Support programs for both community-dwelling people with dementia and their informal caregivers are beneficial

Van't Leven N, Prick A, Groenewoud JG, et al.  Dyadic interventions for community-dwelling people with dementia and their family caregivers: A systematic review  International Psychogeriatrics, 25(10), 1581-1603.

Review question

How effective are programs that support both people with dementia living in the community and their informal caregivers? 

Background

The number of people living with dementia is increasing worldwide, as well as the number of people who care for them. Most people with dementia are dependent on informal care, often provided by their spouses, children, other family members or friends. Different approaches have been developed to provide support and training for both the person with dementia as well as their caregivers. These approaches can help to increase the quality of life and daily functioning for both members.

How the review was done

This is a summary of 23 high quality randomized controlled trials of 20 different programs. The authors included studies of face-to-face programs offered to both people with dementia (age 65+) and their informal caregivers living in the community which were intended to improve participants’ mental health and wellbeing.  Support for people with dementia included information, training in activities of daily living (ADL), exercise and environmental adaptations.  Support for informal caregivers included information, skills training and coping strategies.  The studies measured improvements in behaviour, ADL, number of participants moved into institutional care, caregiver burden and competence, as well as mood and quality of life of both members.

What the researchers found                                  

Support programs for people with dementia and their caregivers are beneficial, however there were many different types, lengths and frequency of programs included in this review which makes it difficult to determine which approach works best. Short term, longer term and programs for people in hospital all helped to improve the behaviour of the person with dementia and the mood and burden of caregivers.  ADL skills training for the person with dementia and communication skills training for the caregiver appear to be valuable approaches.  Benefits of the program are more likely when the program goals match the problem and the needs of participants, both people with dementia and their caregivers.

Conclusion

Overall, programs that support both people with dementia and their caregivers are beneficial for either or both groups. Program goals should meet the needs of participants. More research is needed about the benefits of specific approaches.