Psychological interventions for carers of people with dementia: A systematic review of quantitative and qualitative evidence

Abstract

Rationale: Carers of people with dementia experience significant levels of stress in their everyday role. The National Dementia Strategy in England identifies the key role that carers play in supporting people with dementia living at home, often to the detriment of their social, emotional and physical health. Aims: To add to the substantive knowledge‐base by combining search criteria used by Pinquart and Sörensen (2006) and Gallagher‐Thompson and Coon (2007) to update the literature on psychological interventions for carers of people with dementia published between 2005 and 2011. Method: Following the study inclusion criteria, comprehensive searches were conducted using the electronic databases Medline, PsycINFO, ERIC, and PubMed. Twenty studies were identified, graded and synthesised into the reported systematic review with both quantitative and qualitative studies included to maximise practice application. Results: Consistent with previous findings, three categories of psychological intervention were identified: (i) psychoeducational‐skill building (n=8); (ii) psychotherapy‐counselling (n=1); (iii) multicomponent (n=6). Our review also identified a fourth intervention category, (iv) technology‐based (n=5). The majority of studies in the updated review examine the constructs of depression, burden, social support and well‐being. The development of focused interventions for carers, whether individually tailored interventions or group interventions around a common issue, was significant for developing practice. Future studies across all categories should continue to embed supervision arrangements within their psychological intervention protocols.

Psychosocial intervention for carers of people with dementia: What components are most effective and when? A systematic review of systematic reviews

“…Findings included a shift in participants' attitudes towards becoming more accepting and non-judgemental along with a more optimistic and collaborative view of the future. Elvish et al (2013) concluded that results from this study were undermined by a lack of detail on data analysis.…”

“…One review was rated as high quality (Vernooij-Dassen et al, 2011), the other three were of moderate quality. Elvish et al (2013) and Peacock and Forbes (2003) …”

“…Four reviews presented results from studies evaluating psychotherapeutic interventions for carers of people with dementia (Elvish et al, 2013;Peacock and Forbes, 2003;Pinquart and Sorensen, 2006;Vernooij-Dassen et al, 2011). One review was rated as high quality (Vernooij-Dassen et al, 2011), the other three were of moderate quality.…”

“…Elvish et al (2013) appraisal of role performance for carers) in addition to healthcare utilisation for people with dementia (including admission to residential care, number of GP visits). Peacock and Forbes (2003) included measures of carer well-being along with measures of institutionalisation and healthcare expenditure.…”

“…They reported evidence that the intervention delayed institutionalisation of the person with dementia, even at follow up 3.5 years later. Elvish et al (2013) identified only one study which fitted their criteria for psychotherapy-counselling studies.…”