Supporting carers of people with dementia: What is effective?

Abstract

Carer stress is well documented, especially in those caring for individuals with dementia. A recommendation of all national dementia strategies is to provide excellent support and information to informal carers of people with dementia. NICE guidance suggests that a range of tailored interventions, including psychological input, psychoeducation and training courses, should be offered to reduce caregiver burden and stress, although good-quality outcome-based evidence is lacking. On the basis of a narrative review of the literature, we describe individual and multicomponent carer support packages and discuss their evidence base, reflecting on outcomes for carers. Multicomponent interventions have the best evidence for effectiveness.Learning Objectives• Consider the risks of both physical and psychological harm experienced by carers of people with dementia (often referred to as carer burden or caregiver burden)• Be aware of the interventions available for the support of carers of people with dementia• Consider the evidence for the effectiveness of these interventions and be aware of the limitations of the evidence

Telephone-based behavioral activation intervention for dementia family caregivers: Outcomes and mediation effect of a randomized controlled trial

“…[40]. Telephone counseling has been found to be cost-effective in reducing depressive symptoms and burden as well as increasing self-efficacy caregivers of people with dementia [25,[41][42][43][44][45].…”

Cost-Effectiveness and Effects of a Home-Based Exercise Intervention for Female Caregivers of Relatives with Dementia: Study Protocol for a Randomized Controlled Trial

“…However, the results of these studies have to be considered cautiously, because only a few studies have designed the experiment on the basis of a RCT approach [23], and the available RCT-based studies used small sample sizes [58]. In addition to this limitation, the heterogeneity of the examined variables, such as duration of the intervention, physical exercise intensity, weekly dose of activity, as well as a broad range of used exercises, also make it difficult to generalize the results to a larger population [43,59,60].…”

Effects of a home-based exercise program on mental health for caregivers of relatives with dementia: a randomized controlled trial

“…Over the last few decades, different supportive interventions for caregivers of relatives with dementia have been developed, including support groups, formal approaches to care, respite care, educational programs to perform daily caring tasks, combined interventions, and other multicomponent approaches (Alzheimer's Disease International, 2016;Gaugler and Kane, 2015;Sorensen et al, 2002;Rodriguez-Sanchez et al, 2013;Prick et al, 2015). However, these interventions usually show methodological difficulties, such as overlap among intervention types, lack of details of the interventions, lack of control groups, and insufficient clarity of outcome measures (Jackson and Browne, 2017). Moreover, these interventions usually report low rates of adherence, as they are carried out of home, requiring additional resources for the participants: leave the care recipient at home, the time needed to be invested to participate, attendance to the facilities, and time for trips to the facilities to participate in the intervention (Prick et al, 2015).…”

“…In summary, previous research has suggested that more physical exercise-based supporting strategies should be implemented (Farran et al, 2016a;Jackson and Browne, 2017). Therefore, this study sought to evaluate, whether an individual face-toface home-based physical exercise program that is directed to informal female caregivers and supervised by a trained staff is feasible and effective, and to determine the potential positive impact of this intervention on mental health (Madruga et al, 2020).…”