Most reviews and meta-analyses indicate that CG interventions generally have a positive impact on key outcomes (e.g., Dickinson et al., 2017 Gilhooly et al., 2016). Over the course of the past decade, the literature on the effects of dementia CG interventions has grown considerably. Results of Previous Reviews and Meta-Analyses Multicomponent: Multicomponent interventions combine several approaches into one comprehensive intervention, such as CR training and CG psychoeducation ( Onor et al., 2007), counseling and support groups ( Eloniemi-Sulkava et al., 2009), or counseling, psychoeducation and support groups for both CG and CR ( Bruvik, Allore, Ranhoff, & Engedal, 2013). As CR impairment is related to CG burden, positive effects of CR training interventions can be expected to affect the CG as well (e.g., Kim et al., 2016). Training of the CR: These interventions focus on improving cognitive and functional impairments of the CR (e.g., memory training, reality orientation training, motor training).
Respite: As CGs often report being “on duty” at all times, respite interventions provide a temporary relief for the CG through the provision of substitute care in the form of in-home care, daycare, or temporary admission of the CR to a care facility (e.g., Mossello et al., 2008). This support aims to counteract social isolation and help CGs learn from each other (e.g., Winter & Gitlin, 2006). General support: Befriending schemes, professionally administered support groups, as well as peer support groups, provide a social framework for CGs to discuss their problems and worries with peers who have to deal with similar struggles. Although educational interventions are standardized to some degree, counseling and case management is tailored to specific problems of individual CGs or the CG-CR dyad (e.g., Roberts et al., 1999). This includes passive information provision as well as active skill training (e.g., Bourgeois, Schulz, Burgio, & Beach, 2002).Ĭognitive-behavioral therapy (CBT): These interventions aim to modify behavioral, cognitive, and affective responses to caregiving (e.g., dysfunctional appraisals of caregiving demands), as well as to change the mental health of the CG directly by use of CBT principles (e.g., McCurry, Logsdon, Vitiello, & Teri, 1998).Ĭounseling/case management: These interventions include assessment, planning, facilitation, and advocacy for options and services in order to meet the needs of individual CGs and CRs. Psychoeducational interventions: The goal is the transmission of knowledge and skills regarding dementia, caregiving, available services, and coping with stress. In order to support dementia CGs, many interventions have been developed and evaluated, allowing them to be clustered into the following intervention types according to their dominant component. Furthermore, CG burden increases the risk of nursing home placement of the care recipient (CR Gaugler, Yu, Krichbaum, & Wyman, 2009 Gilley, McCann, Bienias, & Evans, 2005). Compared to non-dementia CGs, dementia CGs are more burdened and report lower subjective well-being (SWB Ory, Hoffman, Yee, Tennstedt, & Schulz., 1999 Pinquart & Sörensen, 2003b). Dementia caregiving is related to reduced subjective health ( Vitaliano, Zhang, & Scanlan, 2003) and reduced health-related quality of life ( Markowitz, Gutterman, Sadik, & Papadopoulos, 2003), higher rates of mortality ( Schulz & Beach, 1999), anxiety ( Brodaty & Donkin, 2009 Schulz, O’Brien, Bookwala, & Fleissner, 1995), and depression ( Pinquart & Sörensen, 2003b Schulz et al., 1995), with more than a fifth of dementia CGs fulfilling clinical criteria for depression ( Cuijpers, 2005). This places a significant burden upon CGs and increases the risk of physical and psychological morbidity ( Chiao, Wu, & Hsiao, 2015 Pinquart & Sörensen, 2003a). Most care for persons with dementia is provided by informal caregivers (CGs) such as spouses or children ( Prince & Jackson, 2009).
Carer, Alzheimer’s disease, Burden, Depression, Review
0 kommentar(er)
