ 42 ].…”

COVID-19: challenges for dementia care and research

“…The daycare has been considered an important health technology in the configuration of support strategies for people with dementia and their caregivers. 11 Proposed as a service model that provides a friendly and caring environment for people with dementia while caregivers take a break to decrease their exposure to primary stressors, the daycare center seeks to reduce the burden of care. 11 , 12 Consequently, social isolation impacts on worsening the lack of a break from daily care in a context in which people with dementia may be presenting changes in their behavior.…”