Interventions supporting caregiver readiness when caring for patients with dementia following discharge home: A mixed‐methods systematic review

Abstract

Objective: To explore programs and information provided to caregivers of inpatients with dementia to assist with readiness to provide care following discharge. Methods: A mixed-methods systematic review with meta-analysis was conducted. Search terms included dementia, inpatient, caregiver, anxiety, discharge and counselling. Results: The search yielded 1938 studies (six databases), 13 met the inclusion criteria. Meta-analysis showed no statistically significant changes in anxiety, depression, burden or quality of life 3 months postintervention. Three emergent qualitative themes for staff consideration were: understanding personal characteristics of both patient and caregiver; presenting an inclusive organisational culture; and providing appropriate information at all stages of admission. A Model of Caregiver Readiness was created from the qualitative results. Conclusion: The programs did not significantly decrease the outcomes measured. However, caregivers identified that inclusion at all stages during hospital admission was a vital factor to reduce stress and increase caregiver readiness.

A systematic review of interventions to improve acute hospital care for people with dementia

“…One was a cluster-randomised controlled trial [32], and two were controlled clinical trials [33,34]. Seven of the studies were systematic reviews [15,16,[35][36][37][38][39]. The systematic reviews were published in 2015 [36] (n = 1), 2017 [35] (n = 1), 2019 [15,16,39] (n = 3) and 2020 [37,38].…”

“…Of the interventional studies, ve studies were conducted in Australia [24,25,30,31,34], three in the United States [22,26,32], two in the United Kingdom [23,28] and each one in Canada [33], Germany [29] and Switzerland [27]. Four systematic reviews were carried out in the UK [15,16,35,36] and three in Australia [37][38][39]. The included interventional studies presented a range of interventions for people with dementia in the acute hospital setting, including educational interventions for healthcare staff [23,26,28,30,33] (n = 5), for healthcare staff and non-clinical staff [31] (n=1) or for volunteers working with people with dementia in the hospital [29] (n = 1).…”

“…Further studies investigated a delirium management programme for people with cognitive impairment [27] (n = 1) and a special non-pharmacological intervention [22] (n = 1). The systematic reviews focussed on educational interventions [15,35] (n = 2), on volunteer programmes [38] (n=1), on special care units for people with dementia [16] (n = 1), on palliative care consultation services for people with advanced dementia [39] (n=1), on interventions to improve caregiver readiness [37] (n=1), and on inpatient rehabilitation interventions for people with dementia after hip fracture on surgical units [36] (n = 1). Table 1 provides information about the characteristics of included studies.…”

“…Another study showed no difference in the level of con dence at three time points and no improvement of staff comfort in engaging with family carers [25]. The systematic review focusing on interventions to prepare caregivers for ful lling their role after hospital discharge showed no signi cant improvement in quality of life, anxiety, depression or family caregiver burden [37]. The family-centred programme investigated by Luxford et al improved family caregivers' satisfaction regarding communication with staff [24].…”

“…nurse education sessions) supporting family caregivers of inpatients with dementia. The aim was to assist caregivers in resuming their role as caregivers after discharge [37].…”