A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia

Abstract

Objective: The aim of this study was to compare the efficacy of two approaches: multicomponent interventions that focus on working with the carer and dyadic interventions that work with both the carer and the person with dementia. Method: A systematic review involving a search of Medline, EMBASE, and PsycINFO in October 2015 was performed. Randomized controlled trials involving carers of people with dementia and comparing multicomponent interventions with usual care were included. Results: Pooling of all studies demonstrated that multicomponent interventions can reduce depressive symptoms, improve quality of life, reduce carer impact, and reduce behavioral and psychological symptoms of dementia as well as caregiver upset with these symptoms. We were unable to find a significant difference in the effects of dyadic interventions in comparison with carer focused interventions for these outcomes. Discussion: Although effect sizes associated with intervention are small, multicomponent interventions are relatively inexpensive to deliver, acceptable, and widely applicable.

Family caregivers: Important but often poorly understood

“…Commonly, family caregiving is attributed to spousal caregivers, failing to recognise that caregiving occurs across the life span and children are frequently engaged in caregiving roles (Evans, ). In older adults, individuals often co‐exist in a delicate balance of assisting each other in living with decreasing functional capacity and chronic illness (Laver, Milte, Dyer, & Crotty, ). The mutual and reciprocal benefit of this relationship may impact on a range of activities of daily living, emotional support and collaborative coping, yet is poorly understood, documented and underappreciated.…”

The nutritional care of people living with dementia at home: A scoping review

“…Given the range of symptoms, the variable rate of progression and the complex nature of adequate nutritional intake, it seems likely that successful interventions for this group will be complex and have built in flexibility to adapt to individuals’ needs. Others have concluded that multi‐component interventions appear to have advantages over single‐component interventions including: reducing symptoms of depression, improving QoL, reducing carer burden, and reducing the behavioural and psychological symptoms of dementia (Laver, Milte, Dyer, & Crotty, ). Therefore, interventions will need to be developed so that they target multiple determinants, across multiple levels of influence.…”

Problem‐solving therapy reduces subjective burden levels in caregivers of family members with mild cognitive impairment or early‐stage dementia: Secondary analysis of a randomized clinical trial

“…[17][18][19][20][21][22][23][24][25][26] A possible reason for the limited impact may lie in the fact that interventions are often evaluated with caregivers who have already served in the caregiving role for years and who report high levels of burden. Yet to date, these interventions have been only moderately effective at alleviating burden and distress (ie, depression and anxiety symptoms) in dementia family caregivers.…”