Effectiveness Of Supporting Informal Caregivers Of People With Dementia: A Systematic Review

Abstract

Dementia is known as a major public health problem affecting both patients and caregivers, and placing a high financial strain upon society. In community-dwelling patients, it is important to support informal caregivers in order to help them sustain their demanding role. Previous reviews about effectiveness of such supporting strategies often included a small number of studies, focused only on particular supportive types, particular outcomes or solely on caregivers. Therefore a general systematic review was conducted investigating effectiveness of different types of supportive strategies on at least well-being of the caregiver or the care-recipient. A systematic literature search was conducted in Web of Science and PubMed. An adapted version of the Downs and Black (1998) checklist was used to assess methodological quality. Forty-six papers met inclusion criteria. Although 87% of the interventions were to some extent effective, methods and findings were rather inconsistent. Psychoeducational interventions generally lead to positive outcomes for caregivers, decrease behavioral problems and delay permanent institutionalization of care-recipients. Cognitive behavioral therapy decreases dysfunctional thoughts among caregivers, and occupational therapy decreases behavioral problems among patients. In general, those interventions tailored on individual level generate better outcomes. Comparative research on respite care was very rare. Despite methodological inconsistency, supporting caregivers appears to be an effective strategy often improving well-being of caregiver or care-recipient and resulting in additional benefits for society. However, there is a need for more research on the (cost)-effectiveness of respite care.