How do activating interventions fit the personal needs, characteristics and preferences of people with dementia living in the community and their informal caregivers?

Abstract

Psychosocial interventions aim to mitigate the serious consequences of dementia for the daily life of people with dementia and their informal caregivers. To deliver a person-centred approach, it is crucial to take needs, characteristics and preferences of people with dementia and their informal caregivers into account. However, these factors are generally not systematically checked in order to determine which intervention will be most appropriate. Additionally, little is known about which intervention suits which needs, characteristics and preferences. Therefore, this study examined how three multiple-component, activating dyadic interventions fitted needs, characteristics, and preferences of both the people with dementia and their informal caregivers: the Pleasant Events Program, the Exercise and Support Intervention for People with Dementia and Their Caregivers, and Occupational Therapy. Semi-structured interviews were held with participants in either one of the interventions, 34 dyads and 19 professionals. The constant comparative method was used for the analysis. Five factors influenced the dyad's 'fit': timing, need for activity, lifestyle, apart-or-together and meaning of (lost) activity. The factors 'timing' and a 'need for activity' were conditional for these activating interventions. Dyads in an early stage of dementia, who were aware of the effects on daily life, were open to a change in routine, and had a need to maintain activities profited from these interventions. Three distinctive factors were important for the fit of one of the three interventions in particular: 'lifestyle', 'apart or together' and 'meaning of (lost) activity'. The Pleasant Events Programme and the Exercise and Support intervention properly addressed the need for activities that afforded daily pastimes or structure. The Exercise and Support Intervention addressed the need for physical activity and emphasized shared activity. Occupational Therapy properly addressed the need for self-sufficiency, maintaining activities and adjustment to physical limitations. These factors can contribute to a more person-centred application of the interventions.

A Systematic Review of Home-Setting Psychoeducation Interventions for Behavioral Changes in Dementia: Some Lessons for the COVID-19 Pandemic and Post-Pandemic Assistance

“…Overall, most psychoeducational and psychosocial interventions aimed to enhance care providers’ knowledge about the required skills of caregiving and, ultimately, to reduce dementia sufferers’ illness deterioration and institutionalization ( 24 , 25 ). Most studies employed personalized and person-centered strategies ( 26 , 27 ) designed to fulfill the needs, characteristics and preferences of both PwD and their caregivers ( 28 ). As an example, the Person-centered care (PCC), widely recognized concept in dementia research and care and the Dementia Care Mapping (DCM), a method for implementing PCC ( 29 ).…”

“…Other examples included multiple activities, such as the Pleasant Events Program, in which a protocol comprised physical exercise, occupational therapy and support intervention for the dyad, have also been employed ( 28 ). The caregivers were encouraged to learn from cognitive stimulation through specific protocols, by dealing with their stress and anxiety feelings and the daily routine; this was the case of the individual Cognitive Stimulation Therapy (iCST) ( 36 ).…”

Motivation to participate in high-intensity functional exercise compared with a social activity in older people with dementia in nursing homes

“…There are several types of physical activity interventions that have been performed in people with dementia [ 31 – 33 ]. Little is known about which interventions suit particular needs and preferences in people with dementia [ 34 ]. Knowledge about motivation is important for the facilitation of exercise participation in this population.…”

Working mechanisms of dyadic, psychosocial, activating interventions for people with dementia and informal caregivers: a qualitative study

“… Notes: Adapted from Van’t Leven et al 46 Abbreviations: AMPS, Assessment of Motor and Process Skills; CDS, Cornell Depression Scale; CES-D, Centre of Epidemic Studies – Depression; CG, informal caregiver; DQoL, Dementia Quality of Life Instrument; ES, effect size; GHQ, General Health Questionnaire; HDRS, Hamilton Depression Rating Scale; MED, mean estimated difference; n (I/C), study population intervention/control group; PWD, people living with dementia; RCT, randomized controlled trial; SCQ, Sense of Competence Questionnaire; SP-36, Sickness Profile-36. …”