Fostering the Resilience of People With Dementia: A Narrative Literature Review

Abstract

Background: Resilience is a process through which people use resources to adapt to adversity. Interventions aiming to support resilience in people with dementia have been developed. However, the optimal content, structure and impact of these interventions is unclear. This literature review explores the factors through which interventions foster resilience in people with dementia and examines their efficacy. Methods: Eight databases were searched systematically, for literature published from 2000 to 2019. Following the removal of duplicate articles, the titles and abstracts of 6,749 articles were screened. Articles were selected if they: reported empirical studies in English; focused on resilience; involved people with dementia and psychosocial interventions. The full text of 53 articles were examined and three studies, reported in six papers, were included in the final review. Data were systematically extracted, and two authors critiqued the studies using the Critical Appraisal Skills Programme check lists. The studies were examined to determine how resilience was defined and operationalized and their findings were synthesized using the theoretical resilience framework. Results: Five interventions aiming to foster resilience were identified: Dementia Advisors; Peer Support Network Services; Visual Arts Enrichment Activities; Memory Makers; and Early-Stage and Beyond Community Activities. All studies defined resilience as a process and most involved people with mild dementia who had family carers. The interventions impacted resilience by reducing the adversity of stigma and social isolation; increasing personal and social resources, providing stigma-free space and reciprocal support. Interventions empowered people with dementia, increasing their self-esteem and self-worth. Resilience can be fostered both during, and after interventions. However, the efficacy of interventions could not be determined because the research designs utilized did not measure efficacy. Conclusions: Interventions need facilitators to ensure they are strength-based, person-centered and they enable reciprocal social interactions. Future research needs to develop interventions that aim to foster the resilience of people with dementia who lack family carers and/or have more advanced dementia through meaningful activities that are identified by people with dementia as important to their resilience. Robust methodologies, including randomized controlled trials should be used to measure effectiveness and explore the impact of interventions regarding the: interplay between individual and community resources; the importance of reciprocity; and temporal aspects of resilience.

Everyday Experiences of People Living with Mild Cognitive Impairment or Dementia: A Scoping Review

“…This is in line with the recommendations of a realist review by Li, Keady and Ward [ 144 ] who state that that the dynamic relationship between people living with dementia and their everyday neighbourhood have impact on their health and especially social health. An everyday lens implies that in order to foster the resilience of people living with dementia there needs to be an additional focus on neighbourhood and asset-based community interventions alongside individual support [ 145 ], in order to promote social inclusion, as stated by the Global Action Against Dementia of the World Health Organization [ 146 ].…”

Positionspapier der Österreichische Alzheimer Gesellschaft (ÖAG)

“…Auch werden Menschen mit Demenz von der so wichtigen Ressource für Resilienz – nämlich den sozialen Kontakten und der zwischenmenschlichen Interaktion – abgeschnitten. In vielen bisherigen Studien zu Resilienz bei Menschen mit Demenz wurde gerade der Faktor von sozialer Unterstützung und sozialer Interaktion als wesentlich und wichtig beschrieben [ 30 ]. Im Rahmen der Demenz nehmen auch Möglichkeiten zur Nutzung und Entwicklung von Coping-Strategien ab.…”

Effectiveness of Resilience Interventions on Psychosocial Outcomes for Persons With Neurocognitive Disorders: A Systematic Review and Meta-Analysis

“…Resilience-centered interventions can be seen as one important approach to adapting to stress and reducing the adverse impact of the stressors ( 7 ). Luthar and Cicchetti ( 14 ) defined resilience as “a dynamic and amendable process,” in which people use resources to acclimate to adversity ( 15 ). Meanwhile, Kunzler et al ( 16 ) highlighted that resilience-centered interventions could be seen as the process of maintenance, withstanding, overcoming, adjustment, adaptation, posttraumatic growth, stress-related growth, rebound from a stressor, or rapid readjustment.…”

“…Windle et al ( 30 ) studied tools for resilience interventions and concluded that the conceptual and theoretical adequacy of the scales was questionable, with no existing “gold standard” of resilience measures. Whelan et al ( 15 ) indicated that key sets of outcomes for resilience in neurocognitive disorders have not been identified. For example, Ghanei Gheshlagh et al ( 7 ) used three scales, which are Resilience Scale-25 (RS-25), Connor–Davidson Resilience Scale-10 (CDRISC-10), and Connor–Davidson Resilience Scale-25 (CDRISC-25), to assess the effectiveness of the resilience process for people with chronic physical diseases.…”

“…However, Regan and Varanelli's ( 33 ) review did not conduct a meta-analysis, so it was unable to draw a clear conclusion about the intervention effect because of the divergent methods of the included studies. Additionally, the narrative review ( 15 ) identified five resilience interventions in three empirical studies of six papers, including Peer Support Network Services, Dementia Advisors, Memory Makers, Visual Arts Enrichment Activities, and Early-Stage and Beyond Community Activities. However, this narrative review included empirical studies, and the effectiveness of the resilience interventions could not be determined due to the study design.…”