Com‐mens: a home‐based logopaedic intervention program for communication problems between people with dementia and their caregivers — a single‐group mixed‐methods pilot study

Olthof-Nefkens, Maria W L J; Derksen, Els; Debets, Frieda; Swart, B.J.M. de; Sanden, M.W.G. Nijhuis-van der; Kalf, J.G.

doi:10.1111/1460-6984.12811

Cited by 2 publications

(1 citation statement)

References 55 publications

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“…Additionally, some carers improved their ‘communication’ during follow-up, through family or formal support. Therefore, ‘communication’ is potentially modifiable when behaviour problems, especially apathy, occur, and can be further enhanced by therapy that focuses on improving skills and coping with language and communication difficulties in dyads ( Olthof-Nefkens et al, 2022 ). A one-year follow-up of people with Alzheimer’s disease and their carers suggested that relationships were ‘dynamic co-constructions’, built from daily interactions ( Graham & Bassett, 2006 ).…”

Section: Discussionmentioning

confidence: 99%

The quality of family relationships in dementia: Mixed methods to unravel mixed feelings

Marques,

Gonçalves-Pereira,

de Vugt

et al. 2023

Dementia

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Objective: Close relationships influence health and quality of life outcomes for people with dementia and their families. Yet, we know little on the role of different relationship domains with quantitative methods having proved to have limitations in this research field. We aimed to study these relationship domains over time, contrasting the views of people with dementia and their family carers, making use of both quantitative and qualitative approaches. Methods: A convergent mixed methods design was adopted, analysing longitudinal data (four time points over three years) from 66 dyads of Portuguese community-dwelling people with dementia and their primary carers, from the EU-Actifcare project sample. Quantitative assessments used sociodemographic and clinical variables, and Positive Affect Index scores, with descriptive and inferential analyses. Qualitative data, collected through individual and joint semi-structured interviews, were explored using thematic analysis. Results: Both quantitative and qualitative findings demonstrated that some domains of relationship quality are affected in different ways, with changes occurring at different stages. Some (e.g., ‘communication’) may even improve after initial decline. ‘Closeness’ was consistently altered over time, from carers’ perspectives, and played an important protective role regarding institutionalisation. Overall, changes in the relationship quality were perceived differently by people with dementia and their carers, and these divergent perspectives often led to tension. Qualitative data revealed that ‘mixed feelings’ (ambivalence) involve complex experiences, arguably more difficult to manage than negative feelings alone. Furthermore, perceived informal support, particularly from the extended family, and receiving formal services’ assistance, seemed to facilitate positive (re)appraisals of the relationship. Conclusions: A deeper understanding of relationship quality and its domains as dementia progresses may help tailoring interventions to tackle modifiable aspects of relationships, meeting the needs and cherishing the resources of dyads and families. Timely assessments could identify relationships at risk and need for support, including for alternative caring arrangements.

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Section: Discussionmentioning

confidence: 99%

The quality of family relationships in dementia: Mixed methods to unravel mixed feelings

Marques,

Gonçalves-Pereira,

de Vugt

et al. 2023

Dementia

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What works to support carers of older people and older carers? an international evidence map of interventions and outcomes

Spiers,

Tan,

Astbury

et al. 2024

BMC Geriatr

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Background Unpaid carers of older people, and older unpaid carers, experience a range of adverse outcomes. Supporting carers should therefore be a public health priority. Our understanding of what works to support carers could be enhanced if future evaluations prioritise under-researched interventions and outcomes. To support this, we aimed to: map evidence about interventions to support carers, and the outcomes evaluated; and identify key gaps in current evidence. Methods Evidence gap map review methods were used. Searches were carried out in three bibliographic databases for quantitative evaluations of carer interventions published in OECD high-income countries between 2013 and 2023. Interventions were eligible if they supported older carers (50 + years) of any aged recipient, or any aged carers of older people (50 + years). Findings 205 studies reported across 208 publications were included in the evidence map. The majority evaluated the impact of therapeutic and educational interventions on carer burden and carers’ mental health. Some studies reported evidence about physical exercise interventions and befriending and peer support for carers, but these considered a limited range of outcomes. Few studies evaluated interventions that focused on delivering financial information and advice, pain management, and physical skills training for carers. Evaluations rarely considered the impact of interventions on carers’ physical health, quality of life, and social and financial wellbeing. Very few studies considered whether interventions delivered equitable outcomes. Conclusion Evidence on what works best to support carers is extensive but limited in scope. A disproportionate focus on mental health and burden outcomes neglects other important areas where carers may need support. Given the impact of caring on carers’ physical health, financial and social wellbeing, future research could evaluate interventions that aim to support these outcomes. Appraisal of whether interventions deliver equitable outcomes across diverse carer populations is critical.

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Com‐mens: a home‐based logopaedic intervention program for communication problems between people with dementia and their caregivers — a single‐group mixed‐methods pilot study

Cited by 2 publications

References 55 publications

The quality of family relationships in dementia: Mixed methods to unravel mixed feelings

The quality of family relationships in dementia: Mixed methods to unravel mixed feelings

What works to support carers of older people and older carers? an international evidence map of interventions and outcomes

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